Ophthalmology -FA > Refractive errors - Cataract - Glaucoma > Flashcards

Refractive errors - Cataract - Glaucoma Flashcards

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1
Q

Refractive errors - correctable or not?

A

correctable with glasses

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2
Q

Refractive errors - types

A
  1. Hyperopia
  2. Myopia
  3. Astigmatism
  4. Presbyopia
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3
Q

hyperopia - mechanism

A

Eye too short for refractive power of cornea and lens

–> light focused behind retina

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4
Q

Myopia - mechanism

A

eye too long for refractive power of cornea and lens –> light focused in front of retina

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5
Q

Astigmatism - mechanism

A

abnormal curvature of cornea –> different refractive power at different axis

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6
Q

Presbyopia - mechanism

A

Age - related impaired accommodation (focusing on near objects), 1ry due to decreased lens elasticity

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7
Q

Cataract - definition

A

opacification of lens

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8
Q

Cataract - unilateral or bilateral / type of pain

A
  • often bilateral

- painless

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9
Q

Cataract often results in

A

decreased vision

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10
Q

Cataract - risk factors (10)

A
  1. increased age 2. ethanol 3. prolonged corticosteroid use 4. Diabetes mellitus (sorbitol) 5. trauma 6.smoking 6. excessive sunlight 7. infection
  2. congenital risk factors (a. classic galactosemia, b. galaktokinase deficiency, c. trisomies (13, 18, 21),
    d. Torches infection, e. Marfan f. Alport g. Mytonic dystrophy h. Neurofibromatosis 2)
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11
Q

Uveitis - definition

A

inflammation of uvea

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12
Q

uveitis is divided to (according the place) (AKA)

A
  1. anterior uveitis (iritis)
  2. intermediate uveitis: pars planitis
  3. posterior uveitis (choroiditis and/or retinitis)
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13
Q

Uveitis may have - symptoms/findings

A
  1. hypopyon (accumulation of pus in anterior chamber)

2. conjuctival redness

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14
Q

Uveitis is associated with

A

systemic inflammatory disorders:

  1. Sarcoidosis 2. Rheumatoid arthritis 3. juvenile arthritis
  2. Bechet disease 5 . HLA-B27
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15
Q

HLA associated with Uveitis

A

HLA-B27

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16
Q

optic disc is AKA

A

optic nerve head

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17
Q

optic disc is

A

the point of exit for ganglion cell axons leaving the eye.

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18
Q

The optic disc is shaped like a (and why)

A

doughnut with a pink neuroretinal rim and a central white depression called the physiologic cup.

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19
Q

Glaucoma - definition

A

optic atrophy with characteristic cupping, usually elevated intraocular pressure and progressive peripheral visual field loss

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20
Q

Glaucoma - characteristic cupping

A

thinning of outer rim of the optic nerve head versus normal

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21
Q

Glaucoma - intraocular pressure

A

usually elevated

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22
Q

glaucoma is divided to

A
  1. open angle

2. closed angle

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23
Q

open angle glaucoma is associated with

A
  1. increased age
  2. African american race
  3. family history
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24
Q

