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J Ophthalmology > Eye conditions > Flashcards

Eye conditions Flashcards

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1
Q

roth spots (red dots in fundus)

A

infective endocarditis

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2
Q

brushfield spots (white spots in iris)

A

downs syndrome

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3
Q

previous eye trauma/surgery in one eye
bilateral granulomatous uveitis
floaters in eye

A

sympathetic ophthalmia

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4
Q

aetiology of monocular blindness (2)

A 
optic neuritis (inflammation of optic nerve) 
tumours

something in optic canal

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5
Q

aetiology of bitemporal hemianopia (1)

A

pituitary tumour

something in optic chiasm

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6
Q

aetiology of missing vision on either left or right side (in both eyes) (3)

A

demyelination
tumour
vascular disease (stroke)

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7
Q

what is optic neuritis

A

inflammation of optic nerve

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8
Q

why is there pain on eye movement in optic neuritis

A

bc the optic nerve sheath is attached to the common tendinous ring for the rectus extraocular eye muscles

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9
Q

pain behind eye on movement
colour desaturation
unilateral vision loss over 24 hours

A

optic neuritis

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10
Q

emmetropia definition

A

no refractive error

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11
Q

ametropia definition

A

generic term for refractive error eg myopia, hypermetropia

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12
Q

whats another name for hypermetropia

A

long sightedness (can see things far away fine but not far away things)

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13
Q

which type of glasses are used for hypermetropia

A

convex

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14
Q

whats another name for myopia

A

short sightedness (can see things close by fine but not far away things)

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15
Q

which type of glasses are used for myopia

A

concave (bc CAVES are LONG and you want to fix their LONG sight so they can see in the CAVE)

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16
Q

astigmatism definition

A

rugby ball shaped cornea

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17
Q

astigmatism presentation

A

long and short sight is blurry (funny shaped cornea = distorted image passed on to retina)

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18
Q

presbyopia definition

who get it

A

loss of accommodation reflex

middle aged people (happens to most people)

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19
Q

treatment of presbyopia

A

reading glasses

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20
Q

amblyopia (cortical blindness) definition

A

no pathological problem but one eye can see better than the other (one has gained more cortical territory and the other has lost its function as a result)

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21
Q

example of when amblyopia (cortical blindness) can occur

A

untreated wandering eye in kids

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22
Q

another name for a tropia

A

squint

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23
Q

if you cover a patients eye and the other moves outwards, what type of squint is it

A

esotropia (was previously in)

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24
Q

if you cover a patients eye and the other moves inwards, what type of squint is it

A

exotropia (was previously out)

