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Year 4 Medicine Manchester > Ophthalmology > Flashcards

Ophthalmology Flashcards

(78 cards)

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1
Q

What do you call a dinosaur which can’t see?

A

A Do-you-think-he-sarus!

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2
Q

Apologise because…

A

these jokes are getting cornea and cornea

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3
Q

When testing visual acuity, what does a pin hole allow is to asses?

A

Improvement with a pinhole suggests a refractive error and therefore should be referred to the opticians for lens prescription

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4
Q

If the patient cannot read the top line after being moved closer to the Snellens chart then what should be done?

A

Test finger counting, hand movements and finally light perception.

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5
Q

Eyes described as Gritty and feel like they want to close often indicates…

A

Dry eyes

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6
Q

Where does a sharp or stabbing pain indicate a problem of the eye?

A

the surface of the eye

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7
Q

Where does a dull or toothache like pain of the eye originate?

A

inside the eye or scleritis

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8
Q

What paediatric questions are relevant to a ophthalmological focus history?

A

Did you have a lazy eye?

Has one eye been weaker than the other with spectacles?

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9
Q

What is contained in the previous ophthalmic history?

A

Previous ophthalmic surgery, eye conditions?
Injury to the eye?
Use of glasses or contact lenses?
lazy or weaker eye?

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10
Q

What questions are relevant to a social history?

A

Smoking
Drinking
Job and ADLs
Driving - DVLA

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11
Q

What is assessed on fundoscopy which looking at the optic disc?

A

Contour
Colour
Cup

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12
Q

What is the cup disc ration and what is a normal value?

A

The ration of the cup height is 1/3 of the height of the optic disc

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13
Q

What may an increased cup to disc ratio indicate?

A

Glucomatous change

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14
Q

What is the normal colour of the optic disc?

A

Orange/ yellow. If more pale may indicate pathology

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15
Q

What is the significance of the contour of the optic disc?

A

Papilloedema

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16
Q

What risk factors are there are Dry age related macula degeneration (ARMD)?

A

Female
Smoking
HTN
Previous cataracts

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17
Q

What may be seen on fundoscopy which indicate dry ARMD?

A

Dürsen

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18
Q

What is the treatment for dry ARMD?

A

lifestyle advice, prescription
Beta-caretene (contraindicated in smokers)
Other anti-oxidants

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19
Q

What additional treatments are there for wet ARMD?

A

monthly injections of anti-VEGF

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20
Q

What conditions can cause loss of peripheral vision - tunnel vision?

A

Glaucoma
Retinitis pigmentosa
Papilloedema
hysteria

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21
Q

What risk factors are there fore glaucoma?

A 
FH 
Myopia (hyperopia for acute) 
Afro-carribean
DM 
Age 
Female
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22
Q

Is there screening for glaucoma when there is a FH?

A

35yo +

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23
Q

What is an Amsler grid used for?

A

detecting problems with the macula or optic disc. Useful in in ARMD

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24
Q

Hyperopia patient with progressive headache, red eyes blurry vision and N+V. MLD?

