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Eye Flashcards

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1
Q

Name the risk factors for Open Angle Glaucoma

A

African americans
DM
Fx Hx of Glaucoma

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2
Q

How Open angle Glaucoma presents?

A

Gradual loss vision start from periphery

Increase IOP on tonometry

Fundoscopy findings–> Enlarged Optic cup and cupping of the disc

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3
Q

What are t/m options of Open angle glaucoma?

A

first line–> topical prostaglandins–>increases drainage of aqeuous humor via Uvealsacral pathway

2nd line–> BB

Laser tabeculoplasty

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4
Q

Important point of Open angle glaucoma

A

Avoid to use steriods as it decreases outflow of aqeuous humor from anterior chamber

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5
Q

How steroid causing Open angle glaucoma?

A

decrease drainage of aqueous fluid leads to increase IOP–> Open angle glaucoma
corneal edema leads to central blurriness

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6
Q

How close angle glaucoma presents?

A

seen in old age with headache and nausea
Red,painful eye and blurred vision
Pupil is fixed and mid-dilated without ulceration

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7
Q

Important point of close angle glaucoma

A

Avoid to use pupil dilating medication or sitting in dark place as it will lead to pupil dilation

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8
Q

How to dx Close angle glaucoma?

A

Gold standard–> gonioscopy

Also tonometry

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9
Q

How to t/m closed angle glaucoma?

A

IV acetazolamide and Pressure lowering eye drops

definitive laser iridotomy

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10
Q

D/f b/w in terms of pupil of uveitis / close angle glaucoma / conjunctivitis

A

Uveitis: pupil is constricted with a poor light response

close angle glaucoma:: pupil is dilate with a poor light response

conjunctivitis:: size and response to light are normal without affecting visual acuity

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11
Q

Fundoscopy findings of DM retinopathy

A

Microaneurysm and Hard exudates

Retinal Hx and sometimes neovascularisation

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12
Q

How fundoscopy findings of DM retinopathy from Open angle glaucoma?

A

DM retinopathy::
Disc is normal
and Visual field defects are patchy

Open angle Glaucoma::
Cupping of disc
and visual field defects starts from peripheral

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13
Q

Fundoscopy findings of HTN retinopathy::

A

AV nicking and copper wiring
flames hx and cotton wool spots
optic disc edema

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14
Q

How Aged related macular degeneration d/f from DM retinopathy?

A

In Age related macular degeneration, gradual loss of cental vision

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15
Q

Fundoscopy findings of AGMR

A

Subretinal drusen and pigment anomalies

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16
Q

How Nor-arteritic anterior ischemic optic neuropathy d/f from DM retinopathy?

A

Nor-arteritic anterior ischemic optic neuropathy:::
Painless mono-ocular vision loss
Optic disc edema and afferent pupillary defect

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17
Q

Triad of Optic neuritis

A

acute mono-ocular vision loss
Pain with extra ocular movement
U/L optic disc edema

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18
Q

Name the medicines for glaucoma

A

Trabecular outflow:: muscarinic agonists

Uveoscleral Outflow:: Prostaglandin Agonists

Aqueous humor inflow:: BB / Alpha agonist / carbonic anhydrase inhibitors

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19
Q

What is dacryocystitis?

A

Infection of the lacrimal sac with inflammatory changes in the medial canthal region of eye.

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20
Q

Name the bacteria of causing dacryocystitis

A

S.aureus

B-Hemolytic strept

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21
Q

How dacryocystitis presents?

A

Seen in infants and adults over age 40yrs
sudden onset pain with edema
redness in medial canthal region
Purulent discharge from punctum

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22
Q

What is episcleritis?

A

Inflammation or infection of the episcleral tissue between the conjunctiva and sclera
or inflammation of white of the eye w/o involvement of uveal tract

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23
Q

How episcleritis presents?

A

Sudden onset pain with photophobia

Watery discharge without affect vision or cornea

Diffuse or focal bulbar conjunctival injection

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24
Q

What is hordeolum?

