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Difficult concepts > Ophtalmology > Flashcards

Ophtalmology Flashcards

(54 cards)

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1
Q

Age related macular degeneration types

A

Wet - with neovascularisation, 10% of cases

Dry - 90% of cases

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2
Q

Age related macular degeneration findings

A

Drusen (yellow protein and lipid deposits between retinal pigment and Bruch’s membrane)
Atrophy of retinal pigment epithelium
Photoreceptor degeneration
Neovascularisation from choroid in wet AMD

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3
Q

AMD risk factors

A

Older
Smoking
FHx
CVD
Obesity
Diet high in fat and low in vitamins

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4
Q

Presentation of AMD

A

Gradual central vision loss
Reduced visual acuity/struggle reading
Wavy appearance of straight lines (metamorphosia)

Wet more acute (complete 2-3 years)

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5
Q

Examination findings in AMD

A

Reduced visual acuity
Scotoma
Amsler grid test abnormal
Drusen on fundoscopy

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6
Q

Investigations in AMD

A

Amsler grid test
Snellen chart
Fundoscopy
Slit lamp
Optical coherence tomography - moniotring
Fluorescin angiography - wet

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7
Q

Treatment for AMD

A

Wet - anti-VEGF (ranibizumab, aflibercept, bevacizumab) once a month injections

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8
Q

Grading of diabetic retinopathy

A

Fundoscopy

Background
Pre-proliferative
Proliferative

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9
Q

Background diabetic retinopathy findings

A

microaneurysms, retinal haemorrhages, hard exudates (yellow-white deposits of protein and lipids), cotton wool spots (damage to nerves)

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10
Q

Pre-proliferative diabetic retinopathy changes

A

venous beading, multiple blot haemorrhages, intraretinal microvascular abnormality (tortuous and dilated cappilaries, shunt)

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11
Q

Proliferative diabetic retinopathy changes

A

neovascularisation
vitreous haemorrhage

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12
Q

Diabetic maculopathy

A

Exudates within the macula
Macular oedema

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13
Q

Complications of diabetic retinopathy

A

Vision loss
retinal detachment
Vitreous haemorrhage
Rubeosis iridis (can lead to neovascular glaucoma)
Optic neuropathy
Cataracts

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14
Q

Managment of non-proliferative diabetic retinopathy

A

Close monitoring
glycaemic control

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15
Q

Managment of proliferative diabetic retinopathy

A

Pan retinal photocoagulation
Anti-VEGF
Surgery (vitrectomy)

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16
Q

Macular oedema treatment

A

Intravitreal dexamethasone implant

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17
Q

Findings in hypertensive retinopathy

A

Silver wiring
AV nipping
Hard exudates
Cotton wool spots
Retinal haemorrhages
Papilloedema

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18
Q

Keith Wagener classification of hypertensive retinopathy

A

1 - mild arteriole narrowing
2 - focal constriction of vessels, AV nicking
3 - cotton wool spots, exudates and haemorrhages
4 - papilloedema

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19
Q

Risk factors for cataracts

A

Age
Smoking
Diabetes
Alcohol
Steroids
Hypocalcaemia

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20
Q

Cataract presentation

A

Asymmetrical
Progressively opaque lens
Slow reduction in visual acuity
Progressive blurring
Faded colours
Starbursts around light

