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Ophthalmology > Acute Eye > Flashcards

Acute Eye Flashcards

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1
Q

What investigation is useful to determine areas of epithelial loss?

A

Fluorescein (blue light)

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2
Q

Blood in the anterior chamber of the eye is called

A

Hyphaema

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3
Q

Commotio retinae is AKA…

A

Bruised retina

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4
Q

What test is useful to see if there is a penetrating injury in the eye?

A

Fluorescein (blue light)

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5
Q

Where do small particles commonly lodge in the eye?

A

Sub-tarsal, conjunctiva, corneal (most common)

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6
Q

Intra-ocular foreign bodies are most commonly associated with what activity/ injury mechanism?

A

Fast moving objects (e.g. hammer and chisel injuries).

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7
Q

What investigation should always be performed in suspected foreign body of the eye?

A

X-ray (for intra-ocular foreign bodies)

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8
Q

Alkali burn injures to the eye will penetrate little/lots?

A

Lots (penetrates deep to the intra-ocular structures)

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9
Q

Acid burn injuries penetrate little/lots?

A

Little (these will coagulate the eye proteins)

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10
Q

Ciatrising changes to the conjunctiva and cornea suggests what type of injury?

A

Alkali burn

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11
Q

Limbal ischaemia is a poor prognostic factor for what injury type?

A

Alkali burns

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12
Q

How should eye chemical burns be managed? (5)

A

1) Quick history 2) Check Toxbase if available 3) Check pH of eye 4) Irrigate +++ (at least 2L of saline) 5) After this check slit-lamp

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13
Q
A
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14
Q

List some causes of acute vision loss

A

Vascular changes, vitreous haemorrhage, retinal detachment, wet-type ARMD, closed angle glaucoma

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15
Q

Is CRAO painful?

A

No, it is a cause of sudden painless visual loss

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16
Q

CRAO causes what degree of vision loss?

A

Profound

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17
Q

A CRAO will have what fundus appearence

A

Pale, oedamteous, small retinal vessels

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18
Q

What does this fundoscopy show?

A

CRAO (pale, cherry red spot)

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19
Q

How is CRAO managed? (<24 hours presentation)

A

Ocular massage (try to convert CRAO to BRAO)

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20
Q

Transient CRAO leads to what visual change? How is it treated?

A

Amaurosis fugax (usually lasts 5 minutes).

Treated with urgent stroke clinic referal and aspirin.

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21
Q

What are some signs of CRVO? (3)

A

Retinal haemorrhage, dilated tortuous veins, disc swelling and macular swelling

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22
Q

What does this fundoscopy show?

A

CRVO (haemorrhages, dilated veins and disc swelling)

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23
Q

How is CRVO treated?

A

Anti-VEGF intravitreal

Older treatment laser treatment to avoid haemorrhages

Treat risk factors (HT, DM)

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24
Q

What does this fundoscopy show?