A

abscess of the eyelid due to Staph.aureus

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25
How external hordeolum (stye) presents?
erythematous tender nodule at the lid margin
26
How to t/m external hordeolum(stye)?
``` warm compresses if persistent(>1-2wks), incision and curettage ```
27
How internal hordeolum presents?
Involvement of meibomian gland | tender nodule visible at the palpebral conjunctiva
28
How chalazion presents?
Granulomatous inflammation of meibomian gland presents hard painless lid nodule
29
Triad of Orbital cellulitis
Sudden onset fever proptosis Restriction of Extra ocular movement is restricted Eyelids are red and edema
30
How herpes zoster ophthalmicus presents?
Dendriform corneal ulcer and conjunctivitis vesicular rash in V1 region of trigeminal area Burning and itching sensation in the periorbital region
31
Name the condition which show hutchinson signs?
herpes zoster ophthalmicus
32
How herpes simplex keratitis presents?
Dendritic corneal ulcer and vesicles Pain with photophobia and decreased vision Minor clear vesicles in the corneal epithelium
33
How to t/m conjunctivitis due to adenovirus?
Cool/warm and moist compresses | with or without antihistamine/ decongestant drops
34
How to t/m conjunctivitis due to bacteria?
if contact lens wearer: quinolone drops Erythromycin ointments polymyxin-trimethoprim drops azomax drops
35
How to t/m conjunctivitis due to allergic?
antihistamine/ decongestant drops for intermittent SxS | antihistamine/mast cell stabilizer for frequent episodes
36
Differentiation d/f causes of conjunctivitis
Allergic:: B/L involve with watery scant discharge and itch Stuck shut of eye with no reappearance of discharge after wiping Bacterial:: B/L or U/L involve with purulent thick unremitting discharge Stuck shut of eye with reappearance of discharge after wiping Viral:: B/L involve with watery scant discharge and burning/gritty Stuck shut of eye with no reappearance of discharge after wiping
37
Findings of bacterial conjunctivitis Vs | viral conjunctivitis Vs allergic conjunctivitis
bacterial conjunctivitis Diffuse non follicular injection viral conjunctivitis Diffuse bumpy / follicular injection allergic conjunctivitis Diffuse bumpy / follicular injection conjunctival edema (chemosis)
38
How endophthalmitis presents?
Conjunctival irritation Purulent haziness of the ocular content Layering out of pus in the anterior chamber (Hypopyon)
39
Whom is more prone to develop bacterial keratitis?
Contact lens wearers
40
Triad of Subconjunctival Hx
Local trauma / cough, sneezing, vomiting well demarcated patch of extravasted blood beneath the conjunctiva Require no t/m as benign condition
41
How retinal detachment presents?
seen in 40-70yrs with Underlying trigger happened before condition occur sudden onset Photopsia and floaters Ophtho findings show grey elevated retina with fold and /or a tear
42
Name the condition in which patient says curtain coming down over the eyes
Retinal detachment | amaurosis fugax
43
Name the condition which causes retinal attachment
severe myopia / DM retinopathy | Hx of eye surgery or trauma
44
How to managed Retinal detachment?
laser therapy and cryotherapy to create permanent adhesions b/w neurosensory retina, retinal pigment epithelium and choroid
45
Triad of Choroidal rupture
blurred vision following ''blunt trauma" (cause of it) crescent shaped streak concentric to the optic nerve central scotoma with hx detachment of the macula
46
Fundoscopy findings of CRAO
sudden onset loss of vision pallor of the optic disc with cherry red fovea Boxcar segmentation of blood in the retinal veins
47
Fundoscopy findings of CRVO
blood and thunder appearance Disk swelling with venous dilation tortous retinal Hx cotton wool spots
48
Name the risk factors for CRVO
Factors which increases coagulopathy / glaucoma / atherosclerotic risk factors
49
How to confirm CRVO and t/m?
Fluorescein angiography if macular edema--> Intravitreal injection of VEGF inhibitors if no macular edema or neovascularisation-->managed conservatively with close observation
50
What is the mcc of vitreous hx?
DM
51
triad of Vitreous hx presents
Sudden onset loss of vision and onset of floaters d/f to visualise the fundus stat consultation otherwise do upright position during sleep
52
Triad Age related macular degeneration
seen in over 50 yrs old patient B/L progressive loss of central vision Intact peripheral and navigational vision
53
How the ARMG patient describes the findings of Grid tests?
Vertical lines bent and wavy
54
D/f types of AGMR
Atrophic form--> multiple sores in the macular region | Exudative form--> newly blood vessels leak/ bleed and scar the retina
55
Triad of Posterior capsule opacification
Posterior capsule opacification (thickening of the capsule holding the artificial lens) developed post-cataract surgery Presents as cloudy vision T/m is laser
56
How fungal keratitis presents?
cornea multiple stromal abscess
57
Fundoscopy findings of CMV retinitis
Typically painless condition | fluffy Or granular retinal lesion located near the retinal vessel/yellow white exudates and associated Hx
58
How to t/m CMV retinitis?