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21
Q

Examination findings in cataract

A

Loss of red redlex
Ophtalmoscope - lens gray

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22
Q

Managment of cataracts

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A

None
Surgery - artifical lens

23
Q

Complication of cataract surgery

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A

Endophatlmitis
- vision loss
-intravitreal Abx

24
Q

Causes of an acute painless red eye include

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A

Conjunctivitis
Episcleritis
Subconjunctival haemorrhage

25
Causes of an acute painful red eye include
Acute angle-closure glaucoma Anterior uveitis Scleritis Corneal abrasions or ulceration Keratitis Foreign body Traumatic or chemical injury
26
Conjunctivitis does not need treatment exepct
In neonates Neonates under one month with conjunctivitis need urgent ophthalmology assessment. Neonatal conjunctivitis may be caused by gonococcal infection, which can cause serious complications (e.g., permanent vision loss)
27
Anterior uveitis inspection findings
Hypopyon refers to a fluid collection containing inflammatory cells seen at the bottom of the anterior chamber on inspection
28
Anterior uveitis associated conditions
Seronegative spondyloarthropathies IBD Sarcoidosis Behcets disease
29
Anterior uveitis presentation
Pain, red eye Reduced visual acuity Photophobia Lacrimation
30
Examination findings in anterior uveitis
Ciliary flush (red ring) Miosis Abnormal shape of pupil Hypopyon
31
Managment of anterior uveitis
Ophtalmology Steroids Cycloplegics (cyclopentolate/atropine drops)
32
Scleritis associated conditions
RA Vasculitis (gwpa)
33
Scleritis vs episcleritis
Scleritis painful and affects eye function, should be referred phenylephrine drops will blanch vessels in episcleritis, episcleritis more acute
34
Organism associated with contact lense abrasion + differential
Pseudomonas Herpes keratitis
35
Lubricating eye drops
Hypromellose drops are the least viscous (the effects last around 10 minutes) Polyvinyl alcohol drops are the middle viscous choice Carbomer drops are the most viscous (the effects last about 30-60 minutes)
36
Investigation for herpes keratitis
Slit lamp - gold standard Fluorescein - dendritic corneal ulcer Corneal scrapings for virology
37
Managment of herpes keratitis
Referral urgently topical/oral aciclovir corneal transplant if permanent damage
38
Risk factors for subconjunctival haemorrhage
Hypertension Bleeding disorders (e.g., thrombocytopenia) Whooping cough Medications (e.g., antiplatelets, DOACs or warfarin) Non-accidental injury
39
Subconjunctival haemorrhage presentation
Bright red blood painless NOT affecting vision
40
Managment of subconjunctival haemorrhage
None Lubricant
41
Retinal detachment risk factors
Lattice degeneration Posterior vitreous detachment Trauma Diabetic retinopathy Retinal malignancy FHx
42
Retinal detachment presentation
Peripheral vision loss (curtain) Blurry vision Flashes and floaters
43
Managment of retinal detachment
Immediate referral Tear - laser/cryotherapy Detachment - vitrectomy, scleral buckle, pneumatic retinopexy
44
Retinal vein occlusion risk factors
Hypertension High cholesterol Diabetes Smoking High plasma viscosity (myeloma) Myeloproliferative disorders Inflammatory conditions (SLE)
45
46
Fundoscopy findings in retinal vein occlusion
Macular oedema Retinal haemorrhages Dilated tortuous retinal veins Flame and blot haemorrhages Cotton wool spots Hard exudates
47
Managment of retinal vein occlusion
Immediate referral Treat oedema and neovascularisation Anti-VEGF (ranibizumab, aflibercept) Dexamethasone intravitreal implant Laser photocoagulation
48
Central retinal artere occlusion risk factors
Atherosclerosis/CVD Giant cell arteritis - white, old, femal, polymyalgia rheumatica
49
Retinal artery occlusion presentation
Sudden painless loss of vision - curtain coming down
50
Retinal artery occlusion findings
Relative afferent pupillary defect Pale retina and cherry red spot
51
Retinal artery occlusion managment
ESR + temporal artery biopsy occular massage anterior chamber paracentesis inhaled carbogen sublingual isosorbide dinitrate oral pentoxifylline IV acetazolamide IV mannitol topical timolol
52
What does retinitis pigmentosa affect
Rods
53
Retinitis pigmentosa presentation
Night blindness
54
Retinitis pigmentosa fundoscopy
Bone spicule pigmentation

Difficult concepts (9 decks)

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