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Part 3 – PM3A > (PM3A) Ocular Conditions > Flashcards

(PM3A) Ocular Conditions Flashcards

1
Q

What is uveitis?

A

Inflammation or swelling of the middle layer of the eye

Of uvea/ uveal tract

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2
Q

Where is the uvea?

A

Middle layer of the eye

(1) Anterior: Ciliary body + iris
(2) Posterior: Choroid

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3
Q

What are some of the symptoms of uveitis?

A

(1) Ache/ pain
(2) Red eye
(3) Small pupil, irregular outline
(4) Blurred vision
(5) Cloudiness
(6) Headaches/ light sensitivity

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4
Q

What are some of the causes of uveitis?

A

Unclear

(1) Inflammation of the uvea/ iris
(2) Mainly affects children + young adults
(3) Association with trauma or autoimmune

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5
Q

What is the treatment for uveitis?

A

Depends on which areas of the eye are affected

(1) Corticosteroid eye drops
(2) Corticosteroid injections
(3) Mydriatic eye drops, e.g. atropine sulfate

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6
Q

What is blepharitis?

A

Chronic inflammation of the eye lid

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7
Q

What are some of the symptoms of blepharitis?

A

(1) Itchy/ red + sore eye lids
(2) Eye lids stick together
(3) Problems opening eyes upon waking
(4) Crusty eyelashes
(5) Burning/ gritty sensation
(6) Photophobia
(7) Abnormal eyelashe growth + loss

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8
Q

What are the potential causes of blepharitis?

A

Sebaceous gland dysfunction

Can be caused by:

(1) Staphylococci infection
(2) Infestation of lice/ demodex lice
(3) Allergic reactions
(4) Fungal infection
(5) Viral infection

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9
Q

What is the typical treatment for blepharitis?

A

(1) Daily eye lid cleaning

(2) ABx for more severe cases - topical/ oral

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10
Q

Describe the usual onset of blepharitis symptoms.

A

Repeated episodes

Separated by periods without symptoms

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11
Q

What is a stye?

A

External hordeolum

Small + painful lump on inside/ outside of eyelid

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12
Q

What is an external hordeolum?

A

Stye

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13
Q

What are some of the common symptoms of a stye?

A

(1) Swollen/ lumpy
(2) Redness
(3) Swelling/ tenderness lasting several days
(4) Often a white head in the centre of the swelling

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14
Q

What are some of the potential causes of a stye?

A

(1) Acute staphylococcal infection of the sebaceous glands
(2) In-growing eyelash
(3) Can be associated with blepharitis
(4) Recurrent in diabetics
(5) Positive correlation with stress

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15
Q

What is the typical treatment for a stye?

A

Usually self-limiting (days-weeks)

Topical ABx if severe

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16
Q

What is conjunctivitis?

A

Inflammation of the conjunctiva

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17
Q

What are some of the different types of conjunctivitis?

A

(1) Bacterial conjunctivitis
(2) Allergic conjunctivitis
(3) Chlamydial conjunctivitis

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18
Q

What are some of the common symptoms of conjunctivitis?

A

(1) Uni/bilateral
(2) Sudden onset - seasonal
(3) Reddening of eyes
(4) Itchy + sore
(5) Watery eyes
(6) Swollen eyelids

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19
Q

What are some of the potential causes of conjunctivitis?

A

(1) Pollen - hay fever
(2) Dust mites
(3) Makeup
(4) Animal fur
(5) Eye drops
(6) Unclean contact lens
(7) Bacterial/ viral

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20
Q

What is the typical treatment for conjunctivitis?

A

Usually self-limiting within 2 weeks

(1) Allergic conjunctivitis: azelastine hydrochloride eye drops
(2) Infective conjunctivitis: chloramphenicol/ fusidic acid

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21
Q

What is keratitis?

A

Inflammation of the cornea

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22
Q

What are some of the symptoms of keratitis?

A

(1) Eyelid oedema
(2) Conjunctival inflammation
(3) Dicharge
(4) Corneal ulceration
(5) Pink eye

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23
Q

What are some of the potential causes of keratitis?

A

(1) Bacterial - contact lenses/ trauma
(2) Viral - herpes simplex
(3) Fungal - Candida
(4) Parasitic - pools/ hot tubs/ contact lens solution

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24
Q

What is the most common cause of blindness?

A

Keratitis

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25
Q

What is the typical treatment for keratitis?

A

(1) Depends on severity of infection
- Oral ABx + ABx ointment/ eye drops

(2) Antiseptic drops - chlorhexidine/ brolene/ hexamidine
- Anti-amoebic effect

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26
Q

Why may antiseptic eye drops be given for treatment of keratitis?

A

Anti-amoebic effect

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27
Q

What is ectropion?

