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Year 6 > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Symptoms of acute closed angle glaucoma

A

Severe pain
Reduced acuity
Haloes around light
Semi-dilated non reactive pupil
Hazy pupil
Hypermetropia
Pain worse with mydriasis- may be caused by mydriasis drop

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2
Q

Management of acute closed angle glaucoma

A

Urgent referral

IV acetazolamdie

Eyedrops
Beta blockers and para agonist

Pilocarpine- contract ciliary muscle- cholinergic agonist
Timolol- decrease production - beta blocker
Brimonidine

Definitive- laser iridotomy

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3
Q

Primary open angle glaucoma symptoms

A

Peripheral vision loss- nasal scotoma
Decreased acuity
Optic disc cupping- larger centre (cup)

Can have normal pressure
Increased cup to disc ratio

Myopia

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4
Q

Risk factors for POAG

A

Family history- need screening from 40
Steroids
DM

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5
Q

Tx of POAG

A

Beta blocker- timolol
Prostaglandin analogue- Iatanoprost

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6
Q

Causes of gradual vision loss

A

Common- DM, open able glaucoma, age related macula degeneration, cataracts

Rare- retinitis pigmentosa, HTN, optic atrophy

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7
Q

Symptoms of ARMD

A

Central vision loss
Worse at nigh t
Blurring of small words
Straight lines curvy
Dry- white fluffy spots- fat deposits

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8
Q

Causes of sudden vision loss

A

Anterior ischaemic optic neuropathy
Optic neuritis
Vitreous haemorrhage
Retinal detachment
Retinal vessel occlusion

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9
Q

Anterior ischaemic optic neuropathy symptoms and causes

A

Posterior ciliary arteries damaged
Artieritic- GCS
Non- HTN, DM, lipids

Sudden visual loss, RAPD

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10
Q

Key questions of sudden loss of vision

A

Headache- GCA
Eye movements - optic neuritis
Lights- detached retina
Like curtain- vessel occlusion
Poorly controlled DM- vitreous bleed

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10
Q

Key questions of sudden loss of vision

A

Headache- GCA
Eye movements - optic neuritis
Lights- detached retina
Like curtain- vessel occlusion or retinal
Poorly controlled DM- vitreous bleed
Photophobia- anterior uveitis

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11
Q

Optic neuritis sx

A

CRAP
Centeal scotoma
RAPD
Acuity Loss
Pain on Eye movements

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12
Q

Cause of optic neuritis

A

MS

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13
Q

Vitreous haemorrhage sx

A

Small bleed- small black dots in vision
Large- loss of red reflex- retina not visualised- redness obscuring fundoscopy

Worse when lying flat

Fundoscopy- red with bleed

Caused by new vessels in DM

No pain

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14
Q

Retina detachment sx

A

Caused from DM- due to scarring
Curtain coming down

Peripheral to central vision loss- gradual

Floaters
Flashes
Field loss
Fall in acuity
Painless

Fundoscopy- tear and half is one yellow colour

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15
Q

Fundoscopy showing of AION, optic neuritis, vitreous haemorrhage, retinal detachment

A

AION- pale optic disc
Optic neuritis- swollen optic disc - oedema around it
VH- bleed- red
RD- macula lifts off retina

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16
Q

Types of retinal vessel occlusion

A

CRAO- sudden painless, total loss of vision+ RAPD
BRAO- sudden painless- partial LOV
Cherry red spot

Occurs centrally

CRVO- ischaemic- Suden painless, TLOV +RAPD
Non- ischaemic- mild-mod LOV
BRVO- asymptomatic unless involving macula

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17
Q

Diabetic retinopathy stages

A

Background- hard exudates, micro aneurysms, blot haemorrhages

Pre-prolif- cotton will spots- patch of ischameia

Proliferative- angiogenesis

Maculopathy- hard exudates near macula

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18
Q

Mx of DM retinopathy

A

Background- glycemic and BP control

Proliferative- pan retinal photocoagulation and inftervitreal anti VEGF

Maculopathy- grid/focal retinal photocoagulation

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19
Q

Cataracts symptoms

A

Haloes
Blurred vision
Increased myopia- near sighted

Loss of red reflex

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20
Q

Near vs far sighted

A

Near- see near objects- myopia- good at concentrating or eye too long
Far objects infant of retina
Need Concave lens

