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Phase 3b/Finals revision > Ophthalmology > Flashcards

Ophthalmology Flashcards

(54 cards)

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1
Q

Risk factors for age-related macular degeneration

A

Advancing age
Female > male
Smoking
FHx
Hypertension, dyslipidaemia + DM - cardiovascular disease
White or Chinese ethnic origin

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2
Q

Characteristic features of dry macular degeneration

A

Atrophics
Drusen - yellow round spots in Bruch’s membrane

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3
Q

Characteristic features of wet macular degeneration

A

Choroidal neovascularisation

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4
Q

Features of both wet + dry macular degeneration

A

Atrophy of retinal pigment epithelium
Degeneration of photoreceptors
Can have drusen in bot

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5
Q

Symptoms of ARMD

A

Gradual worsening central visual field loss
Reduced visual acuity
Crooked or wavy appearance to straight lines

More acute in wet

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6
Q

Signs of ARMD

A

Amsler grid test - distortion of straight ligns
Snellen chart - reduced acuity
Scotoma - central patch of vision loss
Fundoscopy –> Drusen

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7
Q

Managament of dry AMD

A

Lifestyle measures to slow progression:
- Avoid smoking
- Control blood pressure
- Vitamin supplementation

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8
Q

Management of wet AMD

A

Anti-VEGF (vascular endothelial growth factor) medications e.g.
- Ranibizumab
- Bevacizumab
- Pegaptanib
injected into vitreous chamber once a month

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9
Q

Risk factors for vitreous haemorrhage

A

Diabetes - proliferative diabetic retinopathy is most common cause
Trauma
Anticoagulants
Coagulation disorders
Severe short sightedness

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10
Q

Symptoms of vitreous haemorrhage

A

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

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11
Q

Signs of vitreous haemorrhage

A

Decreased visual acuity
Visual field defect if severe haemorrhage

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12
Q

Pathophysiology of acute angle-closure glaucoma

A

Rise in intraocular pressure, secondary to impairment of aqeuous outflow

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13
Q

Factors predisposing to acute angle-closure glaucoma//risk factors

A

Hypermetropia (long-sightedness)
Pupillary dilatation
Lens growth associated with age
Increasing age
Female
FHx
Chinese + East Asian ethnic origin
Shallow anterior chamber

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14
Q

Glaucoma

A

Optic nerve damage caused by significant rise in intraocular pressure

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15
Q

Medications that may precipitate acute angle-closure glaucoma

A

Adrenergic medications e.g. noradrenlaine
Anticholingeric medications e.. oxybutynin + solifenacin
Tricyclic antidepressants e.g. amitryptiline, due to anti-cholinergic effects

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16
Q

Symptoms of AACG

A

Severely painful red eye
Blurred vision
Halos around lights
Headache, N+V

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17
Q

Signs of AACG

A

Red-eye
teary
Hazy cornea
Decreased visual acuity
Dilatation of pupil
Fixed pupil size
Firm eyeball on palpation

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18
Q

Initial management of AACG

A

Lie on back without pillow
Pilocarpine eye drops - to constrict pupil
Acetazolamide 500mg oral
Analgesia + antiemetic

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19
Q

Medical options for secondary care management of AACG

A

Pilocarpine
Acetazolamide - oral or IV
Hyperosmotic agents e.g. glycerol or mannitol
Timolol = beta-blocker
Dorzolamide
Brimonidine

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20
Q

Definitive treatment for AACG

A

Laser iridotomy

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21
Q

Blepharitis

A

Inflammation of eyelid margins

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22
Q

Causes/associations with blepharitis

Study These Flashcards
A

Meibomian gland dysfunction
Seborrhoeic dermatitis/staphylococcal infection
More common in rosacea

23
Q

Feature of blepharitis

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A

Usually bilateral
Grittiness + discomfort - especially around eyelid margins
Eyes may be sticky in morning
Eyelid margins may be red
Can lead to styes + chalazions

24
Q

Management of blepharitis

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A

Hot compresses twice daily
Gentle cleaning of eyelid margins - use cotton wool dipped in sterilised water + baby shampoo
Consider lubricating eye drops e.g. hypromellose, polyvinyl alcohol + carbomer

