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Ophthalmology Flashcards

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1
Q

Disadvantage if mast cell stabilisers in eyes?

A

Takes time to work need loading dose

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2
Q

What is shown?

A

Pappiloedema blurred disc

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3
Q

Non proliferative severe retinopathy no macula oedema?

If proliferative?

A

Consider Photocoagulation (laser)

urgently do if proliferative or very high risk

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4
Q

Risks for corneal ulcers?

A

Contact lense wear and overnight wear

Immune compromise

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5
Q

What is this?

What grade or hypertensive retinopathy has this?

A

Grade iv pappiloedema

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6
Q

What is shown? firstline treatment?

What makes this the diagnosis rather than another similar?

A

Stye- warm compress unless associated conjunctivitis

Likely to be painful wheras chalazion is nto and not inflamed also a stye not blepharitis because it features a small area that is white and bulging

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7
Q

What investigation will find a cataract?

A

Slit lamp examination, normal fundus and optic nerve seen on ophthalmoscopy

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8
Q

Features of acute glaucoma?

A

Severe pain- occular and or headache

Reduced visual acuity

Symptoms worse with mydriasis dilation(big word)

Semi dilated pupil (non reactive), halos around lights

Syetmic upset- unwell nausea

Hazy cornea- red eye

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9
Q

Eyelids burn, itch, and stick together.

Symptoms are worse in the mornings.

Both eyes are affected.

Symptoms come and go and flare?

A

Blepharitis

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10
Q

Proliferative vs non proliferative retinopathy?

A

comparison shown

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11
Q

Complications of cataract surgery?

A

Poterior capsule opacification, retinal detachment, inflammation of vitreous humour

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12
Q

AV nipping grade of hypertensive retinopathy?

A

Grade II silver/copper wiring

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13
Q

What is this what may cause it? Symptoms?

A

Dendritic ulcer often caused by herpes simplex- refer to ophthal and give topical aciclovir

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14
Q

See a defect in red reflex in elderly adult think?

A

Cataract as light can not reach retina

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15
Q

What has happened here?

A

Old laser burns from treatment of diabetic retinopathy (proliferative)

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16
Q

How to perform an RAPD test?

A

Swing lgiht from eye to eye, eye with problem will consistently start dilating whne light is shone on it and signifies a problem on that side with optic nerve

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17
Q

Initial treatment acute glaucoma?

A

Beta blockers (caution asthma) and steroids applied topically and pilocarpine (constrict pupil)

IV acetazolomide is used (caution sickle cell)

Surgery: peripheral iridotomy

Offer analgesia and antiemtic also

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18
Q

Non proliferative non-severe retinopathy and no macula oedema?

A

Observe

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19
Q

Most common blindness cause 35-65 years?

A

Diabetic retinopathy

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20
Q

Causes of cataract?

A

Smoking, alcohol, diebetes, trauma, steroids

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21
Q

What is this? best treatment?

A

Cataract- surgery

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22
Q

Symptoms of diabetic retinopathy?

A

Spots or dark strings floating in your vision (floaters)

Blurred vision.

Fluctuating vision.

Impaired color vision.

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23
Q

Conservative management of cataracts?

A

Stronger lenses.glasses, brighter lighting, does not slow progression, only improves vision for a while

