Eye Flashcards
1
Q
Leucokoria: Clinical Presentation (Cp)
A
White pupil
2
Q
Leucokoria: Differential Diagnosis (DD)
A
Congenital cataract, Retinoblastoma
3
Q
Leucokoria: First Step
A
Refer immediately (vvvvvvvvvvvimp)
4
Q
Retinopathy : Risk Factor
A
Prematurity
5
Q
Retinopathy of Prematurity: High Flow Oxygen
A
Vasoproliferative scarring and blindness
6
Q
Retinopathy of Prematurity: Treatment (TTT)
A
Laser
7
Q
Retinoblastoma: Incidence
A
Rare, most common malignant intraocular tumor
8
Q
Retinoblastoma: Clinical Presentation (Cp)
A
Leukocoria, Strabismus
- most common intraocular tumor in children
- Leukocoria (white cornea or Cat’s eye)
-strabismus - initial: US (intraocular calcification)
- best dilated indirect
ophthalmoscopic examination under anesthesia
9
Q
Retinoblastoma: Investigation (Inv)
A
CT (NO BIOPSY…SPREAD)
10
Q
Retinoblastoma: Treatment (TTT)
A
Surgery, good prognosis
11
Q
Corneal Abrasion: Symptoms
A
Pain, tearing, photophobia, decreased vision
12
Q
Corneal Abrasion: Investigation (Inv)
A
Fluorescein staining
13
Q
Corneal Abrasion: Treatment (TTT)
A
Pain relief and antibiotics
14
Q
Foreign Body: First Step
A
Excessive irrigation with saline
15
Q
Foreign Body: Metal Foreign Body
A
Emergent removal under anesthesia
16
Q
Foreign Body: If deeply embedded
A
Refer
17
Q
Penetrating Eye Injury: Management
A
Urgent referral, X-ray, Tetanus vaccine, Antibiotics
18
Q
Orbital vs. Periorbital Cellulitis: Common Organism
A
Staph
19
Q
Orbital vs. Periorbital Cellulitis: Clinical Presentation (Cp)
A
Erythema, Edema, Chemosis
20
Q
Orbital Cellulitis: Clinical Presentation
A
Cannot move eye, diplopia
21
Q
Periorbital Cellulitis: Clinical Presentation
A
Normal eye movements, no diplopia
22
Q
Orbital Cellulitis: Investigation (Inv)
A
CT (vvvvvvvvvvvimp)
23
Q
Periorbital Cellulitis: Investigation (Inv)
A
FBC and blood culture
24
Q
Orbital Cellulitis: Treatment (TTT)
A
Admission and IV ceftriaxone and IV flucloxacillin
25
Periorbital Cellulitis: Treatment (TTT)
Mild: Amoxicillin/Clavulanate; Moderate: Flucloxacillin; Severe: Flucloxacillin and Ceftriaxone 50 mg/kg
26
Aniridia: Definition
Defect of the iris
27
Aniridia: Check for
Wilm's tumor
28
WAGR Syndrome: Components
Wilms tumor, Aniridia, Genitourinary malformation, Retardation
WAGR syndrome is a rare genetic disorder that stands for:
1. Wilms Tumor: A type of kidney cancer that primarily affects children.
2. Aniridia: Absence of the iris, the colored part of the eye, leading to visual impairment.
3. Genitourinary Anomalies: Various abnormalities of the genitals and urinary tract. In males, this might include undescended testes (cryptorchidism) or hypospadias. In females, it might include streak ovaries or other genital malformations.
4. Intellectual Disability (previously referred to as “mental Retardation”): Developmental delays and intellectual disability of varying degrees.
29
Congenital Cataract: Most Common Causes
Rubella (cataract, deafness, PDA), Galactosemia
30
Strabismus: Transient
Common up to 4 months
31
Strabismus: Time to Correct
1-2 years
32
Strabismus: Correction Deadline
Before 7 years
33
Neonatal Conjunctivitis: First Day
Chemical (silver nitrate)
34
Neonatal Conjunctivitis: 2-5 Days
Gonococcal infection
35
Neonatal Conjunctivitis: Gonococcal Treatment
Single dose IV ceftriaxone
36
Neonatal Conjunctivitis: 5-14 Days
Chlamydia (more common)
37
Neonatal Conjunctivitis: Associated Condition
Pneumonia
38
Neonatal Conjunctivitis: Investigation
Swab for PCR
39
Neonatal Conjunctivitis: Treatment (TTT)
Chlamidya
Oral azithromycin 3 days
40
Nasolacrimal Duct Obstruction: Clinical Presentation (Cp)
Excessive watery secretions
41
Nasolacrimal Duct Obstruction: Treatment (TTT)
Massage
The appearance differs from conjunctivitis in that the child will not have any discomfort and the conjunctiva remains white. Gentle massage of the lacrimal sac may cause expression of mucus.
