Term
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Definition
Proteins in the lens denature resulting in cloudy sight
**removal of lens, insertion of a disc. APAP for pain, do not rub, do not lower head below heart |
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Term
| What is macular degeneration? |
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Definition
Retinal pigment epithelium + photoreceptors in macula degenerate - caused by incr VEGF, inflammation
**Advanced form can lead to blindness |
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Term
| What are the types of macular degeneration? |
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Definition
- Advanced non-neovascular - DRY AMD. Drusen/deposits, slow central vision loss
- Advanced neovascular - WET AMD, drusen + leaking blood vessels
**Risk factors: SMOKING and increased age |
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Term
| What is a self test for macular degeneration? |
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Definition
| Amsler grid - see a hole and wavy lines |
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Term
| How is macular degeneration prevented? |
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Definition
- Stop smoking!
- Control BP
- Wear sunglasses
- Increase antioxidants, Lutein, zeaxanthin, omega 3's |
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Term
| What is AREDS and AREDS-2? |
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Definition
- AREDS - Zinc, Antioxidant (C, E, beta carotene), Zinc + antioxidant (most effective!), or placebo. Decr. risk of advanced disease
- AREDS2 - Placebo, Lutein + Zeaxanthin, Omega-3's, or 2+3. Still ongoing
**Smokers should not take beta carotene |
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Term
| What Rxs can be used for macular degeneration? |
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Definition
- Ranibizumab - Lucentis®
- Pegaptanib - Macugen® - least effective
- Aflibercept - Eylea®
- Bevacizumab - Avastin® - not FDA approved, but cheaper
**AE: pain, hemorrhage, floaters.
Stop progression. |
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Term
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Definition
- Aging
- Lid defects, decr tears
- Autoimmune
- Systemic meds - anticholinergics, antihistamines, isotretinoin, antipsychotics, muscle relaxers, TCA
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Term
| What is Keratoconjunctivitis sicca? |
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Definition
Chronic dry eye - a chronic inflammatory disease, abnormal tear film surface
- Incr age, autoimmune disorder, post-menopausal
**Artificial tears and restasis |
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Term
| How do artificial tears work? |
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Definition
Stabilizes tear film for acute or chronic dry eyes. Many examples
Use BID or up to QID |
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Term
| What are the steps to treating dry eye? |
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Definition
- Trial of OTCs
- If doesn't work: Change products, increase drops, add ointment at bedtime
- If doesn't work, use RX |
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Term
| What RX can be used for dry eyes? |
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Definition
Cyclosporine/Restasis - reduces inflammation and increases tear production. 1 gtt each eye BID, wait 15 min before using artificial tears
**AE: pain, foreign body sensation. No systemic effects. Do not use in active infection |
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Term
| What antihistamine/decongestant combos are used for allergic conjunctivitis? |
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Definition
| - Pheniramine + Naphazoline --> Naphcon, Visin, Opcon-A. Only use for 3 days, do not use w/ contacts |
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Term
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Definition
A mast cell stabilizer - patanol or pataday - HA with no NLO
**Azelastine/Optivar also a mast cell stabilizer/H1 antagonist |
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Term
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Definition
| Ketorolac eye drops - anti-inflammatory. Remove contacts |
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Term
| How are steroids used for conjunctivitis? |
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Definition
| - Not first line, only short term. Can incr IOP if used >10 days |
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Term
| What can be used to treat viral conjunctivitis? |
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Definition
- Adenovirus - supportive care, artificial tears
- Herpes simplex - Trifluridine/Viroptic |
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