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25
if you cover a patients eye and the other moves upwards, what type of squint is it
hypotropia (was previously down)
26
if you cover a patients eye and the other moves downwards, what type of squint is it
hypertropia (was previously up)
27
diplopia treatment
prism glasses
28
aetiology of horizontal diplopia
CN VI palsy
29
which 5 extraocular muscles (and 1 intraocular) are affected in a CN III palsy
``` medial rectus superior rectus inferior rectus inferior oblique levator palpebrae superioris sphincter pupillae ```
30
how does a CN III palsy present
down out and dilated eye | bc the lateral rectus, superior oblique and sphincter pupillae (that causes constriction) all still work
31
is there a normal pupillary reflex in CN III palsy
no
32
bc of the down and out nature of the eye in CN III palsy, what may happen to the eyelid
dropping (ptosis)
33
if a CN III palsy (down out and dilated pupil) is PAINFUL what is the cause treatment
aneurysm treat fast!
34
general aetiology of CN palsies (4)
vascular disease (stroke) tumours demyelination congenital
35
presentation of CN IV palsy (2)
``` tripping downstairs head tilt (to compensate) ``` trochlear nerve not working = superior oblique not working = cant look down
36
presentation of CN VI palsy (2)
``` permanent adduction (medial deviation) of affected eye diplopia (double vision) ```
37
general treatment of eye infection
chloramphenicol
38
general treatment of eye inflammation
steroids
39
treatment of eye swelling form allergy
anti histamines
40
general treatment of painful eye
topical NSAIDs
41
most common type of gradual vision loss
age related macular degeneration (ARMD) dry type
42
someone with eye pain and change of appearance of eyes AND weight loss
thyroid eye disease (hyperthyroidism)
43
aetiology of central retinal artery occlusion
emboli from carotid (or heart)
44
risk factors for central retinal artery occlusion (4)
hypertension, diabetes, high cholesterol, smoking
45
what is the vision loss like in central retinal artery occlusion (sudden/gradual? painful?) think about it
painless and sudden
46
how bad is the vision loss in central retinal artery occlusion what can they see
v bad cant see Snellen chart, can count fingers
47
fundoscopy in central retinal artery occlusion
pale/oedematous retina cherry red spot macula thread like/non tortious veins
48
what investigations would you want to do after diagnosing a central retinal artery occlusion why
carotid US to find source of emboli
49
treatment of central retinal artery occlusion (2)
``` ocular massage (rub eye within 24 hours to try and dislodge it into one of the branches) surgery if ocular massage ineffective ```
50
if a central retinal artery occlusion isnt fixed within 70 mins what happens vision prognosis
irreversible ischaemia probs vision loss
51
another name for transient central retinal artery occlusion
amaurosis fugax
52
how long does transient central retinal artery occlusion last for
<5 mins
53
what is the vision loss like in transient central retinal artery occlusion (amaurosis fugax) (sudden/gradual? painful?) think about it
sudden painless vision loss
54
how would a patient describe their vision in transient central retinal artery occlusion (amaurosis fugax)
'like a curtain coming down'
55
treatment of transient central retinal artery occlusion (amaurosis fugax) (prophylaxis of full central retinal artery occlusion) where do you refer them, why
aspirin refer to stroke - at risk of having a stroke
56
'like a curtain coming down' <5mins
transient central retinal artery occlusion (amaurosis fugax)
57
'like a curtain coming down' >5mins
retinal detachment
58
cherry red spot on macula pale fundus non tortious veins
central retinal artery occlusion
59
dark tortious veins blood and thunder fundus retinal haemorrhages new vessel formation
central retinal vein occlusion
60
sudden painless vision loss differentials in some with hypertension (2) how do you differentiate between them
central retinal artery occlusion central retinal vein occlusion fundoscopy
61
how bad is the vision loss in central retinal vein occlusion what can/cant they see
v bad can see Snellen chart or counting fingers, can see some light
62
aetiology of central retinal vein occlusion
emboli
63
why is there haemorrhages etc in central retinal vein occlusion
bc its the veins the blood thats behind the blockage is in the eye (in central retinal artery occlusion is behind the eye)
64
treatment of central retinal vein occlusion by what method why
