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Flashcards in Ophthamology Deck (27):
1

What are 4 red flags for orbital (post-septal) cellulitis?

1) Ophthalmoplegia
2) Pain with eye movement
3) Proptosis
4) Decreased visual acuity

2

What do you call the condition with decreased peripheral vision progressing to blurry vision, pale optic discs, and pain with eye movement?

What condition is associated with this?

Tx?

Optic neuritis

Multiple Sclerosis

IV methylprednisolone

3

Dendritic lesions in the cornea via fluorescein imaging is diagnostic for what?

What NOT to give?

Herpes ophthalmicus (zoster OR simplex)
- Zoster = vesicular rash in trigeminal distribution (forehead, nose, eyes)
- Simplex = NO RASH

NO steroids!

4

2 mo child presents for wcc. Ophthalmo exam shows white reflex in the R eye. What must you consider? What is best course of action?

Leukocoria (white reflex) --> considered RETINOBLASTOMA until proven otherwise!!

Must refer to Ophthalmologist!

5

What does asymmetric red reflexes or corneal light reflexes. When the normal eye is covered, the mis-aligned eye shifts to realign. What is this?

Strabismus

Tx: with patching

6

Person has progressively worsening vision in the R eye. When covering the L eye and looking at a grid chart, the vertical lines appear bent and wavy to him. What is going on?

Macular degeneration

Distortion of straight lines (appear wavy) on grid test

Drusen deposits in the macula

7

In person with HIV, what causes progressive bilateral keratitis and conjunctivitis with eye pain. Visual loss rapidly follows. Fundoscopy reveals multiple pale, peripheral retinal lesions w/ central necrosis of the eye. What is it?

HSV retinitis

8

What is sympathetic ophthalmia?

"Spared eye injury" --> after penetrating trauma injury to one eye, the OTHER eye develops immune-related inflammation (uncovering "hidden" antigens)

*Anterior uveitis

9

Agents to give in acute glaucoma?

Mannitol
Acetazolamide
Pilocarpine
Timolol

10

Agent NOT to give in acute glaucoma? Why?

Atropine -- causes mydriasis (dilation) of eye and further increases intra-ocular pressure

11

Patient has chronic headaches, a bruit noted in subclavian area, pain when chewing, and now developed sudden onset loss of vision in R eye. What is it? next best step?

Giant cell (Temporal) arteritis

*High dose IV corticosteroids

12

Sudden onset of flashing lights and blurred vision in person's R eye. Ophthalmo exam shows retinal tears and grayish coloration of retina. What is the cause?

Retinal detachment

*Look for past hx of trauma to eye - including cataract surgery

13

If CN III is affected by diabetes, what is the mechanism an signs?

If CN III is affected by compression, what are the signs?

Diabetes causes ischemic neuropathy of blood vessels to nerves --> somatic and parasymp fibers of CN III have SEPARATE blood supplies --> in diabetes the somatic are only affected
**"Down and out" gaze but accommodation and pupil's light response remain INTACT

Compression of CN III will affect BOTH somatic and parasymp
**Ptosis, "down and out" gaze, fixed, dilated pupil, no accommodation

14

7 days after cataract surgery in L eye, woman develops decreased visual acuity in L eye. Her eyelid is swollen and has red conjunctiva with exudates in the anterior chamber. What is it?

Post-op endophthalmitis

15

80 yo male has sudden loss of vision in his L eye. Ophthalmic exam shows swelling of optic disk, retinal hemorrhages, dilated and tortuous veins, and cotton wool spots. What is it?

Central retinal vein occlusion

16

Severe eye pain with blurred vision associated with nausea and vomiting. The eye is red and the pupil is dilated and non-reactive to light. What is it?

Acute angle-closure glaucoma

17

What condition causes gradual loss of peripheral vision over several years with eventual tunnel vision and cupping of the optic disc?

Tx?

Open angle glaucoma

Tx: B-blocker (Timolol drops)

18

What part of the vision does macular degeneration affect?

Central vision

19

Sudden onset redness, watery discharge, and itching of both eyes. There is b/l injection with granular appearance of conjunctiva. The lungs have few scattered wheezes present. What is it?

Allergic conjunctivitis

No tx needed - resolves in 24 hrs

20

32 yo woman has decreased visual acuity, sluggish afferent pupillary response to light, and changes in color perception. Fundoscopy reveals a swollen disc. What is the most likely diagnosis?

What is a common association?

Optic neuritis

*Multiple Sclerosis

21

Most common cause of orbital cellulitis?

Bacterial sinusitis

22

3 phases of diabetic retinopathy?

1) Background/simple --> micro aneurysms, hemorrhages
2) Pre-proliferative --> cotton wool spots
3) Proliferative --> neovascularizaiton

23

This drug used for SLE can cause retinopathy and eye damage?

Hydroxychoroquine

24

What causes B/L loss of central vision?

Macular degeneration

25

One-sided sudden loss of vision with reduced light perception in the same eye. Fundoscopic exam shows loss of fundus details and floating debris with a dark red glow?

Vitreous hemorrhage

26

38 yo with AIDS has decreased vision in both eyes. Currently afebrile. Fundoscopic exam shows yellow-white patches of retinal opacification and retinal hemorrhages. What is it?

CMV retinitis

27

Sudden, painless loss of vision in one eye in person with carotid bruit. Exam of the eye shows visual acuity 20/60 and subtle retinal whitening. What is it? What is next best step in mgmt?

*Central retinal artery occlusion --> embolism (vasculitis, carotid artery disease, endocarditis)

Tx: Ocular massage + high flow O2