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83 Cards in this Set
- Front
- Back
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What structures go awry in acne rosacea?
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Dysfunctions of the sebaceous glands of the face, neckand shoulders
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What are the opthalmic symptoms of acne rosacea?
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Redness
Blurring Foreign body sensation Pain |
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What are the systemic findings of acne rosacea?
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Midfacial erythema
Papules Pustules Rhinophyma |
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What are the ocular findings of acne roseacia?
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Blepharitis
Aqueous tear deficiency Eyelid margin telangiectasia Chronic conjunctivitis Corneal neovascularization |
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What are the three components of the tear film? Which are ruined in acne roseacea?
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Liquid
Lipid Mucosal Acne roseacea ruins the liquid, lipid |
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What is the management of acne rosacea?
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Systemic tetracyclines
Topical metronidazole Artificial tears If lots of inflammation, topical steroids |
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How do tetracyclines alter the tear film in acne rosacea?
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Altering lipid-->better film
Inhibition of MMPs Killing bacteria that are on the lid |
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What are the findings on an eye exam during HIV retinopathy?
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Cotton wool spots
Retinal hemorrhages |
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What are some infections that people with HIV are particularly vulnerable to?
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Cytomegalovirus
Toxoplasmosis Syphilis HSV, zoster Cryptoccus |
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What is a type of neoplasm in HIV that can effect the eyelid?
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Kaposi's sarcoma
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When does CMV retinitis ocur?
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CD4< 50
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What are the treatments for CMV retinitis?
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Ganciclovir
Foscarnet Cidofovir |
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What does a retina look like during hypertensive retinopathy?
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Variable spectrum
Arterial narrowing to retinal hemorrhages to disc edema |
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What are the symptoms for hypertensive retinopathy?
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Again, a spectrum.
Anywhere from no changes to a severe visual loss |
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What is the management for hypertensive retinopathy?
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KEEP THAT BP DOWN.
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Where does giant cell arteritis take place?
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Medium size branches of the carotid artery
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What kind of a disorder is giant cell arteritis?
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Autoimmune
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Who gets giant cell arteritis?
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Elderly people
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What are the complications secondary to giant cell arteritis?
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Arteritic ischemic optic neuropathy
Central retinal artery occlusion Ocular motor cranial nerve palsy |
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What are the symptoms of giant cell arteritis?
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Headache
Scalp tenderness Jaw claudication Fever, malaise Proximal muscle stiffness |
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If you think that someone might have giant cell arteritis, what labs should you order?
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Sed rate
CRP |
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What is the treatment for giant cell arteritis?
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High dose corticosteroids
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What kind of a disease is Graves disease?
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Autoimmune
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What is the pathology that happens in Graves disease?
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An autoimmune reaction takes place that binds to TSH receptors, causing super high levels of T3 and T4
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What are the two phases of Graves disease?
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Hypermetabolic state
Lymphocytic infiltrative state |
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What are the sympoms of Graves disease?
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Red, watery eyes
Eye prominence (THEY LOOK VERY SERIOUS.) Double vision |
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What are the signs of Graves disease?
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Lid retraction
Conjunctival injection Tearing Proptosis Reduced eye movement Optic neuropathy |
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What happens to the eyes during the hypermetabolic state?
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The muscles above the eyes are stimulated to contract: you can see the sclera both ABOVE and BELOW the cornea
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What happens to the eyes during the infiltrative state of Graves' disease?
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There's a lymphocytic infiltration of the extraocular muscles causing the eyes to bulge out
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What is the treatment of Graves disease?
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Symptomatic:
Artificial tears (for dry eyes) Immunosupression (for the acute lymphocytic infiltrate) Curative: SURGERY!!! Thyroid regulation |
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What is a serious complication that can happen to the eyes in MS?
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Optic neuritis
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Where does ocular neuritis present in MS patients?
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Retrobulbar without optic nerve edema
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What's the treatment of optic neuritis in the context of optic neuritis?
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High dose steroids
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What are the ophthalmic complications related to myasthenia gravis?
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Fluctuating ptosis
Diplopia |
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What are some systemic medications that can cause problems with the eyes?
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Anticholinergics
Corticosteroids Ethambutol hydrochloride Hydroxychloroquine sulfate Isoniazid Minocycine hydrochloride Sidenafil citrate Tamulosin Topiramate |
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What is the prototypic anticholinergic drug?
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Atropine
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What are indications for anticholinergics?
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GI/UT disorders
Parkinson's Psychotic disorders Reactive airway disease |
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What is the effect of the anticholinergics on the eyes?
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Loss of accommodation
Pupil dilation RARE BUT TERRIBLE: angle closure glaucoma |
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What are some of the corticosteroids that can have an effect on the eyes?