anti-VEGF (vascular endothelial growth factor) intravitreal injection stops new vessel growth
65
aetiology of posterior ciliary artery occlusion
giant cell arteritis
66
what does posterior ciliary artery occlusion do to the optic nerve
causes ischaemia
67
is posterior ciliary artery occlusion (associated with giant cell arteritis and optic nerve ischaemia) reversible
no
68
what happens to the vitreous gel in old people that makes them more susceptible to retinal detachment
it becomes more liquid = tugs on retina and pulls it in
69
what is the sensory retina detached form in retinal detachment
retinal pigment epithelium
70
is retinal detachment painful
no
71
what is the loss of vision like in retinal detachment onset
'curtains in field of vision' >5mins
72
as well as painless vision loss, what else might someone with retinal detachment experience in their vision
sudden onset flashes and floaters
73
what do you see on fundoscopy of retinal detachment
line where retina has detached
74
treatment of retinal detachment explanation (2 steps) how fast
surgery aspirate vitreous gel (it is the thing thats pulling on the retina) reattach retina urgent!
75
most common cause of blindness in UK
age related macular degeneration (ARMD)
76
what is the presentation of both wet and dry type age related macular degeneration why
central vision 'missing' because the macula is degenerated (duh) = central vision affected
77
which type of ARMD (age related macular degeneration) is sudden
wet as soon as the haemorrhage happens = vision affected (in the dry type theres no sudden pathological changes = no sudden vision loss)
78
which type of age related macular degeneration is gradual
dry
79
why is dry age related macular degeneration called the 'dry type'
no leakage of blood vessels (haemorrhage)
80
treatment of wet age related macular degeneration administration method
anti-VEGF intra vitreal injection
81
what does anti-VEGF do
stops new vessel formation
82
why is wet age related macular degeneration called the 'wet type'
haemorrhage (leakage of blood vessels)
83
is dry age related macular degeneration sudden or gradual vision loss why
gradual bc there is no haemorrhage (and it is the haemorrhage in wet type that makes the vision loss sudden)
84
fundoscopy in wet age related macular degeneration
haemorrhage new vessel formation atrophic retina near macula
85
fundoscopy in dry age related macular degeneration
drunsen (build up of waste products, white flecks) | atrophic retina near macula
86
treatment of dry age related macular degeneration
nothing - magnifying glasses, bright stickers etc
87
which angle is important in classifying glaucoma
iridocorneal angle (between iris and cornea)
88
generally speaking, what is glaucoma caused by
increased intraocular pressure
89
in glaucoma, increased intraocular pressure does what to the optic nerve head
atrophy
90
in closed angle glaucoma, increased pressure at ... causes the trabecular meshwork to be blocked
iris/lens
91
what fluid cannot be drained in glaucoma
aqueous humour
92
iatrogenic cause of closed angle glaucoma (trabecular meshwork is block by something)
mydriatic eye drops - as they cause pupil dilation = pupil blocks angle rare!!
93
what other common eye condition is associated with closed angle glaucoma
hypermetropia (long sighted)
94
presentation of someone with closed angle glaucoma (5) pain? onset look of eye (2)
``` vomiting and nausea severe pain sudden onset red eye fixed pupil, mid dilated ```
95
initial treatment of closed angle glaucoma (to preserve vision) example mechanism
EMERGENCY carbonic anhydrase inhibitor acetazolamide PO, dorzolamide eye drops decrease aqueous humour production = decrease intraocular pressure = prevent blindness
96
curative treatment of closed angle glaucoma mechanism potential complication (cosmetic)
surgery (laser iridotomy) make hole in iris (at the top) to relieve pressure sclera contents may spill over onto iris = white dip at top of iris
97
alternative to acetazolamide for closed angle glaucoma (before surgery)
prostaglandin anaglogue (bimatoprost + nbenzalkonium to reduce bimatoprost conc)
98
which type of glaucoma (open or closed angle) has sudden visual loss and is a ophthalmic emergency
closed angle
99
in open angle glaucoma, if the iridocorneal angle is open (no pressure from iris/lens) then what is it that causes the increased intraocular fluid
something in the meshwork itself blocking it
100
``` is vision loss in open angle glaucoma; sudden or gradual painful? central or peripheral? red eye? ```
gradual not painful (usually asymptomatic) peripheral vision loss no red eye (not an ophthalmic emergency unlike closed angle)
