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Opthalmology > Opthalmology > Flashcards

Opthalmology Flashcards

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1
Q

Treatment of a stye

A

fusidic acid

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2
Q

Associated conditions with dry eye

A

sjrogens
mumps
sarcoidosis
amyloidosis

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3
Q

Treatment of strabismus

A

3 Os
Optical - spectacles
Orthoptic - patches
Operations - resection and recession of the rectus muscles

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4
Q

Explain what you would see in a RAPD

A

loss of direct consensual reflex in good eye but not in bad eye as efferent still intact

light shone in the affected eye, unaffected eye also does not constrict
light shone in unaffected eye, affected eye also constricts
light shone in affected eye again, pupil goes back to same size (looks dilated)

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5
Q

Name 3 causes of RAPD

A 
retinal detatchment
central retinal artery occlusion
central retinal vein occlusion
optic nerve ischaemia
optic neuritis
glaucoma
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6
Q

What would you see if an eye had an efferent defect

A

ptosis
fixed dilated pupil
down and out eye

(CN3 mediated eye movement and lid retraction)

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7
Q

name 3 causes of an efferent defect

A

cavernous sinus lesions
superior orbital fissure syndrome
diabetes
posterior communicating artery aneurysm

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8
Q

How does horners syndrome present

A

small (miotic) pupil
partial ptosis
pupil does not dilate in the dark
reduced unilateral swearing

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9
Q

Damage to what causes horners syndrome

A

sympatheric nerves to the face

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10
Q

Name 3 causes of horners syndrome

A

posterior inferior cerebellar artery occlusion
MS
Cavernous sinus thrombosis
Pancoast tumour (tumour of the apex of lung - non-small cell)
Hypothalamic lesions
Cervical adenopathy
Mediastinal masses

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11
Q

A patient presents with an acutely painful red eye - name 3 differentials

A 
acute angle closure glaucoma
anterior uveitis
scleritis
iritis
corneal abrasion
corneal ulcer
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12
Q

What is the pathophysiology of acute angle closure glaucoma?

A

blocked flow of aqueous from the anterior chamber via the canal of Schlemm (dilation of the pupil ie in darkness worsens this)

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13
Q

Name 3 features of acute angle closure glaucoma

A 
red painful eye
headaches
nausea
blurred vision 
haloes around lights
raised IOP
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14
Q

Drug treatment of acute angle closure glaucoma

A

pilocarpaine (miosis opens a blocked drainage angle)
IV acetazolaminde
Mannitol
Topical steroids and antihypertensive drops

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15
Q

Surgical treatment of acute angle closure glaucoma

A

peripheral iridectomy

clear lens extraction

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16
Q

What structures make up the uvea?

A

iris
ciliary body
choroid

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17
Q

What 2 tests highlight anterior uveitis

A

talbots test - pain gets worse with convergence

slit lamp - white precipitates on the back of the cornea

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18
Q

Treatment of anterior uveitis

A

prednisolone drops
cyclopentolate
adalimumab

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19
Q

Treatment of corneal ulcer

A

chlormaphenicol

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20
Q

What is scleritis associated with

A

connective tissue disorders

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21
Q

Treatment of scleritis

A

oral steroids and ciprofloxacin

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22
Q

Name 3 symptoms of anterior ischaemic optic neuropathy

A 
malaise
jaw claudication
tender scalp
thickened temporal arteries
neck pain
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23
Q

Name 3 conditions that are associated with anterior ischaemic optic neuropathy

A 
temporal arteritis
hypertension
hyperlipidaemia
DM
smoking
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24
Q

