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Ophthalmology 2 Flashcards

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1
Q

What is blepharitis?

A

Inflammation of eyelid margins
Meibomian gland dysfunction

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2
Q

What is a stye?

A

Infection of the glands of the eyelid

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3
Q

What is a chalazion?

A

Meibomian cyst

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4
Q

What is entropion?

A

In-turning of eyelids

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5
Q

What is ectropion?

A

Out turning of eyelids

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6
Q

Mx stye (2)

A

Hot compress and analgesia

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7
Q

A dendritic corneal ulcer is a common presentation of what condition?

A

Herpes simplex keratitis

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8
Q

Herpes simplex keratitis features (5)

A

Red, painful eye,
Epiphora - excessive tear production
Photophobia
Reduced vision

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9
Q

Fluorescein staining for herpes simplex keratitis may show?

A

Epithelial ulcer

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10
Q

Rx herpes simplex keratitis (2)

A

Urgent ophthalmology referral
Aciclovir

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11
Q

Vesicular rash around eye = which condition?

A

Herpes zoster ophthalmicus

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12
Q

What is Hutchinson’s sign?
Which condition?

A

Rash on the tip or side of the nose
Herpes zoster ophthalmicus

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13
Q

Mx herpes zoster ophthalmicus (3)
When should treatment start?

A

Urgent ophthalmology review if eye involvement
Oral aciclovir for 7-10 days
Topical steroids if any inflammation of the eye

Start within 72 hours

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14
Q

Hypertensive retinopathy classification (4)

A

I - arterial narrowing + tortuosity, silver wiring
II arteriovenous nipping
III - cotton wool exudates, flame and blot haemorrhages
IV - papilloedema

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15
Q

Bacterial (2) versus viral conjunctivitis (3)

A

Bacterial - purulent discharge, eyes tuck together
Viral - serous discharge, recent URTI, pre-auricular lymph nodes

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16
Q

Mx infective conjunctivitis
How long will it last?
Rx for non pregnant and pregnant people

A

Normally self limiting 1-2 weeks
Chloramphenical drops 2-3 hourly or ointment QDS
Pregnant - Fusidic acid rx BD

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17
Q

What is keratitis?

A

Inflammation of the cornea

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18
Q

Pseudomonas aeruginosa causing keratitis is seen in what kind of patients?

A

Contact lens wearers

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19
Q

Most common bacteria causing keratitis

A

Staph Aureus

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20
Q

Amoebic keratitis more common with exposure to?

A

Soil or contaminated water

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20
Q

Keratitis features (4)

A

Red painful eye
Grittiness
Hypopyon - pool of white cells
Photophobia

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21
Q

Mx keratitis (2)

A

Topical quinolones
Cycloplegic for pain relief

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22
Q

What is epiphora?

A

Watering eye

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23
Q

What is dacryocystitis?

A

Infection of the lacrimation sac

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24
Dacryocystitis features (2)
Epiphora Swelling and erythema at the inner canthus of the eye
25
Congenital lacrimal duct obstruction usually resolves at what age?
12 months
26
Causes of mydriases (dilated pupil) (3)
Third nerve palsy Phaeo Holmes adie
27
What is the most common cause of a persistent watery eye in an infant?
Nasolacrimal duct obstruction
28
Nasolacrimal duct obstruction mx (1) Majority resolve in how long? When do you refer?
Massage of lacrimal duct Majority resolve by 1 year Otherwise ophthalmology referral
29
What is hyphema? Mx (3)
Blood in the anterior chamber of the eye Strict bed rest + daily ophthal review + daily IOP checks
30
Rock hard eyelids RAPD Proptosis Eye pain =
Orbital compartment syndrome
31
Orbital compartment syndrome mx
Urgent lateral canthotomy
32
Causes of optic neuritis (3)
MS Diabetes Syphyillis
33
Pain worse on eye movement RAPD Central scotoma Red desaturation (poor differentiation of colours) Unilateral decrease in visual acuity over hours or days = which condition?
Optic neuritis
34
Mx optic neuritis Recovery length
High dose steroids 4-6 weeks
35
Features of papilloedema (6)
Venous engorgement Loss of venous pulsation Optic disc blurring Elevation of optic disc Loss of optic cup Paton's lines VELLOP
36
Papilloedema causes (8)
Hydrocephalus Idiopathic intracranial hypertension Malignant hypertension Vitamin A toxicity Hypoparathyroidism Space occupying lesions Hypercapnia Hypocalcaemia
37
What is glaucoma?
Optic neuropathies associated with raised IOP which in turn damages the optic nerve
38
Raised IOP =
IOP >24mmHg
39
Open angle glaucoma Mx 1st line (1) 2nd line (3)
1st line PG analogue 2nd line BB Carbonic anhydrase inhib Sympathomimetic eyedrop
40
Example of PG analogue
Latanoprost
41
Example (2) of BB in context of eye drops
Timolol Betaxolol
42
Sympathomimetics example
Brimonidine
43
Carbonic anhydrase example (1)
Dorzolamide
44
Miotics examples (1)
Pilocaripine
45
All except which two medications reduce aqueous production? (Medications for the management of primary open angle glaucoma)
Miotics PG analogues
46
RF glaucoma (7)
Age FH Afro Caribbean Myopia (near sightedness) HTN DM Steroids
47
Open angle glaucoma features Onset (2 further features)
Insidious Peripheral visual field loss (tunnel vision) Optic disc cupping
48
Name five fundoscopy signs of POAG
Optic disc cupping Optic disc pallor Bayonetting of vessels Cup notching Disc haemorrhages
49
Severe pain, red eye Vision loss Haloes Semi-dilated pupil Hazy cornea = which condition?
Acute angle closure glaucoma
50
Red eye, pain, visual loss following intraocular surgery =
Endophthalmitis
51
Purulent discharge, clear discharge =
Bacterial/ viral conjunctivitis
52
Trauma + coughing bouts + red eye + normal vision = How long till it resolves?
Subconjunctival haemorrhage 2-3 weeks
53
Severe pain, worse on movement, underlying autoimmune condition =
Scleritis
54
Small, fixed, oval pupil, ciliary flush Pain, red eye, blurred vision and photophobia =
Anterior uveitis
55
What is RAPD? AKA
Swinging light test Pupil dilates when light is shone Marcus Gunn pupil
56
RAPD causes (2)
Retinal detachment Optic neuritis
57
Pupillary light reflex Nerves
In on two out on three Retina --> optic nerve --> lateral geniculate body --> midbrain Edinger Westphal nucleus (midbrain) --> occulomotor nerve
58
New onset floaters or flashers Sudden onset, painless progressive visual field loss Curtain or shadow Loss of red reflex =
Retinal detachment
59
Retinal detachment RF (5)
Diabetes Myopia (near sightedness) Age Prev surgery for cataracts Eye trauma
60
Tunnel vision Night blindness is the initial sign Black bone spicule shaped pigmentation =
Retinitis pigmentosa
61
RA ocular manifestations (x5 total) Most common =
Keratoconjunctivitis sicca Episcleritis Scleritis Corneal ulceration Keratitis
62
What is the cover test in identifying the nature of a squint? Mx
Ask the child to focus on an object Cover one eye Observe movement of the other eye Cover other eye and repeat test Mx refer to secondary care

AKT (52 decks)

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