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Derm, Opth + ENT > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Uveitis S+S + management

A

Unilateral burning, red eye
Blurred vision + photophobia

Treat with prednisolone + ciclosporin
Cyclopentolate to paralyse ciliary body

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2
Q

Scleritis S+S + management

A

Pain worse with movement
Watering + photophobia

Treat with NSAIDs and prednisolone

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3
Q

Optic neuritis S+S + management

A

Swollen optic nerve
Periocular pain, gradual vision loss

Treat with methylprednisolone

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4
Q

Corneal ulcer S+S + management

A

White hazy mark on cornea
Pain + redness

Treat with acyclovir

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5
Q

Open angle glaucoma S+S, fundoscopy + management

A

Cupping and pallor of optic disc
Slow onset painless peripheral visual field loss
Raised IOP

Treat with prostaglandin analogs (pilocarpine)

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6
Q

Angle closure glaucoma S+S + management

A

Sudden severe eye pain, blurred vision, haloes, fixed mid-dilated pupil
Redness + N+V

Treat with timolol, prednisolone, pilocarpine + acetazolamide (IV)

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7
Q

Conjunctivitis S+S + management

A

Pain, burning, redness
Itching + discharge

Treat with chloramphenicol

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8
Q

Horners S+S + pathology

A

Sympathetic nerve interruption from hypothalamus to orbit
Ptosis
Miosis
Bloodshot conjunctiva

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9
Q

Retinitis pigmentosa S+S + management

A

Reduced night vision
Loss of mid peripheral visual field
Photophobia
Myopia

Fundoscopy = peripheral pigment deposits

Treat with Vit A and acetazolamide

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10
Q

Detached retina S+S

A

Floaters, flashes of light
Painless visual field loss
Risk: myopia

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11
Q

Macula degeneration S+S + how to diagnose

A

Central vision loss
Use Amsler grid to diagnose
Wet = haemorrhages + scarring

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12
Q

Diabetic retinopathy pathology

A

Blurred vision, darkened images

Dot blot haemorrhages, cotton wool spots + hard exudates + neovascularisation

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13
Q

Cataracts S+S

A 
Gradual onset blurred vision 
Glares/ haloes 
Nystagmus 
Sensitivity to light 
Loss of red reflex
Opacity within lens
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14
Q

Orbital cellulitis S+S + management

A

Redness, swollen eye
Pain

Cefotaxime + flucloxacillin + metronidazole (IV)

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15
Q

What is ocular hypertension?

A

Raised IOP without glaucoma

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16
Q

RF for acute angle closure

A

Females
Asian
Long sighted
Older age

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17
Q

RF for cataracts

A

Family hx
Corticosteroids
Smoking
Prolonged exposure to UVB

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18
Q

Cataracts management

A

Surgery

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19
Q

Types of stye

A 
Internal = occurs on conjunctival surface of eyelid caused by infection of meobomian gland 
External = appears along edge of eyelid caused by infection of eyelash follicle
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20
Q

Complications of styes

A

Periorbital cellulitis

Meibomian cyst

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21
Q

Stye management

A

Self-limiting
Warm compresses
Epilate eyelash or incision + drainage

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22
Q

Causes of infective conjunctivitis (viral + bacterial)?

A

Adenovirus
Staph aureas
H influenza
Strep pneumoniae

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23
Q

What is hyperacute conjunctivitis?

A

Rapidly developing severe conjunctivitis caused by Neisseria gonorrhoea

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24
Q

What is ophthalmia neonatorum?

A

Conjunctivitis in first 4 weeks

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25
Q

Who is at greatest risk of complications from conjunctivitis?

A

Contact lens wearers + immunosuppressed pts

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26
Q

What are the complications of conjunctivitis?

A

Keratitis

Keratoconjunctivitis (usually viral) - vision loss + light sensitivity

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27
Q

Pathology + types of allergic conjunctivitis

A 
IgE hypersensitivity reaction 
Seasonal
Perennial 
Vernal (hot arid environments)
Atopic 
Giant papillary (due to chronic micro-trauma)
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28
Q

S+S of allergic conjunctivitis

A

Itching
Watery discharge
Redness

29
Q

Management of allergic conjunctivitis

A

Topical anti-histamines or mast cell stabilisers

30
Q

Types of detached retina

A

Rhegmatogenous detachment - occurs as vitreous shrinks
Exudative detachment - due to leakage of fluid into subretinal space due to inflammation or malignancy
Tractional - due to diabetes where abnormal vasculature causes contraction of vitreous

31
Q

Types of uveitis

A 
Anterior = iritis, iridocyclitis 
Intermediate = ciliary body, pars plana + anterior vitreous 
Posterior = choroiditis, retinitis, optic nerve head (papillitis)
32
Q

Causes of uveitis

A

Autoimmune disorder, infection, trauma, neoplasia

33
Q

Complications of uveitis

A

Cystoid macular oedema
Secondary cataracts
Secondary glaucoma

34
Q

Types of blepharitis

A 
Anterior = inflammation of eyelash base (bacterial or seborrhoeic dermatitis) 
Posterior = inflammation of meobomian glands
35
Q

S+S blepharitis

A

Worse in AM

Burning, itching, erythema + crusting

36
Q

What conditions are associated with blepharitis?

