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Neuro Exam 3 > opthalmology > Flashcards

opthalmology Flashcards

1
Q

Near-sightedness occurs when the
optical power of the eye is too
large and causes light to focus in
______ of the retina.

A

front

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2
Q

Viral Conjunctivitis is More common than bacterial
conjunctivitis, Most commonly occurs after an
upper respiratory tract infection with _______
being the most common organism.

A

Adenovirus

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3
Q

Viral Conjunctivitis is associated with

A

Moderate inflammation of the conjunctiva (appears pink).
Watery discharge.
May have a pre-auricular lymph node enlargement.

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4
Q

Bacterial Conjunctivitis

• Most common organisms are: _________

A

Staphylococcus aureus and

Streptococcus pneumoniae.

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5
Q

what are the treatments for Bacterial Conjunctivitis
• Treatment:
– Cultures are not routinely taken and empirical treatment is started.
–

– Alternatives include sulfacetamide or tobramycin.
–

A

Antibiotic eye drops usually for one week.

– Preferably 3rd or 4th generation fluoroquinolone (ciprofloxacin,ofloxacin, or moxifloxacin))

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6
Q

In bacterial conjuctivitis Tx, _______ drops can be toxic and cause irritation with prolonged use

A

Gentamicin

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7
Q

Iritis is a form of _______ with

inflammation of the iris

A

uveitis

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8
Q

what are the Symptoms of Iritis

A 
ocular or periorbital eye pain, 
photophobia,
blurred or cloudy vision.
Redness (near the limbus).
May have an irregular shaped
pupil.
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9
Q

Iritis

• Treatment:

A

– Topical Steroid Eye Drops (prednisolone acetate, difluprednate)
– Dilating Eye Drops help prevent synechiae within the eye and with pain
(cyclopentolate, atropine)
– Occasionally Topical Glaucoma Drops (brimonidine, timolol)

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10
Q

Herpetic keratitis is a common
viral infection that affects the
corneal epithelium, primarily caused by ______

A

HSV1.

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11
Q

Patient presents with
unilateral eye redness (can be
bilateral), pain, photophobia,
decreased vision, and tearing, what does shoe most likely have?

A

Herpetic keratitis

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12
Q

In Herpetic keratitis, _______ on the ocular surface
shows dendritic epithelial ulcer in
branching pattern with terminal
bulbs.

A

Fluorescein

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13
Q

Patient presents with
unilateral eye redness (can be
bilateral), pain, photophobia,
decreased vision, and tearing, what does shoe most likely have?

A

Herpetic keratitis

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14
Q

In Herpetic keratitis, _______ on the ocular surface
shows dendritic epithelial ulcer in
branching pattern with terminal
bulbs.

A

Fluorescein

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15
Q

what is the Treatment for Herpetic keratitis

A

– Topical trifluridine Q2H.
– Oral acyclovir 400mg 5x/day or
valacyclovir 1g TID.

– Most cases will resolve
spontaneously within three
weeks. Medication can shorten
the duration.

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16
Q 
• Herpes Zoster Ophthalmicus is a
reactivation of VZV. Represents about
10-25% of all cases of Herpes Zoster
and up to \_\_\_\_\_\_\_  may develop ocular
manifestations.
A

65%

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17
Q

Herpes Zoster Ophthalmicus has Dermatological involvement of _____ distribution.

A

V1

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18
Q

• Symptoms of Herpes Zoster Ophthalmicus are ?

A

prodromal period
of fatigue, low-grade fever, unilateral
rash on forehead, upper eyelid and
nose.

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19
Q

Fluorescein applied to corneal
surface can reveals multiple swollen
lesions with staining around them. what does this patient have?

A

Herpes Zoster Ophthalmicus

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20
Q

Herpes Zoster Ophthalmicus

• Treatment:

A

– Oral acyclovir 800mg 5x/day for 10 days

– Oral valacyclovir 1g 3x/day for 10 days

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21
Q

Subconjunctival Hemorrhage

• Risks factors:

A 
– Sneezing
– Coughing
– Excessive eye rubbing
– Anti-coagulation
– Trauma (if there is a history then the should have a complete eye exam)
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22
Q

Benign fibrovascular tumor, UV

induced, often inflammed is called _____?

