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20  Common Eye Diseases Lynn E. Lawrence, CMSgt (ret), 20  Common Eye Diseases Lynn E. Lawrence, CMSgt (ret),

20 Common Eye Diseases Lynn E. Lawrence, CMSgt (ret), - PowerPoint Presentation

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20 Common Eye Diseases Lynn E. Lawrence, CMSgt (ret), - PPT Presentation

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

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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?