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FLASH FINALS > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Acute angle closure glaucoma predisposing factors

A

Hypermetropia
Pupillary dilation
lens growth assoc. w/ age

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2
Q

Acute angle closure glaucoma features

A

Semi-dilated non-reacting pupil
haloes around lights, symptoms worse w/ mydriasis
severe pain w/ vomiting

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3
Q

Acute angle closure glaucoma mx.:

A

Pilocarpine (parasympathomimetic)
Timolol
a2-agonist

IV acetazolamide

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4
Q

Acute angle closure glaucoma definitive mx.:

A

Laser peripheral iridotomy

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5
Q

Distortion of line perception on amsler grid testing

A

Age-related macular degeneration

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6
Q

Dry age-related macular degeneration tx.

A

Combination of zinc and anti-oxidant vitamins A,C,E

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7
Q

Wet macular degeneration tx:

A

anti-VEGF (ranibizumab, bevacizumab, pegaptanib)

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8
Q

Allergic conjunctivitis mx:

A

Topical or systemic anti-histamines

Mast-cell stabilisers - sodium cromoglicate

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9
Q

Anterior uveitis pupil:

A

Small, irregular due to sphincter muscle contraction

Hypopyon

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10
Q

Anterior uveitis tx.

A

Urgent review
Cycloplegics (dilate pupil to relieve pain/photophobia)
Steroid eye drops

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11
Q

Argyll-Robertson pupil

A

Small irregular pupils which do NOT react

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12
Q

Anterior blepharitis causative conditions:

A

Seborrhoeic dermatitis/staphylococcal infection

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13
Q

Posterior blepharitis causative conditions

A

Meibomian gland dysfunction

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14
Q

Metabolic disorder causing cataracts

A

Hypocalcaemia

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15
Q

Reduced vision, fading colour vision, glare (lights appearing brighter than usual), haloes around lights

A

Cataracts

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16
Q

Non-proliferative diabetic retinopathy - features of moderate disease:

A

Microaneurysm, blot haemorrhages, hard exudate

cotton wool spots (infarction)

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17
Q

Non-proliferative diabetic retinopathy - features of severe disease:

A

Blot haemorrhages and microaneurysms in 4 quadrants
venous beading in at least 2 quadrants
IRMA in at least 1 quadrant

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18
Q

Key features of proliferative diabetic retinopathy

A

Retinal neovascularisation
fibrous tissue forming anterior to retinal disc
more common in T1DM

MACULOPATHY

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19
Q

Management for maculopathy in PDR

A

Anti-VEGF

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20
Q

Management PDR:

A

Panretinal laser photocoagulation
intravitreal VEGF inhibitors
vitreoretinal surgery

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21
Q

Topical chemical used to differentiate between scleritis and episcleritis

A

Phenylephrine

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22
Q

Herpes simplex keratitis mx:

A

Immediate referral

Topical aciclovir

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23
Q

What is Hutchinson’s sign:

A

Herpes zoster ophthalmicus
Rash on the tip or side of the nose, indicates nasocilliary involvement and is a strong risk factor for ocular involvement

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24
Q

Herpes zoster ophthalmicus mx.:

A

ORAL antiviral treatment for 7-10 days

Topical anti-viral is not given
Topical corticosteroids may be given to treat any inflammation in the eye

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25
Q

Holmes-adie pupil:

A 
Dilated pupil (unilateral m/c) 
once pupil has constricted it remains small for an abnormally long time
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26
Q

Holmes-adie syndrome:

A

Holmes-adie pupil w/ absent ankle/knee reflexes

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27
Q

Horner’s syndrome: central lesion cause:

A

Anhidrosis of the face arm and trunk

28
Q

Horner’s syndrome examples of central lesions:

A 
Stroke 
Syringomyelia 
Multiple sclerosis 
Tumour 
Encephalitis
29
Q

Horner’s syndrome: pre-ganglionic lesions cause ->

A

Anhidrosis of the face only

30
Q

Horner’s syndrome: examples of pre-ganglionic lesions

A

pancoast TUMOUR
Thyroidectomy
Trauma
cervical rib

The Ts

31
Q

Horner’s syndrome: post-ganglionic lesions cause ->

A

No anhidrosis

32
Q

Horner’s syndrome: examples of post-ganglionic lesions:

A

Carotid artery dissection
Carotid aneurysm
Cavernous sinus thrombosis
Cluster headache

The Cs

33
Q

Hypertensive retinopathy stages:

