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MB2: Ophthalmology > Eye disease > Flashcards

Eye disease Flashcards

(68 cards)

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1
Q

in who is eye trauma more common

A

males 25-36 in machinery or assault

females >60 who have fallen

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2
Q

how many with poor outcome due to eye trauma have no light perception?

A

50%

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3
Q

what parts of eye should be examined in trauma

A 
lids 
conjunctiva 
cornea 
anterior segment 
pupils
fundus 
fluroscien
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4
Q

golden rules of eye trauma?

A 
hx key 
take visual acuity 
fluroscein drops 
handle globe rupture with care 
Xray or CT IORB
irrigate chemical injuries
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5
Q

what may cause blowout fracture and what is a consequence

A

trauma to globe or to orbital rim may transmit to orbital plates
can trap inferior rectus and patient may not be able to look up
may cause subconjunctival haemorrhage

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6
Q

what is hyphaemia

A

blood in ant chamber or in vitreous cavity leaking in

can circulate around but if enough then will settle

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7
Q

describe the process of traumatic retinal detachment

A

slight tear of retina causes vitreous to get behind and cause total detachment

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8
Q

how can a corneal lateration or penetrating injury present

A

aqueous leaking out, ant chamber flat/shallow

iris may be pulled into wound to cause irreg pupil

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9
Q

what is siedels test

A

use of fluroscein to determine corneal penetration as it is diluted by aqueous

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10
Q

what is sympathetic ophthalmia

A

injury to one eye leads to AA uveitis in both eyes due to systemic exposure of intraocular antigens
can lead to bilateral blindness

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11
Q

what may cause small particle corneal damage

A

hammer and chisel

machinery

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12
Q

management of corneal abrasion or small particle in eye

A

slit lamp/local anaesthetic
use edge of needle to scrape out
chloramphenicol ointment 4x daily for 1 week

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13
Q

what may raise suspicion of anterior chamber penetrating injury

A

irreg pupil
shallow ant chamber
localised cataract
gross inflammation

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14
Q

what may cause intra-ocular penetrating trauma and what must be done

A

hammer and chisel or other fast moving objects

always X ray/CT

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15
Q

what is the china white sign

A

ischaemia and white areas caused by alkali destruction of blood vessels

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16
Q

alkali damage can cause corneal vascularisation - what is this?

A

blood vessels growing over cornea following alkali damage

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17
Q

true/false - acid burns are more penetrating than alkali

A

false - alkali generally have better penetration and can cause corneal/conjunctival scarring

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18
Q

management of chemical burns to the eye

A 
quick Hx with nature of chemical 
check its not cement or lime 
check toxbase and pH 
irrigate with 2L saline or until pH normal 
assess at slitlamp
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19
Q

prevention of eye trauma?

