Opthalmology Flashcards
(110 cards)
1
Q
blepharoptosis (ptosis)
A
drooping or abnormal relaxation of upper eyelid
2
Q
hypopyon
A
inflammatory cells in the anterior chamber. It is an exudate rich in WBC that settles due to gravity. It can be sterile (in case of bacterial corneal ulcer) or not sterile (in case of fungal corneal ulcer)
3
Q
endopthalmitis
A
inflammation of anterior eye. Is a common complication of cataract surgery. Infectious causes are most common.
4
Q
epiphora
A
overflow of tears onto face not due to crying
5
Q
cycloplegia
A
paralysis of ciliary muscle resulting in loss of accomodation
6
Q
accomodative exotropy
A
crossed eyes when trying to focus
7
Q
keratitis sicca
A
inadequate tear production leading to corneal or conjunctival inflammation. is due to secondary sjogren syndrome and VA deficiency
8
Q
atonic pupil
A
no damage to ciliary ganglion or short ciliary nerves. Is a responsive pupil
9
Q
exotropia
A
is a form of strabismus where the eyes are deviated outward. (lack of tone of medial rectus seen in neurogenic ptosis)
10
Q
eyelid xanthelasma
A
yellow spots due to lipid (cholesterol) deposition
11
Q
blepharitis
A
inflammation of eyelids
12
Q
quinsy
A
peritonsillar abscess
13
Q
xeropthalmia
A
dry eye- eye doesn’t produce enough tears. Due to severe VA deficiency
14
Q
order of operation for red eye diagnosis
A
- inspection
- Pain/pressure test (if pain is gone with eye drops its conjunctivitis/keratitis, if not then glaucoma/uveitis/scleritis)
- pupil reflex
- corneal appearance (window reflex/infiltrates)
15
Q
what pathology makes the eye red and rock hard
A
glaucoma
16
Q
WIDE UNREACTIVE PUPIL (MYDRIATIC )AND RED EYE MEANS ? NARROW PUPIL (MIOTIC)+PHOTOPHOBIA MEANS?
A
acute glaucoma attack/
UVeitis (pain goes away when you dilate the pupil)
17
Q
would you give miosis inducing drops in acute glaucoma attack
A
yes
18
Q
symptoms of conjunctivitis
A
pain burning itching eyelids stuck together redness/secretion/follicles (nodular hyperplasia in allergies)/membranes
19
Q
identify secretion types in conjunctivitis
A
- serous/foamy means viral
- catarrhal/yellow means bacterial
20
Q
follicles appear in what conjunctivitis
A
acute viral
21
Q
list the tests and their purposes for the eye
A
- fluorescein dye:
- shirmer: tear production in ml (should be > 20ml)
- break up time:see dry patches on conjunctiva. Should be >20s
- bengala: to see conjunctival erosion
- water into nasolacrimal duct to check patency of passage
- GAG test
- dacryocystography
- lysozyme test
22
Q
dacriocystitis
A
acute inflammation of lacrimal sac due to blockage of lacrimal duct
23
Q
pachymetry measures
A
measures the thickness of the cornea
24
Q
define refractive errors
A
when shape of eye prevents light from focusing directly on the retina
25
in hyperopia you want to make the lens more/less steep
more
26
LASIK is not recommened for
severe hyperopia
27
in phakic IOL the eye's natural lens is
kept in the eye, we only add another lens infront/behind the iris
28
what color is a nuclear cataract
yellow/brown
29
cataract that appears as spoke like opacities towards the centre is called
cortical cataract, Later becomes a white cataract
30
morgagnian cataract
total liquifaction of the cortex allows nucleus to sink inferiorly
31
intumescent cataract
During the immature phase of the cataract, it starts to absorb aqueous humor and becomes swollen. It can result in secondary glaucoma. NOTE THAT IT EXPLODES WHEN CUTTING
32
operative complications of cataract
vitreous loss, posterior loss of lens fragment, suprachroidal hemorrhage (expulsive)
33
early post op complications of cataract
iris prolapse (sutures dont hold up), striate keratopathy, acute bacterial endophalmitis
34
late post op complications of cataract
capsule opacifications (secondary cataract), implant displacement, retinal detachemtns, chronic bacterial endopthalmitis
35
are artifical lenses flexible
no so they cant accomodate
36
list ocular anomalies that lead to congenital cataract
aniridia, coloboma
micropthalmos
buphthalmos
37
what is a round central shell like opacity surrounding a clear nucleus called
a lamellar cataract
38
where is a sutural cataract
it is a congenital cataract where the opacity follows the shape of the Y sutur
39
phimosis
anterior capsular phimosis is the centripetal fibrosis and contraction of the capsulorhexis after cataract extraction
40
striate keratopathy is
corneal edema and folds in descemets membrane due to damage to endothelium during surgery
41
diabetic retinopathy progression to vision loss
(1) retinal capillary leakage leading to macular edema
(2) retinal capillary occlusion leading to proliferative DR leading to vitreous hemorrhage/retinal detachment/neovascular glaucoma
42
hard exudates are present in
diabetic retinopathy they are waxy yellow
43
cotton wool spots are found in
diabetic retinopathy
44
why is there retinal vessel occlusion in DR
Thickening of capillary basement membranes
Abnormal proliferation of capillary endothelium
Increased platelet adhesion
Increased blood viscosity
Defective fibrinolysis
45
what causes blindness in DR
diabetic macular edema
46
treatment of DR causing vision loss
if controlling glycemia doesnt work, then use laser to stop vessel leakage, and anti-VEGF antibodies
47
differentiate AMD early and late
early has focal drusens in between bruchs membrane and RPE.
