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YEAR 3 & 5 CORE CONDITIONS > Ophthalmology > Flashcards

Ophthalmology Flashcards

(54 cards)

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1
Q

What are the different types of conjunctivitis? What is the discharge like for each?

A

Bacterial - mucopurulent
Viral - watery
Chlamydial - watery
Allergic - stringy

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2
Q

What is the main treatment for bacterial conjunctivitis?

A
  1. Chloramphenicol - risk of aplastic anaemia

2. Fusidic acid

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3
Q

How does blepharitis present?

A 
Burning feeling
Crusting = staph infection
Gunking = secretions from Meibomian glands
Loss of eyelashes
Frothy tears
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4
Q

Differentiate between entropion and ectropion?

A

Entropion = inversion of eyelids caused by lower lid laxity so orbicularis muscle overrides tarsal plate

  • Red, itchy, sore, gritty, uncomfortable eyes
  • Irritation from eyelashes can cause corneal ulcer

Ectropion = eversion of eyelids due to laxity causing exposure of tarsal conjunctiva

  • Dryness, redness
  • Frequently discharging
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5
Q

What is a chalazion?

A

Meibomian cyst

Blockage of gland within tarsal plate traps sebaceous secretions, leading to chronic granulomatous inflammation

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6
Q

How can you treat a chalazion?

A

Hot compresses
Massage
Incision + curettage to drain

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7
Q

What can cause ptosis?

A

Age-related degeneration of levator muscle aponeurosis
CNIII palsy/Horner’s syndrome
Myasthenia gravis/muscular dystrophy

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8
Q

What most commonly causes a corneal ulcer?

A

Contact lenses

Bacteria
Viruses
Acanthamoeba (live in water)
Fungi (immunocompromised)

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9
Q

How does anterior uveitis present?

A

Pain worse in bright lights (spasm of iris muscles)
Headache
Blurred vision

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10
Q

What would you see on examination of uveitis?

A

Hypopyon = leukocyte exudate in the anterior chamber

Red eye

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11
Q

What conditions is uveitis associated with?

A

HLA-B27

  • Ankylosing spondylitis
  • Psoriasis
  • IBD
  • Sarcoidosis
  • Behcet’s
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12
Q

How do you treat uveitis?

A

Prednisolone 1% eye drops

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13
Q

How would scleritis present?

A 
Deep boring pain
Wakes patient up from sleep
Radiates to forehead
Red eye 
Vision may decrease
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14
Q

What conditions is scleritis associated with?

A

Rheumatoid arthritis

SLE

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15
Q

How is episcleritis different from scleritis?

A

There is no pain
Vision is normal
It is associated with IBD

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16
Q

Define glaucoma

A

Optic neuropathy usually with high intraocular pressure (>21mmHg), optic disc cupping and progressive visual loss

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17
Q

What type of glaucoma is most common? How does it present?

A

Open angle glaucoma

Bilateral peripheral visual loss (can be asymptomatic)

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18
Q

What are the risk factors for open angle glaucoma?

A

Family history
Hypertension
Diabetes
Myopia = short sighted

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19
Q

How does closed angle glaucoma present?

A 
Acute eye pain
Associated nausea + vomiting
Decreased visual acuity
Haloes when look at lights
Abdominal pain
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20
Q

What causes angle closure glaucoma?

A

Long sightedness (small eyes) - when the pupil is mid-dilated the iris blocks the drainage of fluid so pressure increases

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21
Q

What is the treatment for open angle glaucoma?

A

Latanoprost (prostaglandin analogue) - increases outflow

Timolol (beta-blocker) - reduces aqueous

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22
Q

What are the side effects of latanoprost?

Study These Flashcards
A

Thicker, darker, longer lashes

Darker iris + skin around eyes

23
Q

What is the treatment of acute angle closure glaucoma?

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A

IV acetazolamide (carbonic anhydrase inhibitor) - reduces aqueous production

24
Q

What are the red flags in a red eye?

