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ENT/Ophtho (Other (retinal detachment (common in patients with high myopia…

- - - - 80%m, nonexudative deposition of yellow Extracellular material between Bruch membrane and retinal pigment epithelium Drusen spots
      - gradual loss of vision. give multivitamin and antioxidant supplements
  - - - damaged capillaries leak blood --> lipids/fluid seep into retina --> hemorrhages and macular edema
    - - chronic hypoxia --> new blood vessel formation --> traction on retina
        
        treat - peripheral retinal photocoagulation, surgery, anti-VEGF
  - - - hemorrhage and venous engorgement, edema in affected area
  - - - preceded posterior vitreous detachment - flashes/floaters and monocular loss [curtain drawn down]
  - - - painless, prog vision loss. begins with night blindness [rods first]. bone spicule-shaped deposits around macula
  - - - often viral [CMV, HSV, VZV], bacterial, parasitic.
      - assc. with immunosuppression
  - - - bilateral due to high ICP.
      - enlarged blind spot and elevated optic disc with blurred margins
- - - - damage to optic nerve or severe retinal injury
      - decreased bilateral pupillary constriction when light shone in affected eye swinging flashlight test
- - - - affected by vascular disease, low diffusion of oxygen and nutrients to interior fibers
      - ptosis, down/out gaze
    - - fibers on periphery are first to be affected
      - Pcom aneurysm, uncle herniation
      - sxs: blown pupil with down/out gaze
  - - - lesions may be unilateral or bilateral
      - right/left INO refers to which eye is paralyzed
    - - CN6 nucleus actives ipsilateral lateral rectus, contralateral CN3 has to stimulate medial rectus to contract.
      - abducting eye gets nystagmus - CN6 overtires to stimulate CN3
- - - - air-filled with three bones.
    - - cochlea. auditory nerve signaling --> brain stem
  - - - bone>air
      - localizes to affected ear
    - - normal rinne test and weber localizes to unaffected ear
    - - damage to sterociliated cells. loss of high frequency first.
    - - aging related sensorineural hearing loss [high frequency] due to destruction of hair cells at cochlear base
  - - - inner ear etiology
      - semicircular canal debris, vestibular nerve infection, meunière disease, benign paroxysmal positional vertigo
      - positional testing --> delayed horizontal nystagmus
    - - brain stem or cerebellar lesion
      - stroke affecting the vestibular nuclei or posterior fossa tumor
      - directional or purely vertical nystagmus, skew deviation, diplopia, dysmetria
      - positional testing --> immediate nystagmus in any direction. focal near findings
- - - - enlarged/forward movement of lens against central iris --> obstruction of aqueous flow --> fluid build up in iris, push peripheral iris against cornea and impeding flow through trabecular meshwork
    - - hypoxia from retinal disease --> vasoproliferation in iris that contracts angle
    - - ask. with damage to optic nerve and peripheral vision
    - - emergency. increased IOP pushes iris forward, angle closes abruptly. painful red eye, sudden vision loss, HALOS AROUND LIGHTS, frontal HA, mid-dilated pupil.
      - DONT GIVE EPI - mydriatic effect