open angle glaucoma is divided to

A
  1. primary

2. secondary

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25
causes of primary open glaucoma
unclear
26
causes of secondary open glaucoma
blocked trabecular meshwork from a. WBC (eg uveitis) b. RBCs (eg vitreous hemorrhage) c. retinal elements (eg retinal detachment)
27
open angle glaucoma special characteristic
PAINLESS
28
closed/narrow angle - divided to
1. primary 2. secondary or 1. chronic closure 2. acute closure
29
primary closed/closed narrow angle - mechanism
enlargement or forward movement of lens against central iris (pupil margin) --> obstruction of normal aqueous flow through pupil --> fluid builds up behind iris, pushing peripheral iris against cornea and impeding flow through trabecular meshwork
30
secondary closed/narrow angle - mechanism
hypoxia from retina disease (diabetes mellitus, vein occlusion) --> vasoproliferation in iris that contracts the angle
31
disease associated with secondary closed/closed narrow angle
1. diabetes mellitus | 2. vein occlusion
32
chronic closed/narrow angle - symptoms and findings
1. often asymptomatic 2. damage to optic nerve 3. damage to peripheral vision
33
acute closed/narrow angle is a ....
true ophthalmic emergency
34
acute closed/narrow angle - mechanism
elevated intraocular pressure pushes iris forward --> angle closes abruptly
35
acute closed/narrow angle - do not give (and why)
epinephrine because of its mydriatic effect
36
acute closed/narrow angle - symptoms and signs
1. very painful 2. red eye 3. sudden vision loss 4. halos around halos 5. rock hard eye 6. frontal headache
37
congenital risk factors for cataract a. classic galactosemia, b. galaktokinase deficiency, c. trisomies (13, 18, 21), d. Torches infection, e. Marfan f. Alport g. Mytonic dystrophy h. Neurofibromatosis 2)
a. classic galactosemia, b. galaktokinase deficiency, c. trisomies (13, 18, 21), d. Torches infection e. Marfan f. Alport g. Mytonic dystrophy h. Neurofibromatosis 2
38
Conjunctivitis - definition/presentation
inflammation of the conjuctiva --> red eye
39
Conjunctivitis - types and presentation (and MC)
1. Allergic --> itchy eyes 2. Bacterial --> pus 3. Viral (MC)--> sparse mucous discharge, swollen preauricular node
40
Conjunctivitis - treatment
bacterial --> antibiotics | viral --> self resolving
41
viral conjunctivitis is often due to
adenovirus
42
allergic conjunctivitis - characteristic
bilateral
43
Viral vs bacterial conjunctivitis - transmissible
Virus easy | Bacterial poorly
44
Viral vs bacterial conjunctivitis - adenopathy
Only virus (preauricular)
45
characteristics of Viral conjunctivitis
bilateral, Watery discharge, easily transmissible, normal vision. itchy, preauricular adenopathy, no specific therapy
46
characteristics of Bacterial conjunctivitis
unilateral, purulent + thick discharge, poorly transmissible, normal vision, not itchy, no adenopathy, topical antibiotics
47
red eye (opthalmologic emergencies) - types and presentation
1. conjunctivitis: itchy eyes with discharge 2. uveitis autoimmune disease 3. glaucoma: pain 4. abrasion: trauma
48
red eye (opthalmologic emergencies) - types and eye findings
1. conjunctivitis: normal pupil 2. uveitis: photophobia 3. glaucoma: fixed midpoint pupil 4. abrasion: like sand in the eye
49
red eye (opthalmologic emergencies) - types and most accurate test
1. conjunctivitis: clinical diagnosis 2. uveitis: slit lamp examination 3. glaucoma: tonometry 4. abrasion: fluorescein stain
50
red eye (opthalmologic emergencies) - types and best initial therapy
1. conjunctivitis: topical antibiotics 2. uveitis: topical steroids 3. glaucoma: acetazolamide, mannitol, pilocarpine, laser trabeculoplasty 4. abrasion: no specific therapy, patch not clearly beneficial
51
glaucoma treatment if medical treatment fails
laser trabeuloplasty
52
it can precipitate closed angle glaucoma
walking into a dark rook can precipitate pain because of pupillary dialation (SOS)
53
acute angle-closure glaucoma - the diagnosis is confirmed by
tonometry
54
acute angle-closure glaucoma - treat with (and why)
1. IV acetazolamide 2. IV mannitol: osmotic driving of fluid out of the eye 3. Pilocarpie, beta-blockers and apracloinidine to constrict the pupil and enchance and enchance drainage) 4. laser iridotomy
55
keratitis - definition / presentation
infection of cornea | the eye may be very red, swollen and painful, but do not use steroids
56
hepres keratitis - never use .... (why)
steroids --> make it worse / increase the production of the virus
57
hepres keratitis - diagnosis
Fluorecein staining of the eye helps confirm the dendritic pattern seen on examination
58
hepres keratitis - treatment
oral acyclovir, famciclovir or valacyclovir | topical anthepretic treatment is trifluridine and idoxuridine
59
Cataracts - diagnosis
early Cataracts: ophthalmoscope or slit lamp exam | advanced: visible on examination
60
1. Hypertropia is corrected by | 2. myopia is corrected by
1. convex lens | 2. biconcave lens
61
1. astigmatism is corrected by | 2. presbyopia is corrected by
1. cylindric lens | 2. convex lens
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