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Flashcards in Ophthalmology Deck (130):
1

CNIII palsy

down + out pupil (diplopia), ptosis, mydriasis

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down + out pupil, ptosis, mydriasis

CNIII palsy

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surgical CNIII palsy

down + out pupil (diplopia), ptosis, mydriasis, fixed dilated pupil

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down + out pupil, ptosis, mydriasis, fixed dilated pupil

surgical CNIII palsy

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ciliary body produces

aqueous humour

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aqueous humour is produced by the

ciliary body

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Horner's syndrome

partial ptosis, fixed constricted pupil

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partial ptosis, fixed constricted pupil

Horner's syndrome

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superior oblique is supplied by

CNIV

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CNIV supplies the

superior oblique

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lateral rectus is supplied by

CNVI

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CNVI supplies the

lateral rectus

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surgical CNIII palsies are most likely caused by

posterior communicating artery aneurysms

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(non-surgical) CNIII palsies are more likely caused by

ischaemia

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levator palpebrae

lid opening, CNIII

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Muller muscle

lid opening, sympathetic

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orbicularis oculi

lid closing, CNVII

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why partial ptosis in Horner's?

sympathetic affected, levator palpebrae superior still able to open the eye a bit

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lid opening, CNIII

levator palpebrae

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lid opening, sympathetic

Muller muscle

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lid closing, CNVII

orbicularis oculi

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8-20 mmHg

normal intraocular pressure

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things to describe on fundoscopy (optic disk)

colour, CDR, contour, anything else (tortuous blood vessels, neovascularisation, haemorrhage, drusen)

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Argyll-Robertson pupil

small irregular pupils, no response to light but response to accommodate

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small irregular pupils, no response to light but response to accommodate

Argyll-Robertson pupil

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Argyll-Robertson pupil

ARP but PRA = accommodation reflex present but pupillary reflex absent

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ARP but PRA = accommodation reflex present but pupillary reflex absent

Argyll-Robertson pupil

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Holmes-Adie pupil

ux, dilated pupil, once constricted remains small for a long time

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ux, dilated pupil, once constricted remains small for a long time

Holmes-Adie pupil

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Holmes-Adie pupil is associated with

absent ankle/knee reflexes

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absent ankle/knee reflexes are associated with

Holmes-Adie pupil

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Argyll-Robertson pupil is caused by

diabetes mellitus, syphilis

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diabetes mellitus, syphilis can cause

Argyll-Robertson pupil

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ghost veins

sign of a previous occlusion, remnants of the vessel

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sign of a previous occlusion, remnants of the vessel

ghost vessels

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blot haemorrhage vs aneurysm on fundoscopy

can't tell the difference

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asteroid hyalosis

degenerative condition, small white opacities in vitreous humour

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degenerative condition, small white opacities in vitreous humour

asteroid hyalosis

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ocular hypertension

intraocular presssure over 20, without nerve damage

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intraocular presssure over 20, without nerve damage

ocular hypertension

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glaucoma pressure

intraocular presssure over 20, with nerve damage

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intraocular presssure over 20, with nerve damage

glaucoma

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posterior vitreous detachment

age related change where vitreous shrinks and pulls some of the retina with it

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age related change where vitreous shrinks and pulls some of the retina with it

posterior vitreous detachment

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photocoagulation

using laser to seal off holes in retina, shrink unhealthy tissue/blood vessels

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using laser to seal off holes in retina, shrink unhealthy tissue/blood vessels

photocoagulation

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drusen

yellow round spot in Bruch's membrane, linked with dry/early age-related macular degeneration

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yellow round spot in Bruch's membrane, linked with dry/early age-related macular degeneration

drusen

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types of AMD (age-related macular degeneration)

dry/early = drusen, changes to retinal pigment epithelium
wet/late = exudative, choroidal neovascularisation, worse prognosis, potential for rapid decrease in visual acquity

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AMD (age-related macular degeneration) risk factors

over 60, smoking, family history, Caucasian, sunlight exposure, female sex

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over 60, smoking, family history, Caucasian, sunlight exposure and female sex are risk factors for what

age-related macular degeneration

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features of age-related macular degeneration

reduced visual acquity (blurred, distorted, central vision affected first, straight lines appear crooked/wavy), central scotoma

