Cataracts
The cause can be congenital or acquired; deposition of protein in THIS part of the eye causes light scattering
Lens
Up to 90% of glaucomas are OAG; what are some risk factors involved? (age, lifestyle, ethnicity)
>55 years old; diabetes (due to neovascularization); family history; African-American ethnicity
Is this a chronic or acute condition?
Acute - requires emergency referral
This is the leading cause of which type of blindness?
Irreversible blindness
Poor control of this disease after 10-15 years causes retinopathy
Diabetes
Type 1 -- >15 years = 80%
Type 2 -- 84% & 53% after 19 years with/without taking insulin
This condition is a medical emergency. It involves a sudden, progressive and painless monocular vision loss. Patient may experience curving of straight lines, floaters, flashing light. Retina may appear elevated, grey with dark blood vessels. Loss of red reflex. Immediate referral to ophthalmologist. Often caused by retinopathy.
Retinal detachment
What is this condition the most common cause of?
Blindness
Does the pathophysiology involve an increase or decrease in ocular pressure? This then leads to optic nerve and retinal damage.
Increase
What are two main sudden-presenting symptoms?
Deep, UNILATERAL eye pain
Photophobia
Also: rapid onset of vision change (halos), headache, nausea
What are some risk factors associated with this condition? (age, lifestyle, co-morbidities)
>65 years old, smoking, family history, diabetes/cardiovascular disease
Up-regulation of VEGF causes angiogenesis (new leaky blood vessels) which pushes vitreous away (traction), eventually leading to THIS condition of the retina
Retinal detachment
This may be caused by damage from dust, metal particles, contact lenses etc.Presents with eye pain, "gritty" feeling in eye, headache, sensitivity to light. Diagnosed with fluorescein stain with wood lamp - will have green appearance.
Corneal abrasion
What are some risk factors involved? (Age, lifestyle, comorbidity)
>55 years old, diabetes, UV exposure/smoking; Wilson disease, atopic dermatitis
The neuro-retinal rim of the optic nerve becomes progressively thinner which enlarges the optic-nerve cup. Clinically, can we expect to see an increased or decreased cup to disc ratio? Will the patient experience pain?
Increased; No pain
What might be observed clinically after performing a light-reflex test?
Decreased pupillary reactivity to light
In THIS type of ARMD, we can expect deposits called drusen in the Bruch membrane under the retina, with angiogenesis and atrophy of the retinal layer.
Non-neovascular (atrophic, dry)
85%
In a fundoycopic exam, we would expect to see what two characteristics of blood vessels?
Copper wiring
This condition requires referral for fundoscopy. Associated with history of MS; involves inflammation and demyelination of optic nerve (CN II). Swelling of optic nerve head causes PAPILLEDEMA. Fundoscopy shows blurred disc margins. Patient presents with blurred vision, central vision loss, decreased visual acuity (problems with dim light or seeing colours)
Optic Neuritis
In terms of symptoms, patient may experience lenticular opacities (tinting of coloured vision) and impaired/blurry vision especially at NIGHT. Would the patient experience pain?
No
Does this condition develop quickly or slowly?
Slowly - this is a chronic, lifelong condition -- slow blockage of drainage canals with a wide and open angle between iris and cornea
Can be slowed by treatment to reduce intraocular pressure.
What are three other physical findings?
Ciliary injection (redness in eye)
Decreased visual acuity
Tears
In the previous question, breakdown of the light-sensitive cells of the macula cause what type of vision loss?
Gradual, central vision loss
In this type of retinopathy, we would expect to see a dry retina with few hemorrhages, visible normal retinal arteries and multiple cotton wool spots
Hypertensive Retinopathy
Central retinal artery occlusion
When performing the red reflex test, what would we expect to see?
Absence of red reflex
What is recommended for people over 40 to screen for this (often initially asymptomatic) condition?
Annual dilated eye exam
Diagnosis involves emergency referral, as well as THIS test, in which the cornea is anesthized, applied pressure and amount of corneal displacement is measured (reflections IOP)
Tonometry
In THIS type of ARMD, the choroid penetrates the Bruch membrane causing leaking and haemorrhage (presents as dark spot on fundoycopic exam), and may lead to retinal detachment. This is a more rapid onset of vision loss.
Neovascular (exudate, wet)
10-20%
*Severe distortion of Amsler grid test
What symptoms might the patient have?
Blurred/double vision, headaches, visual field defects, yellow/white deposits on retina
This is the most common intraocular tumour of childhood <2-3 years old. Presents with loss of red eye reflex, strabismus. Risk factors include family history RB1 gene.May present with erythema of eye, main, floaters.
Retinoblastoma