A

Pterygium

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23
Q 
Ocular redness without irritation
that resolves spontaneously.
• Typically transient (days to
weeks) in 20-50 year olds.
• Classified as nodular or diffuse.
what is it ?
A

Episcleritis

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24
Q

what is the most common form of scleritis?

A

Nodular 44%

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25
Q

Scleritis vessels cannot be moved, and _______with
phenylephrine, whereas episcleritis does ______
with phenylephrine

A

do not blanch,

blanch

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26
Q

which autoimmune diseases can be present with scleritis?

A 
– Rheumatoid arthritis
– Lupus
– Sero-negative spondylarthropathies
       • Wegener’s
       • Polyarteritis nodosa
– Syphilis
– Tuberculosis
27
Q

what are the Sx’s and presentation of Dry Eye Syndrome

A

foreign body sensation, blurred vision, reflex
tearing.

• Condition worsens towards end of
the day and activities that require
attention – reading, computer
work.

28
Q

• describe Squamous cell carcinoma in the eye.

A 
is a malignant epithelial lesion.
– Conjunctival intraepithelial
neoplasia in which cells have
invaded through the conjunctival
basement membrane.
– Rarely invades the sclera.
29
Q

what is the initial Tx for Squamous Cell Carcinoma

A

topical chemotherapeutic agents
– Interferon-alpha
– 5-fluorouracil
– Mitomycin C

30
Q

you see elevated, mobile salmon pink mass on the

conjunctiva, what are you dealing with?

A

Non-Hodgkin B-cell conjunctival

lymphoma

31
Q

Angle closure glaucoma may occur with dilation which results in pupillary block after watching
television in dark room or certain
medications, name the 4 types (a

A

anticholinergics,
antihistamines,
tricyclic antidepressants,
MAO inhibitors

32
Q

what causes Angle Closure Glaucoma

A

Rapid increase in eye pressure due to the iris being pushed forward up against the trabecular meshwork preventing the outflow of aqueous humor.

33
Q

• May occur with dilation which results
in pupillary block after watching
television in dark room or certain
medications, name the 4 types (a

A

anticholinergics,
antihistamines,
tricyclic antidepressants,
MAO inhibitors

34
Q

what are the Sx’s of Angle Closure Glaucoma

A

unilateral severe eye pain,
nausea,
redness,
blurred vision and halos around lights.

35
Q

on Examination, angle closure glaucoma may show sluggish, mid-dilated pupil, conjunctival
injection, ______ cornea and shallow
anterior chamber. When palpating
the eye it may feel _______

A

hazy

hard.

36
Q

In Ocular Burns
• Patients present soon after exposure
complaining of _____

A

eye pain,
redness,
tearing,
decrease in vision.

37
Q

in ocular burns _____ materials are more harmful

A

alkali

38
Q 
In Ocular Burns
• Patients present soon after exposure
complaining of \_\_\_\_\_
•
• Limbal ischemia is a poor prognostic
sign.
A

eye pain,
redness,
tearing,
decrease in vision.

39
Q

Examination of ocular burns may show ______

A

conjunctival injection,
corneal abrasion or
opacity.

40
Q

In Ocular Burns
• ________ is a poor prognostic
sign.

A

Limbal ischemia

41
Q

Corneal ulcer is an infection of

the ________.

A

corneal stroma.

42
Q

what is the treatment for Corneal Ulcer

A

– For small ulcers (<1mm) may treated hourly with a 3rd or 4th generation
fluoroquinolone (ciprofloxacin, ofloxacin, or moxifloxacin).

