Podcast
Questions and Answers
Which of the following is NOT considered a risk factor for developing cataracts?
Which of the following is NOT considered a risk factor for developing cataracts?
A patient describes seeing halos around lights and having difficulty driving at night; which condition could be the cause?
A patient describes seeing halos around lights and having difficulty driving at night; which condition could be the cause?
What is the primary characteristic of the crystalline lens that contributes to the development of cataracts?
What is the primary characteristic of the crystalline lens that contributes to the development of cataracts?
Which of the following best differentiates between dry and wet macular degeneration?
Which of the following best differentiates between dry and wet macular degeneration?
Signup and view all the answers
Which of these statements about the treatment of cataracts is most accurate?
Which of these statements about the treatment of cataracts is most accurate?
Signup and view all the answers
What is the most appropriate immediate action for a patient with a suspected ruptured globe?
What is the most appropriate immediate action for a patient with a suspected ruptured globe?
Signup and view all the answers
Which of the following is a contraindication to the initial management of a suspected open globe injury?
Which of the following is a contraindication to the initial management of a suspected open globe injury?
Signup and view all the answers
A 'blowout' fracture of the orbit is most commonly caused by what type of impact?
A 'blowout' fracture of the orbit is most commonly caused by what type of impact?
Signup and view all the answers
What is a significant complication associated with fractures of the orbital floor?
What is a significant complication associated with fractures of the orbital floor?
Signup and view all the answers
Which imaging modality is preferred for diagnosing orbital fractures?
Which imaging modality is preferred for diagnosing orbital fractures?
Signup and view all the answers
Which of the following is the strongest modifiable risk factor for age-related macular degeneration (AMD)?
Which of the following is the strongest modifiable risk factor for age-related macular degeneration (AMD)?
Signup and view all the answers
What is the primary visual symptom associated with macular degeneration?
What is the primary visual symptom associated with macular degeneration?
Signup and view all the answers
A patient presents with bruising and soft tissue swelling around their eye after being hit by a ball. Which type of fracture is most suspected?
A patient presents with bruising and soft tissue swelling around their eye after being hit by a ball. Which type of fracture is most suspected?
Signup and view all the answers
What is the typical antibiotic regimen started intravenously for an open globe injury?
What is the typical antibiotic regimen started intravenously for an open globe injury?
Signup and view all the answers
What is typically observed during a fundoscopic examination of a patient with macular degeneration?
What is typically observed during a fundoscopic examination of a patient with macular degeneration?
Signup and view all the answers
An emergent ophthalmology consultation is required for which ocular injury?
An emergent ophthalmology consultation is required for which ocular injury?
Signup and view all the answers
Which diagnostic test is typically used to screen for macular degeneration?
Which diagnostic test is typically used to screen for macular degeneration?
Signup and view all the answers
Which of the following is a common risk factor for giant cell arteritis?
Which of the following is a common risk factor for giant cell arteritis?
Signup and view all the answers
A patient presents with new onset headaches, scalp tenderness, and jaw pain. Which condition is most likely?
A patient presents with new onset headaches, scalp tenderness, and jaw pain. Which condition is most likely?
Signup and view all the answers
Which of the following describes the primary mechanism of vision loss with retinal detachment?
Which of the following describes the primary mechanism of vision loss with retinal detachment?
Signup and view all the answers
A patient reports sudden flashes of light, floaters, and a curtain-like shadow in their vision. Which condition is most likely?
A patient reports sudden flashes of light, floaters, and a curtain-like shadow in their vision. Which condition is most likely?
Signup and view all the answers
Which of the following best describes the early stage of diabetic retinopathy?
Which of the following best describes the early stage of diabetic retinopathy?
Signup and view all the answers
Which retinal finding is most indicative of hypertensive retinopathy rather than diabetic retinopathy?
Which retinal finding is most indicative of hypertensive retinopathy rather than diabetic retinopathy?
Signup and view all the answers
What is the primary treatment for severe hypertensive retinopathy?
What is the primary treatment for severe hypertensive retinopathy?
Signup and view all the answers
In a patient with type 1 diabetes, when should the initial screening for diabetic retinopathy occur?
In a patient with type 1 diabetes, when should the initial screening for diabetic retinopathy occur?