Anti virals--> valganciclovir | Intra vitreal injections--> if lesions near fovea Or optic nerve (so to avoid the blindness and retinal detachment)
59
How HIV retinopathy presents?
NO Floaters or blurred vision usually | Cotton wool retinal lesions which are rarely hx
60
How toxoplasmic chorioretinitis presents?
Eye pain & decreased vision | non vascular distribution (not perivascular)
61
How presbyopia presents?
affected near vision | but far vision is un-affected
62
How astigmatism presents?
Typically presents with blurry vision both at a distance and up close
63
How cataract presents?
Hx of d/f with night vision or driving at night
64
Name the d/f types of DM retinopathy
Simple retinopathy or Background Pre proliferative retinopathy proliferative or malignant retinopathy
65
How Simple retinopathy or Background presents?
Micro aneurysms / Hx / Exudates and retinal edema
66
How Pre proliferative retinopathy presents?
Cotton wool spots
67
How proliferative or malignant retinopathy presents?
newly form vessels
68
How to managed the complications of DM retinopathy?
argon laser photocoagulation
69
Triad of Blepharitis
b/L Burning or itching of the lids with discharge and crusting associated with skin disorders T/m is supportive/ warm compresses/ gentle scrubs / lid massage
70
Triad of Retinoblastoma
B/L if inherited and seen in less than 2yrs old absent red light reflex Dx is MRI of brain and eyes with no biopsy b/c of seeding
71
Causes of absent red light reflex | 3R 1C
Retinoblastoma CMV Rubella Retinopathy of prematurity
72
*Triad of Retinitis pigmentosa
progressive inherited night blindness decreased visual acuity visual field loss
73
Important point of Retinopathy of prematurity
retinal detachment causing loss of red reflex | seen in infant born at gestation less than 30 wks
74
How strabismus presents?
Asymmetric corneal light and red reflexes eye deviation with abnormal cover test dilated fundoscopic to dx the condition
75
Name the condition causing strabismus
retinoblastoma
76
Name the complications occur due to Myopia
retinal detachment | macular degeneration
77
What is Hyphema?
blood within the anterior chamber
78
Causes of Hyphema
if spontaneous---> due to bleeding disorder like vWD or DM blunt trauma
79
what is Pterygium?
wedged shaped proliferation of conjunctival tissue that expands from the lateral of the eye towards the cornea occur due to UV light exposure
80
Triad of Retinal micro infarctions
Occur due to ischemia associated with HTN and DM cotton wool spots (yellow white retinal lesion) on fundoscopy
81
Triad of Orbital cellulitis
Painful and limited EOM Proptosis Dx via CT orbit and brain with IV Abs as a t/m
82
Name the risk factors causing Orbital cellulitis
Sinusitis Orbital trauma dental caries or trauma
83
Name the causes of neonatal conjunctivitis
Chemical Gonococcal Chlamydial
84
Triad of Chlamydial neonatal conjunctivitis
Age of onset is 5-14 days after birth Watery/ mucopurulent/ serosangunineous discharge T/m is PO azomax as it doesn’t cause pyloric stenosis
85
Triad of Gonococcal neonatal conjunctivitis
Age of onset is 2-5 days after birth Profuse purulent discharge with eyelid edema PPx is erythromycin ointment or t/m is IM 3rd generation cephalosporin
86
Triad of Chemical conjunctivitis
Age of onset is within 24 hours after birth Due to sliver nitrate usage against gonorrhoea result conjunctival irritation and tearing T/m is eye lubricant
87
How to t/m dacryostenosis (nasolacrimal duct Obs?
Messaging the duct | (It present as U/L tearing and Minimal conjunctival tearing without any eye discharge
88
How endophthalmitis presents?
Pain and decrease visual acuity Occurs within 6 wks of eye surgery due to bacterial or fungal T/m is Intra vitreal ABx injection or vitrectomy is done
89
How orbital compartment syndrome occur?
Swelling and hx within the confined orbital space causes rapidly increasing IOP result ischemia of the optic nerve and globe
90
Triad of Orbital compartment syndrome
Acute eye pain with vision loss and limited EOM Proptosis with peritoneal Edema and rock hard eyelid / APRD Instant surgical decompression
91
How Open global injury presents?
Extrusion of vitreous and eccentric or teardrop pupil Decrease visual acuity and IOP RAPD
92
How Open global injury dx?
Fluorescein drops—-> if large injury and puncture drops may leaked from punctured site
93
What does gonioscopy measure?
Corneal angle
94
How to manage the angle closure glaucoma?
Combination multiple topical therapy given like timolol / Apraclonidine / pilocarpine Given acetazolamide to further reduce aqueous humour And last laser iridotomy as a definitive treatment
95
Triad of Strabismus
Amblyopia Asymmetric red reflex and corneal light reflex Tx: Patching the normal eye OR blurring the vision of the normal eye with cycloplegic drops (like atropine)
96
What are the Examination findigns of Strabismus and what complications would occur if untreated?
- Asymmetric Corneal light and red reflex - Deviation of eye on covering the unaffected eye Complication is ambylopia
97
How to manage Strabismus?
1) Correction of Refractive error | 2) Patching Or atropine (to blur) in unaffected eye as affected get strengthen

Internal Medicine (14 decks)

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