90% of nasolacrimal duct obstructions will spontaneously resolve by 12 months of age. Due to this, referrals should wait until the child is 1 year of age.
42
Nasolacrimal Duct Obstruction: Prognosis
Majority heal spontaneously
43
Children Conjunctivitis: Most Common Cause
Viral
44
Children Conjunctivitis: Most Common Virus
Adenovirus
45
Children Conjunctivitis: Symptoms
Running nose, red eye, clear discharge 2-3 weeks, follicular response, preauricular lymphadenopathy
46
Children Conjunctivitis: Management
Cool compression, no pad
47
Photophobia Differential Diagnosis: Look at the Pupil
Normal: Keratitis
48
Photophobia Differential Diagnosis: Constricted Pupil
Iritis/Uveitis
49
Iritis/Uveitis: Treatment (TTT)
Steroids
50
Photophobia Differential Diagnosis: Dilated Fixed Pupil, No Light Reflex
Acute glaucoma
51
Acute Glaucoma: Symptoms
Sudden onset red painful eye, halos, fixed semi-dilated pupil
52
Acute Glaucoma: Management
Immediate referral to ophthalmology, IV or oral acetazolamide or pilocarpine
53
Photophobia Differential Diagnosis: No Photophobia
Conjunctivitis (bacterial or viral)
54
Herpes Simplex Infection: Clinical Presentation (Cp)
Dendritic ulcer vesicles, gritty watery green, pain, photophobia, lacrimation
55
Herpes Simplex Infection: Treatment (TTT)
Initial management is with topical acyclovir eye ointment administered five times daily.
, refer to ophthalmology
56
Herpes Zoster Ophthalmicus: Clinical Presentation (Cp)
Rash involving trigeminal nerve distribution, dendritiform ulcer
57
Herpes Zoster Ophthalmicus: Treatment (TTT)
Acyclovir
58
Subconjunctival Hemorrhage: Causes
Trauma, severe cough and sneezing
59
Subconjunctival Hemorrhage: Symptoms
Painless, uniform redness
60
Subconjunctival Hemorrhage: Management
Usually none, reassure
If doesn’t cross limbus
61
Acute Glaucoma: Risk Factors
Old age, Female, Hypermetropia, Prolonged time in dark area
62
Acute Glaucoma: Clinical Presentation (Cp)
Sudden severe unilateral pain, halos around lights, dilated fixed pupil, photophobia, lacrimation, blurring of vision, eye injection
63
Acute Glaucoma: Investigation (Inv)
Tonometry
64
Acute Glaucoma: Treatment (TTT)
Emergency room: IV Acetazolamide; Long term: Iridotomy
65
Acute Glaucoma: Drug to Avoid
Atropine
66
Open Angle Glaucoma: Clinical Presentation (Cp)
Bilateral loss of peripheral vision
67
Open Angle Glaucoma: Risk Factors
DM, Myopia, Elderly
68
Open Angle Glaucoma: Fundus Exam
Cupping of optic disc
69
Open Angle Glaucoma: Tonometry
Increased IOP
70
Open Angle Glaucoma: Treatment (TTT)
Timolol; Long term: Trabeculectomy
71
Sudden Unilateral Loss of Vision Differential Diagnosis (DD)
CRAO, CRVO, Amaurosis fugax, Retinal detachment
72
Central Retinal Artery Occlusion (CRAO): Cause
Emboli
73
CRAO: Source
Ipsilateral carotid artery
74
CRAO: Clinical Presentation (Cp)
Sudden painless unilateral loss
75
CRAO: Ophthalmoscopy
Cherry red spot
76
CRAO: First Step
Breathing in a bag (increase CO2), Massage (only first 90 minutes)
Ocular massage using a contact gonioscopy lens was performed. Intravenous acetazolamide and topical medications were given to lower the intraocular pressure. An anterior chamber paracentesis was performed, in which 0.1 mL of aqueous humour was removed using a 25 gauge needle via a limbal approach.racgp
77
CRAO: Treatment if >3 hours
IV acetazolamide (vvvvvvvv imp)
78
Central Retinal Vein Occlusion (CRVO): Clinical Presentation (Cp)
Sudden unilateral painless loss of vision
79
CRVO: Fundoscopy
Disk swelling and venous dilatation
80
CRVO: Treatment (TTT)
No specific treatment
81
Retinal Detachment: Main Risk Factors
Myopia, DM, Macular degeneration
82
Retinal Detachment: Clinical Presentation (Cp)
Flashes of light (key word), curtain coming down (vvvvvvv imp), floaters, loss of vision
83
Retinal Detachment: First Aid
Tilt the head back (vvvv imp)
84
Retinal Detachment: Treatment (TTT)
Laser photocoagulation
85
Amaurosis Fugax: Cause
Emboli
86
Amaurosis Fugax: Source
Ipsilateral carotid artery
87
Amaurosis Fugax: Sign of