A

Dry eye syndrome
Seborrhoeic dermatitis
Rosacea

37
Q

Management of blepharitis

A

Warm compresses

Cloramphenicol 2nd line

38
Q

S+S of corneal FB

A

Irritation, redness + watering
Pain
Repeated blink reflex

39
Q

What is Seidel’s test?

A

Perform if penetrating injury is a possiblity
Apply 10% fluorescein
Observe using slit lamp with cobalt blue (or Woods light)
If penetrative injury is present, stream of clear fluid will be seen in the pool of orange dye

40
Q

Signs of corneal FB

A

Visible FB

Rust ring

41
Q

Management of corneal FB

A

Use topical anaesthetic

Irrigate eye with water or remove FB with cotton wool bud

42
Q

What eye conditions are associated with diabetes?

A

Diabetic retinopathy
Cataracts
Rubeosis iridis + glaucoma
Ocular motor nerve palsies

43
Q

What characteristic features indicate diabetic retinopathy?

A 
Microaneurysms 
Hard exudates 
Hemorrhages 
Cotton wool spots 
Neovascularisation
44
Q

How is diabetic retinopathy classified?

A 
Background = 1 microaneurysm
Non-proliferative = hemorrhages, cotton wool spots 
Proliferative = neovascularisation on disc
45
Q

What is diabetic maculopathy?

A

Macular oedema

Ischemic maculopathy

46
Q

RF for diabetic retinopathy

A

Prolonged hyperglycaemia
HTN + CV RF
Pregnancy
Renal disease

47
Q

S+S of diabetic retinopathy

A

Painless gradual reduction in central vision

Dark, painless floaters

48
Q

Diagnosis of diabetic retinopathy

A

Dilated retinal photography w/ ophthalmoscopy

49
Q

Management of diabetic retinopathy

A 
Glycaemic control (HbA1c <7%) 
BP control 
Lipid control 
Laser treatment 
Intravitreal steroids 
Anti-vascular endothelial growth factor treatments 
Surgery
50
Q

Complications of diabetic retinopathy

A

Macular oedema
Macular ischemia
Vitreous hemorrhage
Tractional retinal detachment

51
Q

Pathology of hypertensive retinopathy

A

Arterial narrowing (copper wiring)
Followed by vascular leakage + arteriosclerosis (arteriovenous nipping)
Hemorrhages + exudates
Choroidal changes may occur

52
Q

S+S of hypertensive retinopathy

A

Usually asymptomatic
Slightly decreased vision
Malignant HTN = headaches + decreased vision

53
Q

Fundoscopy findings in malignant HTN

A 
Macular star (thin white streaks radiating around macular) 
Disc swelling 
Cotton wool spots 
Flame hemorrhages 
Arterial/ venous occlusions
54
Q

What is an ectropion?

A

Lower eyelid turns outwards away from eye

55
Q

Causes of ectropion

A

Old age
Burn/ infection/ eyelid trauma
Facial paralysis

56
Q

S+S of entropion

A

Irritation + pain, watering

57
Q

Management of entropion

A

Taping eyelid to cheek
Injecting muscle with botox
Surgery

58
Q

Difference between episcleritis + scleritis in pathology

A 
Epi = inflammation of superficial, episcleral layer. Common + self-limiting 
Scleritis = inflammation of sclera, severe + can cause complications
59
Q

Types of episcleritis

A 
Simple = vascular congestion 
Nodular = characterised by discrete elevated area of inflamed episclera
60
Q

Difference between epi + scleritis in S+S

A 
Epi = acute onset of redness + discomfort, grittiness
Scleritis = gradual onset of boring eye pain radiating to forehead + jaw, worse with eye movement + at night, associated symptoms (fever, vomiting)
61
Q

DDx for acute light sensitivity

A

Iritis, keratitis, abrasion, ulcer

62
Q

DDx for acute unilateral pain

A

Iritis, keratitis, abrasion, ulcer

Herpes, acute angle closure glaucoma, scleritis

63
Q

DDx for acute white spot on cornea

A

Ulcer

64
Q

DDx for acute non-reactive pupil

A

Acute glaucoma, iritis

65
Q

DDx for acute blurred vision

A

Iritis, keratitis, abrasion, ulcer

Herpes, acute angle closure glaucoma, scleritis

66
Q

S+S of retinal artery occlusion

A

Sudden, painless monocular vision loss

Cherry red spot + retinal pallor on fundoscopy

67
Q

Management of retinal artery occlusion

A

Restore blood flow
Massage globe
Decrease IOP (BB, IV mannitol)

68
Q

CI to dilating pupils

A

shallow anteriorchamber
iris supported lens implant
Potentially neuro abnormality requiring pupillary evaluation
caution with CV disease - can cause tachycardia

Derm, Opth + ENT (6 decks)

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