retinopathy of prematurity(ROP)
treatmentstage 1,2→resolves spontaneously
stage3→photocoagulation(laser therapy)
stage4,5(rare)→vitreous surgery ophthalmologypediatrics Jun 28, 2019, 12:22 AM HirotoShishido
sctomas(loss of central vision)
age-related macular degeneration
central serous chorioretinopathy
→hyperopia
optic neuritis ophthalmology Jun 26, 2019, 6:09 PM HirotoShishido
symptoms/signs/pathogenesis of cataract・Gradual loss of visual acuity
・Excessive glare, halos around bright lights
・Myopic shift
・Opacification of lens
・Loss of red reflex
・Photooxidative damage
Cumulative photooxidative stress is worsened by heavy UV exposure (eg, outdoor occupations), smoking, or ionizing radiation.
・Nuclear sclerosis
・Osmotic injury
accelerated in patients with diabetes mellitus ophthalmologyUWorld May 18, 2020, 6:37 PM HirotoShishido
Pictureleft: "blood and thunder appearance"
→ retinal vein occlusion
right: macular star (exudate, red arrow), cotton-wool spots (blue arrow)
Retinal damage due to chronic uncontrolled HTN. Presence of papilledema requires immediate lowering of BP. ophthalmology Jul 7, 2020, 2:50 AM HirotoShishido
Pictureoptic disk atrophy with characteristic cupping=thinning of outer rim of optic nerve head
→glaucoma
cherry red spot(☆bright red fovea centralis surrounded by a contrasting white macula→ central retinal artery occlusion, metachromatic leukodystrophy, Niemann-Pick, Tay-Sachs)
latanoprost/ iloprost
mechanismlatanoprost→
prostaglandins
☆↑outflow of aqueous humor via uveoscleral pathway
treatment of glaucoma
iloprost→
prostacyclin
direct vasodilatory effects on pulmonary and systemic arterial vascular beds, inhibit platelet aggregation ophthalmologypharmacologyUWorld Apr 12, 2020, 8:37 AM HirotoShishido
mechanism of sorbitol accumulationThe first step in the polyol pathway is the conversion of glucose into sorbitol by aldose reductase. Sorbitol cannot readily cross cell membranes and is therefore trapped inside the cells where it forms.
The second enzyme in the pathway, sorbitol dehydrogenase, is able to convert sorbitol into ☆fructose at a sufficient rate to prevent accumulation when glucose levels are normal.
age-related macular degeneration
symptoms,treatment(degeneration of macula)
metamorhopsia(distortion,変視)
scotomas(loss of central vison,中心暗点)
dry(nonexudative>80%)→multivitamin, antioxidant suppliments
wet(exudative)→anti-VEGF injectioes(bevacizumab, ranibizumab) ophthalmology Jun 24, 2019, 12:16 AM HirotoShishido
adverse effect to ciliary muscle
of α-agonists, β-blockers, cholinomimeticsα-agonists (naphazoline)(↓aqueous humor synthesis (α2))→cannot used for closed angle glaucoma due to ☆mydriasis (α1)
β-blockers (timolol) decrease aqueous humor synthesis (β2) in ☆ciliary epithelium→ no pupillary or vision changes
closed angle glaucoma vs migrane with auraclosed angle glaucoma
→ typically older (> 60yo),
severe pain and conjunctival erythema are common, and vision would not be expected to improve without intervention
structure of lacrimal apparatusPCSN
Lacrimal punctum
Lacrimal canal
Lacrimal sac
Nasolacrimal duct
Inferior meatus ophthalmologyENT国試 Oct 20, 2020, 12:06 AM HirotoShishido
etiology of amblyopia• progressive suppression of visual input from eye receiving suboptimal image(blurry, deviated)
• in approximately half of the cases, amblyopia is secondary to strabismus (mainly ☆esotropia)
• other causes may include ★uncorrected refractive errors, anisometropia 不同視弱視 (asymmetric refractive errors, usually in the more ☆hyperopic eye), and deprivation due to structural ocular problems (ptosis, cataract, corneal opacity/scarring, retinoblastoma) ophthalmology卒試UWorld step2CK Oct 18, 2020, 5:22 AM HirotoShishido