Impending stroke
88
Amaurosis Fugax: Clinical Presentation (Cp)
Sudden painless unilateral loss of vision, curtain falls down, then sees well again
89
Amaurosis Fugax: Examination
Murmur over carotid
90
Amaurosis Fugax: Investigation (Inv)
US for carotid
91
Amaurosis Fugax: Drug of Choice
Aspirin
92
Curtain Falling Down Differential Diagnosis (DD)
Retinal detachment (flashes of light), Retinal emboli (murmur over carotid)
93
Macular Degeneration: Most Common Cause of Blindness
Elderly
94
Macular Degeneration: Clinical Presentation (Cp)
Slowly bilateral loss of central vision, see lines wavy
95
Macular Degeneration: Treatment (TTT)
Better to refer
96
Macular Degeneration: Dry
No treatment
97
Macular Degeneration: Wet
Laser
98
Diabetic Retinopathy: Stages
Non-proliferative: control DM; Proliferative: Laser photocoagulation
99
Diabetic Retinopathy: Screening Frequency
Every 1-2 years
100
Cataract: Most Important Risk Factor
Age
101
Cataract: Other Risk Factors
DM, Smoking, Trauma
102
Cataract: Clinical Presentation (Cp)
Cannot read well at night (key word), cannot see well at daylight (vvvvvv imp)
103
Cataract: Treatment (TTT)
Phacoemulsion (imp)
Definite - lens
104
Eye Floaters Differential Diagnosis (DD)
Retinal detachment, Trauma (bleeding), DM (most common cause)
105
Eye Floaters: Clinical Presentation (Cp)
Black dots moving in front of him
106
Eye Floaters: Investigation (Inv)
Fundoscopy
107
Eye Floaters: Treatment (TTT)
Usually none
108
Pupil Abnormalities Differential Diagnosis (DD): Constricted Pupil
Morphine, Heroin toxicity, Organophosphorus, Intracranial hemorrhage (pontine), Iritis/Uveitis
109
Constricted Pupil: Morphine Treatment
Give naloxone
110
Constricted Pupil: Organophosphorus Treatment
Atropine and oximes
111
Constricted Pupil: Intracranial Hemorrhage (Pontine) Investigation (Inv)
CT is a must
112
Pupil Abnormalities Differential Diagnosis (DD): Dilated Pupil
Amphetamine toxicity, Ecstasy toxicity, Cocaine toxicity, LSD toxicity, Alcohol withdrawal
113
Dilated Pupil: Alcohol Withdrawal Treatment
IV diazepam
114
Dilated Fixed Pupil Differential Diagnosis (DD)
Acute glaucoma, 3rd cranial nerve palsy
115
Trachoma: Organism
Chlamydia
116
Trachoma: Most Common Cause of Blindness
Aboriginal people
117
Trachoma: Prevention
Face wash
118
Trachoma: Spread Prevention
<20%: treat only contact with azithromycin; >20%: treat whole community
119
Trachoma: Clinical Presentation (Cp)
Inflammation and scarring of the eye flees
120
Trachoma: Best Prophylaxis
Wash hands
121
Trachoma: Treatment (TTT)
Azithromycin (DOC), Surgery
122
Dacryocystitis: Clinical Presentation (Cp)
Infection of the lacrimal sac, pain, redness, swelling over inner aspect of lower eyelid
123
Dacryocystitis: Treatment (TTT)
Oral antibiotics, warm compresses; If abscess: incision and drainage
124
Hypopyon: Definition
Pus in the anterior chamber
125
Hypopyon: Cause
Post-operative
126
Hyphema: Definition
Blood in the anterior chamber
127
Episcleritis and Scleritis: Clinical Presentation (Cp)
Both conditions present with a red eye which may be painful but no discharge; Think Rheumatoid arthritis, Herpes zoster
128
Episcleritis and Scleritis: Management
Topical corticosteroids or oral anti-inflammatory medications
129
Episcleritis and Scleritis: Notable Symptom
Painful and no discharge
130
Sudden Loss of Vision in Elderly: First Investigation (Inv)
ESR (vvvvvvvvvvvvvvv imp, even before CT)
131
Stye: Clinical Presentation (Cp)
Red painful swelling on eyelid margin abscess
132
Stye: Management
Hot compression
133
Chalazion: Clinical Presentation (Cp)
Granuloma of the meibomian in eyelid, painless lump
134
Chalazion: Management
Hot compression with massage; If large: refer for incision
135
Blepharitis: Common Organism
Staphylococcus
136
Blepharitis: Symptoms
Feels like something is in the eye, crust or scale near baseline of eyelid
137
Blepharitis: Management
Hygiene
Blepharitis may be treated with a combination of antibiotic or steroid drops. Lid scrubs to remove any excess crusting will also help.
