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Neuro & Special Senses > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Increased UV exposure is a risk factor for what 3 eye conditions

A
  1. Cataracts
  2. Pterygium
  3. Cancers of the eyelid (commonly BCC)
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2
Q

What is tropicamide used for

A

Pupil dilation (e.g. before fundoscopy of slit lamp examination)

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3
Q

How many layers does the cornea have

A

5

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4
Q

How can you distinguish between episcleritis and scleritis

A
  1. Episcleritis blood vessels will blanch with admission of phenlephrine/cotton bud
  2. Episcleritis engorged vessels in cone/wedge shape (thin towards pupil) that can be moved - superficial veins
  3. Actuity unaffected in episcleritis
  4. Scleritis is associated with underlying chronic disease, can be sight treatening as needs urgert referal if posterior scerlitis/if necrotising changes present
  5. Scleritis is painful with eye movement as extraocular muscles insert into sclera
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5
Q

Phenylephrine uses and mechanism of action

A

Symphatomimetic, acts on alpha1 ADRs

dilates eyes (also used as decongestant & to relieve heamorroid for vasocontrictive action via vasocontriction mediated by a1 activation, increases BP)

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6
Q

Proliferative diabetic retinopathy is a risk factor for what cause of sudden painless vision loss

A

Vitreous heamorrage (over 50% of vireous heamorage is caused by proliferative diabetic retinopathy as the new blood vessels grow into the vitreous, are weak and prine to shearing - presenting as floaters)

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7
Q

Characteristic of grade 4 hypertensive retinopathy

A

Papiloedema

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8
Q

Cotton wool exudates and flame heamoorrages indicate what grade of hypertensive retinopathy

A

Grade 3

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9
Q

What type of organism can cause infections/corneal ulcers in contact lense wearers

A

Protozoa - acanthamoebae (common in soil and even tap water)

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10
Q

Four features of horners syndrome

A

LOSS OF SYMPATHETIC TRUNK

  1. Miosis
  2. Anhydrosis
  3. Ptosis
  4. Enopthalomos
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11
Q

Feature that would indicate congenital horners syndrome

A

Heterochromia of eyes

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12
Q

Name two types of carbonic anhydrase drops that can be used in treatment of acute closed angle and open angle glaucoma

A

Acetozolamide

Dorzolamide

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13
Q

What is a relative afferent pupillary defect

A

If you don’t know this look it up, it’s conceptual

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14
Q

What is a Marcus Gunn pupil

A

Pupil with a RAPD (abnormal direct and consensual response to light shining in it due to defect in the afferent - optic nerve to pretectal nucleas bilateral innervation of edinger westphal - pathway of the light reflex)

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15
Q

What is an Argyll - Robinson pupil and in what conditions is it found

A

aka postitues pupil - accomdates but doesn’t react

small pupil, accomodates, no light response

syphillis and diabetes mellitus

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16
Q

What is a Holmes-Aidie pupil

A

Fixed dialated pupil, poor accomdation and poor light response but light is better than accomodation.

Damage to parasympathetic innervation (via ciliary body and short cilary nerve hitchhiking on CN3)

17
Q

What is Hutchinson’s pupil and what underlying pathology does it indicate?

A

Fixed dialated pupil, unresponsive to light, due to compression of oculomotor nerve by a same-sided intracranial mass

18
Q

Whats the proportion of dry to wet ARMD and treatment of both

A

dry to wet - 90% and 10%

Dry - zinc and anti oxidative vitamens ACE to slow disease progresssion

Wet - Anti-VEGF injections (ranibizumab) also laser photocoagulation

19
Q

What are the deposits called in dry ARMD

A

Drusen

20
Q

Investigations used in ARMD

A

Slit lamp examination to visualised deposits/neovascularisation
OCT to obtain 3D image of areas unable to be visualised
Angiography (fluorcsin or indocyanine green) to visulaise neovascularisation and guide anti-VEGF therapy if wet ARMD
Amsler grid testing - distortion of grid & fundoscopy

21
Q

Risk factors of ARMD

A

Age
Smoking
Family history

22
Q

What autoimmune condition is episcleritis and scleritis linked to

A

Rheumatoid arthritis

23
Q

Management of anterior uveitis and what disease is it associated with

A
  1. Urgent ophthal review
  2. Cycloplegic drugs (e.g. atropine, cyclopentolate) to minimise pain and photophobia
  3. steroid eye drops
24
Q

Appearance of anterior uveitis

A

Small, irregular pupil
Red, painful eye
Photophobia
‘snow storm’ of inflammatory cells seen in anterior chamber on examination

25
Q

What do cytoplegic drugs do, how do they work and list 3 with their different uses and why they are used for those

A

Dialate the eye
By opposing parasympathetic constriction by blocking M3 receptors
MUSCARINIC ANTAGONISTS

Tropicamide - fundoscopy, only lasts a few hours
Atropine & cyclopentolate - last longer therefore as an adjunct to treat anterior uveitis

26
Q

What is synechia

A

Attachment of the iris to surrounding structions - e.g. anterior synechia is iris attachment to cornea - precipitating ACA glaucoma, or posterior synechia - attachment to lens

27
Q

What is a chalazion

A

AKA Meibomina cyst
Initial painful internal stye (aka hordeolum internum) affecting meibonian glands, resolves to leave painless cyst, only needs to be treated if big via surgical drianage or if conjuncivitis

28
Q

Give an example of a prostaglandin analogue, how it works in glaucoma treatment, when you would give it specifically and a potential side effect

A

Latanoprost
Increases uveoscleral outflow in glaucoma
First line for open angle glaucoma treatment, especially if asthma contraindicated B blockers such as timolol
Pigmentation of retina & growth of eyelashes is a side effect

29
Q

Two catagories of strabismus, names of the four axis in which there can be a convergence/deviation, test to identify and treatment

A

Paralytic (rare, paralysis of extraocular muscles) or concomitant (imbalance of extraocular muscles)

Esotropia - convergence towards nose/midline
Exotropia - deviation towards temporal area
Hypertropia - upwards
hypotropia - downwards

Cover test

Eye patch, referral to secondary care, corrective surgery is an option

30
Q

5 features of optic neuritis and a common condition it’s seen in

A
  1. red desaturation
  2. central scotoma
  3. painful eye movements
  4. RAPD
  5. unilateral decrease in visual acuity

MS, DM, syphilis

31
Q

Management of optic neuritis, recovery time and extra test + prognosis

A 
High dose steroids (3 days)
recovery 4-6 weeks
 MRI scan (>3 lesions, 5 yr MS risk is 50%)
32
Q

5 causes of cataracts

A
  1. Down’s syndrome
  2. Corticosteriods (subcasular cataracts)
  3. Hypocalcaemia
  4. Uvietis
  5. Diabetes

Neuro & Special Senses (2 decks)

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