WK 2C Ophthalmic Conditions: Diagnostics, Causes, and Treatments

This set of flashcards covers key concepts, definitions, and diagnostic tools related to ophthalmic conditions, particularly focusing on diseases such as Macular Degeneration, Glaucoma, and Diabetic Retinopathy.

What are the leading causes of vision loss over the age of 50?

Age Related Macular Degeneration (AMD), Glaucoma, and Diabetic Retinopathy.

What symptoms are associated with Macular Degeneration?

Blurred central vision, peripheral vision unaffected, and distortion of straight lines.

What is the primary function of Optical Coherence Tomography (OCT)?

To provide cross-sectional images of the retina, allowing for detailed analysis of retinal layers.

What are common risk factors for developing Age Related Macular Degeneration?

Family history, being Caucasian, and smoking.

How is Dry AMD treated?

Depends on the stage but may include dietary supplements for intermediate/late stages.

What is the impact of Wet AMD?

It accounts for most vision loss in macular degeneration and involves abnormal blood vessel growth under the retina.

What is the purpose of a Slit Lamp in diagnostics?

To examine the anterior segments of the eye and provide high-intensity illumination.

What is the significance of Anti-VEGF drugs in treating Wet AMD?

They block the protein Vascular Endothelial Growth Factor to prevent abnormal blood vessel growth.

What are the two primary stages of Diabetic Retinopathy?

Non-Proliferative Retinopathy and Proliferative Retinopathy.

How does Glaucoma affect the optic nerve?

It causes damage due to increased intraocular pressure.

What is the diagnostic method used to measure intraocular pressure?

Tonometry.

What are some symptoms of Closed-Angle Glaucoma?

Severe headache, eye pain, nausea, vomiting, and blurred vision.

What kind of eye drops are commonly used in Glaucoma treatment?

Prostaglandins, beta blockers, and alpha-adrenergic agonists.

How does the Fundus Camera assist in diagnosing eye conditions?

By capturing images of the retina and providing a record for monitoring progression.

What is the significance of the Cup-Disc Ratio in Glaucoma diagnosis?

An increase in the ratio indicates glaucomatous damage to the optic nerve.

What does OCT help monitor in Diabetic Retinopathy?

It helps quantify retina thickness and assess treatment response.

What type of changes does the Slit Lamp reveal in AMD?

Signs such as drusen or pigmentary changes.

What are the advantages of using a Fundus Camera?

Provides a clear record of retinal appearance and is non-invasive.

What is the effect of oxidative stress in AMD?

It contributes to RPE degeneration and photoreceptor damage.

What is the role of lifestyle changes in AMD prevention?

Healthy diet and physical activity can lower the risk of AMD.

What does the treatment for advanced Glaucoma often require?

Surgery or laser treatment may be necessary if medications fail.

What is an important visual feature of Proliferative Diabetic Retinopathy?

Abnormal new blood vessels grow inside the retina.

What do the colors in a Green Filter indicate during examination?

It enhances the contrast of blood vessels and hemorrhages.

How are retinal images utilized in the diagnosis of Glaucoma?

To monitor cup-to-disc ratio changes and document RNFL photography.

What are the primary findings in Non-Proliferative Diabetic Retinopathy?

Microaneurysms and retinal swelling.

What technologies are being integrated into fundus imaging to improve detection?

Artificial intelligence and smartphone imaging.

What are the characteristics of Wet AMD diagnosed through OCT?

Presence of choroidal neovascularization and fluid accumulation.

What are the visual changes characteristic of Diabetic Retinopathy detected with a Slit Lamp?

Microaneurysms and hemorrhages.

What are the typical treatment goals for Diabetic Retinopathy?

Regulate blood sugar levels and manage retinal changes.

What common ocular condition presents as cataract and is diagnosed using Slit Lamp images?

Cloudiness in the lens due to fiber cell disorganization.

How are VEGF inhibitors utilized in the treatment of eye diseases?

To reduce swelling, bleeding, and prevent further vision loss.

What is an advantage of using OCT over other imaging modalities?

It provides high-resolution, cross-sectional images for detailed analysis.

What is a common feature in the diagnosis of Glaucoma?

Increased cup-to-disc ratio observed in optic nerve imaging.

What visualization techniques are used to identify features in Diabetic Retinopathy?

Fundus photography and OCT for detailed analysis.

What procedure may be performed if eye drops for glaucoma are not effective?

Laser trabeculoplasty or filtering surgery.

How does the light source in a Fundus Camera function?

Projects light onto the retina for imaging while capturing reflections.

What is the first step in using a Slit Lamp for examination?

Positioning the patient and dilating the pupil.

What does a normal CRA on OCT look like compared to one with AMD?

Normal displays layers without drusen; AMD shows drusen and structural changes.

What are signs of advanced Dry AMD detectable through imaging?

Atrophy and thinning of retinal layers and accumulation of drusen.

What role does lifestyle play in managing Diabetic Retinopathy?

Maintaining a healthy diet and exercise can prevent progression.

What technological advancements are improving eye care?

Tele-optometry and automated refraction systems for better access.

What is the importance of keeping accurate patient records in eye care?

To track disease progression and treatment effectiveness over time.

Why is timely intervention critical in managing Diabetic Retinopathy?

To avoid irreversible vision loss from progressing stages of the disease.

What are the primary underlying causes of Age-Related Macular Degeneration (AMD)?

The exact causes are complex, but involve genetic predisposition, environmental factors, oxidative stress, inflammation, and the accumulation of drusen in the retina.

How are Anti-VEGF drugs primarily administered for Wet AMD, and what is their mechanism?

