Funny-looking optic discs are a "fun" diversion in an ophthalmology clinic (sarcasm implied here). What was initially a routine exam immediately turns into an agonizing "is this normal or not" exercise. Part of the angst that comes from seeing anomalous optic discs is that some of the congenital disc anomalies are associated with systemic diseases. If there is concurrent visual field loss or decreased visual acuity, the challenge becomes deciding if those defects in the visual system are due to the anomalous nerve, or if there is some other ophthalmic cause that we don't want to miss.
Optociliary Shunt Vessels
Optociliary shunt vessels (retinochoroidal shunts), are normal congenital collaterals between the retinal and choroidal venous circulation. In conditions that cause chronic central retinal vein obstruction, venous outflow becomes redirected to the choroidal venous circulation, resulting in dilation of these collateral vessels.
Papilledema
Lacrimal Gland Tumors
To be honest, I wasn't completely sure whether to categorize this topic under oculoplastics or ophthalmic pathology. Arguments definitely could be made for either, or both.
In any case, there are 3 major tumors that affect the lacrimal gland: orbital lymphoma, pleomorphic adenoma of the lacrimal gland, and adenoid cystic carcinoma of the lacrimal gland. If you see a test question about a tumor of the lacrimal gland, it is going to be one of those three conditions (probably).
Molluscum Contagiosum
There are a lot of practice questions on molluscum contagiosum. Although its clinical appearance and histopathology are fairly distinctive, I often confuse this with keratoacanthoma.
Keratoacanthoma
Keratoacanthomas are very characteristic-appearing lesions on the skin that also look very distinctive on histopathology. I get these confused on histopathology with molluscum contagiosum, so I think this is an important condition to know.
Aniridia
As you can probably tell, I'm starting to skip around a little bit while I put together these OKAP review articles. I have a fairly large list of topics to cover, but hopefully these will all be helpful pieces of information. I decided to skip to aniridia, because it is one of those conditions that seems to be very popular in practice questions.
Hypertension
It seems like a large percentage of our patients have some semblance of hypertension. For most ophthalmologists, the majority of what used to keep us up late at night in medical school - treating hypertensive urgency, adjusting long-term meds, counseling patients about sodium intake, debating whether or not to work someone up for pheochromocytoma, etc. - no longer has any direct relevance. I don't mean this in any negative sense, of course, but the point is, management of hypertension is no longer our field of expertise. However, there are still some key things to remember about hypertension. After all, we're still medical doctors.
Carotid Occlusive Disease
Carotid occlusive disease is another systemic condition that has some very significant ophthalmic manifestations. For the sake of brevity, this article will primarily highlight the systemic information we need to know for the OKAP, including transient ischemic attacks (TIAs). I will post other articles pertaining to some of the ophthalmic manifestations of carotid occlusive disease, such as ocular ischemic syndrome and transient monocular visual loss (specifically amaurosis fugax). Hopefully this will be a shorter one!
Pathophysiology Of Infectious Diseases
There are a ton of infectious diseases we have to know and recognize. While hopefully most of the following are a review of concepts learned in undergrad and medical school, there are some minutiae that I often will forget. Some of these infectious diseases will be addressed in later articles, pertaining to the specific eye condition it may cause. Not all infectious diseases will be discussed; only the ones where there were specific pathophysiology-related discussions listed.
HIV And AIDS
I admit, most of the general medicine categories will be rather broad topics. Truth be told, the main things you need to know about HIV and AIDS are more geared towards the opportunistic illnesses that arise from the immunodeficient state present in the late stages. You'll likely see some of those opportunistic conditions pop up in other sections, as we work through each article.
High-Yield Overview: Vernal Keratoconjunctivitis (VKC)
Classification Of Nonproliferative Diabetic Retinopathy
The modified Airlie House classification has been used to classify nonproliferative diabetic retinopathy (NPDR) since the Diabetic Retinopathy Study (DRS) and Early Treatment Diabetic Retinopathy Study (ETDRS). (1-3) Since this classification determines management of nonproliferative diabetic retinopathy, it is extremely important to know these criteria. This classification has been further refined by Wilkinson et al for international use and was adopted as part of the AAO's Preferred Practice Pattern for Diabetic Retinopathy. (4,5)