Carlos Shared "09 Neurology Ophthalmology + Path" - 58 Picmonics

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09 Neurology Ophthalmology + Path

Eye
Characteristics
Sclera
Cornea
Iris
Lens
Ciliary Muscles
Optic Nerve
Rods
Cones
Retina
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1 min
Cataract
Mechanism
Age-related
Assessment
No Pain
Cloudy Opaque Lens
Decreased Visual Acuity
Occurs Gradually
Treatment
Surgery
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1 min
Open-Angle Glaucoma
Humor has access to trabecular meshwork
Presentation
Painless
African-American
Elderly
Positive family history
Primary Open-Angle Glaucoma
Most common form of Glaucoma
Unknown Mechanism
Secondary Open-Angle Glaucoma
Blocked trabecular meshwork (with Open-Angle)
WBCs
Red Blood Cells (RBC)
Retinal products
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2 mins
Closed-Angle Glaucoma
Primary
Lens causes pupillary obstruction
Aqueous humor builds behind iris
Iris bends forward, obstructing trabecular mesh
Secondary
Hypoxia Causes Neovascular Proliferation
Contraction and obstruction of trabecular mesh
Chronic disease (Crone)
Asymptomatic
Acute Disease
Eye pain and blindness
Rock-hard eye
Headache
Emergency
Epinephrine contraindicated
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2 mins
Age-Related Macular Degeneration (AMD)
Mechanism
Dry (nonexudative)
Wet (exudative)
Signs and Symptoms
Scotomas
Blurred, darkened vision
Loss of central vision
Distortion of vision
Considerations
Drug Therapy
Surgery
Low-vision assistive devices
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2 mins
Detached Retina
Assessment
Flashes of Light
Floaters
Curtain Like Shadow
Interventions
Eye Patch
Bed Rest
Surgical Emergency
Considerations
No Vigorous Activity
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2 mins
Diabetic Retinopathy
Most Common Cause of Blindess in the USA
Retinal Damage due to Chronic Hyperglycemia
Cotton wool spots
Nonproliferative
Nonproliferative
Damaged capillaries leak blood
This causes lipids and fluid to seep into retina
Results in Hemorrhages and Macular Edema
Control Blood Sugar for Treatment
Proliferative
Proliferative
Chronic hypoxia results in new blood vessel formation with resultant traction on retina
Peripheral Retinal Photocoagulation for treatment
Surgery
Anti-VEGF
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Retinal vein occlusion
Blockage of central or branch retinal vein due to compression from nearby arterial atherosclerosis
Retinal hemorrhage
Venous engorgement
Edema in affected area
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Central retinal artery occlusion
Acute, painless monocular vision loss
Retina cloudy with attenuated (thin) vessels
“Cherry-red” spot at fovea (center of macula)
Evaluate
Evaluate for embolic source
Carotid artery atherosclerosis
Cardiac vegetations
Patent Foramen Ovale
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Retinitis Pigmentosa
Inherited retinal degeneration
Night blindness (rods affected first)
Painless, progressive vision loss
Bone spicule–shaped deposits around macula
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Retinitis
Retinal edema and necrosis
Leads to scar
Often viral (CMV, HSV, VZV), but can be bacterial or parasitic
May be associated with immunosuppression (such as AIDS patients)
CMV RETINITIS
Common in AIDS patients
Presents with cotton wool exudates, perivascular hemorrhage, and necrotizing retinitis on funduscopic examination
Can evolve into retinal detachement
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Papilledema
Optic disc swelling (usually bilateral) due to Increased ICP
Enlarged blind spot and elevated optic disc with blurred margins
Common in Pseudotumor Cerebri
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Marcus Gunn pupil
Afferent pupillary defect
Due to optic nerve damage or severe retinal injury
Decreased bilateral pupillary constriction when light is shone in affected eye relative to unaffected eye
Tested with “swinging flashlight test”
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Horner Syndrome
Cause
Sympathetic Denervation of Face and Iris
Associated with lesion of spinal cord above T1
Symptoms
Ptosis
Anhidrosis
Flushing on affected side
Miosis (pupil constriction)
Associated Lesions
Pancoast Tumor
Brown-Séquard Syndrome
Syringomyelia
SYMPATHETIC DENERVATION OF IRIS
If the damage is to the third-order neuron (postganglionic fibers) the pupil will not dilate. If the damage is to first- or second-order neurons the pupil will dilate.
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Visual Field Defects - Anatomy Overview
Optic Nerve
Vision Loss in One Eye
Optic Chiasm
Bitemporal Hemianopia - Both Eyes Outside Vision Loss
Optic Tract
Homonymous Hemianopia - Both Eyes Same Side
Dorsal Optic Radiation
Lower Quadrantic Vision Loss
Meyer's Loop
Upper Quadrantic Vision Loss
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2 mins
Visual Field Defects - Right Anopia
Visual Field Abnormality
Right Anopia
Complete Vision Loss in 1 Eye
Location of Lesion
Right Optic Nerve
Causes
Retinoblastoma
Gliomas
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41 secs
Visual Field Defects - Bitemporal Hemianopia
Visual Field Abnormality
Bitemporal Hemianopia
Both Eyes Outside Vision Loss
Tunnel Vision
Location of Lesion
Optic Chiasm
Causes
Suprasellar Compression
Pituitary Adenoma
Craniopharyngioma
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1 min
Visual Field Defects - Homonymous Hemianopia
Visual Field Abnormality
Homonymous Hemianopia
Vision Loss - Both Eyes Same Side
Location of Lesion
Optic Tract
Parietal Lobe
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1 min
Visual Field Defects - Left Upper Quadrantic Anopia
Visual Field Abnormality
Left Upper Quadrantic Anopia
Pie in the Sky
Location of Lesion
Meyer's Loop
Right Temporal Lobe
Cause
Middle Cerebral Artery (MCA) Infarct
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1 min
Visual Field Defects - Left Lower Quadrantic Anopia
Visual Field Abnormality
Left Lower Quadrantic Anopia
Pie on the Floor
Location of Lesion
Dorsal Optic Radiation
Parietal Lobe
Causes
Middle Cerebral Artery (MCA) Infarct
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1 min

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