51 Questions
What is the most common form of jerk nystagmus?
Gaze-evoked nystagmus
Which type of nystagmus is associated with lesions near the craniocervical junction?
Downbeat nystagmus
What can provoke peripheral vestibular nystagmus?
Sudden shifts in head position
What is a common etiology for pendular nystagmus?
Masses in the brain or along the optic tract
What is the treatment for macular edema?
Intravitreal injections of VEGF inhibitors
What may require urgent referral to an ophthalmologist for hypercoagulable workup?
Optic disc swelling
What is amaurosis fugax?
A transient ischemic attack of the retina
What may worsen glaucoma?
Anticholinergics
What is the leading cause of blindness?
Glaucoma
What is amblyopia characterized by?
Reduced visual acuity not correctable by refractive means
What is the treatment for neovascularization?
Laser photocoagulation
What is the aim of strabismus treatment?
Prevent or reverse sensory effects through interventions in childhood
What is the characteristic of open-angle glaucoma?
Painless and gradual vision loss
What does closed-angle glaucoma diagnosis require?
Optic disc abnormalities, increased intraocular pressure, and visual field loss
What affects 4% of children and is often associated with familial factors?
Strabismus
How is glaucoma treated?
Lowering of intraocular pressure through medication or surgery
What is the common cause of optic neuropathies in older adults with sudden loss of half upper or lower field of vision?
Giant cell arteritis
What urgent treatment is required for arteritic anterior ischemic optic neuropathy (AAION) to prevent blindness?
Steroids
What is a common symptom of toxic optic neuropathy?
Visual loss and bilateral optic disc swelling
What is the characteristic feature of Leber's hereditary optic neuropathy?
Progressive and painless severe central visual loss in one eye
What is the cause of orbital cellulitis usually associated with?
Sinus infection or ophthalmic surgery
What is the main symptom of orbital cellulitis?
Swelling, redness, and fever
What is the treatment for orbital cellulitis?
Emergent referral to ophthalmologist, IV antibiotics, covering for sinus infection or skin bugs, possible surgical drainage if needed
What is the cause of preseptal cellulitis, a milder form not involving the globe, more common in pediatric population?
Sinus infection or skin trauma
What is the characteristic feature of posterior ischemic optic neuropathy?
Uncommon cause of acute vision loss, associated with severe anemia or hypertension
What is the cause of optic disc drusen, refractile particles in the optic nerve?
Not related to macular degeneration, common in Northern European descent
What is the presentation of papilledema, indicating elevated intracranial pressure?
Transient visual obscurations, requires neuroimaging to exclude intracranial lesions
What are the signs and symptoms of open globe fracture?
Corneal or scleral laceration, peaked pupil, and decreased visual acuity
What is the recommended treatment for hyphema?
Head of bed elevation and correction of coagulopathy if present
What is the characteristic presentation of central retinal artery occlusion?
Painless monocular vision loss
What is the recommended initial approach for central retinal artery occlusion?
tPA or ocular massage
What is the characteristic appearance of central retinal vein occlusion?
"Blood & thunder" appearance
What are the risk factors for central retinal vein occlusion?
Diabetes, hypertension, cardiovascular disease, and smoking
What is the recommended treatment for central retinal vein occlusion?
VEGF inhibitors
What is the immediate management for microhyphema suggestive of fulminant ocular infection?
Immediate ophthalmologist attention
What is the initial treatment for blunt or penetrating trauma resulting in open globe fracture?
No eye manipulation, eye shield placement, and IV antiemetic therapy
What is the effect of hyphema on vision if left untreated?
Permanent vision loss
What is the consequence of increasing intraocular pressure in the context of ocular trauma?
Worsening of the injury
What is the recommended approach for immediate management of central retinal artery occlusion?
Emergent referral to ophthalmology
What is the characteristic feature of atrophic (dry) macular degeneration?
Gradual progressive bilateral vision loss
What is the key symptom of diabetic retinopathy?
Spots floating in vision
What is the primary treatment for hypertensive retinopathy?
Better management of hypertension
What is the prognosis for retinal detachment if promptly treated?