Far sighted- hyperopia , see far away, Cant concentrate near objects, eye too short
Give convex lens

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21
Q

Red flags

A

Photophobia, poor vision, fluorescing staining, abnormal pupil, haloes

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22
Q

Anterior uveitis sx

A

Pain, photophobia, reduced acuity- worse pain when using eye
Uvea- iris, ciliary body, choroid
Irregular small pupil
Ciliary flush

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23
Q

Conditions with acute uveitis

A

IBD, sarcoid, behcets, seronegative arthopathies

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24
Q

Mx of anterior uveitis

A

Refer
Prednisilone drops and cycloplegics drops

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25
Q

Anterior uveitis vs glaucoma

A

Both painful and reduced acuity

Photophobia with AU

Hazy cornea with glaucoma

Pupil large in glaucoma but small in AU

High IOP in glaucoma- tonometry

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26
Q

Scleritis vs conjunctivitis

A

Scleritis- severe pain, worse on movement , blue tinge

Conjunctivitis- discharge , discomfort

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27
Q

Corneal abrasion sx

A

Pain, photophobia, blurred vision
Caused by trauma

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28
Q

Corneal ulcer sx

A

eye pain
photophobia
watering of the eye

Caused by bacteria, viral- HSV

Visual loss- emergency

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29
Q

Ix for corneal damage

A

Fluorescein staining

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30
Q

Mx of corneal ulcer

A

Referral to ophthalmology
Topical Abs

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31
Q

Different type of vessel occlusion on fundoscopy

A

Artieral- pale
Central- all
Branch- patch

Venous- haemorrhage- cheese and tomato pizza
Central- all
Branch- patch

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32
Q

orbital cellulitis Sx

A

Inflammation of orbit
Lid swelling
Pain on movement

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33
Q

Tx of orbital cellulitis

A

Referral to opthalmo
IV ABx

34
Q

Dx between periorbital and orbital cellulitis

A

No pain
No acuity loss
No proptosis

35
Q

Cause of floaters

A

Retinal detachment
Vitreous haemorrhage

36
Q

Innervation of the pupil

A

Parasympathetic- oculomotor- constriction
3rd nerve palsy- dilatation

Sympathetic- dilation

37
Q

Mx of age related macular degeneration

A

Dry- vitamin and zinc
Wet- Anti VEGF

38
Q

Ix of ARMD

A

Ampler grid
Fundoscopy- yellow deposits

39
Q

Types of ARMD and how they differ

A

Dry- yellow spots, chronic - Drusen- over years

Wet- fluid leak, haemorrhage, more acute- over months
Choroidal neovascularisation

40
Q

Latanoprost SE

A

Increase in eye lash length

41
Q

RF for retinal detachment

A

Myopia- due to large eye more pressure
DM
Age
Trauma

42
Q

Episcleritis vs scleritis vs conjunctivitis

A

Scleritis- pain, worse With movement, associated with inflammatory conditions
Injected vessels do not move, blue tinge

Episcleritis- painless, injected vessels move, eye redness improves with phenylephrine

