CPOT ABOC Course Description This lecture will focus on 20 common eye diseases It will identify the disease characteristics of the disease and the affects of the disease on the eye The course will also discuss clinical presentations and testing associated with the disease ID: 711360
Download Presentation The PPT/PDF document "20 Common Eye Diseases Lynn E. Lawrence..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
20 Common Eye Diseases
Lynn E. Lawrence, CMSgt (ret),
CPOT, ABOCSlide2
Course Description
This lecture will focus on 20 common eye diseases. It will identify the disease, characteristics of the disease and the affects of the disease on the eye. The course will also discuss clinical presentations and testing associated with the disease.Slide3
20 Diseases of the Ocular System
Lids and Lashes
Cornea
Tear Film
Conjunctiva
Lacrimal SystemCrystalline LensRetinaRefractive SystemSlide4
Lids and lashes
1. Ptosis = muscles
2. Dermatochalasis = skin/fatSlide5
3. Chalazion
Though very common, a careful inspection of the lids is still required to ensure that is the only diagnosis
Reoccurring conditions maybe a reason for concern
(WC Posey,
Diseases of the Eye
, 1902)Slide6
4. Cancer
Many different types of presentations
During the slit lamp exam, please look for missing lashes in suspicious areas
Story of Montana clinicSlide7
4. Bugs!
Story from Nebraska
Cause major eye irritation
Often
mis
-diagnosed by PCPCaution with chemicalsSlide8
5. Corneal Diseases
Fuchs' Dystrophy.
Fuchs' dystrophy is a slowly progressing disease that usually affects both eyes and is slightly more common in women than in men.
Ulcers
Dry Eyes
CloudingArcus Senilus
Keratoconus
*
Keratitus
Viral
Systemic DiseasesSlide9
6. Dry Eyes
Plethora of causes
Difficult to resolve on elderly patients
Medication induced
Environmentally impactedSlide10
Marginal Corneal Ulcer
Viral
Bacterial
Infections can be difficult to treatSlide11
7. Pinguecula vs
8. Pterygium
Little Penguin
Big PterodactylSlide12
9. Keratoconus
Thinning and the “coning of the cornea
This patient presents with unstable
rx
Topography will aid in confirming dxSlide13
Cornea
Herpes
Bacterial Ulcer
Fusarium Keratitis
What of the above is caused by a virus?Slide14
Lacrimal System: Tear Film Layers
oil
aqueous
snot
What functions does each layer of the tear perform?Slide15
Causes of Tearing
Punctal agenesis
Poor/blocked drainage
Trichiasis
Superficial foreign bodies
Poor pump actionEyelid mal-positionsEyelid diseaseTear deficiency or instability
Trigeminal nerve irritation Slide16
Causes of Tearing Cont…
Foreign body sensation
Hypersecretion
Lacrimal secretion and drainage imbalance
Primary or reflex tearing (reflex tearing is more common with ocular surface irritation)
Lacrimal pump failureLacrimal drainage obstructionS/P SurgerySlide17
The Connections
Connections
Lacrimal gland to the eye
From the eye to the lacrimal sac
From the lacrimal sac to the nose
Caniculitis
can cause the blockageSlide18
Clinical Presentation
Chief Complaint
History of present illness
Past medical history
Clinical examination
Nasal ExaminationSlide19
MGDSlide20
Conjunctivitis
The “infamous” pink-eye
Numerous causes:
Bacteria
Viruses
Allergies
Toxic Reactions (chemicals)
Often difficult to diagnose exact etiology
What is the most accurate measure of intraocular pressure?Slide21
MUSCLES
What condition is this?
Which is the dominate eye
When the dominate is covered, which way will the non-dominate move?Slide22
Binocular Vision
Strabismus
Tropia
-manifest deviation of the eyes.
Phoria is a latent deviation held in check by fusional
vergence
Frequency- constant/intermittent
Diplopia
Eso
vs
Exo
What condition is this?
What happens when the
Right eye is covered?Slide23
Is this a Tropia or Phoria/why?
How would you document this condition?
