Optho Flashcards
(24 cards)
Treatment for bacterial keratitis and why that particular antibiotic ?
When to culture ?
Bacterial keratitis, the most common infectious complication of contact lens use, causes pain, eyelid swelling, photophobia, and conjunctival injection.
Start empiric, broad-spectrum topical antibiotics (with Pseudomonas coverage) like gatifloxacin. (Topical florouquinolone)
Erythromycin won’t cover it
Culture (corneal scrapings) or impression cytology is helpful for severe infections or those that don’t respond to initial antibiotics
Apply antibiotics hourly for the first 24-48 hours, and avoid corticosteroids in the acute phase
What condition presents with a cherry-red macula and sudden painless vision loss?
Central retinal artery occlusion (CRAO)
What ocular findings are typical in diabetic retinopathy?
Microaneurysms, hemorrhages, cotton wool spots, neovascularization (if proliferative)
What is the classic symptom triad of acute angle-closure glaucoma?
Severe eye pain, headache, blurred vision with halos, mid-dilated fixed pupil
What visual field defect is associated with a pituitary adenoma?
Bitemporal hemianopsia
What is internuclear ophthalmoplegia (INO)?
Impaired adduction of one eye with nystagmus of the abducting eye; due to MLF lesion (common in MS)
What causes central scotoma with pain on eye movement?
Optic neuritis (think MS)
What is Argyll Robertson pupil?
Pupils accommodate but don’t react to light; seen in neurosyphilis
What is a Marcus Gunn pupil?
Relative afferent pupillary defect (RAPD); swinging flashlight test → pupil dilates when light moved to affected side
What causes diplopia that worsens when looking down and in?
Trochlear nerve (CN IV) palsy
What condition causes ptosis, miosis, and anhidrosis?
Horner syndrome (sympathetic pathway disruption)
What causes down and out gaze with ptosis and mydriasis?
CN III palsy (check for aneurysm!)
What is the first step in managing a suspected globe rupture?
Shield the eye and call ophthalmology; no pressure or drops
What is a hyphema?
Blood in the anterior chamber, often post-trauma
What condition presents with teardrop-shaped pupil and severe pain after trauma?
Globe rupture
What is the risk of alkali burns to the eye?
Liquefactive necrosis → deeper penetration → irrigate immediately!
What are signs of orbital compartment syndrome?
Proptosis, tight eyelids, decreased vision, afferent pupillary defect—requires emergent lateral canthotomy
What eye condition is associated with sarcoidosis?
Uveitis, lacrimal gland enlargement
What systemic infection causes retinal hemorrhages and necrosis in immunocompromised patients?
CMV retinitis (painless vision loss, “pizza pie” fundus)
What eye finding may occur in Marfan syndrome?
Lens dislocation (superotemporal)
What is the most feared ocular complication of giant cell arteritis?
Irreversible vision loss from anterior ischemic optic neuropathy
What autoimmune disease can cause keratoconjunctivitis sicca (dry eyes)?
Sjögren syndrome
What condition causes salt-and-pepper fundus and pigmentary retinopathy in children?
Congenital rubella
What is the most common cause of blindness in the U.S.?
Diabetic retinopathy