A

I - Arteriolar narrowing and tortuosity, silver wiring, increased light reflex

II - AV nipping

III - Cotton-wool exudates, flame and blot haemorrhages

IV - Papilloedema

34
Q

Infective conjunctivitis: symptoms settle themselves w/in

A

1-2 weeks

35
Q

Antibiotic commonly offered in infective conjunctivitis:

A

Chloramphenicol - should not be given to pregnant women - topical fusidic acid instead

36
Q

Keratitis (inflammation of the cornea) causative

bacterial organisms:

A

Staph aureus

Pseudomonas aeruginosa in contact lens wearers

37
Q

Other causative organisms in keratitis:

A

Amoebic - acanthomoebic keratitis - increased incidence if eye exposure to soil or contaminated water

Parasitic - river blindness

38
Q

Keratitis management:

A

STOP contact lenses
Topical QUINOLONES first line
cycloplegic (cyclopentolate) for pain relief

39
Q

Causes of mydriasis

A

CN3 palsy
Holmes-Adie pupil
traumatic iridoplegia
phaechromocytoma

Drug causes: 
Atropine
Amphetamines 
Cocaine 
TCA
40
Q

Orbital compartment syndrome features:

A 
Eye-pain
Swelling 
Proptosis
Rock-hard eyelids 
RAPD
41
Q

Orbital compartment syndrome mx.:

A

Urgent lateral canthotomy (before diagnostic imaging) to decompress orbit

42
Q

Unilateral decrease in visual acuity over hours or days
Red desaturation - poor discrimination of colours
central scotoma
RAPD
Pain ++

A

Optic neuritis

43
Q

Investigation for orbital cellulitis:

A

CT w/ contrast

44
Q

Most common organisms in orbital cellulitis:

A

Streptococcus, staphylococcus, Haemophilus influenzae b

45
Q

Posterior vitreous detachment: symptoms

A 
Sudden appearance of floaters 
Flashes of light in vision 
Blurred vision 
Cobweb across vision 
Appearance of dark curtain descending down vision (means there is also retinal detachment)
46
Q

Posterior vitreous detachment investigations:

A

All should be examined by an ophthalmologist within 24 hours

47
Q

Posterior vitreous detachment management:

A

Symptoms gradually improve over a period of 6 months w/out treatment
if there is a tear then surgery will be required

48
Q

Pre-septal cellulitis management:

A

All cases to secondary care for assessment
Oral antibiotics are usually sufficient
CO-AMOXICLAV

49
Q

Investigation for increased intra-ocular pressure:

A

Applanation tomography

50
Q

Investigation for visual fields:

A

Automated perimetry

51
Q

Mode of action - sympathomimetics in reducing ocular pressure

A

Reduce aqueous production and increases outflow

52
Q

Examples of sympathomimetics:

A

Brimonidine - a2 receptor antagonist

53
Q

Mode of action carbonic anhydrase inhibitors

A

Reduces aqueous production

54
Q

Examples of miotics:

Mechanism of action

A

Pilocarpine - muscarinic receptor agonist

Increase uveoscleral outflow

55
Q

Normal cup to disc ratio

Cup to disc ratio in glaucoma

A

0.4-0.7

>0.7

56
Q

Other name for RAPD:

A

Marcus-Gunn pupil

57
Q

Pathway of pupillary light reflex:

A

Afferent = Retina -> optic nerve -> lateral geniculate body -> midbrain

Efferent: Edinger-Westphal nucleus -> oculomotor nerve

58
Q

Retinitis pigmentosa initial sign:

A

Night-blindness

59
Q

What is retinitis pigmentosa:

A

Primarily affects the peripheral retina resulting in tunnel vision

60
Q

Retinitis pigmentosa on fundoscopy:

A

Black bone spicule-shaped pigmentation in the peripheral retina mottling of the retinal pigment epithelium

61
Q

Occular manifestations of rheumatoid arthritis:

A 
Keratoconjunctivitis sicca (Most common)
Episcleritis 
scleritis 
corneal ulceration 
keratitis
62
Q

What condition may an untreated squint lead to:

A

Ambylopia

63
Q

Causes of vitreous haemorrhage:

A

Diabetes, bleeding disorders, anticoagulants

64
Q

Vitreous haemorrhage px.

A

Painless visual loss or haze
Red hue in the vision
Floaters or shadows/dark spots

65
Q

Vision loss in macular degeneration

A

Reduction in VISUAL ACUITY
Difficulty in dark adaptation
Deterioration in vision at night
Photopsia

FLASH FINALS (34 decks)

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