6857350
Description
Flashcards by Andrew Street, updated more than 1 year ago
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Created by Andrew Street
over 7 years ago
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| Question | Answer |
| Cataracts - what are they and what are the risk factors? | Clouding of lens due to precipitation of proteins. Commonest cause of preventable blindness. Risk factors: * Congenital * Age * Metabolic - DM, galactosaemia, hypocalcaemia, Wilson's DS * Drug-induced - corticosteroids, phenothiazines, miotics, amiodarone * Traumatic - post intra-ocular Sx * Inflammatory - uveitis * DS associated - Down's, dystrophia myotonica, Lowe's syndrome From P-Year notes: https://www.dropbox.com/home/P-Year%20Surgical%20Lectures?preview=Ophthalmology+notes.pdf |
| S & Sx & Rx of cataracts. | S & Sx: * Gradual painless deterioration of vision * Blurring * Haze * Dazzle of bright lights - esp when driving at night * Affects near & distance vision equally * Usually bi-lateral but one can be more advanced * Fields & pupils will be normal Rx is by surgery when ADL's are affected enough to justify the risks. Lens is fragmented & aspirated under LA. It is then replaced by a plastic lens. 1:1000 risk severe permanent sight loss. 1:10 need further laser Sx for opacification of tissue behind the artificial lens. From P-Year notes: https://www.dropbox.com/home/P-Year%20Surgical%20Lectures?preview=Ophthalmology+notes.pdf |
| Early cataract. K & C p1061. | |
| Late/mature cataract. K & C p1061. | |
| Glaucoma is a group of diseases in which the ..... inside the eye is sufficiently elevated to cause o..... n..... damage and result in v..... f..... d...... Normal intraocular pressure (IOP) is .....–..... mmHg. Some types of glaucoma can result in an IOP exceeding 70 mmHg. Glaucoma is the second commonest cause of blindness worldwide and the third commonest cause of blind registration in the UK. | Glaucoma is a group of diseases in which the *pressure* inside the eye is sufficiently elevated to cause *optic nerve* damage and result in *visual field defects*. Normal intraocular pressure (IOP) is *10–21* mmHg. Some types of glaucoma can result in an IOP exceeding 70 mmHg. Glaucoma is the second commonest cause of blindness worldwide and the third commonest cause of blind registration in the UK. K & C p1061. |
| Primary open-angle glaucoma (POAG). Most common type. K & C p1061. | |
| Angle-closure glaucoma. K & C p1061. | |
| Risk factors & S & Sx of POAG. | Risk factors: * Age - main risk factor * Ethnicity - black African, Caribbean * Myopia * ^IOP - only modifiable risk factor S & Sx: * Gradual, insidious, painless loss of peripheral visual fields - usually curved above or below the horizontal * Central fields & acuity usually spared until very late * Usually picked up in early (asymptomatic) stages by opticians measuring IOP during screening * OE an enlarged cup is seen with a thin neuroretinal rim K & C p1061 & https://www.dropbox.com/home/P-Year%20Surgical%20Lectures?preview=Ophthalmology+notes.pdf |
| Cupping as seen in glaucoma. | |
| Rx of POAG. | Rx aims to reduce IOP by reducing aqueous production/^drainage. Can't reverse DS damage. * PG analogue drops (eg latanaprost g.) - ^drainage * Beta-blockers - (eg timolol g.) - reduce aqueous production * Surgery (eg trabeculectomy) From P-Year notes: https://www.dropbox.com/home/P-Year%20Surgical%20Lectures?preview=Ophthalmology+notes.pdf |
| Macular degeneration - what is it, risk factors, what types are there? | Degenerative DS of the central part of the retina (macular). Cause unknown. Commonest cause of visual impairment in the western world in >50 YO's. Risk factors: * Age * Smoking * HT * Hypercholesterolaemia * UV exposure Types: * Dry - lipofuscin deposits (drusen) into retina with ^age * Wet (10%) - neovascularization in the macula leads to disruption of the layers of the retina by leakage of oedema/BD K & C p1064 & https://www.dropbox.com/home/P-Year%20Surgical%20Lectures?preview=Ophthalmology+notes.pdf |
| S & SX & Rx of macular degeneration. | * Dry: > S & Sx - painless & progressive loss of central vision: affects reading (close & distance), recognising faces. Never affects peripheral vision. OE drusen over macula. > Rx - supportive (lighting, low vision aids). Nutritional advice - ^lutein, zeaxanthins (spinach, kale, or tablets). * Wet: > S & Sx - severe central vision loss, fluid in retina causes distortion of straight lines. > Rx - urgent referral, intravitreal anti-VEGF injections (eg lucentis). K & C p1064 & https://www.dropbox.com/home/P-Year%20Surgical%20Lectures?preview=Ophthalmology+notes.pdf |
| Drusen over the macula as seen in dry macular degeneration. K & C p1064. | |
| Sign seen in wet macular degeneration. K & C p1064. | |
| 20% of people with DM I will have retinal changes after 10 years, rising to >95% after 20 years; 20–30% of people with DMII have retinopathy at Dx. What two main effects does it have on retinal capillaries and how are they Rx? | 1) Leakage - leads to retinal haemorrhages (dot & blot), exudates & macular oedema (commonest cause of blindness in DR). Similar to wet AMD - Rx with anti-VEGF injections. 2) Occlusion - causes cotton wool spots. Leads to ischaemia and neovascularization. These new vessels can cause vitreous haemorrhage, tractional RD, glaucoma (block the trabecular meshwork). Rx is by lasering the whole retina excepth the macular removing the ischaemic tissue. |
| What yearly screening is provided for diabetics? | Retinopathy screening which includes examing/taking photos & grading the results for comparison. R0 - no retinopathy R1 - mild non-proliferative (haemorrhages & microaneurysms) R2 - severe non-proliferative (venous abnormalities) R3 - proliferative retinopathy (new vessels at disc or elsewhere) Mo - no maculopathy M1 - maculopathy (significant macular oedema or ischaemic macula) From P-Year notes: https://www.dropbox.com/home/P-Year%20Surgical%20Lectures?preview=Ophthalmology+notes.pdf |
| DR. K & C p1023. |
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