A

Acute closed angle glaucoma

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25
Sudden painful loss of vision in an arteriopath. MLD?
Central retinal artery occlusion
26
What signs may be seen on fundoscopy with a Central retinal artery occlusion?
Cherry red spot
27
What risk factors are there fore retinal detachment?
Trauma | Myopia
28
What symptoms are seen with orbital cellulitis?
Oedema and erythema | Impaired movement of the eye
29
Where does an orbital cellulitis infection commonly originate from?
sinusitis/ sinus infection
30
What is a hypopyon?
Pus in the anterior chamber of the eye
31
What is a hyphema?
A pooling of blood in the anterior chamber of the eye
32
increasing pain with loss of vision. O/E hypopyon reduced pupillary and red reflex. MLD?
Endophthalmitis
33
How is endophthalmitis treated?
Vitreous tap and intra ocular anti-biotics
34
What clinical signs indicate acute closed angle glaucoma?
Blue iris mid-dilated pupil Cloudy cornea Red eye
35
What treatment is there for acute closed angle glaucoma?
bilateral peripheral iridotomy | Phenylephine + Tropicomide
36
What underlying conditions must be excluded first before central retinal artery occlusion diagnosed?
Giant cell arthritis
37
Myopic with floaters. MLD?
retinal detachemnt
38
What investigations need to be done for orbital cellulitis?
FBC conjunctival swab Orbital imaging blood cultures
39
What questions should be asked when seeing a patient with eyes?
``` Wear contact lenses? Contact with anyone with red eyes? Recent URTI? Allergies? Recently sexual active? ```
40
Bilateral sore eyes with mucoid discharge. No changes in vision and reactive pupils. MLD?
Conjuctivitis
41
What is the treatment for conjunctivitis?
Topical antibiotics - Chloramphenicol (0.5%) QDS
42
What appropriate investigations are there for conjunctivitis?
Viral, bacterial and chlamydia swab
43
Flourescine is used on the cornea and a dendritic ulcer appears. MLD?
HSV-1 infection
44
What is the uveal tract?
Choroid, retina, cellar bodies and iris
45
What is anterior uveitis?
Inflammation primarily of the iris. This warrants ophthalmology attention.
46
What eye complication may ankolysing spondylitis cause?
uveitis
47
What its the treatment for a mild contact related ulcer/ bacterial keratitis?
discontinue contact use | Topical abx
48
What treatment is contraindicated in contact related ulcer/ bacterial keratitis?
``` Oral abx (unless severe) Topical steroids ```
49
What good questions are good to ask in history with double vision?
Double vision when covering 1 eye? Are the double vision side by side or on top of each other? Is it worst when looking in a certain direction?
50
Patient experiences maximum diplopia when looking to the right. MLD?
Right CN VI
51
What causes are there for CN VI palsy?
Microvascular | raised ICP
52
The right eye is looking down and out, MLD?
3rd neve palsy
53
What symptoms are there in a 3rd nerve palsy?
Down and out glance ptosis Mydriasis
54
What does mydriasis mean in the context of a 3rd nerve palsy?
Lesion in CN 3
55
What should be done in a patient with 3rd CN palsy with a headache?
Neuroimaging to exclude an aneurysm. Otherwise likely microvascular event.
56
Bruising around eye in the context of trauma. What investigation should be done?
CT head to investigate for blow out/ inferior orbital wall fracture
57
What management is needed for a blow out fracture?
Oral Abx Maxfax review Advice patient not to blow nose.
58
Diplopia which which gradually and variable comes on with progressive ptosis. MLD?
Myesthenia gravis
59
What investigations should be done for myasthenia gravis?
CT/MRI head Edrephonium test Bloods for anti-cholinesterase anti-bodies CXR
60
What is the edrephonium test?
A cholinesterase agent which produces a transient improvement in symptoms
61
What are the causes of a CN4 palsy?
microvascular Trauma Congenital
62
orthoptic management of diplopia?
Eye patch | Fensel prism
63
What are the symptoms of a cavernous sinus thrombosis?
``` Recent facial infection ophthalmoplegia ptosis peri-orbital oedema headache ```
64
What is leukocornia?
White pupil
65
What are the causes of leucornia?
Congenital cataracts | Retinoblastoma (important and malignant)
66
What is treatment of retinopathy of prematurity?
laser photo-coagulation, if left untreated complication could be vitreous haemorrhage and retinal detachment.
67
What is the pathology of retinopathy of prematurity?
After birth increased O2 decreases VEGF and therefore the vessels are underdeveloped in the retina
68
What causes are there for congenital cataracts?
Inherited Viral - Rubella, CMV, Varicella Genetic - Edwards, Downs
69
What is the criteria for routine eye screening in new borns?
Born < 31 w gestation and <1.5kg
70
Eye-infection with limitation or pain on movement of the eye. MLD?
Orbital cellulitis - medical emergency, treat with IV Abx
71
What requirement are there for sight for the DVLA?
6/12 with 120 degrees of vision
72
Features of diabetic eye?
cotton wool spots mircoaneurysm venous bleeds hard exudates
73
What signs would indicate the proliferative stage of diabetic retinopathy (R3)?
neovasculisation, 2nd vitreous haemorrhage.
74
What stage of disease is anti-VEGF used for in diabetic retinopathy?
Proliferative diabetic retinopathy (R3)
75
Sudden painless loss of vision. MLD?
Central artery occlusion Exclude GCA
76
Child with painful, erythematous eye and ptosis. MLD?
Periorbital cellulitis Do MRI
77
Shadow and suddenly floaters appear. MLD?
Retinal detachment more likely with myopia
78
Increasing painful eye, post ophthalmological surgery. MLD?
Endophthalmitis

Year 4 Medicine Manchester (20 decks)

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