A

Condition where eyelids turn outwards

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28
Q

What are some of the common symptoms of ectropion?

A

(1) Permanently watery eye
(2) Eyelid sag
(3) Exposure of conjunctival surface
(4) Exposure of corneal surface
(5) Decreased vision
(6) Ocular surface pain

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29
Q

What are some of the potential causes of ectropion?

A

(1) Weak muscles around the eye - old age
(2) Injury to the skin around the eyes
(3) Bell’s (facial) palsy
(4) Congenital (genetic) defect

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30
Q

What is the typical treatment for ectropion?

A

(1) Mild cases may not require treatment

(2) Operation (surgery) to correct is recommended

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31
Q

What is exophthalmos?

A

Proptosis

Abnormal protrusion of the eye ball

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32
Q

What is proptosis?

A

Exophthalmos

Abnormal protrusion of the eye ball

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33
Q

What are some of the common symptoms of exophthalmos?

A

(1) Forced eyelid widening
(2) Staring expression
(3) Impaired eye movement
(4) Double/ blurred vision
(5) Dry + itchy eyes

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34
Q

What are some of the common symptoms of proptosis?

A

(1) Forced eyelid widening
(2) Staring expression
(3) Impaired eye movement
(4) Double/ blurred vision
(5) Dry + itchy eyes

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35
Q

What are some of the potential causes of exophthalmos?

A

(1) Increase in volume of tissue behind the eyes
(2) Associated with hyperthyroidism
(3) Hereditary disease - Grave’s
(4) Infection of the sinuses - in children only
(5) Protrusion of one eye - cyst/ brain tumour/ blood clot

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36
Q

What is the treatment for exophthalmos?

A

When caused by thyroid eye disease:

(1) Medication to correct thyroid hormone levels
(2) IV corticosteroid therapy
(3) Corrective surgery - following reduction of inflammation

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37
Q

What are some of the potential causes of proptosis?

A

(1) Increase in volume of tissue behind the eyes
(2) Associated with hyperthyroidism
(3) Hereditary disease - Grave’s
(4) Infection of the sinuses - in children only
(5) Protrusion of one eye - cyst/ brain tumour/ blood clot

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38
Q

What is the treatment for proptosis?

A

When caused by thyroid eye disease:

(1) Medication to correct thyroid hormone levels
(2) IV corticosteroid therapy
(3) Corrective surgery - following reduction of inflammation

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39
Q

What are cataracts?

A

Clouding of the lens in the eye

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40
Q

What are some of the common symptoms of cataracts?

A

(1) Blurred/ cloudy/ misty vision
(2) Gradual visual deterioration
(3) Age/ environment related
(4) Discomfort in bright light
(5) Colour fading
(6) Reading/ watching TV more difficult
(7) Glasses becoming less effective

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41
Q

What are some of the potential causes for cataracts?

A

(1) Protein aggregation in lens
(2) Eye injury
(3) Diabetes
(4) Uveitis

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42
Q

What are some of the risk factors for cataracts?

A

(1) Smoking
(2) Overexposure to light
(3) Prolonged steroid use

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43
Q

What is the typical treatment for cataracts?

A

Cataract surgery

No other proven treatment

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44
Q

What is keratoconjunctivitis sicca?

A

Dry eye syndrome

Decreased tear production/ increased tear film evaporation

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45
Q

What is dry eye syndrome?

A

Keratoconjunctivitis sicca

Decreased tear production/ increased tear film evaporation

46
Q

What are some of the common symptoms of keratoconjunctivitis sicca?

A

(1) Ocular irritation - dryness/ soreness
(2) Usually bilateral
(3) Worsens throughout the day
(4) Redness of eyes

47
Q

What are some of the potential complications of keratoconjunctivitis sicca?

A

(1) Scarring
(2) Conjunctivitis
(3) Photosensitivity
(4) Corneal thinning

48
Q

What are some of the potential complications of dry eye syndrome?

A

(1) Scarring
(2) Conjunctivitis
(3) Photosensitivity
(4) Corneal thinning

49
Q

What are some of the common symptoms of dry eye syndrome?

A

(1) Ocular irritation - dryness/ soreness
(2) Usually bilateral
(3) Worsens throughout the day
(4) Redness of eyes

50
Q

What are some of the potential causes of keratoconjunctivitis sicca?

A

(1) Environmental factors
(2) Concomitant illness
(3) Hormonal changes
(4) Ageing

(5) Loss of tear fluid
- Lacrimal gland defect
- Meibomian gland defect
- Eyelid defect
- Cornea defect
- Tear duct/s defect

51
Q

What are some of the potential causes of dry eye syndrome?