What happens when you
cover this eye?Slide24
Components of an Optical Prescription
Prism
Prism is used to correct blurry or double vision due to deviated eyes
A
B
Label the conditions in each of these picturesSlide25
Pupil Testing
Relative Afferent Pupillary Defect
Adie’s Tonic Pupil-slow response to light
Argyll Robertson-no reaction to light; reaction to accommodation
How long should the light be held in front on the eye during pupil testing?Slide26
Pupil Testing
Anisocoria
-
unequal pupil sizes
“
cor” = pupil“aniso
”=difference
Hippus
- “jumping” pupil
Most commonly seen in younger patients
Congenital color vision defect normally impact vision in ______ eyes?Slide27
Anterior Chamber
Iritis
Uveitis
Narrow Angle Glaucoma
Hyphema
PDSCells and Flare Slide28
Cataracts
What is a cataract?Slide29
Crystalline Lens
Cataracts /
Phakia
IOL –
Aphakia
Without a IOL is PseudophakiaSlide30
Hyperopia
A refractive condition where parallel light rays focus behind the retina when the eye is at rest
Termed farsightedness
Patient may have 20/20 vision at distance and near
What type of lens is used to correct hyperopia?Slide31
Myopia
A refractive condition where parallel light rays focus in front of the retina when the eye is at rest
Termed nearsightedness
Patient may have 20/20 vision at near, but distance vision will be reduced
Myopia is corrected with what type of lens?Slide32
Astigmatism
A refractive condition where different meridians of the eye have different powers
Corrected by lenses which incorporate cylinder power
Usually due to different curvatures of the cornea
TRUE/FALSE: A cylindrical lens correct for astigmatism?Slide33
Amblyopia
A condition in which reduced visual acuity with no apparent cause and not correctable by refractive means
Often referred to as “lazy Eye”
It is generally treatable even after age eight
Scientists are exploring whether treatment for amblyopia in older children and adults can improve vision
What is the clinical definition of amblyopia?Slide34
Presbyopia
Reduction in the ability to accommodate
Occurs normally with age
Reduction in lens elasticity
Reduction in strength of the ciliary muscle
Using the Worth 4-Dot test, if only two or three lights are seen ______ is indicated?Slide35
The Retina
AMD
Retinitis Pigmentosa
ERM
Diabetic Retinopathy
GlaucomaThe ultimate receiverSlide36
Age Macular Degeneration
Wet – more aggressive
Dry – can turn more aggressive without warningSlide37
POAG Glaucoma
Increased intraocular pressure
Increased cupping (cup to disc ratio)
Decrease in peripheral/vision retina damage
What is the clinical definition of glaucoma?Slide38
POAG
Case
Hx
Optic Nerve Head (ONH)
Visual function…field testing
Retinal Nerve Fiber Layer
Expert interpretation of results
Corneal thickness…
pachymetry
avg
500
microns
Gonioscopy
POAG
vs
CAG
Trauma
IOP (asymmetric pressure)
Goldmann (industry std)
POAG
Low Tension
Closed or narrow angleSlide39
Acute Angle Glaucoma
Steamy cornea
Elevated pain
Elevated IOP
Decreased vision
Irregular shaped pupilSlide40
Reinoblastoma
A white color (
leukocoria
) in the center circle of the eye (pupil) when light is shone in the eye, such as when taking a flash photograph
Eyes that appear to be looking in different directions
Eye rednessEye swellinga mutation on
chromosome 13
, called the
RB1
geneSlide41
LidsSlide42
Diabetes
Fluctuations with vision
Bleeding in retina is called retinopathy
Dried blood leaves yellowish clumps in the retina called, Exudates
The white spot in this photo come from ________ deposits?Slide43
Optic Nerve Coloboma
Coloboma
of optic nerve
, also called
Morning Glory syndrome
, is a rare defect of the optic nerve that causes moderate to severe
blindness
. It is extremely rare, occurring in only one person per every two million in the United States.Slide44
CRVO
Since the central retinal artery and vein are the sole source of blood supply and drainage for the retina, such occlusion can lead to severe damage to the retina and blindness, due to
ischemia
(restriction in blood supply) and
edema
(swelling).[2]
It can also cause
glaucoma
.Slide45
What do you think?
2
1
3
4Slide46
Were you correct?
Large C/D ratio
RPE
Torturous vessels
Herpetic DendriteSlide47
What is wrong in these photos?
Extreme Blood Pressure/ retinal bleeding
PapilledmaSlide48
Call itSlide49
Call it
cataract
glaucomaSlide50
Call itSlide51
Call it
keratoconus
neovascularizationSlide52
Call itSlide53
Call it
PVD
Macular DegenerationSlide54
Call itSlide55
Call it
Farsighted
Retinal detachmentSlide56
Call ItSlide57
Call It
Shingles/ Herpes Zoster
MGDSlide58
Questions
What is the purpose of the fitting triangle?
Which tonometers require an anesthetic?
What instrument is used to obtain a prescription from a contact or ophthalmic lens?
What is the heaviest lens material?Slide59
Questions
What is the difference between acuity and accommodation?
Spell the scientific name for your eyelid ______________?
What percentage of water is in a low water content ______ or high water content _______ contact lens.Slide60
Questions
The person who normally grinds lenses is called a(n) _________________?
What is the difference between a mydriactic and miotic?
What is the definition of the word “plano”?Slide61
Review Questions
The point where the upper and lower eyelids meet is called?
The blockage of the meibomian gland is called the ___________ when it causes pain, and the _________ when it does not cause pain?
What is a good tear break up time?
What is amblyopia?Slide62
Review Questions
The eyelid will protect your eyes from what?
What main muscles raises the eyelid?
Convert to spherical equivalent
- 1.50 – 1.00 X 180
- 2.25 – 1.50 X 120
What is the main layer of the eye lid?Slide63
Review Questions
What is the difference between visual acuity and accommodation?
What is decentration?
Name a test performed binocularly?
Through a prism the image deviates which way?
_________ is the merging of images from each eye into one image?Slide64
Review Questions
What are the layers of a tear film?
Where is tear mucin produced?
Why is the tear film important in contact lens wear?
What is stereopsis?Slide65
Review
Opia means what?
What is the difference between a tropia and a phoria?
Avascular means what?
How many extra-ocular muscles are oblique?Slide66
Review Questions
Where does aqueous drain?
What drug is used to slow aqueous production?
What is the difference between versions and vergence?
Analyph glasses are used with what test?