Signup and view all the answers
Which of the following visual symptoms is commonly associated with both diabetic and hypertensive retinopathy?
Which of the following visual symptoms is commonly associated with both diabetic and hypertensive retinopathy?
Signup and view all the answers
Which of the following is NOT a typical finding in diabetic retinopathy?
Which of the following is NOT a typical finding in diabetic retinopathy?
Signup and view all the answers
Which condition involves the growth of abnormal new blood vessels on the retina?
Which condition involves the growth of abnormal new blood vessels on the retina?
Signup and view all the answers
Which of the following describes the direction of light through the eye to achieve clear vision?
Which of the following describes the direction of light through the eye to achieve clear vision?
Signup and view all the answers
What is the primary function of the cornea and lens in the process of vision?
What is the primary function of the cornea and lens in the process of vision?
Signup and view all the answers
A patient presents with acute monocular vision loss and pain with eye movement. This is MOST suggestive of:
A patient presents with acute monocular vision loss and pain with eye movement. This is MOST suggestive of:
Signup and view all the answers
The Marcus Gunn pupil, or relative afferent pupillary defect (RAPD), is characterized by which clinical finding during the swinging flashlight test?
The Marcus Gunn pupil, or relative afferent pupillary defect (RAPD), is characterized by which clinical finding during the swinging flashlight test?
Signup and view all the answers
Which diagnostic test is most commonly used to confirm the demyelination of the optic nerve in a patient with suspected optic neuritis?
Which diagnostic test is most commonly used to confirm the demyelination of the optic nerve in a patient with suspected optic neuritis?
Signup and view all the answers
Papilledema is typically associated with which underlying condition?
Papilledema is typically associated with which underlying condition?
Signup and view all the answers
What is NOT typically a symptom of papilledema?
What is NOT typically a symptom of papilledema?
Signup and view all the answers
Which of the following is NOT typically a common cause of blindness?
Which of the following is NOT typically a common cause of blindness?
Signup and view all the answers
Which of the following is NOT a common cause of chronic vision loss in the elderly?
Which of the following is NOT a common cause of chronic vision loss in the elderly?
Signup and view all the answers
What is the fluid-filled space in the anterior part of the eye, that contains the aqueous humor?
What is the fluid-filled space in the anterior part of the eye, that contains the aqueous humor?
Signup and view all the answers
What is the primary function of the ciliary body?
What is the primary function of the ciliary body?
Signup and view all the answers
What is the primary function of the fluid within the eye?
What is the primary function of the fluid within the eye?
Signup and view all the answers
What is the underlying cause of glaucoma?
What is the underlying cause of glaucoma?
Signup and view all the answers
Which of the following is a risk factor associated with acute angle-closure glaucoma?
Which of the following is a risk factor associated with acute angle-closure glaucoma?
Signup and view all the answers
What is a notable symptom of acute angle-closure glaucoma?
What is a notable symptom of acute angle-closure glaucoma?
Signup and view all the answers
Which of these symptoms is NOT typically associated with chronic open-angle glaucoma?
Which of these symptoms is NOT typically associated with chronic open-angle glaucoma?
Signup and view all the answers
What is the best indicator for chronic open-angle glaucoma?
What is the best indicator for chronic open-angle glaucoma?
Signup and view all the answers
What is the primary focus of treatment for chronic open-angle glaucoma?
What is the primary focus of treatment for chronic open-angle glaucoma?
Signup and view all the answers
Which medication increases aqueous humor outflow to lower IOP?
Which medication increases aqueous humor outflow to lower IOP?
Signup and view all the answers
Which medication is a Beta-Blocker that decreases IOP, by decreasing production of aqueous humor?
Which medication is a Beta-Blocker that decreases IOP, by decreasing production of aqueous humor?
Signup and view all the answers
What is the primary mechanism of action of cholinergic agents in treating glaucoma?
What is the primary mechanism of action of cholinergic agents in treating glaucoma?
Signup and view all the answers
What is a treatment for acute angle-closure glaucoma that addresses fluid drainage?
What is a treatment for acute angle-closure glaucoma that addresses fluid drainage?
Signup and view all the answers
Which of these is NOT a medication class used to treat glaucoma?
Which of these is NOT a medication class used to treat glaucoma?