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24
Q

What is shown? ?causes and treatment

A

Corneal ulcer focal staning with fluorescein

Give antibiotics, often gent and a quinolone

Commonly staph or pseudomonas

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25
Cataract presentation?
Reduced vision, faded colour vision, glare and halos around lights
26
What is this? usual treatment?
Blepharitis, good lid hygiene and warm compresses ABX not usually needed unless evidence of infection such as crusting which may indicate staph
27
Signs of hypertensive retinopathy on pictures?
Flame haemorrhages, dots and blots, lots of cotton wool spots
28
Retinal photo features of diabetic retinopathy (non proliferative) ?
microaneurysms blot haemorrhages hard exudates cotton wool spots, venous beading/looping and intraretinal microvascular abnormalities
29
Grade iv hypertensive retinopathy?
Pappiloedema present
30
Thickened macular oedema treatment?
Anti VEGF
31
What type of glaucoma can present suddenly?
Acute angle closure
32
Usual first test for evaluationg ocular trauma?
CT Possible xrays if clear history of radio-opaque injury eg hammering nail or iron filings
33
Causes of RAPD?
Optic neuritis Glaucoma Optic nerve lesion Retinal detachment Ischaemic optic disease
34
What is shown? Diagnosis and why?
Proliferative retinopathy due to new vessel formation in disc and overlying vessels everywhere
35
Recent URTI presents with gritty painful red eye?
Likely viral conjuncitivitis self limiting condition
36
Purulent red eye, eyes stuck together? Treatment?
Acute bacterial conuncitivitis Self limiting often given ABX chloramphenicol or fusidic acid in pregnancy
37
Symptoms of corneal ulcer?
watery eyes, discharge, visual acuity loss, painful, red eye, photophobia
38
Cataract type with diabetes?
Dot opacities
39
What is this what can be seen?
HTN retinopathy lots of cotton wool spots and haemorrhages
40
Subscapular cataract?
Steroid use
41
What should BP be in diabetics with end organ damage eg eye involvement?
130/80
42
Red eyes Itch is prominent the eyelids may also be swollen May be history of atopy What and first line treatment?
Allergic conjunctivitis often associated with hayfever topical antihistamines first line sodium cormiglicate second line
43
Factors that predispose to angle closure glaucoma?
Long sightedness, pupil dilation and lense growth with age
44
Most common type of cataract and cause?
Nuclear changes refractive index of lenses common old age
45
Most common cause of cataract?
Ageing
46
Patient presents with this eye, feels sick has had ocular pain too ... diagnosis?
Acute glaucoma- note reddening and mid dilated pupil with history of vision loss and pain
47
What features are shown? Likely cause?
macular oedema: exudate (yellow arrow), microaneurysms (red arrow), thickened retina (white circle), cystic change at macula (blue arrow) Non-proliferative diabetic retinopathy
48
Inherited cataract type?
Polar
49
Presentation of scleritis and episcleritis? Differentiate?
Both conditions present with a red eye which may be painful Episcleral vessels can be moved with a cotton bud. When phenylephrine 10% is applied, they blanch Scleral vessels appear darker, follow a radial pattern, are immobile and do not blanch.
50
Specific pain of scleritis?
Boring eye pain
51
Onset of episcleritis vs Scleritis?
Epi acute scler insidious
52
Associated symptoms of sclertiis and episcler?
scleritis Yes, nausea vomiting Episcleritis no
53
Visual problems scleritis or episcleritis?
Scleritis
54
Associated diseases with episcleritis?
Often idiopathic but may be common in IBD rarely RA or connective
55
Episcleritis management?
Artificial tears may provide some relief, particularly in nodular disease. The use of topical non-steroidal anti-inflammatory drugs (NSAIDs) can be helpful in more symptomatic patients.
56
Scleritis associated disease? How common?
Very common up to 50% usually RA
57
Suspect scleritis do what? What investigations?
Refer immediately to ophthal think about underlying pathology as very often there is some
58
Scleritis treatment?
Nsaids initially Ibuprofen and then if not effective steroids 80mg If necrotising steroids and immunosupression immediately
59
Anterior uveitis/iritis associated with?
HLA b27 Ank spon
60
What condition is shown?
Uveitis
61
Presentation of anterior uveitis?
Usually unilateral. Pain, redness and photophobia are typical. Eye pain is often worse when trying to read. excessive tearing headache, unreactive and irregular shaped pupil
62
What is entropion?
Invertion of the eyelashes irritating the eyes
63
Types of ARMacDegen and which more common?
Wet and dry- wet 10% dry 90%

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