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11 Cards in this Set

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Diabetic retinopathy

Caused by damage to endothelial lining of small blood vessels of eye




damage --> progressive occlusion --> obstruction and increased pressure




earliest form is non-proliferative retinopathy




advanced form is proliferative retinopathy (neovascularization --> may lead to bleeding and/or blindness)




proliferative retinopathy is most common cause of blindness in adults of Western world

Non proliferative retinopathy

dilation of veins


microaneurysms



retinal edema



retinal hemorrhages

dilation of veins




microaneurysms




retinal edema




retinal hemorrhages

Proliferative retinopathy

As damage increases --> vessels secrete inc amts of angiogenesis factor


Neovascularization covers optic nerve



hemorrhages protrude into vitreous chamber



vitreal hemorrhages threaten sight



Rx with laser photocoagulation and glycemic control

As damage increases --> vessels secrete inc amts of angiogenesis factor




Neovascularization covers optic nerve




hemorrhages protrude into vitreous chamber




vitreal hemorrhages threaten sight




Rx with laser photocoagulation and glycemic control

Retinal detachment

Most common causes are myopia or surgical extraction of cataracts


Can occur spontaneous



Can also occur secondary to prolif retinopathy or age related macular degeneration



p/w blurry vision in one eye w/o pain or redness & seeing "floaters"...

Most common causes are myopia or surgical extraction of cataracts




Can occur spontaneous




Can also occur secondary to prolif retinopathy or age related macular degeneration




p/w blurry vision in one eye w/o pain or redness & seeing "floaters" or flashes at periphery of vision




"curtain coming down" as retina falls off sclera behind it




dx with ophthalmic exam (emergency!), fluorescein angiogram, &/or optical coherence tomography




rx by leaning the patient's head back so retina may fall back in place or surgically via laser photocoagulation, cryotherapy, or injection of expansible gas into vitreal cavity --> if fails, vitreous is removed & retina surgically attached to sclera

Causes of central retinal artery occlusion

secondary to:


carotid artery embolic dz


temporal arteritis


cardiac thrombi or myxoma (eg after angiogram)


thrombophilia (eg Factor V Leiden)

Central retinal artery occlusion

Ophtho emergency!


Sudden, painless, and unilateral loss of vision



No eye redness



Opthal exam shows pale retina, diminished perfusion, and "cherry red" spot at fovea



after dx, pt should undergo carotid artery imaging, echo, & eval for th...

Ophtho emergency!




Sudden, painless, and unilateral loss of vision




No eye redness




Opthal exam shows pale retina, diminished perfusion, and "cherry red" spot at fovea




after dx, pt should undergo carotid artery imaging, echo, & eval for thrombophilia

Central retinal vein occulsion

presentation is similar to central retinal artery occlusion


pts may have HTN



Optho exam shows "blood and thunder" appearance --> disk swelling, venous dilation, tortuosity, and retinal hemorrhages



Retinal hemorrhages distinguish arterial f...

presentation is similar to central retinal artery occlusion




pts may have HTN




Optho exam shows "blood and thunder" appearance --> disk swelling, venous dilation, tortuosity, and retinal hemorrhages




Retinal hemorrhages distinguish arterial from venous occlusion

Closed angle glaucoma

Optho emergency


precipitated by use of medications that have anticholinergic properties



p/w red eye, painful, hard to palpation, and fixed midpoint pupil (can also be vomiting bc of pain)



cornea has hazy cloudiness



marked diminishment o...

Optho emergency




precipitated by use of medications that have anticholinergic properties




p/w red eye, painful, hard to palpation, and fixed midpoint pupil (can also be vomiting bc of pain)




cornea has hazy cloudiness




marked diminishment of visual acuity

Rx of closed angle glaucoma

IV acetazolamide, urea, and osmotic diuretics (eg mannitol or glycerol)




pilocarpine can be used to open canal of Schlemm & b-blocker used to decr humor production




if ineffective --> laser trabeculoplasty

Herpes Simplex Keratitis

Severe eye pain and sensation that something is caught under eyelid


dx via dendritic pattern over cornea on fluorescein staining of eye under blue light

Severe eye pain and sensation that something is caught under eyelid




dx via dendritic pattern over cornea on fluorescein staining of eye under blue light

Rx of herpes simplex keratitis

rx with oral acyclovir, famciclovir, or valacyclovir




can also use topical trifluridin or idoxuridine




NEVER treat with oral or topical steroids --> worsens herpes eruptions