They are given as intravitreal injections to block Vascular Endothelial Growth Factor (VEGF), thereby reducing abnormal blood vessel growth and leakage under the retina.

What is the fundamental cause of vision loss in Glaucoma?

Progressive damage to the optic nerve, often due to elevated intraocular pressure, leading to characteristic visual field loss.

What non-pharmacological treatments are available for Glaucoma besides surgery?

Laser procedures like Selective Laser Trabeculoplasty (SLT) or Argon Laser Trabeculoplasty (ALT) to improve aqueous humor outflow.

What is the primary pathological cause of Diabetic Retinopathy?

Chronic hyperglycemia leading to damage of the small blood vessels in the retina, causing leakage, blockages, and abnormal new vessel growth.

What are the treatment options for advanced Proliferative Diabetic Retinopathy?

Panretinal Photocoagulation (PRP) laser surgery to regress abnormal new blood vessels, and Anti-VEGF injections to reduce bleeding and swelling.

Explain the optical principle of a Slit Lamp and its illumination capabilities.

It uses a variable slit of light to illuminate ocular cross-sections combined with a stereoscopic microscope for 3D views. Its adjustable illumination system allows manipulation of slit dimensions and filters to highlight different structures and pathologies.

How does the 'slit' in a Slit Lamp specifically aid in visualizing anterior and posterior eye structures?

The slit creates an optical cross-section (optical section) of transparent structures like the cornea or lens, revealing their depth and internal abnormalities. With a fundus lens, it can help visualize posterior segment pathologies.

Describe the optical functioning of a Fundus Camera, including its coaxial illumination.

Illumination light is projected into the eye and reflected off the retina, returning through the same optical path to a sensor. Coaxial illumination ensures clear, uniformly lit images by aligning the light and capture axes.

Beyond standard photography, how does a Fundus Camera facilitate comprehensive retinal imaging?

It captures wide fields of view and supports advanced modes like fluorescein angiography (FA) for dynamic blood flow studies, and indocyanine green angiography (ICGA) for choroidal circulation.

Explain the fundamental principle of Optical Coherence Tomography (OCT) and its modern advancements.

OCT utilizes low-coherence interferometry to create cross-sectional and 3D images of tissue microstructure. Modern Fourier-Domain OCT systems offer faster acquisition and higher resolution than older Time-Domain versions.

What light source is used in OCT and what dictates its imaging resolution?

A broadband near-infrared light source is typically used. Axial resolution is determined by the light source's bandwidth, while transverse resolution depends on the numerical aperture and scanning mechanism.

What specific features indicate Dry AMD on Fundus Camera and OCT images?

Fundus images show drusen and RPE atrophy. OCT reveals drusen, RPE irregularities, and thinning of outer retinal layers.

How is Wet AMD identified on OCT scans and Fundus Camera images?

OCT shows choroidal neovascularization (CNV), subretinal/intraretinal fluid, and RPE detachment. Fundus images may reveal hemorrhage, fluid, or subretinal exudates around the macula.

On Fundus Camera images, what are the primary signs of glaucomatous optic nerve damage?

An increased cup-to-disc ratio, thinning of the neuroretinal rim, optic disc pallor, and RNFL defects like notches.

How does OCT specifically aid in recognizing Glaucoma-related damage to the retina?

OCT quantifies the thickness of the Retinal Nerve Fiber Layer (RNFL) and Ganglion Cell Complex (GCC), revealing characteristic patterns of thinning and defects indicative of glaucomatous damage.

What are the key findings visible on Fundus Camera images for Non-Proliferative Diabetic Retinopathy (NPDR)?

Microaneurysms, dot-and-blot hemorrhages, hard exudates, cotton wool spots, and intraretinal microvascular abnormalities (IRMA).

How does OCT assist in identifying and characterizing Diabetic Macular Edema (DME) in Diabetic Retinopathy?

OCT provides cross-sectional views to detect and quantify retinal thickness, intraretinal and subretinal fluid, cysts, and serous detachments of the neurosensory retina or RPE, crucial for DME staging.

Evaluate the Slit Lamp's role in diagnosing and monitoring anterior segment conditions versus posterior segment conditions like AMD/DR/Glaucoma.

Excellent for anterior segment (cornea, lens, angle for glaucoma). For posterior conditions, it is limited to indirect views (with fundus lens) for gross changes but crucial for initial screening or specific findings like neovascularization, but not for detailed quantification or subtle changes.

For what aspects of Macular Degeneration are Fundus Camera and OCT highly valuable in diagnosis and monitoring?

Fundus Camera documents drusen, RPE changes, and hemorrhage for AMD progression. OCT provides high-resolution cross-sectional views for detecting drusen, subretinal fluid, CNV activity, and RPE detachments, crucial for diagnosis, staging, and treatment response of both Dry and Wet AMD.

How are Fundus Camera and OCT synergistically used for diagnosing and monitoring Glaucoma?

Fundus Camera captures optic disc images for cup-to-disc ratio changes and rim assessment. OCT provides quantitative, objective measurements of RNFL and GCC thickness, detecting early structural damage and monitoring progression more precisely than visual assessment alone.

What are the primary advantages of Fundus Camera and OCT in diagnosing and monitoring Diabetic Retinopathy and DME?

Fundus Camera provides a wide-field view to identify microaneurysms, hemorrhages, and neovascularization (staging DR). OCT is essential for detecting, quantifying, and monitoring Diabetic Macular Edema (edema, fluid accumulation, traction), guiding treatment decisions and assessing response to therapy.