A

safe practice
eyewear
education

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20
Q

what is papilloedema

A

optic disc swelling in response to raised ICP

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21
Q

what should optic disk swelling be suspected as

A

always suspect as SOL until proven otherwise

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22
Q

what is a consequence of increase in volume in intercranial cavity

A

herniation of brainstem through foramen magnum

may lead to cord compression, brainsrem compression and death

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23
Q

common vascular cause of papilloedema

A

malignant hypertension

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24
Q

functions of CSF

A 
maintains stable extracellular environment 
buoyancy 
mechanical protection 
waste removal 
nutrition
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25
what happens in chronic optic disk swelling
swelling subsides and disk becomes atrophic and pale | may lead to lost visual function and blindness
26
what is idiopathic intercranial hypertension
common cause of bilateral disc swelling in young females | may be due to blocked CSF absorption or obstructed CSF circulation
27
what may cause CSF blockage to absorption in IIH
vitamin A | microemboli in superior sagittal sinus
28
what may cause obstructed CSF circulation in IIH
increased intra abdo pressure - ie obesity | stenosis of transverse cerebral sinuses
29
what is ischaemic optic neuropathy, how does it present and what is an associated condition
occlusion of posterior ciliary arteries causing occlusion of optic nerve head circulation sudden, painless visual loss with swollen optic nerve associated with temporal arteritis
30
cause of CRAO
carotid artery disease | emboli from heart
31
presentation of CRAO
painless sudden visual loss RAPD pale, oedematous retina with thread like vessels
32
other forms of CRAO
branch retinal artery occlusion | amaurosis fugax
33
what is amaurosis fugax
painless vision loss lasting around 5 mins nothing on examination refer to stroke clinic
34
cause of CRVO
diabetes hypertension cancer virchow's triad
35
signs and symptoms of CRVO
sudden visual loss retinal haemorrhage dilated, tortuous veins optic disc and macula swelling
36
signs and symptoms vitreous haemorrhage
``` sudden loss of vision floaters loss of red reflex haemorrhage on fundoscopy identify cause ```
37
cause of vitreous haemorrhage
retinal vein occlusion, diabetes lead to angiogenesis with leaky blood vessels retinal tear leading to disrupted blood vessel
38
presentation of retinal detachment
painless loss of vision with flashes/floaters may have RAPD tear on fundoscopy
39
what is Wet ARMD
new blood vessels grow causing build up of fluid and scarring
40
presentation and management of wet ARMD
rapid loss central vision, metamorphopsia, scotoma haemorrhage, exudate intra-vitreal VGEF
41
what is closed angle glaucoma
aqueous humour encounters increased resistance through iris/lens channel leading to peripheral iris to bow forward and obstruct trabecular meshwork
42
presentation of closed angle glaucoma
``` painful red eye sudden visual loss headache nausea and vomiting cloudy cornea dilated pupil ```
43
causes of gradual visual loss
``` ABCDG dry ARMD Blur - refractive error cataract diabetes glaucoma ```
44
what is a cataract
clouding of lens - often age related
45
management of symptomatic cataracts
intra-ocular lens implant
46
presentation and management of dry ARMD
gradual vision decline scotoma druden, atrophic retina supportive with low visual aids, social support, registered blind
47
signs/symptoms of open angle glaucoma
often none and may be incidental cupped disc visual field defect
48
how many layers does the retina have
10
49
pathogenesis of diabetic retinopathy
diabetes leads to high sorbitol, outpouching of retinal blood vessels to cause microaneurism, haemorrhage, deposition fo exudate high sorbitol makes blood more viscous so there is slowed flow and ischaemia VGEF leads to angiogenesis, which can lead to retinal traction
50
features of mild/moderate non-proliferative diabetic retinopathy
microaneurism hard exudates small intraretinal haemorrhage
51
features of severe non proliferative diabetic retinopathy
cotton wool spots | venous bleed
52
how can severe non-proliferative diabetic retinopathy be managed
laser therapy
53
management of diabetic macular oedema
anti-VGEF | used to be laser
54
consequence of proliferative diabetic retinopathy
vitreous haemorrhage and retinal traction
55
findings on fundus of pathological myopia
``` lacquer crack subretinal haemorrhage fuch's spot RPE/ choroid haemorrhage cystoid, paving stone, lattice degeneration retinal thinning with holes scleral thinning ```
56
diagnostic criteria for pathologic myopia
spherical equivalent >-8.00D or axial length >26mm
57
what retinal tears need to be treated in case of retinal detachment
horseshoe tears or total dialysis
58
what is a rhegmatogenous PVD
retinal break leads to retinal detachment
59
what is a non-rhegmatogenous PVD
traction or exudate forms scar tissue or exudative fluid that pushes off the retina
60
cause of traction leading to retinal detachment
diabetes
61
cause of exudative retinal detachment
``` choroid tumours post scleritis haradas toxaemia of pregnancy hypoproteinaemia RD surgery excess retinal photocoag choroid neovascularisation uveal effusion ```
62
signs of exudate behind retina?
convex, smooth elevation | may be mobile with fluid shift
63
what is central serous chorioretinopathy
small, focal RPE leak young pt, male, healthy, 30-50, executive job most recover, some recur
64
causes of cystoid macular oedema
``` postop uveitis retinal venous occlusive disease choroid neovascualrisation epiretinal membrane retinitis pigmentosa ```
65
Ia macular hole?
foveolar detachment
66
II macular hole?
full thickness defect <400mm
67
III macular hole
full thickness defect >400mm
68
IV macular hole
stage III with PVD

MB2: Ophthalmology (8 decks)

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