101
what is the positive finding on examination for open angle glaucoma
visual field defect - peripheral vision loss
102
treatment of open angle glaucoma example (2) mechanism
no cure, just want to preserve vision carbonic anhydrase inhibitors acetazolamide PO, dorzolamine eye drops reduced aqueous humour production = reduced intraocular pressure = preserve vision
103
is vision loss in cataracts gradual or sudden do glasses help (patient may have already tried this)
gradual no
104
most common cause of cataracts
aging
105
how is a congenital cataract picked up
no red light reflex at birth
106
glare when driving at night
cataract
107
what is a cataract (generally)
clouding/opacification of lens from denaturation of proteins
108
treatment of cataract
lens replacement
109
what is hydrocephalus associated eye condition
accumulation of CSF papilloedema
110
what is papilloedema
optic disc swelling from increased intracranial pressure
111
most common cause of papilloedema
intracranial tumour
112
anatomically why does increased intracranial pressure cause the optic nerve to be compressed = optic disc swelling
optic nerve is surrounded by meninges = surrounded by CSF
113
what is the vision change like in papilloedema
v vague - can be anything! blurring of vision loss of vision enlarged blind spot
114
what extraocular symptom is associated with papilloedema (think about the aetiology)
headaches for several months!
115
what does the cup look like on fundoscopy in papilloedema (2)
pale colour | blurry contour
116
investigations for papilloedema (3)
``` blood pressure (for hypertension as cause) head MRI lumbar puncture (to look at CSF pressure) ```
117
complication of untreated papilloedema
blindness
118
what is episcleritis
inflammation or the episclera (vascular layer above the sclera)
119
what does episcleritis look like
red sclera (bc vessels are on the surface)
120
is episcleritis common is episcleritis serious
yes no
121
what does scleritis look like
blue/purple sclera (bc vessels are deep)
122
is episcleritis or scleritis painful how painful
scleritis (deeper) v painful - wakes people from sleep
123
treatment of scleritis
PO NSAID
124
which one (episcleritis/scleritis) is serious why
scleritis deeper inflammation
125
what does anterior uveitis present similar to
conjunctivitis
126
is anterior uveitis inflammation or infection
inflammation
127
what is the pupil like in anterior uveitis what is the name of the inflammatory exudate that causes this
small and irregular shaped synechiae
128
white line (filled in from the bottom to the line) along bottom part of iris in anterior uveitis, what is going on what is the name of this
collection of pus in anterior chamber hypopyon
129
is there photophobia in anterior uveitis
yes
130
treatment of anterior uveitis
topical steroids for 4-8 weeks
131
what is bletharitis
inflammation of eyelids
132
where is anterior bletharitis
lashes
133
where is posterior bletharitis
behind the lashes (from meibomain gland) d
134
what is red in anterior bletharitis
lid margin (bit along the bottom)
135
what is red in posterior bletharitis
inside of eyelid
136
which type of bletharitis is the lashes involved in
anterior
137
which type of bletharitis may present like 'a pea in eyelid'
posterior
138
what does bletharitis feel like
gritty eyes/foreign body sensation
139
treatment of bletharitis (2)
lid hygiene | PO doxycycline
140
what do you give to someone with a corneal graft to prevent rejection
steroids
141
what type of hypersensitivity reaction is corneal graft rejection
type IV (delayed)
142
what investigation do you want to do for eye infection
swabs for culture
143
what is the general treatment for eye infections
chloramphenicol ointment
144
alternative to chloramphenicol in extreme cases of eye infection
oxfloxacin
145
is conjunctivitis contagious
yes very
146
how does conjunctivitis present (2) is vision affected
red eyes discharge no
147
if the discharge is watery in conjunctivitis what is the aetiology
viral
148
if the discharge is sticky (v nasty) in conjunctivitis what is the aetiology
bacterial
149
how does chlamydial (follicular) conjunctivitis present on the eyelids
'rice grains' | 'raised cobblestoning of papillae'
150
oedematous conjunctiva is classic of which conjunctivitis
allergic conjunctivitis
151
investigations for conjunctivitis
swab for culture or viral PCR (depending on ?aetiology)
152
treatment of bacterial conjunctivitis
chloramphenicol ointment | NOT hospital admission (v contagious)
153
treatment of viral conjunctivitis (herpes zoster and chlamydial)
