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High Yield Stuff > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Aqueous humour pathway

90%

10%

A

90% trabecular outflow to canal of Schlemm to episcleral vasculature
Increase outflow with M3 agonist

10% uveoscleral outflow
Increase with prostaglandin agonists

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2
Q

Aqueous humour production decreased by which drugs?

ABC

A

A agonists
B blockers
Carbonic anhydrase inhibitors

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3
Q

Hyperopia

A

Eye too short

Light focused behind retina

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4
Q

Myopia

A

Eye too long

Light focused in front of retina

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5
Q

Astigmatism

A

Abnormal curvature of cornea

Different refractive power at different axes

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6
Q

Presbyopia

A

Age related decreased lens elasticity

Need reading glasses

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7
Q

Cataract risk factors acquired

A 
Age 
Smoking 
Alcohol
Sunlight
DM
Trauma
Infection
Corticosteroids
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8
Q

Cataract risk factors congenital

A 
Classic galactosemia
Galactokinase deficiency
Trisomy 13, 18, 21
ToRCHeS infections rubella
Marfans
Alport
Myotonic dystrophy 
NF2
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9
Q

Uveitis a/w systemic inflammatory disorders

A

Sarcoidosis
Rheumatoid arthritis
Juvenile idiopathic arthritis
HLA B27 PAIR

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10
Q

Hypopyon

A

Pus in anterior chamber

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11
Q

Open angle glaucoma
A/w

Secondary causes

A

Age AA FHx PAINLESS

Blocked trabecular meshwork
Uveitis WBC
Vitreous haemorrhage RBC
Retinal detachment

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12
Q

Closed/ narrow angle glaucoma

Chronic

Acute

A

ASx damage to optic nerve

EMERGENCY V PAINFUL rock hard eye halos sudden vision loss frontal headache
DO NOT GIVE EPINEPHRINE

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13
Q

AMD

TX for dry vs wet

A

Dry tx multivitamin and antioxidant supplements

Wet tx anti VEGF injections ranibizumab

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14
Q

Diabetic retinopathy tx

Non proliferative vs proliferative

A

No proliferative blood sugar control

Proliferative
Surgery
Anti-VEGF
Peripheral retinal photocoagulation

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15
Q

Retinal vein occlusion

A

Hemorrhage
Venous engorgement
Edema
Cotton wool spot

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16
Q

Retinal detachments Sx

A

Flashes
Floaters
curtain drawn down

Surgical emergency

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17
Q

Central retinal vein occlusion

A

Acute painless monocular vision loss

Cherry red macula

Look for embolus sources

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18
Q

RP

A

Night blindness
Rods affected first

Bone spicule shaped deposits around macula

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19
Q

Retinitis

A

Edema and necrosis lead to scar

CMV HSV VZV

Immunosuppression

20
Q

Papilledema

A

Optic disc swelling increased ICP

21
Q

Miosis is constriction, parasympathetic

1st Neuron

2nd neuron

A

1: edinger westphal nucleus to ciliary ganglion via CN 3
2: short ciliary nerves to pupillary sphincter muscles

22
Q

Pupillary light reflex pathway

A

Signal from retina via CN 2 to pretectal nuclei in midbrain they activate E-W nucleus and pupils contract bilaterally

23
Q

Mydriasis is dilation and sympathetic

3 neurons involved
What’s the first one?

A

Hypothalamus to ciliospinal centre of Bulge C8-T2

24
Q

What is mydriasis 2nd neuron?

A

Exit at T1 to superior cervical ganglion

25
Q

Mydriasis third neuron?

A

Plexus along ICarotid through cavernous sinus and enters orbit as long ciliary nerve to pupillary dilatory muscles

Sympathetic fibres also supply smooth muscles of eyelids and sweat glands of forehead and face

26
Q

Marcus Gunn pupil

Swinging flashlight test

Positive test?

Causes?

A

Decreased bilateral pupillary constriction when light shone in affected eye

Optic nerve damage
Severe retinal injury
Syphilis

27
Q

Hornets syndrome is a/w any lesion above?

A

T1

Pancoasts
Brown Sequard
Late stage syringomyelia

28
Q

CN 6 innervates

A

Lateral rectus

29
Q

CN 4 innervates?

A

Superior oblique

30
Q

CN 3 innervates

A

The rest!

31
Q

Internuclear ophthalmoplegia

A

MS

32
Q

CN 3 palsy has motor and parasympathetic part

Tell me about the motor output.

A

Vascular disease DM glucose -> sorbitol
Decreased diffusion of O2 and nutrients to interior fibres from compromised vasculature on outside of nerve

Signs ptosis down n out gaze

33
Q

CN 3 palsy has motor and parasympathetic part

Tell me about the parasympathetic output.

A

Fibres on periphery are first affected by compression eg PCA aneurysm, uncalled herniation

Signs
Diminished/ absent pupillary light reflex
Blown pupil down and out gaze

34
Q

CN 4 palsy

A

Eye moves up esp w/ contralateral gaze and head tilt towards lesion

Problems going down stairs, may tilt head the other way to compensate

35
Q

CN 6 palsy

A

Medially directed eye that cannot abduct

36
Q

Anopia

A

Optic nerve

37
Q

Bitemporal hemianopia

A

Optic chiasm

38
Q

Homonymous hemianopia

A

Optic tract

39
Q

Left upper quadratic anopia

A

R temporal lesion MCA

Meyer loop

40
Q

L lower quadratic anopia

A

R parietal lesion MCA

Dorsal optic radiation

41
Q

L hemianopia with macular sparing

A

PCA infarcts occipital lobe visual cortex

42
Q

Central scotoma

A

Macular degeneration

43
Q

Meyer loop

A

Inferior retina

Loops around inferior horn of lateral ventricle

44
Q

Dorsal optic radiation

A

Superior retina

Takes shortest path via internal capsule

45
Q

What goes through the superior orbital fissure?

A

CN 3,4,5(1),6 and superior ophthalmic vein

High Yield Stuff (10 decks)

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