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year 5 > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

P Uvea=

A

iris + ciliary body + choroid

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2
Q

Production and flow of aqueous humour

A

Produced by posterior ciliary body, travels through pupil to anterior chamber. Trabeculum and Cansl of Schlemm take back to venous system.
Maintain 10-21mmHg normal pressure on the eye

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3
Q

Differentials for painful loss of vision

A

GCA, unveitis, keratitis, conjunctivitis, acute angle glaucoma

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4
Q

Differentials for painless loss of vision

A

Retinal detachment, vitreous haemorrhage, retinal artery occlusion, anterior ischemic optic neuropathy

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5
Q

Red flags for visual loss

A

Headache (do an ESR if over 50)
Eye movements painful (optic neuritis)
Lights or flashes preceding visual loss (retinal detachment)
“like a curtain descending” (amaurosis fungax, preceding peripheral vision loss)
Poorly controlled DM (virtuous haemorrhage)

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6
Q

Central retinal artery occlusion appearance on fundoscop

A

Pale retina, macula has cherry red spot. Attenuated blood vessels.

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7
Q

Sudden painless loss of vision, fundoscopy shows many flame haemorrhages in all quadrants: Diagnosis?

A

Central retinal vein occlusion

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8
Q

Risks for retinal detachment

A

pathological myopia
Trauma
Previous retinal detachment
Intraocular surgery

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9
Q

Unilateral swelling of optic disc differentials

A

NIGHT TIC
Neuritis
Infectious
Granulomatous
Hereditary
Toxic

Traumatic
Infiltrative
Compressive

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10
Q

Papilloedema differentials

A

=see bilateral swelling of optic disc specifically due to raised ICP
Space occupying lesion
Idiopathic intracranial hypertension
Obstructive hydrocephalus
Venous sinus thrombosis

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11
Q

Differentials for gradual loss of vision

A

glaucoma
AMD
cataracts
Diabetic and hypertensive retinopathy

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12
Q

open angle glaucoma

A

increased resistance to aqueous outflow leads to slow and Insidious rise in intraocular pressure. May have decreased visual fields and acuity.
Fingins: High IOP
Incteased cup to disc ratio
Scotoma, peripheral field loss, Central sparing

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13
Q

Management of open angle glaucoma

A

Prostaglandin analogues (reduce aqueous humor production)
Beta blockers

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14
Q

Acute angle glaucoma

A

Lens pushes against iris, closed angle blocks aqueous drainage. Acute rise in intraocular pressure -> red, painful eye, photophobia, N&V, red haloes
Cloudy cornea and middilated sluggish pupils

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15
Q

Risks for acute angle glaucoma

A

Hypermetropia
DM
Trauma
Indian ethnicity

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16
Q

Management of acute angle glaucoma

A

Urgently reduce IOP: IV acetazolamide, pilocarpine and beta blocker
Then laser iridotomy

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17
Q

Age-related macular degeneration fundoscopy

A

Yellow spots around macular = drusen, dry AMD, build up of deposits between retinal pigment epithelium and Brooke’s membrane
If haemorrhagic look = wet AMD

18
Q

Symptoms of AMD

A

Metamorphopsia, blurred vision, Central scotoma, visual fluctuation
Most common cause of irreversible visual loss on developed world

19
Q

Risk factors for AMD

A

Age
Smoking
Cardiovascular disease
Cataract surgery
Caucasian ethnicity
Family history

20
Q

Cataracts presentation

A

clouding of lens in different layers, leads to gradual painless loss of vision, glare

21
Q

Stage I Keith Wagener classification of hypertensive retinopathy

A

Arteriolar narrowing and tortuosity. Incr light reflex - silver wiring

22
Q

Stage II Keith Wagener classification of hypertensive retinopathy

A

Arterio-venous nipping

23
Q

Stage III Keith Wagener classification of hypertensive retinopathy

A

Cotton wool exudates
Flame and blot haemorrhages

24
Q

Stage IV Keith Wagener classification of hypertensive retinopathy

A

Papilloedema

25
Q

Fearures of anterior uveitis

A

Acute onset
Ocular discomfort and pain (may incr w use)
Pupil may be small and possibly irregular due to sphincter muscle contraction
Photophobia
Lacrimation
Red eye
Blurred vision
Ciliary flush (ring of red spreading out)
Hypopyon (pus and inflammatory cells in anterior chamber, often visible fluid level)
Visual acuity initially normal but becomes impaired

26
Q

Anterior uveitis associations

A

Ankylosing spondylitis
Reactive arthritis
IBD
Behcet’s disease
Sarcoidosis

27
Q

Management of anterior uveitis

A

Cycloplegics to dilate pupil, eg atropine
Steroid eye drops

28
Q

Pathophysiology of diabetic retinopathy

A

Hyperglycemia leads to increased retinal blood flow, abnormal metabolism in vessel walls. Therefore there is damage to the endothelial cells and pericytes, so increased vascular permeability and formation of exudates; retinal ischaemia and so neovascularisation; pericyte dysfunction and so micrpaneurysms

29
Q

Mild non proliferative diabetic retinopathy

A

1+ microaneurysm

30
Q

Moderate non proliferative diabetic retinopathy

A

Microaneurysms, blot haemorrhages, hard exudates, cotton wool spots, venous beading/looping

31
Q

Severe non proliferative diabetic retinopathy

A

Blot hemorrhages and microaneirysms in four quadrants
Venous bleedijg in at least 2 quadrants
Intraretinal microvasculature abnormal in at least 1 quadrant

32
Q

Proliferative diabetic retinopathy

A

Retinal neovascularisarion (may lead to vitreous haemorrhage)
Fibrous tissue anterior to retinal disc
More common in DM 1
30% blind in 5 years

33
Q

Maculopathy

A

Located in the macula so any pathology is more serious
Hard exudates and other background change
Check visual acuity
More common in DM2

34
Q

Management of non proliferative diabetic retinopathy

A

Optimize glycaemic control
Control BP
Control hypelipidaemia
Regular ophthalmology review
If severe consider panretinal laser photocoagulation

35
Q

Management of proliferative diabetic retinopathy

A

Optimize glycaemic control
Control BP
Control hypelipidaemia
Regular ophthalmology review
Panretinal lazer photocoagulatiom
VEGF inhibitor

36
Q

Pilocarpine in acute angle glaucoma

A

Direct parasympathomimetic
Increases vitreous outflow

37
Q

Timolol in acute angle glaucoma

A

Beta Blocker
Decreases aqueous humor production

38
Q

Apraclonidine in acute angle glaucoma

A

Alpha2 agonist

39
Q

Blepharitis

A

Inflammation of eyelid margins, causes red eye

40
Q

Entropion and ectropion

A

EN= inturned eyelids
EC= outturned eyelids

year 5 (11 decks)

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