25
Risk factors for retinal detachment
Posterior vitreous detachment Diabetic retinopathy Trauma to the eye Retinal malignancy Older age Family History
26
Presentation of retinal detachment
Flashes + floaters = key Painless Peripheral vision loss - sudden + like a shadow Blurred or distorted vision
27
Management of retinal detachment
Immediate ophthalmology referral Reattach retina --> - Vitrectomy - Scleral buckling - Pneumatic retinopexy
28
Where is aqueous humour found
In the anterior chamber - between cornea + iris In the posterior chamber - between lens + iris
29
Normal intraocular pressure
10-21mmHg
30
Open-angle glaucoma pathophysiology
Gradual increase in resistance through the trabecular meshwork --> aqueous humour cannot exit the eye easily --> gradual increase in pressure
31
What causes cupping of the optic disc
Increased pressure in the eye --> pressure on indent, making it wider + deeper
32
What is cupping of the optic disc
When optic cup (central indent in optic disc) > half size of optic disc
33
Presentation of open-angle glaucoma
Often asymptomatic Affects peripheral vision first --> tunnel vision Gradual onset of fluctuating pain, headaches, blurred vision + halos around lights (esp. at night)
34
Risk factors for open angle glaucoma
Increasing age Family History Afro-Caribbean ethnicity Myopia Hypertension Diabetes Mellitus Corticosteroids
35
Signs of open angle glaucoma on fundoscopy
Optic disc cupping Optic disc pallor (atrophy) Bayonetting of vessels Cup notching, disc haemorrhages
36
First line management of open angle glaucoma
Started if intraocular pressure >24 mmHg Prostaglandin analogue eye drops e.g. latanoprost
37
Risk factors for central retinal artery occlusion
Same as for other cardiovascular disease as most common cause = atherosclerosis Also caused by giant cell arteritis --> higher risk if white, >50, already affected by GCA or PMR
38
Presentation of central retinal artery occlusion
Sudden, painless loss of vision Relative afferent pupillary defect
39
Fundoscopy findings in central retinal artery occlusion
Pale retina/opacified Cherry-red spot (macula showing choroid below)
40
Immediate management of central retinal artery occlusion
Immediate ophthalmology referral Ocular massage Remove fluid from anterior chamber Inhaling carbogen to dilate artery Sublingual isosorbide dinitrate Treat + manage underlying condition e.g. GCA with high-dose steroids
41
Stage I hypertensive retinopathy
Mild narrowing of arterioles Increased light reflex
42
Stage II hypertensive retinopathy
Arteriovenous nipping
43
Stage III hypertensive retinopathy
Cotton-wool exudates Flame and blot haemorrhages --> may collect around fovea, causing 'macular star'
44
Stage IV hypertensive retinopathy
Papilloedema
45
What is silver wiring
aka copper wiring Walls of arterioles become thickened + sclerosed --> increased reflection of light
46
What is arteriovenous nipping
Arterioles cause compressions of veins when they cross, due to sclerosis + hardening of the arterioles
47
Features of mild non-proliferative diabetic retinopathy
Microaneurysms
48
Features of moderate non-proliferative diabetic retinopathy
Microaneurysms Dot + blot haemorrhages Hard exudates Cotton wool spots Venous beading
49
Features of severe non-proliferative diabetic retinopathy
Blot haemorrhages + microaneurysms in 4 quadrants Venous beading in 2 quadrates Intraretinal microvascular abnormality in any quadrant
50
Features of proliferative diabetic retinopathy
Neovascularisation Vitreous haemorrhage
51
Diabetic maculopathy
Macular oedema Ischaemic maculopathy
52
Complications of diabetic retinopathy
Retinal detachment Vitreous haemorrhage Rebeosis iridis - new vessel formation in iris Optic neuropathy Cataracts
53
Management of diabetic retinopathy
Laser photocoagulation Anti-VEGF medications Vitreoretinal surgery
54
Scleritis
Inflammation of full thickness of the sclera

Phase 3b/Finals revision (17 decks)

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