A

(1) Environmental factors
(2) Concomitant illness
(3) Hormonal changes
(4) Ageing

(5) Loss of tear fluid
- Lacrimal gland defect
- Meibomian gland defect
- Eyelid defect
- Cornea defect
- Tear duct/s defect

52
Q

What biological factors can cause loss of tear fluid?

A

(1) Lacrimal gland defect
(2) Meibomian gland defect
(3) Eyelid defect
(4) Cornea defect
(5) Tear duct/s defect

53
Q

What is glaucoma?

A

Group of eye diseases

Result in damage to the optic nerve

Causes vision loss

54
Q

What are some of the common symptoms of glaucoma?

A

(1) Largely asymptomatic - slow onset
(2) Impairment of peripheral vision
(3) Hazy/ blurred vision
(4) Rainbow-coloured circles around bright lights
(5) Severe eye/ head pain
(6) Nausea/ vomiting - associated with eye pain
(7) Sudden sight loss

55
Q

What are some of the potential causes of glaucoma?

A

Triggers are unknown

Usually associated with excessive pressure within the eye damaging the optic nerve

Caused by misbalance of production and drainage in the aqueous humour

Trabecular meshwork progressively blocked/ impaired

56
Q

What is the trabecular meshwork?

A

Drainage point of the aqueous humour in the eye

57
Q

What are the main types of glaucoma?

A

(1) Open-angle glaucoma (~90%)

(2) Angle-closure glaucoma

58
Q

Which type of glaucoma is most common?

A

Open-angle glaucoma

59
Q

What is open-angle glaucoma?

A

Most common type of glaucoma (~90%)

Slow clogging of drainage canals

Slow development

Lifelong condition

60
Q

What is angle-closure glaucoma?

A

Least common main type of glaucoma (~10%)

Blocked drainage canals

Sudden rise in intraocular pressure

Develops very quickly

61
Q

What is the likely glaucoma diagnosis for a case with fast onset and a sudden rise in intraocular pressure?

A

Angle-closure glaucoma

62
Q

What are some of the risk factors for glaucoma?

A

(1) Age - more common >40yrs old
(2) Blood pressure - low BP increased risk

(3) Race
- african/ afro-caribbean increased risk of chronic open-angle glaucoma
- asian increased risk of acute angle-closure glaucoma

(4) Family history - increased risk
(5) Short/ long sight
(6) Medical history - diabetes increases risk

63
Q

What is myopia?

A

Short-sightedness

64
Q

What effect does myopia have on glaucoma risk factor?

A

Increased risk of chronic open-angle glaucoma

65
Q

What effect does short-sight have on glaucoma risk factor?

A

Increased risk of chronic open-angle glaucoma

66
Q

What effect does diabetes have on glaucoma risk factor?

A

Increased risk of glaucoma

67
Q

What are some treatment options for glaucoma?

A

(1) Prostaglandin analogues
(2) Beta-blockers
(3) Carbonic anhydrase inhibitors
(4) Sympathomimetics
(5) Miotics

68
Q

Why are prostaglandin inhibitors used for treatment of glaucoma?

A

Increase the flow of aqueous humour fluid out of the eye

Reduces the intraocular pressure

e.g. latanoprost

69
Q

Why are beta-blockers used for treatment of glaucoma?

A

Reduce intraocular pressure

Reduce production of aqueous humour in the eye

e.g. timolol maleate

70
Q

Why are carbonic anhydrase inhibitors used for treatment of glaucoma?

A

Reduce production of aqueous humour

Reduces intraocular pressure

e.g. brinzolamide

71
Q

Why are sympathomimetics used for treatment of glaucoma?

A

Reduces production of aqueous humour

Increases flow of aqueous humour out of the eye

e.g. brimonidine tartrate

72
Q

Why are miotics used for the treatment of glaucoma?

A

Open up blocked trabecular meshwork

Improves drainage of aqueous humour out of eye

e.g. pilocarpine hydrochloride

73
Q

What is acute injury of the eye?

A

(1) Foreign body in eye

(2) Corneal scratch

74
Q

What are some of the common symptoms of acute eye injury?

A

(1) Dry eye sensation
(2) Sensation of a foreign body
(3) Normal appearance with some redness
(4) Excessive tear production

75
Q

What are some of the potential causes of acute eye injury?

A

(1) Superficial eye injury/ trauma (scratch)
(2) Fingernails
(3) Working with power tools
(4) Dirt/ grit

76
Q

What is diabetic retinopathy?

A

Damage to the retina

Resulting from diabetes

77
Q

What are some of the common symptoms of diabetic retinopathy?

A

(1) Few early warning signs
(2) Black spots in the vision
(3) Early stages detectable by fundus photography
(4) Early stages: non-proliferative
(5) Late stages: proliferative

78
Q

What are some of the potential causes of diabetic retinopathy?