What colour goes first in the loss of colour vision

A

red

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25
Fundoscopy reveals a white retina with a cherry red spot on the macula what is the diagnosis
central retinal artery occlusion
26
Fundoscopy reveals cotton wool spots, swollen optic nerve, retinal haemorrhages, macular oedema
central retinal vein occlusion
27
Fundoscopy reveals cupping of the optic disc, vessels emerging from the sic have breaks as they disappear into the cup and are seen at the base again
chronic simple (open angle) glaucoma
28
Treatment of simple glaucoma
``` Latanoprost (prostaglandin analogue) beta blocker (timolol) alpha-adrenergic agonias (brimonidine) acetazolomide (carbonic anhydrase inhibitor) miotic (pilocarpine) ``` Surgery - trabeculectomy
29
What are the four Fs of retinal detachment
Floaters Flashes Field loss Fall in acuity Painless - may be as a curtain falling over the vision
30
Signs of diabetic retinopathy
oedema cotton wool spots (ischaemic nerve fibres) microinfarcts new blood vessels elsewhere
31
What part of the retina has the highest visual acuity?
macula lutea
32
What retinal changes do dry and wet AMD cause?
dry AMD - atrophy of the retina, central scotoma, good peripheral vision wet AMD - new vessel growth under the retinal, localised retinal detachment, distorted central vision and a central scotoma
33
Eye changes with leukaemia
retinal haemorrhages
34
Eye changes with infective endocarditis
roth spots
35
Eye changes with atheroma in carotids
amaurosis fugax
36
Eye changes with wilsons disease
kayser fleicher rings
37
Eye changes with hypoparathyroidsm
lens opacities
38
Eye changes with hyperparathyroidism
conjunctival and corneal calcification
39
Eye changes with TN and sarcoid
choroidretinitis, uveitis
40
Eye changes with SLE
conjunctivitis, scleritis
41
Eye changes with reiters
uveitis (arthritis, urethritis)
42
Eye changes with ankylosing spondylitis
uveitis
43
Persistent watery eye in infant
nasolacrimal duct obstruction - give it a massage
44
Treatment of blepharitis
mechanical removal of the debris from lid margins | Hot compress
45
Causes of painless sudden loss of vision
amaurosis fugax central retinal artery occlusion retinal detachment (curtain coming down) vitreous haemorrhage
46
floaters in a patient with diabetes who has a painless sudden loss of vision
vitreous haemorrhage
47
How does herpes simplex keratitis present
red painful eye photophobia dendritic corneal ulcer decreased visual acuity
48
name 3 features of optic neuritis
``` unilateral decrease in visual acuity over hours or days red desaturation pain worse on eye movement RAPD central scotoma ```
49
Pathways of the pupillary light reflex
afferent: retina → optic nerve → lateral geniculate body → midbrain efferent: Edinger-Westphal nucleus (midbrain) → oculomotor nerve
50
What is the argyll robertson pupil
the prostitutes pupil - neurosyphyllis DM Accomodation Reflex Present but no response to light - bilaterally small irregular pupils
51
Drusens formation is indicative of what condition
dry age related macular degenerationt
52
Treatment of anterior uveiltis
steroid and mydriatic drops
53
Name 3 conditions associated with anterior uveitis
``` ankylosing spondylitis reactive arthritis IBD Behcets disease sarcoidosis (bilateral) ```
54
Glaucoma primarily effects what part of vision
peripheral vision
55
What type of AMD carries the worse prognosis
Wet - Leakage of serous fluid and blood can subsequently result in a rapid loss of vision.
56
What is more common a convergent or divergent squint?
convergent
57
What would wet AMD look like on fundoscopy?
well demarcated red patches that represent intra-retinal or sub-retinal fluid leakage or haemorrhage
58
What does dry AMD look like on fundoscopy?
drusen, yellow areas of pigment deposition in the macular area
59
What is a central scotoma related to?
macular degeneration
60
Open angle glaucoma is associated with what kind of visual loss
peripheral
61
macular degeneration affects what kind of visual loss
central field visual loss
62
Treatment of dry and wet AMD
Dry - Antioxidant supplements | Wet - Ranibizumab
63
Signs of acute angle closure glaucoma
severe pain decrease acuity semi-dilated pupil hazy cornea
64
signs of anterior uveitis
acute onset pain blurred vision and photophobia small fixed oval pupil
65
What medication for glaucoma causes brown pigmentation of the iris and increased eyelash length
latanoprost
66
What glaucoma medication should be avoided in asthmatics and patients with heart block
beta blockers - timolol
67
What side effects does the glaucoma medication pilocarpine have
Miotics - constricted pupil, headache, blurred vision
68
What glaucoma medication do you have to avoid if taking antidepressants?
brimonidine - alpha 2 adrenoreceptor
69
Signs on fundoscopy of background retinopathy
microaneurysms | blot haemorrhages
70
Signs on fundoscopy of pre-proliferative retinopathy
cotton wool spots venous bleeding cluster haemorrhages
71
Signs of proliferative retinopathy
retinal neovascularisation | fibrous tissue
72
Name 3 risk factors that predispose to cataracts
``` Smoking Alcohol Trauma DM Corticosteroids Radiation exposure Downs syndrome Hypocalcaemia ```
73
What is the test for a squint
corneal light reflection test
74
A 64-year-old woman with type 2 diabetes mellitus presents as she has started to bump into things since the morning. Her medications include metformin, simvastatin and aspirin. Over the previous two days she had noticed numerous 'dark spots' over the vision in her right eye. Examination reveals she has no vision in her right eye. The red reflex on the right side is difficult to elicit and you are unable to visualise the retina on the right side during fundoscopy. Examination of the left fundus reveals changes consistent with pre-proliferative diabetic retinopathy. What is the most likely diagnosis?
``` Vitreous haemorrhage - DM - aspirin - inability to visualise the retina 'dark spots' ```
75
What is an Adie pupil?
``` dilated pupil slow reactive to light caused by damage to parasympathetic innervation to the eye due to infection Commonly seen in females Accompanied by absent reflexes ```
76
What is Hutchinsons pupil
unilaterally dilated pupil unresponsive to light | as a result of compression of the occulomotor nerve on the same side by an intracranial mass
77
Name 3 causes of tunnel vision
papilloedema glaucoma retinitis pigmentosa
78
Name 3 causes of papilloedema
``` SOL malignant HTN idiopathic intracranial hypertension hydrocephalus hypercapnia ```
79
Name 3 signs of papilloedema on fundoscopy
venous engorgement loss of venous pulsation loss of optic cup
80
How do you differentiate between scleritis and episcleritis
scleritis is painful whereas episcleritis is not both cause a watery eye with photophobia
81
A patient presents with a sudden loss of vision with severe retinal haemorrhages on fundoscopy (cheese and tomato pizza)
central retinal vein occlusion
82
Symptoms of vitreous/retinal detachment
flashes and floaters sudden painless loss of vision refer urgently
83
Features of herpes zoster ophthalmicus
vesicular rash around the eye | hutchinson sign - rash on the tip or side of nose
84
A 75-year-old lady, who has been a diabetic for over 25 years attend her regular follow-up sessions. During the consultation, the lady mentions to her GP that she has had difficulty with her vision over the past few months, especially in the left eye. She described it as a blurry vision and also reported seeing round figures around lights at night. The lady has never had problems with her vision in the past. She currently also takes medications to manage her blood pressure and cholesterol levels. Physical examination is otherwise unremarkable. What is the diagnosis?
Cataract
85
Anterior uveitis is associated with what diseases?
``` Autoimmune conditions: Ankylosing Spondylitis Behçet’s Disease Juvenile Idiopathic Arthritis Reactive Arthritis (also known as Reiter’s Syndrome) Inflammatory bowel disease Sarcoidosis ```

Opthalmology (1 decks)

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