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Common Eye Diseases - Coggle Diagram

- - - - Compresses on vein, leading to backflow and ischaemia
- - - - Clear
      - Blurred
        
        Indicates swelling of the optic disc
        
        Could be papilloedema
        
        Bilateral optic disc swelling secondary to increase in ICP
        
        Malignant hypertension
        
        Hydrocephalus
        
        Meningitis
        
        Optic neuropathy
- - - - Hypertensive retinopathy / vein occlusion
    - - DR
- - - - Most common cause of reversible blindness
      - Visual tests
        
        Visual acuity: reduced
        
        RAPD: negative
        
        Fundoscope: abnormal red-reflex
    - - Leading cause of irreversible blindness
      - Caused by degeneration of optic nerve and retinal ganglion cells
      - Most commonly asymptomatic
        
        Peripheral vision affected much more than central vision
      - Detection and monitoring is difficult
        
        Glaucoma pts not aware of visual impairment, even at advanced stages
        
        Clinical diagnosis
        
        Detection of a thinned retinal nerve fiber layer (RNFL)
        
        Detection of a narrowed neuroretinal rim
      - Visual tests
        
        Visual acuity: Can be normal or abnormal
        
        RAPD: positive
        
        Indicates optic neuropathy
        
        Glaucoma ON: neuroretinal rim remains pink
        
        Non-glaucoma ON: neuroretinal rim becomes pale
        
        Fundoscope: cupping
        
        Optical coherence tomography (OCT): preferred diagnostic tool
        
        Used to detect thinning of the retinal nerve fiber layer (RNFL)
    - - Myopia
        
        Nearsightedness
        
        Complications
        
        Glaucoma
        
        Retinal detachment
        
        Myopic macular atrophy
        
        Myopic choroidal neovascularisation
      - Hyperopia
        
        Farsightedness
        
        Complications
        
        Primary angle closure glaucoma
      - Visual tests
        
        Visual acuity: improved with pinhole
        
        RAPD: negative
        
        Fundoscope: normal red-reflex
    - - Dry AMD
        
        Progresses slowly over years
        
        Breakdown of cells in the macula
        
        Buildup of yellow deposits called drusen
        
        Presents with geographic atrophy on fundoscope
      - Wet AMD
        
        Progresses rapidly over weeks
        
        Straight lines appear wavy on Amsler grid
        
        Caused by weak vessels growing under retina leaking blood and fluid
        
        Treated with anti-VEGF intravitreal injection
    - - Non-proliferative
        
        Fundoscope
        
        Blot intra-retinal haemorrhage #
        
        Cotton wool spots #
        
        Focal areas of ischaemic necrosis
        
        Hard exudates
        
        Lipoproteins following partial / complete resorption of retinal edema
      - Proliferative
        
        Can cause blindness
        
        Growth of abnormal blood vessels in retina
        
        Vitreous haemorrhage
        
        Loss of vision
        
        Loss of red light reflex
        
        No RAPD
        
        Complication: tractional retinal detachment
        
        Treatment: panretinal photocoagulation, anti-VEGF intravitreal injection, vitrectomy
        
        Vitrectomy for non-resolving vitreous haemorrhage
        
        Complications
        
        Rubeosis iridis
        
        Neovascularisation of the iris
        
        Can lead to neovascular glaucoma
      - Visual tests
        
        Visual acuity: normal or abnormal
        
        RAPD: negative
        
        Fundoscope: retinal haemorrhage, neovascularisation
      - More prevalent in T1DM (80%) compared to T2DM (40%)
- - - - Silver wiring
        
        Muscle walls of arteries become thicker and more light reflective
        
        Suggests atherosclerosis
    - - Arteriovenous nipping
        
        Thickened arteries compressing veins
    - - Cotton wool patches
      - Flame shaped haemorrhage
    - - Grade 3 presentation
      - Swelling of the optic disc (papilloedema)
- - - - Macula lutea
        
        Fovea centralis
        
        Derives nutrition entirely from the underlying choroid
        
        Has the highest density of cone cells in the retina
        
        Yellow due to xanthophyll pigment, which is an anti-oxidant
        
        Xanthophyll = lutein + zeaxanthin