Sensory loss in the aging Patient
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| First signs of presbyopia occur around age | 40
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| Risk factors for cataracts | lifetime UV-B light exposure, age, corticosteroids, smoking, DM, women, AA
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| Cataract Risk reduction | antioxidants, vit. A, C, E, Selenium, Decreased ETOH and Decreased Smoking, Jury still out on Decreased Salt
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| Two types of cataracts | cortical (peripheral), nuclear (central)
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| Signs and Sx of senile cataracts | gradual painless visual loss, generalized rather than field loss, glare with bright light, "second sight" effect in presbyopic patients
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| Efficacy of cataract surgery | 90% regain good vision (covered well by insurance companies)
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| 2nd leading cause of blindness in the US | Glaucoma, leading cause in AA
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| Glaucoma facts | increased intraocular pressure, damage to optic nerve, peripheral visual loss predominates
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| Acute closed-angle glaucoma | Sudden pressure increase associated with sudden onset of pain, ↓ in vision, halos around lights, N/VUnilateral; red eye, steamy cornea, non-reactive pupil
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| Chronic open-angle glaucoma | More commonDevelops slowly; bilateralNormal-appearing outflow trackPeripheral visual loss initially
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| Changes in cup to disc ratio in glaucoma | increased cup to disc ratio
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| #1 cause of severe vision loss in the elderly | age related macular degeneration
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| Macular degeneration facts | begins in one eye, usually becomes bilateral. Dry and slow subcategories
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| Dry (atrophic) AMD | slow onset, loss of macular cells, non-neovascular, represents 90% of cases
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| Wet (exudative) AMD | more acute, less common, abnormal blood vessels are fragile and leak
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| Modifiable risk factors for macular degeneration | smoking, htn, uv exposure, poor diet
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| non modifiable risk factors for macular degeneration | age, caucasian, blue eyes, genetics, severe myopia or hyperopia
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| Fundoscopic findings in macular degeneration | drusen, neovascular - leaky vessels
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| Home screening for macular degeneration | Grid
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| prevention and Tx for Dry AMD | minimize risks, maintain healthy diet (Vit c, E, beta carotene, zinc, antioxidants)
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| Prevention and Tx for Wet AMD | laser tx effective in about 10-15%, Lucentis - intra ocular injection of monoclonal anti-VEGF antibody. FDA approved in 2006
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| Hearing loss complications | decreased ability to hear speech, inability to mask competing sounds, difficulty with sound localization, distortion of sound
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