A

BRVO

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25
Posterior ciliary artery occlusion leads to what clinical condition
Ischaemic optic neuropathy
26
What are the two types of ischaemic optic neuropathy?
Arteritic (GCA), non-arteritic (atherosclerosis)
27
Ischaemic optic neuropathy leads to what degree of vision loss?
Sudden, profound visual loss
28
Signs of GCA
Amaurosis fugax, scalp tenderness, enlarged and non-pulsatile scalp arteries
29
Sign of vitreous haemorrhage
Loss of red reflex
30
How is vitreous haemorrhage managed
Vitrectomy
31
Is retinal detachment a painful loss of vision?
Painless loss of vision
32
What 2 conditions (loss of vision) may cause floaters?
Vitreous haemorrhage, retinal detachment
33
Commonest cause of blindness in western world?
ARMD Wet (sudden loss) Dry (gradual loss)
34
What is the underlying cause of wet ARMD?
New blood vessels grow under retina
35
What kind of visual loss does wet ARMD cause?
Central (also distorted)
36
How is wet ARMD treated?
Laser, photodynamic therapy, now anti-VEGF
37
Is closed-angle glaucoma painful or painless?
Painful (red eye, visual loss, headache)
38
How is closed-angle glaucoma treated?
Acutely: Acetazolamide (CA inhibitor) Chronically: Laser iridotomy
39
List some causes of gradual visual loss (5)
1) Cataracts 2) Dry ARMD 3) Refractive error 4) Glaucoma 5) Diabetic retinopathy
40
What is the worldwide #1 preventable cause of blindness?
Cataracts
41
Cataracts cause gradual/ acute decline in vision?
Gradual (especially glare at night)
42
Dry ARMD tends to affect what part of the vision?
Central vision (scotoma)
43
How is dry ARMD treated?
Visual aids - no cure
44
Drusen sign + atrophic patches on retina indicates what
Dry ARMD
45
Refractive error types
Myopia (short-sighteded) Hypermetropia (long-sighted) Presbyopia (loss of accomodation with ageing) Astigmatism (irregular corneal curveature)
46
Hypermetropia focuses the light where? What kind of lens is needed to correct?
Focuses the light behind the retina Needs convex lens
47
Myopia focuses the light where? What kind of lens is needed to correct?
In front of the lens. Needs concave lens.
48
Is open-angle glaucoma painful?
No, often asymptomatic
49
Haloing at night is a sign of what eye condition
Acute closed angle
50
What is papilledema?
A specific term for swollen optic discs secondary to any raised intra-cranial pressure (swollen optic disc can be due to any cause e.g. ischaemic optic neuropathy)
51
All patients with bilateral optic disc swelling are suspected of having what
Raised ICP due to a space-occupying lesion until proven otherwise (medical emergency)
52
What does this show
Papilledema
53
Papilledema occurs because of raised ICP within what space
Subarachnoid
54
CSF is produced where
Choroid plexus of the lateral ventricles, 3rd and 4th ventricles
55
How does raised ICP kill?
Compression of brainstem as it herniates through the foramen magnum. Loss of respiratory drive.
56
Do all patients with papilledema have a space-occupying lesion?
No, other causes include malignant hypertension (\>180/120mmHg)
57
Why is it important to check BP after examining eyes?
Malignant Hypertension can cause swollen disc (\>180/120)
58
Will patients with raised ICP always have signs on CT?
No - idiopathic intracranial hypertension.
59
T/F: Papilledema is always rapidly fatal.
False - it can become chronic (leading to visual loss)
60
Blepharitis is inflammation of what
Eyelid
61
What are some causes of anterior blepharitis
Seborrheoic (scales on lashes) or staphyloccocal infection (lash follicles involved)
62
What is a cause of posterior eyelid inflammation
Meibomian / tarsal gland dysfunction
63
How can anterior and posterior blepharitis be differentiated?
Anterior: lid margins will be red Posterior: margins look normal
64
Scales and dandruff on the eyes indicates what
Seborrheic anterior blepharitis
65
Meibomian/ Tarsal gland blepharitis is associated with what
Acne rosacea
66
How is blepharitis treated?
Lid hygiene (daily bathing) Supplementary tear drops Oral doxycycline 2-3 months
67
Is vision changed in conjunctivitis?
No
68
Symptoms of conjunctivitis
Red eyes, gritty eyes, discharge (sticky), itch
69
Most common bacterial conjunctivitis causes
S. aureus, S. pneumoniae, H. influenzae
70
Chemosis is what
Conjunctival Oedema
71
What are the layers of the cornea?
Epithelium, stroma, endothelium
72
What are causes of corneal ulceration
Infective, peripheral (autoimmune; RA, hypersensitivity)
73
T/F: Corneal ulcers are usually painless
False - very painful (needle-like)
74
Dendritic corneal ulcer is indicative of what
Herpes simplex infecton
75
How are bacterial ulcers treated?
Ofloxacin eyedrops hourly
76
How is herpetic corneal ulcer treated
Aciclovir ointment 5x a day
77
Is vision affected in anterior uveitis?
Yes (unlike conjunctivitis)
78
Synechiae is what
Small or irregular pupil
79
Keratic precipitates is buzzword for what
Anterior uveitis
80
81
How is anterior uveitis treated?
Topical steroids, mydriatics.
82
Episcleritis is assoicated with what condition
Gout
83
Scleritis is painless, T/F?
False - extremely painful
84
How is scleritis treated
PO NSAIDs, PO steroids
85
What does this fundoscopy show?
Diabetic retinopathy (dot + blot haemorrhages, hard exudate, cotton-wool patches)
86
What does this fundoscopy show?
Diabetic retinopathy - new vessels on disc
87
What is this ocular sign called? What it is indicative of?
Rubeosis iridis. End-stage diabetic retinopathy.
88
By what 3 mechanisms do diabetic patients lose vision?
1) Retinal oedema affecting the fovea 2) Vitreous haemorrhage 3) Scarring of retina
89
What is the "severest" form of diabetic retinopathy?
Proliferative retinopathy
90
How is diabetic retinopathy managed? (3)
1) Optimise BG control 2) Laser ablation 3) Vitrectomy
91
T/F: The only cause of retinopathy is diabetes?
False - also hypertensive retinopathy
92
Are cotton-wool spots specific to diabetic retinopathy?
No, they appear in hypertensive retinopathy as well
93
Condition affecting the lungs (hilar lymphadenopathy), eyes and retina?
Sarcoidosis
94
Sjogren's Syndrome is a triad of what
1) Dry eyes 2) Xerostomia (dry mouth) 3) Rheumatoid arthritis
95
Symblepharon formation (a connection between fornix and cornea) indicates what condition?
Stevens-Johnson Syndrome

Ophthalmology (6 decks)

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