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Derm, Opth + ENT > Ophthalmology > Flashcards

Ophthalmology Flashcards

(68 cards)

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1
Q

Uveitis S+S + management

A

Unilateral burning, red eye
Blurred vision + photophobia

Treat with prednisolone + ciclosporin
Cyclopentolate to paralyse ciliary body

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2
Q

Scleritis S+S + management

A

Pain worse with movement
Watering + photophobia

Treat with NSAIDs and prednisolone

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3
Q

Optic neuritis S+S + management

A

Swollen optic nerve
Periocular pain, gradual vision loss

Treat with methylprednisolone

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4
Q

Corneal ulcer S+S + management

A

White hazy mark on cornea
Pain + redness

Treat with acyclovir

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5
Q

Open angle glaucoma S+S, fundoscopy + management

A

Cupping and pallor of optic disc
Slow onset painless peripheral visual field loss
Raised IOP

Treat with prostaglandin analogs (pilocarpine)

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6
Q

Angle closure glaucoma S+S + management

A

Sudden severe eye pain, blurred vision, haloes, fixed mid-dilated pupil
Redness + N+V

Treat with timolol, prednisolone, pilocarpine + acetazolamide (IV)

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7
Q

Conjunctivitis S+S + management

A

Pain, burning, redness
Itching + discharge

Treat with chloramphenicol

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8
Q

Horners S+S + pathology

A

Sympathetic nerve interruption from hypothalamus to orbit
Ptosis
Miosis
Bloodshot conjunctiva

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9
Q

Retinitis pigmentosa S+S + management

A

Reduced night vision
Loss of mid peripheral visual field
Photophobia
Myopia

Fundoscopy = peripheral pigment deposits

Treat with Vit A and acetazolamide

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10
Q

Detached retina S+S

A

Floaters, flashes of light
Painless visual field loss
Risk: myopia

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11
Q

Macula degeneration S+S + how to diagnose

A

Central vision loss
Use Amsler grid to diagnose
Wet = haemorrhages + scarring

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12
Q

Diabetic retinopathy pathology

A

Blurred vision, darkened images

Dot blot haemorrhages, cotton wool spots + hard exudates + neovascularisation

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13
Q

Cataracts S+S

A 
Gradual onset blurred vision 
Glares/ haloes 
Nystagmus 
Sensitivity to light 
Loss of red reflex
Opacity within lens
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14
Q

Orbital cellulitis S+S + management

A

Redness, swollen eye
Pain

Cefotaxime + flucloxacillin + metronidazole (IV)

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15
Q

What is ocular hypertension?

A

Raised IOP without glaucoma

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16
Q

RF for acute angle closure

A

Females
Asian
Long sighted
Older age

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17
Q

RF for cataracts

A

Family hx
Corticosteroids
Smoking
Prolonged exposure to UVB

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18
Q

Cataracts management

A

Surgery

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19
Q

Types of stye

A 
Internal = occurs on conjunctival surface of eyelid caused by infection of meobomian gland 
External = appears along edge of eyelid caused by infection of eyelash follicle
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20
Q

Complications of styes

A

Periorbital cellulitis

Meibomian cyst

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21
Q

Stye management

A

Self-limiting
Warm compresses
Epilate eyelash or incision + drainage

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22
Q

Causes of infective conjunctivitis (viral + bacterial)?

A

Adenovirus
Staph aureas
H influenza
Strep pneumoniae

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23
Q

What is hyperacute conjunctivitis?

A

Rapidly developing severe conjunctivitis caused by Neisseria gonorrhoea

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24
Q

What is ophthalmia neonatorum?

