Opthalmology Flashcards
(16 cards)
What is the most common cause of blindness in the UK
Age-related macular degeneration
What are the 2 types of macular degeneration?
Dry macular degeneration (early age-related macular degeneration): formation of yellow drusen, accounts for 90% of MD
Wet macular degeneration (late age-related macular degeneration): neovascularisation leads to leakage of serum/blood exudate and can lead to a more rapid decline in vision - accounts for 10% and has worse prognosis
What is the typical presentation of macular degeneration?
Presents with loss of visual acuity, especially for near-objects - this is gradual in dry but more sub-acute in wet.
Difficulty with adjusting to darkness / worsened vision at night
Fluctuant visual acuity day-to-day
Notice flickering / flashing lights (photopsia)
What is the treatment for macular degeneration?
Dry - Zinc combined with Vits A, C , E
Wet - Anti-VEGF (e.g Ranibizumab, Bevacizumab, Pegaptanib) injection, usually 4 weekly
What is the typical presentation of Horner’s syndrome?
Horner’s syndrome - the triad of ptosis / dropping of the eyelid, constricted pupil and anhydrosis (Lack of sweating on the one side)
Caused by lesions that affect the stellate ganglion of the sympathetic nervous system either pre-ganglionic e.g pancoast tumour or postganglionic for example problem with the central nervous system e.g MS
True or false - prolonged use of inhaled corticosteroid can cause increased ocular pressure and are associated with glaucoma development
True!
What is the first line treatment for chronic open angle glaucoma?
A prostaglandin analogue such as latanoprost
What are the differentiating symptoms to help you differentiate between preseptal and orbital cellulitis?
The below features suggest orbital (post-septal cellulitis) - pain on eye movements, restricted eye movements, decreased visual acuity, proptosis
What is the typical presentation of optic neuritis?
Often presents in young-middle age women
PAINFUL vision loss (often with pain on eye movements and loss of vision in a central scotoma)
Also get relative afferent pupillary defect and loss of colour vision
What is a common opthalmological side effect of Amiodarone that presents with glare during night driving?
Corneal microdeposits
- may present with halos and glare during night-driving
Normal reversible on stopping amiodarone
what are the different types of eye drops available for glaucoma and what is their mechanism of action?
1st line = prostaglandin analogues e.g Latanoprost, Bimatoprost.
Reduce pressure by increasing the drainage of aqueous humour through the uveroscleral pathway
Minimal systemic side effects - can cause thickening and darkening of the eyelashes and darkening eye colour
Additional options:
Beta blockers - Timolol, Betaxolol - reduce the production of acqueous humour
CAN NOT BE USED IN RESPIRATORY OR CARDIOVASCULAR DISEASE
Carbonic anhydrase inhibitors e.g Brinzolamide = also reduce acqueuous humour production
Alpha agonist - e.g Brimonidine - both increase the outflow and reduce the production of acqueuous humour
What eye drops can be used for allergic eye symptoms e.g during hayfever?
Topical mast cell stabilisers e.g Sodium Cromoglicate or Lodoxamide
What is the typical presentation of a dendritic corneal ulcer and what organism causes it?
Presents with unilateral painful red eye with photophobia and lacrimation + and irregular uptake of fluroscein stain
Caused by herpes simplex virus
Treatment = refer for immediate ophthalmology assessment + aciclovir eye drops
What is the difference between a stye and a chalazion?
A stye or hordoleum is angry / pustulated and painful = infected eyelash follicle
A chalazion or meibomian cyst is PAINLESS and a slow-growing due to blockage of meibomian glands - can settles with warm compress, but if persistent after a few months can refer for injection or surgical excision
What is the typical presentation of scleritis?
Boring eye pain, with dilated scleral vessels all over the eye with reduced visual acuity
Should be referred for same day opthalmic assessment
What is the typical presentation of iritis?
Circumlimbial redness (ie redness concentrating around the cornea)
Pain
Photophobia
Reduced visual acuity
Constricted pupil
