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TAS > Ophthalomolgy > Flashcards

Ophthalomolgy Flashcards

1
Q

Embryology of eye = when does optic fissure close

A

Closes in sixth week of gestation

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2
Q

What is aniridia

A

malformation of the whole eye

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3
Q

What is part of anterior segment of the eye

A

Conjuctiva
Episclera
Externally visible portion of sclera
Cornea
Anterior chamber
Iris
Lens

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4
Q

What is posterior segment of eye

A

Vitreous cavity
Retina
Retinal pigment epithelium
Choroid
Posterior sclera

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5
Q

What is the retina a continuation of?

A

Posteriorly - optic nerve
Anteriorlgy - fuses with the epithelium of the ciliary body

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6
Q

What does the outmost layer of the retina made up of

A

Photoreceptors
Rods
Cones

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7
Q

What does the macular retina provide?

A

Central and colour vision

Centre is called fovea

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8
Q

What are rods sensitive to ?

A

Low levels of high - peripheral and night vision

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9
Q

What is the fovea responsible for?

A

Visual acuity

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10
Q

What do the photoreceptors do?

A

Sensory receptors of the Retina

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11
Q

When does vascularisation of the retina begin

A

Begins at 14 weeks gestation
Not complete until term

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12
Q

What is vascularisation of the retina stimulated by

A

Stimulated by vascular endothelial growth factor (VEGF-A) and insulin-like growth factor (IGF-1)

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13
Q

What is retinopathy of prematurity ROP

A

Neovascular disorder affecting infants born at less than 32 weeks

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14
Q

What are other risk factors for ROP

A

Extremely low birth weight <1000g
Early supplemental oxygen requirement
Acidosis

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15
Q

Two phases of ROP

A
  • Hyperoxic phase - premature delivery into high oxygen environment causes down regulation of VEGF
    Hypoxic phase - unvascularized anterior retina becomes ischaemia as it matures - VEGF unregulated and leads to neovascularisation
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16
Q

Stages of ROP

A
  1. Demarcation line at anterior edge of vascularised retina
  2. Line becomes thickened ridge
  3. Ridge develops neovascularisation
  4. Localised tractional retinal detachment
  5. Funnel retinal detachment
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17
Q

Cataracts

A

Disorganised protein fibre structure or accumulation of abnormal metabolic produce within the lens causes opacification

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18
Q

Unilateral congenital cataracts

A

Most commonly result from abnormal regression of enbryological hyaloid vascular system

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19
Q

Childhood glaucoma is characterised by

A

Raised intra-ocular pressure and optic disc cupping

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20
Q

What does uncontrolled glaucoma lead to?

A

Loss of peripheral visual fields

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21
Q

What is normal intra-ocular pressure in children

A

6 and 18 mmHg

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22
Q

What causes increase in intra-ocular pressure

A

Result of impaired aqueous outflow through the trabecular meshwork rather than overproduction of aqueous by ciliary body

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23
Q

When does primary congenital glaucoma present

A

Presents within 1st year of life
Usually bilateral

24
Q

Causes of secondary glaucoma

A

Anomalies of anterior segment
Sturge-Weber sydnrome
Following congenital cataract surgery
Topical, inhaled or oral steroid therapy

25
Q

How does steroid therapy increase risk of glaucoma

A

Increases accumulation of glycosaminoglycans or trabecular meshwork-inducible glucocorticoid response protein

26
Q

Retinal haemorrhage in NAI

A

Due to acceleration/ de-acceleration injury causes multiple multi-layer haemorrhages and retinoschisis (Splitting of layers of retina)

27
Q

Characteristic of child glaucoma

A

eyes watering
photophobia
corneal hazing

28
Q

What are first signs of diabetic retinopathy

A

Dot haemorrhages - weakened capillaries and therefore microanuerysm

29
Q

What does the surface ectoderm form

A

Lens
Corneal epithelium

30
Q

What does the neuroectoderm form

A

Retina
Iris
Cillary body
Optic nerve

31
Q

What does the meschyme form?

A

Vasculature of the eye

32
Q

Pathological nystagmus causes

A

Infantile sensory nystagmus
Infantile idopathic motor nystagmus
Acquired nystagmus secondary to neurological disease
Acquired vestibular nystagmus

33
Q

Infantile nystagmus

A

Usually horizontal
Jerks
Conjugate and similar in both eyes
Ass. head oscillation
Worsens when one eye is covered
Need to be reviewed by ophthalmologist

34
Q

Conjugacy

A

Both eyes demonstrate the same movement

35
Q

Why does disconjugate nystagmus trigger concern

A

Potenital neurological disease

36
Q

See-saw nystagmus

A

Pendular (phases of quell velocity)
One eye elevates and rotates inwards whilst other eye depressed and rotates out

Causes - supra-cellar and rostral midbrain lesion

37
Q

Upbeat nystagmus

A

Jerk
Vertical with fast phase upwards

Causes - lesions of cerebellar vermis and brainstem

38
Q

Downbeat nystagmus

A

Jerk
Vertical with fast phase downwards

Causes - Arnold chair malformation

39
Q

What drug causes nystagmus

A

Carbmazepine

40
Q

What is spasmus nutans

A

Triad of head turn, head nodding and nystagmus

41
Q

Which direction is the slow phase in vestibular nystagmus directed in?

A

Slow phase directed to side of lesion

42
Q

Which direction is fast phase in cerebellar nystagmus directed in?

A

fast component directed to side of lesion

43
Q

Amblyopia

A

Causes reduced vision in one eye
‘lazy eye’
Unilateral and persists despite correction with glasses

44
Q

What is anisocoria

A

Difference in size of pupils

45
Q

Myopia

A

Short sighted - distance objects blurred

46
Q

Features of diabetic retinopathy

A

Dot and blot heamorrhages
Cotton wool spots
Venous bleeding
micro aneurysm

47
Q

Stage 1 sickle cell retinopathy

A

salmon patches and sunburst spots

48
Q

Stage 2 sickle cell retinopathy

A

artierovenous anatomies

49
Q

Stage 3 sickle cell retinopathy

A

sea-fan neovascularisation pattern

50
Q

Stage 4 sickle cell retinopathy

A

retinal haemorrhage -> vitreous detachment

51
Q

What does meschyme form

A

vasculature and vitreous

forms zonular fibres - affected in marfans sydndrome

52
Q

Vascularisation complete ?

A

40 weeks

starts at 14 weeks

53
Q

If you have an exotorpia where is the eye

A

Deviated outwards

54
Q

Tropia

A

Always deviated

55
Q

Phoria

A

sometimes deviated

56
Q

When d you pick up a phoria

A

during cross cover test

TAS (18 decks)

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