80% recovery rate without recurrence
What is the earliest stage of retinal involvement in diabetic retinopathy?
Nonproliferative diabetic retinopathy
What is the characteristic sign of hypertensive retinopathy?
AV nicking
What is the key factor in preventing diabetic retinopathy?
Good glycemic, BP, and lipid control
What is the characteristic feature of wet macular degeneration?
Breakdown of cells in the macula
What is the primary diagnostic method for diagnosing wet macular degeneration?
Fluorescein angiography
What is the characteristic presentation of retinal detachment?
Sudden visual field loss
What is the primary treatment for atrophic (dry) macular degeneration?
Lifestyle changes such as stopping smoking and adopting a Mediterranean diet
What is the key factor in the improved outcomes of wet macular degeneration?
Early use of VEGF-inhibitors
Study Notes
Ocular Trauma and Emergency Eye Conditions
- Blunt or penetrating trauma can cause open globe fracture
- Signs and symptoms include corneal or scleral laceration, peaked pupil, and decreased visual acuity
- Immediate ophthalmology consult is necessary with avoidance of increasing intraocular pressure
- Treatment includes no eye manipulation, eye shield placement, and IV antiemetic therapy
- Hyphema, blood in the anterior chamber, can result in permanent vision loss
- Treatment for hyphema involves head of bed elevation and correction of coagulopathy if present
- Microhyphema, suggestive of fulminant ocular infection, requires immediate ophthalmologist attention
- Central retinal artery occlusion presents as painless monocular vision loss and requires emergent referral to ophthalmology
- Treatment may involve tPA or ocular massage, with checks for ESR, CRP, and hypercoagulable workup
- Central retinal vein occlusion is characterized by painless monocular vision loss with "blood & thunder" appearance
- VEGF inhibitors are used in the treatment of central retinal vein occlusion
- Risk factors include diabetes, hypertension, cardiovascular disease, and smoking
Common Retinal Disorders and Their Treatment
- Wet macular degeneration is characterized by breakdown of cells in the macula, most commonly occurring in individuals over 50 and associated with smoking.
- Diagnosing wet macular degeneration involves fundoscopic exam, fluorescein angiography, and Amsler grid test, with early use of VEGF-inhibitors showing improved outcomes.
- Atrophic (dry) macular degeneration is characterized by extracellular debris deposits around the macula, resulting in gradual progressive bilateral vision loss.
- Treatment for atrophic macular degeneration includes intraocular injection of VEGF antagonists and lifestyle changes, such as stopping smoking and adopting a Mediterranean diet.
- Retinal detachment can lead to sudden visual field loss and is related to retinal tear, often preceded by floaters or shadow-like disturbances.
- Prognosis for retinal detachment is good if promptly treated, with 80% recovery rate without recurrence, but detachment of the contralateral eye occurs in 25% of cases.
- Hypertensive retinopathy can be classified as mild, moderate, or severe based on fundoscopic exam and may present with various signs and symptoms such as AV nicking, retinal hemorrhages, and optic disc edema.
- Treatment for hypertensive retinopathy involves better management of hypertension and emergent management of pressure if papilledema is present.
- Diabetic retinopathy, a leading cause of blindness in the US, can be nonproliferative or proliferative, with symptoms including spots floating in vision, blurred vision, and dark streaks.
- Nonproliferative diabetic retinopathy is the earliest stage of retinal involvement, while proliferative diabetic retinopathy is the most severe type, characterized by abnormal blood vessels growing in the retina.
- Treatment for diabetic retinopathy involves prevention through good glycemic, BP, and lipid control, and may include VEGF inhibitors, laser, or surgical vitrectomy.
- Diabetic retinopathy is characterized by microaneurysms, cotton wool spots, and exudates on exam, with prevention being key through good glycemic, BP, and lipid control.
Test your knowledge of ocular trauma, emergency eye conditions, and common retinal disorders and their treatments with this quiz. Explore topics such as open globe fractures, hyphema, central retinal artery occlusion, wet and dry macular degeneration, retinal detachment, hypertensive retinopathy, and diabetic retinopathy.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