Signup and view all the answers
What is the primary symptom associated with cataracts?
What is the primary symptom associated with cataracts?
Signup and view all the answers
What is considered a normal range for IOP, as measured by a Tonopen?
What is considered a normal range for IOP, as measured by a Tonopen?
Signup and view all the answers
Study Notes
CAM I: Ophthalmology 2
- Course taught by Professor Boucher
- Course offered at South College
Learning Objectives
- Recognize and explain basic types and treatment of eye trauma
- Describe the etiology, signs, symptoms, and physical examination findings for diabetic retinopathy and hypertensive retinopathy
- Recognize and describe common ocular abnormalities (nystagmus and retinal detachment)
- Describe the visual pathway
- Recognize and describe common abnormalities of the optic nerve and orbital cavity
- Describe the signs, symptoms, diagnosis, and treatment of glaucoma
- Compare and contrast diseases causing blindness
- Describe the pathophysiology, diagnosis, signs, symptoms, and treatment of cataracts
- Describe the pathophysiology, diagnosis, signs, symptoms, and treatment of macular degeneration
Eye Trauma
- Ruptured globe ("open globe") is trauma to the eye, usually from a sharp object or projectile
- Full thickness break of the eye wall (sclera and cornea)
- Requires emergency ophthalmic consultation
- Leave the eye alone
- Apply an eye shield
- Do not put anything in the eye
- Avoid any pressure on the globe or eye exam procedures
- Avoid topical meds
- CT scan of orbits
- IV antibiotics (typically Vancomycin + Ceftazidime)
Orbital Fractures
- Common in young males, usually caused by assaults, MVCs, or being struck by an object to the face/eye
- Involves any of the bones surrounding the eye
- Superior orbital rim, roof of orbit - Frontal bone; frontal sinus; supraorbital nerve
- Lateral wall of orbit - Sphenoid bone; lateral canthal ligament
- Infraorbital rim & floor of orbit - Zygoma; inferior oblique & inferior rectus muscles; maxillary sinus; infraorbital nerve
- Medial wall of orbit - Maxillary & ethmoid bones; medial canthal ligament; lacrimal duct system.
Blowout Fracture
- History of small, round, high-speed object impact to eye/orbit (e.g., baseball)
- Often involves the inferior wall or floor of the orbit
- Symptoms include bruising, soft tissue swelling, and pain
- Diagnosed with CT imaging
- Requires ophthalmology referral and hospitalization
- Significant consequence: entrapment of inferior rectus muscle and/or orbital fat
- Potential ischemia of muscle & subsequent loss of muscle function from edema and hemorrhage
Chemical Ocular Injury
- Urgent evaluation and treatment needed for eye contact with any acids or alkalis to prevent vision loss
- Severity depends upon agent, exposure duration & penetration depth
- Alkaline substances (e.g., drain cleaners, bleach) can cause more severe damage than acids (can eat through the eye quickly)
- Referral to ophthalmology before leaving the office is critical
- Treat with continuous irrigation with water or saline until neutral pH
Retinopathy
- Complication of conditions like hypertension (HTN) or diabetes mellitus (DM)
- Damages blood vessels in the light-sensitive tissue at the back of the eye (retina)
- Involves abnormal growth of blood vessels within the retina
- Can cause preventable blindness, particularly in the 20-74 age range
- Patients with risk factors should have regular eye exams
Diabetic Retinopathy
- Microvascular complication of DM.
- Damage to retinal blood vessels leads to retinal ischemia and edema
- Presentation: Asymptomatic until late stages
- Nonproliferative (early): Microaneurysms, dot & blot hemorrhages, hard exudates, cotton wool spots.
- Proliferative (late): New abnormal vessels grow onto the retina.
- Requires urgent treatment. Early detection and management are crucial to prevent vision loss.
Hypertensive Retinopathy
- Retinopathy related to chronic elevated blood pressure.
- Leads to ischemia
- Presentation: Asymptomatic until late stages causing vision impairment.
- Findings include copper/silver wiring of arterioles, exudates, flame-shaped hemorrhages, subretinal edema, optic disc swelling, and AV nicking.
- Early detection and management is essential to prevent vision loss.
Visual Pathway
- Light travels through cornea, aqueous humor, lens, and vitreous humor to the retina.