| late has drusens in subretinal space, and RPE atrophy, If even later then vessels grow in bruchs membrane
48
drusen vs exudates
Drusen occur beneath the retina and are usually, but not always, a sign of age-related macular degeneration (breakdown of tissues in the back of the eye). Exudates typically are within, or immediately under, the retina and typically associated with problems in the retinal blood vessels. Both are fatty deposits
49
metamorphopsia
objects appear distorted
50
amsler test
the Amsler grid is used to check whether lines look wavy or distorted, or whether areas of the visual field are missing
51
treatment of AMD
antioxidant tablets, or anti VEGF tablets (-mab) (NOTE YOU CANNOT REVERSE THIS CONDITION)
52
which vessels does indocyanin green dye show? which does FAG show?
IGD: choroidal vessels
FAG: retinal vessels
53
FA has hyperfluorescence characterised by leakage/pooling/staining what do these words mean
Leakage: Hyperfluorescence progressively enlarges with fuzzy borders. The dye permeates out of leaky, incompetent blood vessels in the setting of neovascularization, retinal vasculitis, vascular malformations, tumors, or disc edema (dye leaks from prepapillary capillaries).
Pooling: Hyperfluorescence progressively enlarges to fill the fluid cavity and then becomes fixed in size. Usually the dye fills a cavity like the subretinal space or sub-RPE space (in a PED).
Staining: Late hyperfluorescence due to accumulation of fluorescein dye. The hyperfluorescence gradually gets brighter, but the size stays the same. Usually a mild amount of fluorescence is seen, but it is never very bright. The optic disc always stains. Additionally, drusen and fibrosis will stain.
54
FA hypofluorescence is
blocking (due to preretinal or vitreous hemorrhage) or filling defect (retinal artery occlusion)
55
RF for AMD
mainly age >50.
| white race and low antioxidant levels
56
HTN retinopathy signs:
- siegrist streaks
- elsching sign
- exudative detachment
- linear pigmented streaks
- focal ischemia
- damage to RPE pump
57
arterial/venous retinal vessel occlusion has worse prognosis?
arterial. It is comparable to stroke, somehow an embolus has entered the eye instead of going to the brain
58
a cilio retinal artery is beneficial in what scenarios
for arterial vessel occlusion
59
amblyopia
lazy eye
60
blepharochalsis
loss of elasticity of the skin of the upper eyelid
61
mullers muscle is
the inferior tarsal muscle
62
proptosis
buldging eye
63
most common ocular tumor
Is basal cell carcinoma
64
meibomian glands produce
oil for tears
65
ziess glands produce
oil for eyelashes
66
moll glands
sweat glands
67
a chalazion is a
meibomian gland cyst
68
whats a hordeolum
A hordeolum (ie, stye) is a localized infection or inflammation of the eyelid margin involving hair follicles of the eyelashes (ie, external hordeolum) or meibomian glands (ie, internal hordeolum).. A hordeolum usually is painful, erythematous, and localized
69
chemosis
swelling/edema of the conjunctiva
70
sjogren syndrome is associated with
dry eye and chronic darcyoadenitis
71
what do you need for retinal detachment?
