Opthalmology Flashcards Preview

General Medicine > Opthalmology > Flashcards

Flashcards in Opthalmology Deck (63):
1

Symptoms of acute angle closure glaucoma

Pain
Headache
Blurred vision
Halo around light
Nausea
Red eye
Unreactive pupil
Increased intraocular pressure

2

Symptoms of a blowout fracture

Fractured orbital floor
Upward gaze palsy
Diplopia on upward gaze

3

Causes of sudden loss of vision

Retinal artery occlusion
Retinal vein occlusion
Amaurosis fugax
Migraine
Episcleritis
Optic neuritis
Retinal detachment

4

Normal intra-ocular pressure

10-21mm/Hg

5

Diabetes is a risk factor for which eye diseases

Cataracts
glaucoma
Retinal vein occlusion
Diabetic retinopathy
Pre-proliferative retinopathy
Maculopathy
3rd N palsy

6

What is aniscoria

Unequal pupil size

7

What is presbyopia

Refractive error due to failure of accommodation with age

8

What is myopia

Short sightedness (long eyeball)

9

What is hypermetropia

Long sightedness (short eyeball)

10

What is astigmatism

Variation in corneal curvature

11

What are mydriatics

Act to dilate the pupils
Tropicamide = short acting
Cyclopentolate = long acting

12

What are miotic agents

Contstrict pupils
- pilocarpine

13

What is schirmer's test

Rate at which strip of paper suspended from lower eyelid is wetted by tears

14

What is Sjögren's syndrome

Systemic autoimmune disease
Immune cells attack exocrine glands that produce tears and saliva

15

Do pupils change time with age

Yes - become smaller

16

Signs + symptoms of Horner's syndrome

Miosis
Ptosis
Absence of sweating
Enopthalmos
Bloodshot conjunctiva
(Distinguish peripheral and central lesions by instilling1% cocaine)

17

What is retinoblastoma

Mutation in Rb-1 on long arm of c.13
Autosomal dominant
Rapidly developing cancer
Increased risk of extra-retinal cancer
95% cure by surgery

18

What eye condition is a common complication of child birth

Subconjunctival haemorrhage
High pressure --> burst vessels in conjunctiva
No tx needed

19

Symptoms of viral conjunctivitis

Watery eye
Itch
Pink eye
Often associated with URTI or cold

20

What is ophthalmia neonatorum

Bacterial conjunctivitis contracted by newborns during vaginal delivery.
Caused by N. gonorrhoea or chlamydia
Can cause blindness

21

What is hypopion

Pus In anterior chamber of eye

22

Symptoms of keratitis

Infection and inflammation of cornea
Pain
Redness
Discharge
Photophobia
Foreign body sensation
Tearing
Burred vision
Decreased visual acuity
Corneal erosion

23

What is dacryoadenitis

Inflammation of lacrimal glands
Swelling eyelid
Pain
Excess tears

24

What is trichiasis

Abnormally positioned eyelashes that grow backward into the eye
--> irritation, red, watery eye

25

Reiters syndrome triad

Reactive arthritis
Urethritis
Conjunctivitis

26

What is ulcerative keratitis

A corneal ulcer
Infection involving disruption of the epithelium

27

What is episcleritis

Irritation + inflammation of the episclera
May be associated with RA, SLE, IBD, HSV, gout

28

Characteristics of diabetic retinopathy

Hard exudates
Microaneurysms
New vessel formation

29

Causes of cataracts

Diabetes
Hypoparathyroidism
Blunt injury
Steroids
Eczema
myotonic dystrophy
Galactosaemia
Congenital toxoplasmosis
Wilson's disease

30

What is scleritis

Serious inflammatory disease affecting the sclera
Occurs in SLE, RA, wergeners granulomatosis

31

Symptoms of retinal detachment

Photopsia (flashes of light)
Sudden dramatic increase in floaters
Dense shadow progressing from periphery
Straight lines appear curved
Central loss of vision

32

Symptoms of acute angle closure glaucoma

Sudden onset eye pain
Red eye
Decreased visual acuity
Halo around lights
Like looking through frosted glass
Vomiting

33

Features of primary open angle glaucoma

Asymptomatic
Peripheral visual field loss
Cupped optic disc

34

Chronic angle closure glaucoma symptoms and signs

Un-noticed visual loss
Increased or normal IOP
Cupped optic disc

35

Risk factors for retinal vein occlusion

Glaucoma
Hypertension
Diabetes
Haematological disorders
Systemic inflammatory conditions