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reduced visual acquity (blurred, distorted, central vision affected first, straight lines appear crooked/wavy), central scotoma are features of

age realted macular degeneration

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general treatment for age related macular degeneration

stop smoking, high dose beta carotene, vitamins C, E, zinc

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stop smoking, high dose beta carotene, vitamins C, E, zinc is advised in

age related macular degeneration

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wet/late age-related macular degeneration treatment

photocoagulation, photodynamic therapy, anti-VEGF

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photocoagulation, photodynamic therapy, anti-VEGF is treatment for

wet/late age related macular degeneration

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general cataract causes

age, sunlight exposure

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age, sunlight exposure generally cause

cataracts

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systemic causes of cataracts

diabetes mellitus, steroids, infection (congenital rubella), metabolic (hypocalcaemia, galactosaemia), myotonic dystrophy, Down syndrome

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diabetes mellitus, steroids, infection (congenital rubella), metabolic (hypocalcaemia, galactosaemia), myotonic dystrophy, Down syndrome are systemic causes of

cataracts

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ocular causes of cataracts

trauma, uveitis, high myopia, topical steroids

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trauma, uveitis, high myopia, topical steroids are ocular causes of

cataracts

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classification of cataracts

nuclear = change lens refractive index, common in elderly
polar = localised, inherited, in visual axis
subcapsular = steroid use, in visual axis
dot opacities = normal lenses, diabetes, myotonic dystrophy

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acute angle closure glaucoma symptoms

red eye, severe pain, reduced visual acquity, hazy cornea, haloes, semi-dilated pupil

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anterior uveitis symptoms

red eye, acute onset, pain, blurred vision, photophobia, small fixed oval pupil, ciliary flush

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red eye, severe pain, reduced visual acquity, hazy cornea, haloes, semi-dilated pupil are symptoms of

acute angle closure glaucoma

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red eye, acute onset, pain, blurred vision, photophobia, small fixed oval pupil, ciliary flush are symptoms of

uveitis

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scleritis symptoms

red eye, severe pain (maybe worse on movement), tenderness, ?underlying autoimmune condition e.g. rheumatoid arthritis

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red eye, severe pain (maybe worse on movement), tenderness, ?underlying autoimmune condition e.g. rheumatoid arthritis are symptoms of

scleritis

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conjunctivitis symptoms

red eye, purulent discharge (bacterial), clear discharge (viral)

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red eye, purulent discharge (bacterial), clear discharge (viral) are symptoms of

conjunctivitis

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subconjunctival haemorrhage

red eye, history of trauma/coughing

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red eye, history of trauma/coughing are symptoms of

subconjunctival haemorrhage

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blepharitis causes

meibomian gland dysfunction (common posterior blepharaitis), or seborrhoeic dermatitis/staphylococcal infection (less common, anterior blepharitis)

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meibomian gland dysfunction (common posterior blepharaitis), or seborrhoeic dermatitis/staphylococcal infection (less common, anterior blepharitis) are causes of

blepharitis

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blepharitis is more common in patients with

roseacea

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patients with roseacea are more likely to develop

blepharitis

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features of blepharitis

bilateral, grittiness, discomfort around lid margins, morning sticky eyes, red eyelid margins, swollen in staphylococal blepharitis, styes + chalaxion are more common, secondary conjunctivitis may occur

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bilateral, grittiness, discomfort around lid margins, morning sticky eyes, red eyelid margins, swollen, styes + chalaxion are more common, secondary conjunctivitis may occur in

blepharitis

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management of blepharitis

hot compressions BD, mechanical removal of debris, artificaial tears

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hot compressions BD, mechanical removal of debris, artificaial tears is the management of

blepharitis

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most common causes of sudden painless loss of vision

ischaemic optic neuropathy, occlusion of central retinal vein, artery, vitreous haemorrhage, retinal detachment

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ischaemic optic neuropathy, occlusion of central retinal vein, artery, vitreous haemorrhage, retinal detachment are the most common cause of

sudden painless loss of vision

85

ischaemic optic neuropathy may be due to

arteritis (e.g. temporal arteritis) or atherosclerosis (hypertensive, diabetic, older patient)

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arteritis (e.g. temporal arteritis) or atherosclerosis (hypertensive, diabetic, older patient) may cause

ischaemic optic neuropathy

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the pathophysiology of ischaemic optic neuropathy is

occlusion of the short posterior ciliary arteries causing damage to the optic nerve, leading to sudden painless loss of vision

