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SAQ for finals > Opthalmology > Flashcards

Opthalmology Flashcards

(56 cards)

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1
Q

In very general terms, what can cause conjunctivitis?

A

bacterial or viral infection of the conjunctiva

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2
Q

Give 3 important causes of painful red eye

A

Anterior uveitis
Acute angle glaucoma
Scleritis
Keratitis
Foreign body

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3
Q

Name of the eye-drop medication for conjunctivitis

A

Chloramphenicol or fusidic acid

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4
Q

what general advice will you give to child and mother for conjunctivitis?

A

avoid towel sharing
regular hand washing
don’t rub eye
keep it clean

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5
Q

If a 5 day old neonate has conjunctivitis, what important causal organism should you consider?

A

Chlamydia trachomatis

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6
Q

Most important diagnosis to consider in absence of red reflex

A

Retinoblastoma

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7
Q

‘cotton wool spot’ with small new vessels around the optic disc area

a) what is a ‘cotton wool spot’?

b) what stage of diabetic retinopathy is described here?

A

a) ischaemic nerve fibres
b) proliferative

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8
Q

other than cotton wool spot, name 3 other possible findings in diabetic retinopathy

A

Microaneurysms
Blot or flame-shaped haemorrhages
Hard exudates

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9
Q

best way of preventing diabetic retinopathy

A

Good glycaemic control

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10
Q

Gradual deterioration of the centre of vision in diabetic retinopathy - what do you expect is happening

A

Maculopathy

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11
Q

Other than maculopathy, name 2 other eye conditions that diabetic patients are at risk of

A

Cataracts
Glaucoma
Vitreous haemorrhage
Retinal detachment

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12
Q

How is the severity of hypertensive retinopathy classified?

A

Keith-Wagner staging 1-4

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13
Q

Name 4 findings on the retina characteristic of severe hypertensive retinopathy

A

Silver wiring
AV nipping
Cotton wool spot
Flame-shaped haemorrhages
Papilloedema

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14
Q

What are changes consistent with grade 2 hypertensive retinopathy

A

AV nipping
Arteriolar constriction

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15
Q

238/122 BP, blurred vision, palpitations

Fundoscopy: absence of venous pulsation, blurring of disc margins

a) What is this ophthalmological sign?

b) What endocrinological disease might be causing this presentation?

A

a) papilloedema
b) phaeochromocytoma

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16
Q

Pt losing their vision - state 6 questions to ask

A

pain?
central or peripheral?
sudden or gradual?
bilateral or unilateral?
red eye?
symptoms of stroke?
trauma?

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17
Q

Name 2 differential diagnoses other than cataract for loss of vision

A

Retinal detachment
Optic neuritis
Vitreous haemorrhage
GCA
TIA
Retinal vein occlusion
Retinal artery occlusion

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18
Q

Name 2 risk factors for the development of cataracts

A

Diabetes
Eye trauma
Uveitis
Long term steroids
Congenital

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19
Q

One positive finding on cataract examination

A

Clouding of the lens
Absent red-light reflex

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20
Q

a) What is the surgical procedure used for the treatment of cataracts?

b) Name 1 complication

A

Phaco-emulsification

Posterior capsule rupture

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21
Q

What is used to measure intraocular pressure?

screening and gold-standard

A

Non-contact tonometry (screening)
Goldmann applanation tonometry (gold-standard)

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22
Q

What does gonioscopy assess in open-angle glaucoma, and what can it distinguish between?

A

Iridocorneal angle (distinguishes open and closed)

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23
Q

Name 2 common risk factors for open-angle glaucoma

Study These Flashcards
A

Myopia
Black
Increasing age
FHx

24
Q

Name 4 medical treatments used to treat open-angle glaucoma

Study These Flashcards
A

Eye drops:

1st line - Prostaglandin analogue e.g. latanoprost increases uveoscleral outflow

Beta blocker e.g. timolol
Carbonic anhydrase inhibitors e.g. dorzolamide
Sympathomimetics e.g. brimonidine
all reduce production of aqeuous humour

25
If a pts vision deteriorates, what organisation will you advise them to get in contact with
DVLA
26
'lamp posts and door frames look wiggly' what type of ARMD do you suspect?
Wet
27
What investigations or examinations would you perform for suspected ARMD? (2)
Amsler chart Slit-lamp fundoscopy Flurescein angiography
28
4 changes found in the macular area of the retina in wet ARMD?
Drusen Atrophic change Choroidal neovascularisation Leaking blood vessels (causing oedema)
29
Management option for wet ARMD and route
Anti-vascular endothelial growth factor injected intravitreal
30
What 4 pieces of counselling or advice will you offer a patient with ARMD?
Inform DVLA Stop smoking Eat diet rich in green vegetables Should only affect central vision
31
State 1 risk factor for acute angle closure glaucoma
Chinese Female Increasing age Family history
32
4 positive features O/E in AACG
Decreased visual acuity Hazy cornea Fixed dilated pupil Red eye
33
Why is there blurred vision in AACG
Corneal oedema
34
Why can AACG resolve when going to bed
Pupil constricts on going to sleep and so pulls iris out of the angle
35
Name 2 agents in immediate treatment of AACG
pilocarpine eye drops acetazolamide
36
What is the definitive management of AACG
Laser iridotomy
37
State 3 causes for sudden painless loss of vision
Retinal detachment Vitreous haemorrhage CRAO CRVO cerebrovascular accident
38
Loss of upper half of visual field in right eye Area of retina that has detached?
Lower half
39
Other than visual field loss, name 2 other symptoms a pt may experience in retinal detachment
Floaters, flashes, decreased visual acuity
40
Who is at greater risk of retinal detachment between pts w/ myopia or hypermetropia
Myopia (thinning of retina as it is stretched over larger area)
41
Name 2 options for treatment for retinal detachment
Laser therapy Cryotherapy Vitrectomy
42
Name 4 steps in the general examination of a patient's eyes
Acuity Pupil response Fundoscopy Visual field
43
Other than eyes, name 2 other parts of your examination in high suspicion of central retinal artery occlusion
Blood pressure Auscultate carotids for bruits Auscultate heart for murmur Pulse for AF
44
What is the commonest cause of central retinal artery occlusion?
Thromboembolism from carotid artery or heart
45
Pupillary responses in CRAO
Relative afferent pupillary defect
46
Classical finding on fundoscopy of CRAO
Pale retina with cherry-red spot at the macula
47
Immediate management of CRAO
IV high-dose steroids (if due to GCA then 6 hour window to save sight)
48
What virus causes shingles?
Varicella zoster virus (Human herpes virus 3)
49
4 symptoms a patient may have prior to eruption of shingles rash
Burning, itching, paraesthesia, headache, fever, myalgia
50
Nerve affected in shingles that causes lesions to extend down to tip of patients nose - significance / what is this sign called?
Nasociliary nerve - means there will likely be corneal involvement (Hutchinson's sign)
51
What chemical agent is used to visualise any ulceration of cornea?
Fluorescein
52
What is the classical shape of ulcers that form on the cornea in opthalmic shingles?
Dendritic
53
what is vital to test for as part of your eye examination in opthalmic shingles and why?
Corneal sensation - can leave the eye exposed to corneal ulceration
54
Treatment for proliferative diabetic retinopathy
Pan-retinal photocoagulation
55
Treatment for optic neuritis
High dose steroids
56
Pathophysiology of acute angle glaucoma
The iris bulges forward and seals off the trabecular meshwork from the anterior chamber This prevents aqueous humour from draining Increasing the ocular pressure Which further exacerbates the angle closure, and places pressure on the optic nerve

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