36

Common syx and signs of retinal vein occlusion

Sudden painless loss of vision
Flame haemorrhage
Cotton wool spots
Swollen optic disc

37

Risk factors for retinal artery occlusion

Emboli from carotid or heart valve
Thrombosis
Arteritis

38

Symptoms and signs of retinal artery occlusion

Sudden painless loss of vision
Curtain coming down
Pale oedematous retina
Cherry red spots on macula
Narrowed arteries
White emboli

39

Symptoms of anterior uveitis

Photophobia
Red eye
Watery eye
Lacrimation
Miosis
Blurred vision

40

Causes of anterior uveitis

Herpes simplex
Herpes zoster
RA
ankylosing spondylitis
Sarcoidosis
Behçet's disease

41

Commonest cause of blindness in <65yo

Diabetic eye disease

42

What is thrombotic ischaemia

A severe form of secondary glaucoma.

= Neovascular glaucoma due to new vessel formation in angle of anterior chamber.
Occurs in DM - proliferative retinopathy

43

Treatment of an acute attack of angle closed glaucoma

Acetazolomide

44

Features of background diabetic retinopathy

Capillary Microaneurysm (dot)
blot haemorrhage
hard exudate

45

Features of pre-proliferative diabetic retinopathy

Capillary Microaneurysm (dot)
blot haemorrhage
hard exudate
AND
Venous haemorrhages
Cotton wool spots (soft exudates)

46

Features of proliferative diabetic retinopathy

New vessels (neovascularisation) - thin walls, prone to rupturing
Fibrosis

Plus all other features - dot and blot haemorrhages, hard and soft exudates

47

Features of diabetic maculopathy

Hard exudates involving the macula

48

Presentation of retinal detachment

Visual floaters
Reduced visual acuity
Visual loss like a curtain coming across

49

What is an oculogyric crisis

Dystonic reaction
Often associated with drugs
Presents with restlessness, agitation, confusion
Fixed upward deviation Of the eyes
+/- fixed flexion deformity of the neck
+/- open mouth and protruding tongue

50

When do flame shaped retinal haemorrhages occur

Hypertensive retinopathy

51

microvascular abnormalities associated with Hypertension on Funduscopy

arterial narrowing (copper or silver wiring),
arteriovenous nipping
Flame shaped haemorrhage

Malignant hypertension:
hard exudates appear as a 'macular star' (thin white streaks radiating around the macula),
disc swelling,
cotton wool spots,
flame haemorrhages
arterial or venous occlusions

52

What is a Scotcoma

Visual field defect surrounded by normal vision

53

A lesion atthe optic nerve produces what visual field defect

Monocular visual field loss

54

Lesion at the optic chiasm produces what visual field defect

Bitemporal hemianopia

55

A lesion of the right optic tract produces what visual field defect

Left homonymous hemianopia

56

Confusion at the temporal radiation produces what visual field defect

Homonymous upper quadrantinopia

57

Lesion at the parietal radiation produces what visual field defect

Lower homonymous quadrantinopia

58

A lesion at the occipital pole produces what visual field defect

Homonymous hemianopia with central sparing

59

Signs of optic neuropathy

Optic disc pallor
Reduced visual acuity
Loss of red colour vision
Central scotoma
RAPD

60

Causes of optic atrophy

Chronic glaucoma
Demyelination - e.g. MS
Trauma
Compression - e.g. Tumour
Diabetes
Methanol / ethambutol
Retinal artery occlusion
Retinal vein occlusion

61

What are miosis and mydriasis

Miosis = pupil constriction
Mydriasis = pupil dilation

63

Management of acute angle closure glaucoma

Refer immediately - day or night.
Lie the patient down
Topical agents include:
- Beta blockers, eg timolol 0.5%, one dose
- Steroids, eg prednisolone 1%,
- Apraclonidine 0.5-1%
- pilocarpine 1-2%,
**Acetazolamide IVI **
Offer analgesia ± antiemetics

Surgical - peripheral iridotomy / iridectomy

64

Investigation and management of acute angle closure glaucoma

Examination - red eye + non-reactive mid-dilated pupil.
Palpation of the globe - hard
Measure the IOP >21 mmHg
slit lamp