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occlusion of the short posterior ciliary arteries causing damage to the optic nerve causes

ischaemic optic neuropathy

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field defects in ischaemic optic neuropathy are

altitudinal field defects

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altitudinal field defects are

when only the upper or lover half of the field is affected by vision loss

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when only the upper or lover half of the field is affected by vision loss

altitudinal field defect

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altitudinal field defects are seen in

ischaemic optic neuropathy

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central retinal artery occlusion is due to

thromboembolism (from atherosclerosis) or arteritis (temporal arteritis)

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thromboembolism (from atherosclerosis) or arteritis (temporal arteritis) can cause

central retinal artery occlusion

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central retinal vein occlusion incidence

increases with age, more common than central retinal artery occlusion

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increases with age, more common than central retinal artery occlusion

central retinal vein occlusion

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causes of central retinal vein occlusion

glaucoma, polycythaemia, hypertension

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glaucoma, polycythaemia, hypertension can cause

central retinal vein occlusion

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central retinal vein occlusion on fundoscopy

severe retinal haemorrhages

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severe retinal haemorrhages seen of fundoscopy

central retinal vein occlusion

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features of central retinal artery occlusion

relative afferent pupillary delay, cherry red spot on a pale retina, sudden painless loss of vision

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relative afferent pupillary delay, cherry red spot on a pale retina, sudden painless loss of vision are features of

central retinal artery occlusion

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causes of vitreous haemorrhage

diabetes, bleeding disorders

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diabetes, bleeding disorders can cause

vitreous haemorrhage

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features of vitreous haemorrhage include

sudden painless visual loss (large bleeds), dark spots (moderate bleeds), floaters (small bleeds)

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sudden painless visual loss, dark spots, floaters

vitreous haemorrhage

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posterior vitreous detachment features

photopsia (peripheral vision), floaters (temporal side of central vision)

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photopsia (peripheral vision), floaters (temporal side of central vision) are features of

posterior vitreous detachment

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retinal detachment features

dense shadow (starts peripherally, moves centrally), veil/curtain over field of vision, straight lines appear curved, central vision loss

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dense shadow (starts peripherally, moves centrally), veil/curtain over field of vision, straight lines appear curved, central vision loss are features of

retinal detachment

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symptoms of retinitis pigmentosa

night blindness, tunnel vision

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night blindness, tunnel vision are symptoms of

retinitis pigmentosa

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retinitis pigmentosa on fundoscopy

black bone spicule shaped pigmentation in peripheral retina, mottling of retinal pigment epithelium

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black bone spicule shaped pigmentation in peripheral retina, mottling of retinal pigment epithelium on fundoscopy indicates

retinitis pigmentosa

115

features of dacryocystitis

epiphoria, swelling and erythema at the inner canthus of the eye

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epiphoria, swelling and erythema at the inner canthus of the eye are features of

dacryocystitis

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management of dacryocystitis

systemic antibiotics (IV if periorbital cellulitis)

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systemic antibiotics (IV if periorbital cellulitis) is the management for

dacryocystitis

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congenital lacrimal duct obstruciton features

epiphoria, secondary infection may occur, resolves by 1 year of age

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epiphoria, secondary infection may occur, resolves by 1 year of age describes features of

congenital lacrimal duct obstruction

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suspected CNIII palsy management

CTA head to rule out post communicating a aneurysm

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CTA head to rule out post communicating a aneurysm

in suspected CNIII palsy

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retinoblastoma

leukocoria

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leukocoria causes

retinoblastoma, cataracts

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retinoblastoma management

radiotherapy, chemotherapy, eye enucleation, surveillance of other eye (if inheritable form), genetic counselling

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radiotherapy, chemotherapy, eye enucleation, surveillance of other eye (if inheritable form), genetic counselling management for

retinoblastoma

127

optic neuritis

inflammation of optic nerve, sudden deterioration in VA, colur desaturation, eye pain, think MS

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inflammation of optic nerve, sudden deterioration in VA, colur desaturation, eye pain, think MS

opti neuritis

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osteogenesis imperfecta eye signs

blue tinge to sclera

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blue tinge to sclera

osteogenesis imperfecta