Term
| ______ is the leading cause of blindness in working age Americans. |
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Definition
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Term
| Appropriate referral and treatment of diabetic retinopathy reduces visual loss by _____. |
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Definition
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Term
| Incidence of retinopathy in type I diabetes is ___ at 5 years and ___ after 15 years. |
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Definition
23% at 5 years
80% at 15 years |
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Term
| Name the 3 most important steps to the pathophysiology of diabetic retinopathy. |
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Definition
Hyperglycemia leads to vascular and endothelial dysfunction
Leakage of blood or lipid into retina
Capillary occlusion and ischemia of retina |
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Term
| Name 5 stages of diabetic retinopathy. |
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Definition
1 No retinal disease
2 Background retinopathy with microaneurysms
3 Exudative retinopathy with hard exudates
4 Preproliferative diabetic retinopathy (PPDR) with cotton wool spots
5 Proliferative diabetic retinopathy (PDR) with neovascularization and potential vitreous hemorrhage |
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Term
| What proportion of diabetic patients with proliferative diabetic retinopathy progress to blindness in 5 years? |
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Definition
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Term
| Give the follow up and whether laser treatment is indicated: no retinopathy detected. |
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Definition
| 12 month follow up. No laser therapy indicated. |
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Term
| Give the follow up and whether laser treatment is indicated: background retinopathy detected. |
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Definition
| 6-12 month follow up. No laser therapy indicated. |
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Term
| Give the follow up and whether laser treatment is indicated: Non-clinically significant macular edema. |
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Definition
| 4-6 month follow up. No laser therapy indicated. |
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Term
| Give the follow up and whether laser treatment is indicated: clinically SIGNIFICANT macular edema. |
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Definition
| 2-4 month follow up. Focal laser therapy may be indicated. |
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Term
| Give the follow up and whether laser treatment is indicated: preproliferative diabetic retinopathy. |
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Definition
| 4-6 month follow up. No laser therapy indicated, with exception of severe PPDR or unreliable follow up. |
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Term
| Give the follow up and whether laser treatment is indicated: proliferative diabetic retinopathy. |
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Definition
| 2-4 months follow up. Panretinal photocoagulation indicated. |
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Term
| Name 6 non-retinal ocular findings that may occur in patients with diabetes. |
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Definition
Rapid changes in eyeglass prescription/ blurry vision
Cornea - dry eye, contact lens intolerance
Iris - poorly reactive pupils, light-near dissociation
Lens - cataract at younger age
Glaucoma - ^ risk of open angle glaucoma
EOM deficits 2/2 paresis of CN III, IV and VI |
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Term
| This occurs when exudate affects the macula and can lead to visual loss in diabetic patients. |
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Definition
| Macular edema. May be clinically significant or nonsignificant. |
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Term
| Loss of visual acuity not correctable by glasses in an otherwise healthy eye. |
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Definition
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Term
| Amblyopia affects ____ of the US population |
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Definition
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Term
| 3 major causes of amblyopia. |
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Definition
Strabismus
Asymmetric refractive error
Occlusion of one eye |
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Term
| Vision loss due to amblyopia that is not corrected by the age of ___ is generally not correctable. |
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Definition
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Term
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Definition
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Term
| Outward deviation of an eye. |
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Definition
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Term
| Vertical deviation of eye. |
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Definition
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Term
| 4 etiologies of amblyopia |
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Definition
1 Sensory - poor vision in one eye
2 Accommodative - most common
3 Restrictive - EOM trapped
4 Paretic - EOM denerved |
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Term
| Opacity of the crystalline lens. |
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Definition
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Term
| Incidence of cataract is ___ in people between 65 and 74, and ___ in people over 75. |
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Definition
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Term
| Other than normal aging, name 5 etiologies of cataract formation. |
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Definition
Trauma
Inflammation
Metabolic defects (diabetes, steroids)
Radiation
Congenital |
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Term
| Name 6 presenting symptoms of cataracts. |
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Definition
Change in refractive error
Image blur
Glare
Monocular diplopia
Image distortion
Altered color perception
(Top 3 most common) |
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Term
| Most obvious signs of cataract. |
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Definition
Decreased red reflex
Potentially leukocoria |
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Term
| 3 major types of cataract that can be distinguished on slit lamp exam. |
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Definition
Nuclear - yellowing/clouding of central lens
Cortical - Intermediate layer opacification
Posterior subcapsular - posterior lens capsule opacity |
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Term
| Name 6 potential complications of cataract surgery. |
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Definition
Corneal decompensation
Glaucoma
Retinal swelling
Retinal detachment
Infection
Bleeding |
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Term
| A group of diseases which result in characteristic optic nerve damage and visual field loss. Often associated with elevated intraocular pressure. |
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Definition
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Term
Aqueous humor is produced by ...
and leaves the eye ... |
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Definition
the ciliary body
through the trabecular meshwork and Schlemm's canal. |
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Term
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Definition
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Term
| Most important cause of blindness in African-Americans. |
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Definition
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Term
| Name 4 risk factors for glaucoma development. |
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Definition
Family history
African-american heritage
>45 years old |
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Term
| Name 4 important signs of primary open angle glaucoma. |
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Definition
Elevated intraocular pressure
Normal anterior chamber angle
Cup/disk >0.6 (?)
Visual field defects |
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Term
| Treatment of primary open angle glaucoma is aimed at... |
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Definition
| lowering intraocular pressure to arrest further damage to the optic nerve. |
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Term
| If increased IOP leads to glaucoma, what is the thought about the etiology of normal tension glaucoma? |
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Definition
Exaggerated fluctuation in IOP
Artificial low measured pressures due to thin corneas
Higher susceptibility of optic nerve to damage |
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Term
| In what age do patients develop pigmentary glaucoma? |
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Definition
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Term
| Describe the most common patient with pigmentary glaucoma. |
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Definition
20-40 y/o myopic male
(20s and 30s; men more than women; nearsighted patients) |
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Term
| What is the pathophysiology of pigmentary glaucoma? |
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Definition
| Rubbing of pigmented layer of iris against lens causes shedding of pigment which may clog the trabecular meshwork. |
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Term
| Name 2 risk factors for pseudo-exfoliation syndrome glaucoma. |
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Definition
>50 years old
European or Russian descent |
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Term
| Pseudo-exfoliation syndrome glaucoma shares the same signs as primary open angle glaucoma, except it has this one which is unique. |
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Definition
| "Dandruff like" material deposited on lens iris and trabecular meshwork |
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Term
| What is the pathophysiology of pseudo-exfoliation syndrome glaucoma? |
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Definition
| Clogging of trabecular meshwork with the pseudoexfoliation material. |
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Term
| Name 7 risk factors for angle closure glaucoma. |
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Definition
Hyperopia
Asian descent
Family history
Prolonged dilation (prolonged dark time)
Anticholinergics
Dilation for eye exam
Emotional stress |
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Term
| Name symptoms/signs of acute attack of angle closure glaucoma. |
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Definition
Symptoms: Intense pain, blurry vision, halos around lights
Signs during attack: ^^ IOP, cloudy swollen cornea, conjunctival injection, intraocular inflammation, closed angles |
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Term
| Name 5 classes of medications available for glaucoma. |
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Definition
Beta blockers
Miotics (pilocarpine)
Alpha adrenergic
Carbonic anhydrase inhibitors
Prostaglandins |
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