41 Questions
What is the most common form of jerk nystagmus?
Horizontal
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 type of abnormalities to the optic disc may lead to optic neuritis?
$Cupping$
Which type of macular degeneration involves extracellular debris deposits around the macula?
Dry macular degeneration
What are the VEGF inhibitors used for diagnosing and treating wet macular degeneration?
Bevacizumab and Ranibizumab
What is a characteristic sign of hypertensive retinopathy?
AV nicking
What is the most severe type of diabetic retinopathy characterized by abnormal blood vessels growing in the retina?
$ ext{Proliferative diabetic retinopathy}$
What can occur spontaneously in individuals over 50 and is often preceded by floaters or shadow-like disturbances?
$ ext{Retinal detachment}$
What is used to treat macular degeneration?
Intraocular injection of VEGF antagonists and photocoagulation
What is the leading cause of blindness in the US?
Diabetic retinopathy
What is a characteristic sign of diabetic retinopathy on examination?
Cotton wool spots
What is vital for new-onset symptoms of retinal disorders?
Prompt referral to ophthalmology
What can lead to blindness if the macula has detached but can lead to good recovery without recurrence with emergency treatment?
Retinal detachment
What are used for the prevention of diabetic retinopathy?
VEGF inhibitors, laser, and surgical vitrectomy
What are the symptoms of orbital floor fracture due to blunt trauma?
Restricted eye movement, dropped eye, and crepitus
What are the characteristics of open globe fracture?
Obvious corneal or scleral laceration, peaked pupil, and subconjunctival hemorrhage
What is hyphema?
Blood in the anterior chamber
What is hypopyon indicative of?
A sight-threatening ocular infection
How does central retinal artery occlusion present?
Painless vision loss, cherry red spot or boxcar appearance
What are the risk factors for central retinal artery occlusion?
Carotid disease, cardiogenic emboli, and small artery disease
What is the prognosis for central retinal artery occlusion?
Poor visual outcome in most cases
What is the treatment for optic neuritis?
Steroids
What is the characteristic feature of Leber's hereditary optic neuropathy?
Progressive, painless vision loss in young men
What is the urgent treatment required for arteritic anterior ischemic optic neuropathy (AAION)?
Steroids
What is the leading cause of blindness in older adults?
Macular degeneration
What is the recommended treatment for orbital cellulitis?
IV antibiotics
Which condition is associated with refractile particles in the optic nerve and causes visual obscurations?
Optic disc drusen
What is the characteristic feature of Posterior Ischemic Optic Neuropathy?
Sudden vision loss
What is the inheritance pattern of Leber's hereditary optic neuropathy?
Maternally inherited
What is the key difference between Orbital cellulitis and Periorbital (preseptal) cellulitis?
Involvement of orbital septum
What is amaurosis fugax characterized by?
Sudden vision loss in one or more visual fields
What is the leading cause of blindness in African Americans?
Open-angle glaucoma
What are the common causes of amblyopia?
Strabismus, uremia, alcohol, and tobacco
What are the symptoms of angle-closure glaucoma?
Painful, red eye and cloudy cornea
What is the management for a TIA of the retina?
Oral aspirin and finding underlying causes
What is the association between optic disc swelling and systemic conditions?
It warrants urgent referral to an ophthalmologist for comprehensive workup to identify and treat systemic conditions associated with macular edema, neovascularization, and hypercoagulability.
What are the risk factors associated with glaucoma?
Elderly age, narrow anterior chamber angle, enlarged lens, farsightedness, diabetes, hypertension, and myopia
What is the diagnosis criteria for closed-angle glaucoma?
Presence of optic disc abnormalities, increased intraocular pressure, and visual field loss
Which medications can worsen glaucoma?
Alpha/beta agonists, anticholinergics, antihistamines, psychiatric drugs
What are the treatment options for closed-angle glaucoma?
Laser peripheral iridotomy or surgical iridectomy
Study Notes
Ophthalmologic Conditions and Treatments
- Amaurosis fugax is a transient ischemic attack of the retina, leading to sudden vision loss in one or more visual fields, often associated with Hollenhorst plaque and carotid disease, warranting urgent referral and carotid ultrasound.
- Amblyopia is characterized by reduced visual acuity not correctable by refractive means and fixed ocular deviation, commonly caused by strabismus, uremia, or toxins like alcohol and tobacco.
- Glaucoma encompasses a group of diseases with optic nerve damage and elevated intraocular pressure, with open-angle and angle-closure subtypes, presenting with varied symptoms and exam changes.
- Open-angle glaucoma is often asymptomatic, a leading cause of blindness in African Americans, and is managed with betablockers and prostaglandin drops to lower intraocular pressure.
- Angle-closure glaucoma presents with a painful, red eye, cloudy cornea, and dilated fixed eye, requiring urgent referral and immediate pressure-lowering with medications like timolol and pilocarpine.
- Glaucoma has an increased prevalence in the elderly, individuals with narrow anterior chamber angle, enlarged lens, farsightedness, and is associated with conditions like diabetes, hypertension, and myopia.
- Optic disc swelling warrants urgent referral to an ophthalmologist and comprehensive workup to identify and treat any systemic conditions associated with macular edema, neovascularization, and hypercoagulability.
- A TIA of the retina presents with sudden visual loss, and the management includes oral aspirin and finding underlying causes, similar to the workup for CRAO, focusing on ischemia, cardiac emboli, and GCA.
- Strabismus is a deviation from ocular alignment, affecting 4% of children and potentially leading to amblyopia, and it is associated with muscular imbalance, trauma, brain tumors, and elevated intracranial pressure.
- Closed-angle glaucoma diagnosis requires the presence of optic disc abnormalities, increased intraocular pressure, and visual field loss, while treatment involves urgent ophthalmology referral, IOP-lowering agents, and laser or surgical options.
- Medications that worsen glaucoma include alpha/beta agonists, anticholinergics, antihistamines, psychiatric drugs, inhaled beta 2 agonists, and antibiotics, potentially exacerbating the condition.
- Ophthalmologic procedures for glaucoma include laser therapy, trabeculectomy surgery, and medications like timolol, prostaglandin analogs, and carbonic anhydrase inhibitors, with considerations for osmotic diuretics and potential adverse effects.
Test your knowledge about wet age-related macular degeneration, its definition, epidemiology, etiology, and diagnosing VEGF-inhibitors.
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