- Light is refracted by the cornea and lens (and perhaps glasses or contacts)
- Focused onto the retina
- Transformed into an electrochemical signal
- Transmitted via the optic nerve to occipital lobes
Optic Neuritis
- Acute inflammation and demyelination of the optic nerve
- Causes acute monocular vision loss and pain with eye movement
- Often associated with multiple sclerosis (MS).
- Symptoms: Monocular vision loss (one eye only), blurred vision & pain in affected eye
- Diagnosis: Fundoscopy (blurred optic disc), Relative afferent pupillary defect (RAPD), swinging flashlight test, MRI.
- Treatment: intravenous methylprednisolone, referral to neurology
Papilledema
- Swelling of the optic disc due to increased intracranial pressure
- Classically bilateral
- Symptoms often include headache, dizziness, nausea/vomiting, and minimally impaired vision.
- Diagnosis: Fundoscopy reveals a diffuse optic disc swelling.
- Management focuses on treating the underlying cause to decrease intracranial pressure as quickly as possible (e.g., head injury, tumor)
- Need immediate referral to neurology for diagnosis and treatment
Blindness
- Common causes include: uncorrected refractive errors (myopia, hyperopia, astigmatism, presbyopia), cataracts, glaucoma, age-related macular degeneration, and diabetic retinopathy
- Leading causes worldwide include cataracts (39%), uncorrected refractive errors (18%), and age-related macular degeneration (17%).
Chronic Vision Loss
- Common causes in the elderly: glaucoma, cataracts, and age-related macular degeneration
- Regular screening is essential to catch these conditions early to preserve vision
Glaucoma
- Chronic open-angle glaucoma - characterized by gradual vision loss
- Acute angle-closure glaucoma - medical emergency with a rapid increase in intraocular pressure. This leads to severe pain and decreased vision.
- Features include raised intraocular pressure (IOP), haziness of the cornea, and dilated pupils
- Early detection and treatment are necessary for significant damage
Cataracts
- Opacity of the lens causing blurring or distorted vision
- Most common cause of blindness worldwide.
- Risk factors include aging, UV exposure, smoking, etc
- Diagnosis typically includes a complete ophthalmic exam, including the dilated fundus exam.
- Treatment usually involves surgical removal.
Age-Related Macular Degeneration (AMD)
- Most common cause of vision loss
- Gradual vision loss mostly affecting central vision.
- Usually more chronic (Dry AMD) though can be more acute and sudden (Wet AMD)
- Risk factors include age (>65 years old), smoking.
- Diagnosis includes thorough fundoscopic exam, Amsler Grid test, and OCT testing
- Management includes treatment with anti-VEGF drugs for Wet AMD and vitamins/nutrients to slow progression.
- Drusen - a defining feature of this condition.
Giant Cell Arteritis
- Inflammation of the arteries near the temples, most often in older adults
- Risk factors include age (>60-70 years old) and correlation with polymyalgia rheumatica
- Symptoms include headaches, scalp tenderness, jaw pain (claudication), unexplained fever, and significant vision problems
- Left untreated can lead to blindness
- Diagnostics: elevated ESR, CRP levels
- Treatment: IV steroids (methylprednisolone), and hospital admission for temporal artery biopsy.
Retinal Detachment
- Medical emergency where the thin layer of tissue lining the back of the eye (retina) detaches.
- Hallmark signs include flashes of light, floaters, sudden vision loss, or a curtain-like shadow in the visual field
- Risk factors include increasing age, myopia, family history, and prior eye surgeries.
- Diagnosis by fundoscopy
- Treatment is usually ophthalmologic emergency with pneumatic retinopexy (air injection), or cryoretinopexy to reattach retina.
Retinoblastoma
- Rare malignant eye cancer
- Commonly found in children
- Physical examination: absence of the red reflex.
Visual Field Defects
- General term for loss of sight or impairment in vision.
- Various causes for this condition, including glaucoma, cataracts, age-related macular degeneration, retinal detachment, and others.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz, part of Professor Boucher's course at South College, focuses on key aspects of ophthalmology including eye trauma, diabetic and hypertensive retinopathy, glaucoma, cataracts, and macular degeneration. Test your understanding of ocular abnormalities and the visual pathway as you prepare for advanced studies in eye health.