Conjunctivitis- sore, with discharge

43
Q

RF of cataracts

A

DM
long term CS
Hypocalcaemia

44
Q

Organism for keratitis

A

Staph
Pseudomonas aeruginosa if contact lens

45
Q

Hypopyon

A

Leukocytes in anterior chamber due to severe inflammation

46
Q

Sx of keratitis

A

Red eye
Photophobia
Gritty sensation
Hypopyon

47
Q

Mx of stye

A

Analgesia and warm compress

48
Q

Mx of foreign body in eye

A

Refer to opthalmo
Due to infection risk

49
Q

Red eye after surgery

A

Endophthalmitis

50
Q

Screening for ophthalmology chronic glaucoma

A

Screening from 40

51
Q

Cream-coloured swirl with the bright red on fundosscooy

A

Retinal detachment

52
Q

RF for glaucoma

A

Hypermetropia, old age, female FHx

53
Q

If shingles goes to nose what is patient at risk of

A

Anterior uveitis

54
Q

RF for retinal detachment

A

Myopia
Prev eye surgery
Trauma

55
Q

Bilateral grittiness in both eyes

A

Blepharitis

56
Q

Herpes zoster ophthalmicus

A

Varicella reactivation in opthalmic distribution

57
Q

Endophthalmitis sx

A

Inflammation of the aqueous and/or vitreous humour, is a rare but recognised complication of cataract surgery

Periphlebitis, pain, red eye,

58
Q

Definitive management of ACAG

A

laser peripheral iridotomy

59
Q

Stages of HTN retinopathy

A

I Arteriolar narrowing and tortuosity
Increased light reflex - silver wiring

II Arteriovenous nipping

III Cotton-wool exudates
Flame and blot haemorrhages- dark

IV Papilloedema

60
Q

Causes of Horners syndrome

A

anhydrosis determines site of lesion:

head, arm, trunk = central lesion: stroke, syringomyelia

just face = pre-ganglionic lesion: Pancoast’s, cervical rib

absent = post-ganglionic lesion: carotid artery- usually painful

61
Q

Squint Mx

A

Refer to secondary care
Eye patch to prevent amblyobia

62
Q

Fresh water swimming with contact lens can cause

A

acanthamoebic keratitis

63
Q

Elderly patient dizzy on extension of neck

A

Vertebrobasilar ischaemia

64
Q

Scleritiis mx

A

Urgent referral

65
Q

Corneal ulcer mx

A

Topical acyclovir and referal

66
Q

Argyll Robertson vs Holmes pupil

A

Argyll- bilateral small pupils
React poorly to light
But briskly to accommodation
Midbrain or syphillis

Holmes- reacts slowly to light and accommodation
Absent leg reflexes
Anisocoria worse in bright light implies a problem with the dilated pupil

67
Q

Ix of refractive error

A

Pin hole occluder

68
Q

Scleritis risks to eye

A

Globe perforation

69
Q

Papiloedema fundoscopy

A

Blurring of optic disc margin

70
Q

Herpes zoster ophthalmicus mx

A

Herpes on eye- or on tip of nose

Oral aciclovir

71
Q

Firm painless lump in eyelid

A

chalazion

72
Q

Dx of squint

A

Cover test
Look at object and cover one eye and observe movement

73
Q

Tx of blepharitis

A

Warm compress and clean debris

Stye can be present

74
Q

Latanoprost moa

A

Increase uveoscleral outflow

75
Q

Contact lens wearing with red gritty eyes mx

A

Contact lens wearers who present with a red painful eye should be referred to eye casualty to exclude microbial keratitis

76
Q

New flashes or floaters mx

A

Same day opthalmo assessment

77
Q

Retinopathy due to hydroxy px

A

Painless reduction in acuity

78
Q

Entropion

A

inward turning of the eyelid margin

79
Q

Tx of cataracts

A

Surgery- if visual impairment

80
Q

Unilateral decrease in visual acuity over days and has poor discrimination of colours, red desaturation.

A

Optic neuritis

Change in colours- red in one eye and washed out in the other

81
Q

Assocaited with scleritis

A

rheumatoid arthritis: the most commonly associated condition
systemic lupus erythematosus
sarcoidosis
granulomatosis with polyangiitis

82
Q

Classifying diabetic retinopathy

A

Non-proliferative diabetic retinopathy

Mild NPDR (background)
1 or more microaneurysm

Moderate NPDR
microaneurysms
blot haemorrhages
hard exudates
cotton wool spots, venous beading/looping

Severe NPDR
blot haemorrhages and microaneurysms in 4 quadrants
venous beading in at least 2 quadrants
IRMA in at least 1 quadrant

Proliferative- neovascularisations

Year 6 (28 decks)

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