– Larger ulcers require culture to determine the organism.

corneal transplant can be performed in certain cases

43
Q

________ is a progressive disease of the optic nerve that is often associated with elevated intraocular pressure.

A

• Open angle glaucoma

44
Q

what is the treatment for Corneal Ulcer

• Fortified antibiotics including vancomycin and tobramycin.
– Slow healing and can require weeks of therapy.
– Once healed can leave a corneal scar with permanent vision loss.
– In some cases where the ulcer does not decrease in size despite medical
therapy or if the cornea becomes too thin and there is a risk of
perforation then a

A

– For small ulcers (<1mm) may treated hourly with a 3rd or 4th generation
fluoroquinolone (ciprofloxacin, ofloxacin, or moxifloxacin).

– Larger ulcers require culture to determine the organism.

corneal transplant can be performed in certain cases

45
Q

________ is a progressive disease of the optic nerve that is often associated with
elevated intraocular pressure.

A

• Open angle glaucoma

46
Q

_______is a gradual clouding of
the eye’s natural lens. Purpose of
the lens is to focus light on the
retina.

A

Cataracts

47
Q

what are the causes of cataracts in younger patients

A

– diabetes
– systemic steroids
– trauma
– radiation

48
Q

what are the 2 mechanisms of orbit fractures?

A 
BUCKLE (ROOF FX IN KIDS)
BLOW OUT (FLOOR ADULTS)
49
Q

what do you see in an ORBITAL FLOOR FX

A

ENOPHTHALMOS (posterior displacement of the eyeball)

HYPOGLOBUS (downward displacement of the eye)

50
Q

thyroid eye disease is a PRIMARY INFLAMMATORY DISEASE OF THE ORBITAL SOFT TISSUE,
AUTO-IMMUNE DISEASE (TARGET IS THE ORBITAL ______ )
ASSOCIATED WITH AUTO-IMMUNE THYROID DISEASE (MOST COMMONLY ________).

__________ IS NOT THE CAUSE

A

FIBROBLAST,
GRAVES DISEASE,
DYSTHYROIDISM

51
Q

thyroid eye disease ultimately results in ________

A

Hypertrophy if the extra ocular muscles

52
Q

basal cell cancer accounts for ____ OF EYELID SKIN Cancer.

COMMONLY INVOLVES _______ EYELID

A

90%,

LOWER

53
Q

treatment for basal cell cancer

A

TREATMENT IS EXCISION WITH MARGIN CONTROL
(FROZENS OR MOHS)
RECONSTRUCTION >
Tarsoconjunctival flap + FTSG (Full thickness skin graft)

54
Q

what is the TX for NASOLACRIMAL DUCT

OBSTRUCTION

A

DCR (DACRYOCYSTORHINOSTOMY)

55
Q

what presentation is seen in chronic NASOLACRIMAL DUCT OBSTRUCTION

A 
Epiphora  (overflow of tears onto the face)
chronic DACRYOCYSTITS (pain, redness, and swelling in the inner corner of the eye)
56
Q

describe the management diabetic retinopathy

A

Glycemic control
Blood Pressure control
Screening eye exams
Laser photocoagulation
Diabetic macular edema – Focal laser
PDR – Panretinal photocoagulation

57
Q

what findings are seen in acute Hypertensive Retinopathy

A

Retinal hemorrhage
Macular edema and exudate
Optic disc edema (Papilledema)

58
Q

describe what you see in Central retinal vein occlusion

A
  • often related to HTN

- dilated veins and extensive hemorrhage

59
Q

describe what you see inCentral retinal artery occlusion

A
  • ‘stroke’ to eye

- cherry red spot

60
Q

what is the #1 cause blindness >50 yr old

A

Age-related Macular Degeneration (AMD)

61
Q

what is the Tx for Nonexudative (Dry) AMD

A

antioxidant vitamins

62
Q

whats is the Tx for exudative (wet) AMD

A

Anti-VEGF intravitreal injections

63
Q

describe the management of gluacoma

A 
Lower IOP
    Medications 
           Decrease aqueous production
           Increase outflow
Laser
Surgery – with or w/out drainage implants

Neuro Exam 3 (19 decks)

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