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78 Cards in this Set
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- Back
- 3rd side (hint)
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legal definition of blindness
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best corrected of 20/200 or less than 20deg in best eye
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name the dz: bilateral drusen and RPE hyper/hypo pigmentation
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dry macular degeneration
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Clinical course of dry macular degeneration?
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slowly progressive, peripheral vision remains intact
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Tx for Dry macular degen?
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Zn and antioxidants slow progression
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None
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Name the dz: sudden visual loss with distortion, hemorrhage, edema, exudates, RPE changes
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wet macular degeneration
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None
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Tx for wet macular degeneration?
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lasers, VEGF inhibition
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Glaucoma definition:
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iop that is high enough to damage the optic nerve and cause visual loss
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What does an increased cup/disc ratio mean?
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Glaucoma
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Name the dz: hazy cornea, red eye, fixed mid dilated pupil
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closed angle glaucoma
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Indication for cataract surgery?
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when vision loss impacts daily life
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Tx for closed angle glaucoma?
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laser iridotomy in BOTH eyes
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Which class of glaucoma medications stings?
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carbonic anhydrase inhibitors (diamox and trusopt)
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Common ADRs of carbonic anhydrase inhibitors (diamox/trusopt)
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bitter taste/tingling (systemic), burning (ocular), STEVENS JOHNSON
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Common ADRs of alpha agonists in the eye?
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allergic conjuctivitis, mydriasis (local)
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Contraindications to alpha agonists?
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kids, MAOIs
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Which classes of glaucoma meds DO NOT work by decreasing aqeous production?
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PGF2a analogues (incr uveoscleral outflow); miotics (increased trab flow, decr uveoscleral flow)
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None
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Contraindications for beta blockers?
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pulmonary dz, heart dz
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Side effects of beta blockers in the eye?
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blurred vision, depression, impotence (systemic)
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Which hyperosmolar agent is safest in DM?
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isosorbide
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When do you use miotics for glaucoma?
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acute only
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Contraindications to miotics?
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parkinsons, inflamed eye, angle closure glaucoma
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Side effects of Prostaglandins (xalatan)?
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eyelash growth, skin/iris darkening, eye redness (take in PM)
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Which drug is first line in glaucoma?
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PGF2a analogues
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Contraindications for PGF2a analogues?
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pregnancy, inflammatory conditions
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Ocular complications of roids?
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roid induced glaucoma (GAGs in trabecular network), cataracts
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Name the Dz and Tx: lots and lots of purulent discharge from eye
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hyperacute conjuctivitis (gonococcal) tx w/systemic abx
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Tx of corneal ulcers
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abx drops around the clock
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Name the Dz and Tx: tree branch pattern in eye w/fluorescein dye
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HSV keratitis. No roids.
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Tx for chalazion
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warm compresses
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Tx for uncomplicated conjuctivitis
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cool compress and artificial tears
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Which red eye conditions require referral?
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corneal infxn, iritis, angle closure glaucoma, trauma
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Name the Dz: dishcarge from eye, no pain, nl, vision, nl pupil
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conjuctivitis
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Name the dz: d/c from eye, pain, decreased va, small pupil
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keratitis
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Name the dz: no d/c, pain (light sensitivity), decreased va, small pupil
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iritis
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Name the dz: no d/c, pain, decreased va, dilated pupil
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glaucoma
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Tx for chlamydia
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tetracycline or emycin for 3-6 weeks
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Sequelae for chlamydia in the neonate?
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systemic dz (otitis, pneumonitis)
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Requirements for normal visual development>
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symmetric refraction error, straight eyes
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Up to what age does a lack of a clear image focused on the retina lead to amplyopia?
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7 years old
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What is amblyopia?
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impairment not due to an ocular lesion and not fully correctable by an artificial lens
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Etiology of comitant strabismus?
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GOK
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Etiology of incomitant strabismus?
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cranial nerve palsy, graves, myasthenia, mechanical restriction of muscle
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Tx for congenital esotropia?
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surgery
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Tx accommodative esotropia?
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glasses (85%)
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Tx for sensory comitant strabismus?
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surgery is cosmetic and lasts 10yrs
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Sxs of 3rd nerve palsy?
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ptosis, mydriasis, eye down and out
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None
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tx for 4th or 6th nerve palsies?
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prism glasses (if not surgery)
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Indications for surgery in orbital injuries?
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persistent diplopia (7-10 days), fracture which will result in enophthalmus
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pathophys of cotton wool spots?
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microinfarcts and axoplasmic damming in the nerve fiber layer (cytoid bodies?)
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None
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Which layer are hard exudates seen in?
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outer plexiform layer
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Name the dz: slow visual loss, rubeosis iridis, dilated non-tortuous retinal veins, periorbital pain (caused by?)
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occular ischemic syndrome (due to 90% carotid occlusion)
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name the dz: cherry red foveola
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central retinal artery obstruction
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Most common causes of cotton wool spots?
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DM, HIV, SLE
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What defines Grade III HTN in the eye? (pressure?)
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hemorrhage, cotton-wool spots, exudates (diastolic over 110)
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What defines Grade IV HTN in the eye? (pressure?)
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optic disc swelling (diastolic over 130)
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What defines grade II HTN in the eye?
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AV nicking
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Which Hgb phenotype is the worst for retinopathy?
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Hgb SC
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Tortuous vs non tortuous veins in the eye?
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tortuous = venous dz; non-tortuous = arterial dz
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When do you watch out for retinopathy of prematurity/
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less than 1500g, less than 36wks
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Risk factors for retinal detachment?
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myopia, cataract extraction, ocular trauma, FH or other eye hx, lattice degeneration
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Causes of exudative retinal detachments?
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tumor, infxn, inflammation
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Early findings in diabetic retinopathy?
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pericyte dropout, microaneurysms, basement membrane thickening
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Leading cause of vision loss in DM?
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macular edema
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Indications for vitrectomy?
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non clearing vitreous hemorrhage, traction retinal detachment
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When would a diabetic not have an eye exam immediately after diagnosis?
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If age of onset is less than 30 (exam 5 yrs after dx)
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When do you get eye exams more often than yearly/
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preggers (q 3 months)
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what imaging studies are useful for optic neuritis?
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mri or T2 FLAIR
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what should you do for a pt w/optic neuritis?
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MRI, IV corticosteroids (if lesions on MRI), NO ORAL ROIDS
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what to do? Pt w/bilateral optic disc swelling
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REFER to ophto immediately
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name the dz: sudden painless unilateral vision loss in a vasculopath
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non arteritic ischemic optic neuropathy
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Tx for NAION?
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none
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What key sxs are associated with AION?
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Jaw claudication and elevated CRP
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Tx for Giant Cell Arteritis?
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immediate high dose roids to protect the other eye
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Which muscles are most affected in Graves'?
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IR>MR>SR>LR
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Imaging for Graves'?
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CT
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Indications for orbital decompression?
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Optic Neuropathy, exposure keratopathy, high IOP, globe luxation, cosmetic
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Definative dx for giant cell arteritis?
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temporal artery bx w/in 10 days of onset
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Tx for thyroid related orbitopathy?
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during inflammatory phase give roids or rad…when stable for 6 months do surgery
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