Cataracts, retinopathy, retinal detachment, macular degeneration

cataracts

opacity of lens prevent light transmission to retina

etiology of cataracts

aging, blunt/penetrating trauma, smoking, alc, UV exposure, drugs, ocular inflammation

cataracts patho

altered metabolic process in lens causes buildup of water and change in lens, changes transparency of lens

s/s cataracts

painless, gradual decrease in vision, abnormal color perception, glare (worse at night when pupil dilates)

management of cataracts

encourage use of visual aids (glasses, magnifiers), surgery

retinopathy

microvascular damage to retina, often w DM, HTN

nonproliferative diabetic retinopathy

most common- capillary microaneurysms, retinal swelling, hard exudates

nonproliferative diabetic retinopathy- macular edema

plasma leaks from macular blood vessels, can cause hemorrhaging, and then loss in central vision

proliferative diabetic retinopathy

new blood vessels form that are fragile and leak, causes severe vision loss

s/s diabetic retinopathy

floaters, blurry vision, poor night vision, vision loss, impaired color

hypertensive retinopathy

blockages in retinal blood vessels from HTN

papilledema

HTN can cause sudden visual loss from swelling of optic disc and nerve in both eyes

hypertensive retinopathy treatment

lower BP

retinal detachment

separation of sensory retina in pigment epithelium, fluid accumulates in between the 2 layers

etiology retinal detachment

myopia, age, trauma to head, eye tumor, cataract surgery

s/s retinal detachment

sudden, unilateral, painless, floaters, flash of light, vision loss (curtains being pulled down over vision)

retinal breaks

interruption on full thickness of retinal tissue- can be hole or tear

retinal hole

spontaneous atrophic retinal break

retinal tear

vitreous humor shrinks during aging and pulls on the retina

treatment of retinal detachment

medical emergency- intervention depends on severity of tear

macular degeneration

progressive eye disease that affects macula (center of retina), leading to vision loss

age related macular degeneration- wet type

rapid development of abnormal blood vessel in the macula, most severe

age related macular degeneration- dry type

slowly progressive, close vision tasks start to become harder, macular cells atrophy

etiology age related macular degeneration

retinal aging, genetics, fam hx, light-colored eyes, UV light, smoking, HTN

protective factor for age related macular degeneration

eating dark leafy green veggies

dry AMD patho

yellow drusen deposits in retinal pigment epithelium, atrophy of macular cells occur over time

wet AMD patho

new blood vessels grow in retinal epithelium that leak fluid and bleed, causes scar tissue

s/s AMD

acute vision loss, blurred/darkened spots (scotomas), metamorphopsia (distortion of vision)

treatment of wet AMD

meds injected into vitreous cavity every 4-6 weeks

what do the injections of medications do in wet AMD

slow vision loss by stopping new vessels from forming