Opthalmology Flashcards Preview

Buzzwords > Opthalmology > Flashcards

Flashcards in Opthalmology Deck (51):
1

A 78 year old man presents with a painful scalp on combing his hair, and with a recent history of homonymous hemianopia?

Temporal arteritis

2

A 58-year-old diabetic presents with sudden vision loss. The red reflex is absent and his retina is difficult to visualise at fundoscopy

Vitreous haemorrhage
-commonly seen in diabetics

3

A 72-year-old man, who is hypertensive, presented yesterday with a sudden loss of vision, which he described as like a 'curtain coming down'. His vision has returned within 24 hours.

TIA

4

A 16-year-old young woman presents with a transient sudden visual loss and painful eye movements. Fundoscopy is normal

Optic neuropathy
CARDINAL SIGN IS RAPD

5

A 26 year old man presents with painful red eyes with a transient loss of vision

Uveitis
-pupil is smaller than the affected side
-a hypopyn may be seen in severe cases when keratic precipitates will be visible on slit lamp examination

6

RAPD is the cardinal sign of what?

Optic neuropathy

7

Aggregates of cells on the posterior surface of the cornea?

Hypopyn

8

Aterio-venous nipping and papilloedem

Hypertensive retinopathy

9

Haemorrhages, hard exudates and microaneurysms?

Background diabetic retinopathy

10

Cotton wool spots, venous beading/looping, deep/dark cluster haemorrhages, intra-retinal microvascular abnormalities (IRMAs)

Pre-proliferative (severe non-proliferative) diabetic retinopathy

11

A 55 year old man describes sudden onset of severe pain in one eye associated with vomiting coming on in the evening. He has noticed impaired vision and haloes around lights. Examination reveals an inflamed and tender eye with a fixed and semi-dilated pupil

Acute angle closure glaucoma

12

Treatment for glaucoma?

IV acetazolamide and pilocarpine to constrict the pupil

13

Dendritic corneal ulceration

Herpes simplex associated ulcerative keratitis

14

Opthalmia neonatorum

Conjunctivitis of the newborn

15

A 24-year old man presents to his GP complaining of itching burning eyes and lacrimation. On examination you find mild erythema in both eyes, but visual acuity is normal. He is also complaining about painful eye movements

Viral conjunctivitis

16

A 65 year old man complains about sudden-onset left eye pain, which started while driving his car. On examination the eye is red and visual acuity is reduced. He claims to see a 'halo' around lights and describes his visual loss as 'looking through frosted glass'

Closed angle glaucoma

17

'Halos' and visual loss like 'looking through frosted glass'

Closed angle glaucoma

18

A 48 year old man with a recent injury of his left cheek was admitted with marked left-sided periorbital swelling, red eye and blurred vision. He has high fever and is drowsy

Acute cellulitis

19

Treatment for acute cellulitis?

Emergency
Anti-staph antibiotics, such as flucloxacillin in combination with penicillin

20

Bilateral itchy eyes with profuse watery discharge. The tarsal conjunctiva reveals a follicular appearance. Normal visual acuity

Viral conjunctivitis
-presence of FOLLICLES helps differentiate it from other causes of conjunctivitis

21

Painful red eye with a mucopurulent discharge. There is circumcorneal redness, with a hypopyon and a white opacity of the cornea

Keratitis

22

When is a hypopyon seen?

When pus cells accumulate in the anterior chamber of the eyes

23

Unilateral red eye pain, photophobia and mild reduction in visual acuity, and a small pupil?

Iritis
-the pupil is smaller than the unaffected side

24

Where are keratic precipitates seen?

These are aggregates of cells on the posterior surface of the cornea

25

Severely painful red eye in an elderly man with reduced visual acuity, nausea and vomiting. The pupil is fixed and semi-dilated. There is intense engorgement of the corneal and episcleral vessels with corneal oedema.

Acute glaucoma

26

Which condition is most commonly seen in older patients with long-sightedness?

Glaucoma

27

Photophobia and acute painful erythema limited to the inferolateral quadrant of the eye in a 35 year old woman

Scleritis
-usually self-limiting over 7-10 days
-can prescribe artificial tear or even mild topical steroids if the discomfort is severe
-episcleritis can also be limited to a particular area of the sclera but it is characteristically less painful and more of an irritation

28

Holmes-Adie pupil

Characterised by a dilated pupil, which shows a delayed and incomplete constriction to light
If this occurs in association with reduced deep tendon reflexes, it is called Holmes-Adie syndrome

29

A 35 year old female patient presented with photophobia and an enlarged left pupil, which showed a delayed and incomplete constriction to light. Accomodation was relatively normal. A pilocarpine test was positive and no other neurological abnormality was found?

Holmes-Adie syndrome

30

Treatment for anterior uveitis?

Topical steroids and mydriatics

e.g. pred. forte and cyclopentolate

31

Treatment for meibomian cyst?
(chalazion)

Apply heat and massage daily
-self limiting
-no role for topical antibiotics

32

In predisposed individuals, certain drugs can induce angle closure. Name some examples

Nebulised ipratropium and TCA
(because of their anti-muscarinic effects)

33

Short-acting mydriatic

Tropicamide (most commonly used)

34

What is phenylephrine?

Intermediate acting mydriatic

35

Long acting mydriatic

Cyclopentolate and atropine

36

In which condition would adrenaline dilate the pupil?

Horner's syndrome (pupil is sensitised to effects of adrenalina)

37

Hypromellose

Artificial tears
-you could use these in Sjogrens

38

Initial treatment for chronic glaucoma?

Topical beta blocker (e.g. timolol)
-if this doesn't work, you can try parasympathomimetics (e.g.pillocarpine), carbonic anhydrase inhibitors (e.g. dorzolamide) and prostaglandin analogues (e.g. latanoprost). If medical treatment fails --> trabeculectomy

39

Complete third nerve palsy and dilatation of the pupil?

Yes

40

Results from loss of heterozygosity of the normal Rb gene?

Retinoblastoma
(Rb was actually the first tumour suppressor gene to be discovered lol)

41

"Cat's eye" appearance of pupil (white/grey) and loss of red reflex

Retinoblastoma

42

Blue sclera

Ehlers-Danlos syndrome

43

Brushfield spots

Down syndrom

44

Band keratopathy

Hypercalcemia

45

Lisch nodules

Neurofibromatosis

46

Bitot's spots

Vitamin A deficiency

47

Kayser-Fleischer rings

Wilson's disease

48

The presence of inflammatory cells in the aqueous is hallmark of what?

Anterior uveitis

49

This is typified by the presence of drusen (waste products from the retinal pigment epithelium)

Macular degeneration

50

A 34 year old man presents to his GP complaining of pain in both eyes, which is worse when he presses on them through closed eyelids. He is sensitive to bright lights and has noticed that both his eyes look red, although there has been no discharge. In examination his visual acuity is normal. His conjunctiva look red

Anterior uveitis

51

Treatment for autosomal dominant hereditary optic atrophy

Fundoscopy: scrambled egg appearance to the macula

Laser therapy