- liquid vitreous
- tractional forces
- retinal break
72
what retinal detahment is for diabetes?
tractional RD, is a non rhegmatogenous RD
73
treatment for RD is
- scleral buckle
- retinopexy
- intra vitreal gas insertion
- vitrectomy
74
types of retinal tears
```
flap/horseshoe
giant
operculated hole
dialysis
macular hole
atrophic retinal hole
```
75
retinoschisis is
separation of the layers of the layer of the retina but still attached to RPE
76
RF for retinal detachment
- cataract surgery
- lattice degeneration
- pseudophakia/aphakia
77
types of retinal detachment
rhegmatogenous
tractional
exudative
78
explain anatomy of vitreous
the vitreous humor is encapsulated by an anterior hyaloid membrane (separating humor from lens) and a posterior hyaloid membrane (separating humor from retina). This attachement is strongest anteriorly at the ora serrata
79
OCT is based on
interferometry which is superimposing 2 or more waves to detect the differences
80
FAG dye is
Sodium fluorescein which is 80% bound to proteins
81
list dye characteristics in FAG
- autofluorescence
- hypofluorescence (due to blockage/filling defect)
- hyperfluorescence (staining/pooling/filling)
82
name the accessory lacrimal glands
krause and wolfring
83
discharges in corneal/conjunctival infections
- watery: acute virl or acute allergic
- mucoid: chronic allergic C or dry eye
- mucopurulent: chlamydia/acute bacterial
- severly purlent: Gonococcal
- moderately purulent: acute Bacterial
84
multiple small hemorrhages mean
viral conjunctivitis
85
large diffuse hemorrhages mean
bacterial conjunctitivits
86
signs of acute bacterial conjunctivitis
mucopurulent discharge, superficial corneal puncta epithelial erosions, redness, grittiness, burning
87
define corneal dystrophy
is when material deposits in the layers of the cornea and reduces transparency and presents irregular astigmatism (high order aberration)
88
deposits in corneal dystrophy can be in the periphery or in the center, what are the repercussions on corneal shape with these new depositions
at periphery: corneal flattening
| at center: corneal steepening
89
reiss bucklers CD affects what layer
bowmans layer
90
fuch corneal dystrophy affects what layer
descements/endothelial membrane
91
keratoconus is
progressive thinning of the cornea
92
penetrating keratoplasty has less risk of x than lasik because y
x: ectasia (the expansion of a hollow or tubular organ)
Y: it doesnt involve the endothelium like lasik does
93
types of corneal dystrophy
granular and macular CD
94
therapy for ocular migraines
- triptans/NSAID
| - preventative: BB/triptans/antidepressants/antiepileptics
95
explain the morphological classification of uveitis
- anterior: of the iris. Is most common (also with sarcoidosis)
- intermediate: of the vitreous and ciliary body
- posterior: of the retina and choroid
- panuveitis: of the entire uvea
96
anterior vs posterior synechiae
anterior: iris adheres to cornea
posterior: iris adheres to lens
97
aniskoria is
unequal pupil size
98
symptoms of acute anterior uveitis?
| Of chronic anterior uveitis?
- photophobia/pain/watery discharge/blurry vision
- if none of the acute symptoms are present then the first sign of uveitis you'll see are complications like cataracts, glaucoma, and keratopathy
99
signs of anterior UVeitis slit lamp
```
Koeppe nodules (inflammatory cell precipitates which lie at the pupillary margin and could be found in non-granulomaous as well as granulomatous uveitis) Bussaca nodules (lie on the iris surface) which are pathognomonic for granulomatous uveitis.
Keratitic percipitates (mutton)
```
100
treatment of anterior uveitis
corticosteroids, cyclopleigics, mydriatics, anti rheumatoids for long term
101
juvenile idiopathic artritis can cause
anterior uveitis in children. treat with steroids, methotrexate, adalimumab
102
components of the trabecular meshwork are
- uveal (innermost)
- corneoscleral (thickest)
- juxtacanalicular
103
where does the trabecular network drain
schlemm canal
104
aqueous humor is made by
the ciliary body pars plicata
105
why is there optic nerve damage in glaucoma
1) due to pressure at lamina cribosa
| 2) ischemic atrophy
106
congential glaucoma is due to
misformed angle
- iris touching cornea
- mesoderm is still present
- no canal of schlemm
107
acquired open angle glaucoma is due to
sclerosis of meshwork and lining of schlemm (THIS IS THE MOST COMMON TYPE OF GLAUCOMA)
108
types of secondary glaucoma are
- pigmentary
- pseudoexfoliative sydrome
BOTH ARE OPEN ANGLE
109
Drugs given to treat glaucoma
- diuretics
- alpha 2 agonists to decrease aqueous humor production
- BB
110
phempigoid
autoimmune disease causing blisters on skin and mucous membranes that may be present in dye eye