A

(1) Microvascular changes - due to poor glycaemic control degenerating vascular walls
(2) 80% of diabetic patients >10 years

79
Q

What percentage of diabetic retinopathy cases are preventable if monitored and treated correctly?

A

90%

80
Q

What percentage of patients with diabetes for longer than 10 years will develop diabetic retinopathy?

A

80%

81
Q

What are the typical treatments for diabetic retinopathy?

A

(1) Laser treatmetn
(2) Management of diabetes
(3) Intravitreal injections/ implant with fluocinolone acetonide
(4) Operation to remove blood/ scar tissue

82
Q

What is fluocinolone acetonide?

A

Corticosteroid

83
Q

What is a sub conjunctival haemorrhage?

A

Bleeding underneath the conjunctiva

84
Q

What are some common symptoms of subconjunctival haemorrhage?

A

(1) Blood form burst blood vessel cover surface of eyeball - not in eyeball itself
(2) Initial pain disappears quickly
(3) No change in vision

85
Q

What is a potential cause of subconjunctival haemorrhage?

A

Mild physical trauma

86
Q

What is the typical treatment for subconjunctival haemorrage?

A

No treatment required if infection not present

Check for significant trauma

87
Q

What is age related macular degeneration (AMD)?

A

Painful eye condition

Causes loss of central vision

Usually bilateral

88
Q

What are some of the common symptoms of age related macular degeneration (AMD)?

A

(1) Difficulty reading
(2) Less vibrant colours/ dulling
(3) Difficult recognising faces
(4) Does not affect peripheral vision

89
Q

What are the types of age related macular degeneration (AMD)?

A

(1) Dry age related macular degeneration

(2) Wet age related macular degeneration

90
Q

What is dry age related macular degeneration (AMD)?

A

Cells of macula become damaged

Due to build up of deposits called drusen

Most common type of AMD

Least severe type of AMD

~90% of all AMD cases

91
Q

What is wet age related macular degeneration?

A

Also known as neovascular AMD

Develops when abnormal blood vessels form under macula

Damage macula cells

92
Q

What is neovascular age related macular degeneration?

A

Also known as wet age related macular degeneration

Develops when abnormal blood vessels form under macula

Damage macula cells

93
Q

Where is the macula?

A

At the back of the eye

94
Q

What does damage to the macula do?

A

Distorts the macula + bleeds

Affects central vision

95
Q

What are some of the risk factors for age related macular degeneration (AMD)?

A

(1) Smoking
(2) Obesity
(3) Cardiovascular disease
(4) Family history

96
Q

What is the treatment for age-related macular degeneration?

A

No cure for either type of AMD

Wet AMD: Treated monthly with intraocular injections with anti-vascular endothelial growth factor (anti-VEGF) medication
- e.g. ranibizumab

97
Q

What are some symptoms of myopia?

A

(1) Distant objects appear blurred
(2) Close objects are clear
(3) Manifests from childhood to 25 years old

98
Q

What percentage of the UK population have myopia?

A

30%

99
Q

What causes myopia?

A

(1) Rays of light are focused short of the retina in the eye
(2) Eye is too long from front to back
(3) Cornea too steeply curved

100
Q

What is hyperopia?

A

Long-sightedness

101
Q

What is another term for long-sightedness?

A

Hyperopia

102
Q

How can myopia or hyperopia be corrected?

A

(1) Contact lenses
(2) Glasses
(3) Myopia - concave lens (minus)
(4) Hyperopia - convex lens (plus)

103
Q

How are contact lenses held in the eye?

A

Thin transparent discs

Sit on the cornea

Held in place by eyelid pressure + tear film surface tension

104
Q

What types of contact lenses are there?

A

(1) Rigid - hard/ gas permeable

(2) Soft - hydrogel/ silicone hydrogel

105
Q

What care advice must be given for contact lens wearers?

A

(1) Worn for a limited number of hours per day
(2) Require strict cleaning
(3) Daily disposables are best option

106
Q

What are some complications of wearing contact lenses?

A

(1) Papillary conjunctivitis
(2) Ulcerative keratitis
(3) Acanthamoeba keratitis - sight threatening parasite

107
Q

What is papillary conjunctivitis?

A

Allergic reaction of the eye

108
Q

What is ulcerative keratitis?

A

Inflammation + ulceration of the cornea

109
Q

What is acanthamoeba keratitis?

A

Sight threatening parasite

110
Q

Name some rarer conditions of the eye, besides those known in more detail.

A

(1) Cancer
(2) Keratoconus - corneal degeneration
(3) Limbal stem cell deficiency
(4) Corneal dystrophies
(5) Cicatrical pemphigoid - autoimmune blistering

Part 3 – PM3A (28 decks)

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