Opthal Flashcards
(25 cards)
“Severe Pain
↓ Acuity
Worse in Dark (Mydriasis)
Haloes around light
Semi - Dilated Non - Reactive Pupil
N + V + Abdo Pain
Hypermetropia (Long SIghted)”
Acute angle closure glaucoma
Investigations for AACG
“Tonometry (raised pressure)
Gonioscopy (see the angle)”
Management for AACG
“Initial:
Muscarinic: Pilocarpine
Beta - Blocker: Timolol
Alpha - 2 Agonist: Apraclonidine
Intravenous Acetazolamide
Definitive:
Peripheral Laser Iridotomy”
“Peripheral visual field loss
↓ Acuity
optic cupping
Myopia (Short Sighted)”
Primary open angle glaucoma
risk factors for POAG
increasing age
affects < 1’5 in individuals under 55 years of age
but up to 10% over the age of 80 years
genetics
first degree relatives of an open-angle glaucoma patient have a 16% chance of developing the disease
Afro Caribbean ethnicity
myopia
hypertension
diabetes mellitus
corticosteroids
fundoscopy signs of POG
Optic cupping
optic disc pallor
bayonetting of vessels
investigations POAG
Fundoscopy (Optic Disc Cupping)
Slit Lamp Examination
Tonometry
Gonioscopy
Treatment for POAG
Latanoprost
“Acute onset
Pupil small +/- irregular
Photophobia
Red eye
Tearing
Hypopyon”
Anterior Uevitis
Associated conditions with Anterior uveitis
ankylosing spondylitis
reactive arthritis
ulcerative colitis, Crohn’s disease
Behcet’s disease
sarcoidosis: bilateral disease may be seen
Investigations for anterior uveitis
“Goniocopy
Tonometry
Slit-lamp investigation
Full eye exam”
Management for Anterior Uveitis
urgent review by ophthalmology
cycloplegics (dilates the pupil which helps to relieve pain and photophobia) e.g. Atropine, cyclopentolate
steroid eye drops
acute or subacute onset of:
painless visual loss or haze (commonest)
red hue in the vision
floaters or shadows/dark spots in the vision
Vitreous Haemorrhage
Investigations for vitreous haemorrhage
dilated fundoscopy: may show haemorrhage in the vitreous cavity
slit-lamp examination: red blood cells in the anterior vitreous
ultrasound: useful to rule out retinal tear/detachment and if haemorrhage obscures the retina
fluorescein angiography: to identify neovascularization
orbital CT: used if open globe injury
“Gradual worsening central vision loss.
Reduced visual acuity.
Crooked/wavy appearance to straight lines.
Wet AMD: more acute - vision loss over days “
Macular degeneration
unilateral decrease in visual acuity over hours or days
poor discrimination of colours, ‘red desaturation’
pain worse on eye movement
relative afferent pupillary defect
central scotoma
Optic neuritis
Causes of optic neuritis
multiple sclerosis: the commonest associated disease
diabetes
syphilis
Investigations for optic neuritis
Investigation
MRI of the brain and orbits with gadolinium contrast is diagnostic in most cases
Management of optic neuritis
Management
high-dose steroids
recovery usually takes 4-6 weeks
Risk factors for macular degeneration
75<
smoking
family history ischaemic cardiovascular disease, such as hypertension, dyslipidaemia and diabetes mellitus.
What is dry macular degeneration
90% of cases
also known as atrophic
characterised by drusen - yellow round spots in Bruch’s membrane
What is wet macular degeneration
10% of cases
also known as exudative or neovascular macular degeneration
characterised by choroidal neovascularisation
leakage of serous fluid and blood can subsequently result in a rapid loss of vision
carries the worst prognosis
Investigations and findings of AMD
“Fundoscopy:
Drusen.
Amsler Grid Testing:
Distortion of Straight Line.
Snellens Chart:
Reduced Acuity.
Scotoma (central patch of vision loss).
Slit Lamp Microscopy.”
Treatment for AMD
“Dry:
Avoid Smoking
Control BP
Vitamin Supplementation (zinc, A, C and E).
Wet:
Monthly Intra - vitreal Anti-VEGF “