acyclovir if herpes zoster | oxytetracycline if chlamydial
154
complication of recurrent conjunctivitis with scar formation under eyelid how does it present
trachoma blindness this is a big issue in developing countries that dont treat conjunctivitis
155
what is keratitis
infection of the cornea
156
infection with white blobs on cornea
bacterial keratitis
157
aetiology of keratitis (corneal infection) in someone with contact lenses
acanthemoeba fungi
158
aetiology of herpetic keratitis
herpes virus
159
aetiology of keratitis after a URTI
adenovirus
160
why is keratitis v sore
cornea has high sensory innervation
161
what does herpetic keratitis look like
dendritic corneal ulcer (looks like a white tree branch on cornea)
162
PMH of cold sores and has keratitis
herpetic keratitis
163
just like coldsores, what can make herpetic keratitis worse (2)
stress | fatigue
164
investigations for keratitis
swabs for culture
165
bacterial keratitis treatment
gentamicin and cefuroxime
166
herpetic keratitis treatment
acyclovir anti-viral
167
what happens if you give herpetic keratitis steroids
corneal melt/perforation
168
complication of keratitis
corneal ulcer
169
treatment of corneal ulcer
treat keratitis
170
what autoimmune condition can cause corneal ulcers
sjogrens (sicca symptoms)
171
what is endopthalmitis
infection of entire globe (infront and behind septum)
172
who gets endopthalmitis
post surgery
173
microbio of endopthalmitis (think of aetiology)
staph epidermidis (from skin)
174
presentation of endopthalmitis
v painful v red decreasing vision
175
treatment of endopthalmitis
intravitreal antibiotics asap
176
prognosis of endopthalmitis
poor - will probs loose eye
177
what is orbital cellulitis
infection of the orbit (behind the septum)
178
how do kids get orbital cellulitis
from paranasal sinusitis
179
does orbital cellulitis present in one or 2 eyes
1
180
what does orbital cellulitis look like
red and swollen skin around eye, confined to eye socket
181
systemic presentation of orbital cellulitis in kids (2) | think of aetiology
pyrexia (fever) runny nose aetiology is probs paranasal sinusitis
182
investigation for orbital cellulitis what should you find
CT paranasal sinus on affected side filled with fluid
183
treatment of orbital cellulitis
broad spectrum antibiotics (flucloxacillin, metronidazole, ceftriaxone IV)
184
what can happen to the cavernous sinus in orbital cellulitis
cavernous sinus thrombosis
185
prognosis of vision in orbital cellulitis
probs loose vision
186
what is chorioretinitis
infection of the choroid and retina
187
3 aetiology of chorioretinitis
``` CMV (cytomegalovirus) toxoplasma gondii (raw meat) toxocara canis (cats and dogs) ```
188
chorioretinitis aetiology someone with AIDS/HIV 'mozzarella pizza/pizza pie fundus' (white ischaemia, red haemorrhages)
CMV (cytomegalovirus)
189
what is dacrocystitis
blockage of lacrimal canal = infection of lacrimal sac (stagnant tears)
190
how does dacrocystitis present (infection of lacrimal sac from blockage)
red and swollen medial to eye
191
ocular trauma blow out fracture aetiology
squash ball
192
ocular trauma which bones tend to fracture in blow out fractures why
inferior and medial bony orbit walls bc theyre thinner
193
ocular trauma which nerve is most likely to be damaged in blow out fracture why
infraorbital (CN V2) bc it travels through the infraorbital canal and foramen (in the maxilla?)
194
ocular trauma which muscle is most likely to be damaged in blow out fracture how does this present
inferior oblique pain on upgaze
195
ocular trauma how does blow out fracture present on CT
'tear drop sign' (blood is in the paranasal sinus)
196
ocular trauma treatment of orbital blow out fracture
probs nothing surgery if v bad
197
ocular trauma which nerve may be damaged in zygomatic fracture
infraorbital (CN V2)
198
ocular trauma zygomatic fracture causes ... to fall which ... the eyeball
suspensory ligament drops
199
ocular trauma why done kids' eyes turn red when there are fractures in ocular trauma
bones are soft in kids
200
complication of penetrating trauma to eye how does it present
sympathetic ophthalmia bilateral inflammation even though trauma was in one eye
201
how does an acid burn look on the eye
v v red
202
how does an alkali burn look on the eye
'china white appearance' of sclera
203
are alkali or acid burns worse prognosis
alkali (even though they probs look better bc theyre white)
204
treatment of acid/alkali burn to eye
immediate irrigation, 2l saline

J Ophthalmology (6 decks)

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