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A 
Severe pain
Reduced vision
Photophobia
Proptosis (protrusion of eye)
Miosis in affected eye
25
What are the 5 stages of cellulitis?
``` I = preseptal II = orbital III = subperiosteal abscess IV = orbital abscess V = cavernous sinus thrombosis ```
26
What organisms most commonly cause preseptal and orbital cellulitis? How do you treat each?
Preseptal - Staph aureus - Abx: co-amoxiclav 10 days Orbital - Strep pneumoniae - Abx: flucloxacillin/ceftriaxone IV
27
How can you differentiate between preseptal and orbital cellulitis?
Preseptal - Normal eye - Normal vision - No proptosis Orbital - Red eye - Blurred vision - Proptosis
28
What are the main complications of orbital cellulitis?
Blindness Meningitis Cavernous sinus thrombosis
29
What can cause a painful loss of vision?
``` Acute angle closure glaucoma Giant cell arteritis Optic neuritis Uveitis, slceritis, keratitis Shingles Orbital cellulitis ```
30
What can cause a painless loss of vision?
``` Cataracts Retinal detachment Retinal vessel occlusion Diabetic retinopathy Age-related macular degeneration Optic nerve compression (Berry aneurysm) ```
31
What are the symptoms of retinal detachment?
4 Fs Flashes = photopsia Floaters Fall in visual acuity Field loss - 'curtain coming down' NO pain
32
What is amaurosis fugax?
TIA of a retinal artery Causes transient monocular blindess due to transient retinal ischaemia
33
What does fundoscopy of a retinal artery occlusion look like?
Pale retina with oedema Cherry-red macula Arteriolar narrowing
34
What causes retinal vein occlusion?
Arteries go over veins so if the artery is hardened due to longstanding hypertension, the vein is nipped
35
What would fundoscopy of retinal vein occlusion show?
``` Cotton-wool spots = nerves dying due to ischaemia Tortuous dilated vessels Flame haemorrhages (sudden hypertension) Disc oedema Macular oedema ```
36
How do you manage retinal vein occlusion?
anti-VEGF Vascular endothelial growth factor is released to recruit new blood vessels
37
What is the triad for presentation of optic neuritis?
Unilateral reduced vision Reduced colour vision (especially red) Eye pain
38
What can cause optic neuritis?
Acute demyelination - MS Ischaemic optic neuropathy - GCA, diabetes Other - steroids, TB, syphilis, orbital cellulitis, B12 deficiency, amiodarone
39
What are the macula and fovea?
``` Macula = 3mm temporal from optic disc Fovea = centre of macula ```
40
Differentiate between dry and wet age-related macular degeneration
Dry - Atrophic - Drusen in macula (yellow spots) Wet - Exudative - Neovascularisation - Subretinal haemorrhages in/around macula
41
What are the risk factors for age-related macular degeneration?
``` Smoking Cardiovascular disease Malnutrition Obesity UV light ```
42
How does ARMD present?
Progressive central visual deterioration
43
How do you treat wet ARMD?
Anti-VEGF - prevents neovascularisation | Laser phocoagulation
44
What are cataracts?
Lens opacities
45
What are congenital cataracts associated with?
TORCH - Toxoplasmosis - Rubella - CMV - Herpes EBV Chickenpox
46
How does herpes simplex present in the eye?
Dendritic ulcer Red eye Extremely painful No discharge
47
What are the stages of diabetic retinopathy?
``` Background - Microaneurysms (dots) - Haemorrhages (blots) - Hard exudates (yellow clouds) Pre-proliferative - Cotton-wool spots (nerve infarcts) - Haemorrhages Proliferative - Neovascularisation Maculopathy - Oedema around fovea ```
48
How do you treat diabetic retinopathy?
Laser phocoagulation
49
What does retinal detachment look like on fundoscopy?
Grey retina ballooning fowards
50
How does giant cell arteritis present?
Vision goes dark
51
What signs would vitreous haemorrhage give with fundoscopy?
No red reflex Can't see retina (if you can't see in and patient can't see out, it is likely vitreous haemorrhage and retinal detachment is the differential)
52
What causes optic atrophy (big cup)?
Optic neuritis End stage glaucoma Tumour compressing optic nerve
53
How does papilloedema look in fundoscopy?
Bilateral swollen discs
54
How do you treat giant cell arteritis?
High dose IV steroids

YEAR 3 & 5 CORE CONDITIONS (30 decks)

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