A

Conjunctivitis in first 4 weeks

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25
Who is at greatest risk of complications from conjunctivitis?
Contact lens wearers + immunosuppressed pts
26
What are the complications of conjunctivitis?
Keratitis | Keratoconjunctivitis (usually viral) - vision loss + light sensitivity
27
Pathology + types of allergic conjunctivitis
``` IgE hypersensitivity reaction Seasonal Perennial Vernal (hot arid environments) Atopic Giant papillary (due to chronic micro-trauma) ```
28
S+S of allergic conjunctivitis
Itching Watery discharge Redness
29
Management of allergic conjunctivitis
Topical anti-histamines or mast cell stabilisers
30
Types of detached retina
Rhegmatogenous detachment - occurs as vitreous shrinks Exudative detachment - due to leakage of fluid into subretinal space due to inflammation or malignancy Tractional - due to diabetes where abnormal vasculature causes contraction of vitreous
31
Types of uveitis
``` Anterior = iritis, iridocyclitis Intermediate = ciliary body, pars plana + anterior vitreous Posterior = choroiditis, retinitis, optic nerve head (papillitis) ```
32
Causes of uveitis
Autoimmune disorder, infection, trauma, neoplasia
33
Complications of uveitis
Cystoid macular oedema Secondary cataracts Secondary glaucoma
34
Types of blepharitis
``` Anterior = inflammation of eyelash base (bacterial or seborrhoeic dermatitis) Posterior = inflammation of meobomian glands ```
35
S+S blepharitis
Worse in AM | Burning, itching, erythema + crusting
36
What conditions are associated with blepharitis?
Dry eye syndrome Seborrhoeic dermatitis Rosacea
37
Management of blepharitis
Warm compresses | Cloramphenicol 2nd line
38
S+S of corneal FB
Irritation, redness + watering Pain Repeated blink reflex
39
What is Seidel's test?
Perform if penetrating injury is a possiblity Apply 10% fluorescein Observe using slit lamp with cobalt blue (or Woods light) If penetrative injury is present, stream of clear fluid will be seen in the pool of orange dye
40
Signs of corneal FB
Visible FB | Rust ring
41
Management of corneal FB
Use topical anaesthetic | Irrigate eye with water or remove FB with cotton wool bud
42
What eye conditions are associated with diabetes?
Diabetic retinopathy Cataracts Rubeosis iridis + glaucoma Ocular motor nerve palsies
43
What characteristic features indicate diabetic retinopathy?
``` Microaneurysms Hard exudates Hemorrhages Cotton wool spots Neovascularisation ```
44
How is diabetic retinopathy classified?
``` Background = 1 microaneurysm Non-proliferative = hemorrhages, cotton wool spots Proliferative = neovascularisation on disc ```
45
What is diabetic maculopathy?
Macular oedema | Ischemic maculopathy
46
RF for diabetic retinopathy
Prolonged hyperglycaemia HTN + CV RF Pregnancy Renal disease
47
S+S of diabetic retinopathy
Painless gradual reduction in central vision | Dark, painless floaters
48
Diagnosis of diabetic retinopathy
Dilated retinal photography w/ ophthalmoscopy
49
Management of diabetic retinopathy
``` Glycaemic control (HbA1c <7%) BP control Lipid control Laser treatment Intravitreal steroids Anti-vascular endothelial growth factor treatments Surgery ```
50
Complications of diabetic retinopathy
Macular oedema Macular ischemia Vitreous hemorrhage Tractional retinal detachment
51
Pathology of hypertensive retinopathy
Arterial narrowing (copper wiring) Followed by vascular leakage + arteriosclerosis (arteriovenous nipping) Hemorrhages + exudates Choroidal changes may occur
52
S+S of hypertensive retinopathy
Usually asymptomatic Slightly decreased vision Malignant HTN = headaches + decreased vision
53
Fundoscopy findings in malignant HTN
``` Macular star (thin white streaks radiating around macular) Disc swelling Cotton wool spots Flame hemorrhages Arterial/ venous occlusions ```
54
What is an ectropion?
Lower eyelid turns outwards away from eye
55
Causes of ectropion
Old age Burn/ infection/ eyelid trauma Facial paralysis
56
S+S of entropion
Irritation + pain, watering
57
Management of entropion
Taping eyelid to cheek Injecting muscle with botox Surgery
58
Difference between episcleritis + scleritis in pathology
``` Epi = inflammation of superficial, episcleral layer. Common + self-limiting Scleritis = inflammation of sclera, severe + can cause complications ```
59
Types of episcleritis
``` Simple = vascular congestion Nodular = characterised by discrete elevated area of inflamed episclera ```
60
Difference between epi + scleritis in S+S
``` Epi = acute onset of redness + discomfort, grittiness Scleritis = gradual onset of boring eye pain radiating to forehead + jaw, worse with eye movement + at night, associated symptoms (fever, vomiting) ```
61
DDx for acute light sensitivity
Iritis, keratitis, abrasion, ulcer
62
DDx for acute unilateral pain
Iritis, keratitis, abrasion, ulcer | Herpes, acute angle closure glaucoma, scleritis
63
DDx for acute white spot on cornea
Ulcer
64
DDx for acute non-reactive pupil
Acute glaucoma, iritis
65
DDx for acute blurred vision
Iritis, keratitis, abrasion, ulcer | Herpes, acute angle closure glaucoma, scleritis
66
S+S of retinal artery occlusion
Sudden, painless monocular vision loss | Cherry red spot + retinal pallor on fundoscopy
67
Management of retinal artery occlusion
Restore blood flow Massage globe Decrease IOP (BB, IV mannitol)
68
CI to dilating pupils
shallow anteriorchamber iris supported lens implant Potentially neuro abnormality requiring pupillary evaluation caution with CV disease - can cause tachycardia

Derm, Opth + ENT (6 decks)

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