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Prednisone
Fluticasone |
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What are the clinical indications for the corticosteroids?
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Immunosuppression
Asthma |
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What are the effects of corticosteroids?
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CATARACTS!!!
Open angle glaucoma Intracranial hypertension in kids |
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What's the indication for ethambutol hydrochloride?
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TB treatment
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What is the effect of ethambutol hydrochloride on the eyes?
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Optic neuropathy in high doses
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Why is ethambutol such a worry with ophthalmic manifestations?
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People are on it for very long time
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What is the indication for hydroxychloride sulfate?
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Immunosuppression
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What is the ophthalmic effect of hydroxychloroquine sulfate?
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irreversible retinopathy in high doses over a long period of time (BULLS EYE RETINOPATHY!)
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What are the uses of isoniazid?
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TB treatment
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What is the ophthalmic effect of isoniazid?
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Optic neuropathy in high doses
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What are the uses of minocycline hydrochloride?
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Acne
Antibiotics |
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What are the ophthalmic effects of minocycline hydrochloride?
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Papilledema from intracranial HTN
Young people especially get this guy. |
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What are the uses of sidenafil citrate?
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Erectile dysfunction
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What are the ophthalmic effects of sidenafil citrate?
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Transient bluish vision
Ischemic optic neuropathy |
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What is tamulosin used for?
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Benign prostatic hyperplasi
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What are the ophthalmic manifestations of tamulosin?
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It causesa floppy iris: hard to operate on.
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What are the uses of topiramate?
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Seizure, migrane prophylaxis
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What are the ophthalmic effects of topiramate?
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Angle-closure glaucoma
Myopic shift |
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What are the uses of alpha2 adrenergic agonists with relation to the eyes?
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Glaucoma
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What is the mechanism by which alpha2 adrenergic agonists act at the eyes?
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Reduce the aqueous humor production, increase aqueous outflow
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What are the systemic effects of alpha2 adrenergic agonists?
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Dry mouth
Lethargy Hypotenson Seizures ENCHAOPATHY IN KIDS! |
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What population should you not prescribe alpha2 adrenergic agonists to?
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KIDS.
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What are the clinical indications for beta-adrenergic antagonists?
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Glaucoma
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What is the mechanism in the eyes that beta adrenergic agonists?
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Decreasing aqueous humor production
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What are the systemic effects of the beta adrenergic angagonists?
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Bradycardia
Bronchospasm Hypotension Reduced libido Depression |
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What are some of the oral carbonic anhydrase inhibitors?
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Acetazolamide
Methazolamide |
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What are the clinical indications of the oral carbonic anhydrase inhibitors?
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Glaucoma
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What is the mechanism of the oral carbonic anhydrase inhibitors?
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Decrease aqueous humor production
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What are some of the systemic side efects of the oral carbonic anhydrase inhibitors?
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Stevens-Johnson syndrome
Kidney stones Tingling Abnormal taste K depletion Blood dyscrasias |
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What are some of the topical carbonic anhydrase inhibitors?
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Brinzolamide
Dorzolamid |
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What are the clinical indications for the topical carbonic anhydrase inhibitors?
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Glaucoma
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What is the mechanism of the topical carbonic anhydrase inhibitors?
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Decrease aqueous humor production
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What are the systemic effects of the topical carbonic anhydrase inhibitors?
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Bitter taste
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What kinds of carbonic anhydrase inhibitors are first line?
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The oral ones before the topical ones
They're more effecacious |
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What are some of the different prostaglandin analogs?
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Bimatoprost
Latanoprost Travoprost |
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What are the indications for the prostaglandin analogs?
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Glaucoma
Hypotrichosis |
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What is the mechanism for the prostaglandin analogs?
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Increased aqueous outflow
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What are the systemic effects of the prostaglandin analogs?
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Flu-like symptoms (rare)
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What are some of the parasympotholytics used in ophthalmology?
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Atropine
Cyclopentolate Homatropine Scopolamine Tropicamide |
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What are the clinical indications for the parasympatholytics?
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Dilation of the eyes
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What is the mechanism of the parasympatholytics?
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Block the muscarinic receptors of the iris sphincter and ciliary muscles
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What are some of the systemic effects of the parasympatholytics?
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Fever
Skin flush Tachycardia Confusion Seizures (rarely) |
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What are some of the sympathomimetics used in ophthalmology?
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Phenylephrine
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What are the clinical indications for the sympathomimetics?
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Dilation of the eyes by stimulating the iris dilator muscle
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What are the side effects of the sympathomimetics?
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Very rare!
HTN Cardiac arrhythmia MI |
