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Year 4 - Ophthalmology > Pathology > Flashcards

Pathology Flashcards

1
Q

what are eye cataracts

A

opacification / clouding of the lens

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2
Q

causes of cataracts

A 
age 
diabetes 
sunlight - UVB 
steroids 
hypertension 
smoking
ocular trauma  
metabolic disorders 
genetic
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3
Q

symptoms of cataracts

A

gradual painless loss of vision
diplopia
difficulty reading / writing
halos around lights

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4
Q

signs of cataracts on examination

A

clouded lens

absent red reflex

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5
Q

management of cataracts

A

phaco-emulsification with intra ocular lens replacement surgery

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6
Q

what is a consequence of uncorrected cataracts in children

A

amblyopia (lazy eye) - eye fails to achieve visual acuity and vision does not develop properly

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7
Q

what is conjunctivitis

A

inflammation of the conjunctiva

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8
Q

what is scleritis

A

inflammation of the sclera

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9
Q

symptoms of scleritis

A

associated with pain on movement
red eye
impaired vision
associated with autoimmune conditions - SLE, RA

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10
Q

phenylephrine testing in scleritis is positive/negative

A

negative

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11
Q

what is episcleritis

A

inflammation of episclera

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12
Q

symptoms of episcleritis

A

no pain on movement
superficial
self limiting

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13
Q

phenylephrine testing in episcleritis is positive/negative

A

positive

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14
Q

How can you differentiate between scleritis and episcleritis

A

phenylephrine drops will cause blanching of vessels in episcleritis (positive) and no change in scleritis (negative)

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15
Q

what is glaucoma

A

progressive optic neuropathy usually due to an abnormal increase in intra-ocular pressure as a result of blockage to aqueous humour drainage (trabecular meshwork or canal of Schlemm)

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16
Q

what ultimately happens in glaucoma

A

pressure builds up and greatly impacts on optic nerve/disc resulting in a blindspot

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17
Q

what are the types of glaucoma

A

open and closed angle

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18
Q

which is more common, open or closed angle glaucoma

A

open angle

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19
Q

what is the pathology behind open angle glaucoma

A

blockage of drainage of aqueous humour

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20
Q

onset of open angle glaucoma

A

slow onset

asymptomatic

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21
Q

signs of open angle glaucoma on fundoscopy

A

cupping of the optic disc
characteristic field changes
raised IOP

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22
Q

what is the pathology behind closed angle glaucoma

A

the drainage system is fine but the iris BULGES FORWARD to block drainage angle meaning fluid can’t circulate and it accumulates behind the iris

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23
Q

acute closed angle glaucoma is an emergency, true or false

A

true!

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24
Q

symptoms of closed angle glaucoma

A 
acute red eye 
severe headache 
N+V
hazy cornea 
fixed mid dilated pupil 
reduced vision 
pain
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25
management of closed angle glaucoma
laser a hole through the iris
26
what is ARMD
ARMD is characterised by appearance of drusen in the macula
27
what is drusen
fatty protein and lipid deposits
28
what are the types of ARMD
dry and wet
29
describe dry ARMD
no significant vascular proliferation more common less severe essentially wear and tear of RPE layer
30
describe wet ARMD
``` significant vascular proliferation always begins as dry ARMD neurovascularisation in choroid mediated by VEGF these new vessels are leaky and fragile more likely to lead to loss of vision ```
31
management of dry ARMD
conservative
32
management of wet ARMD
monoclonal Ab to VEGF
33
commonest causes of retinopathy
hypertension and DM
34
what is an Argyll Robertson Pupil
ocular sign usually seen bilaterally accommodates but does not react
35
causes of an Argyll Robertson Pupil
late stage neurosyphilis DM MS stroke
36
what is rubeotic glaucoma
neovascularisation on surface of the iris | seen in severe DM or severe retinal vein occlusion
37
features of diabetic retinopathy
``` leaky vessels aneurysms oedema dot and blot haemorrhages flame haemorrhages ```
38
what is papilloedema
swelling of the optic disc die to raised intracranial pressure
39
what is CRAO (central retinal arterial occlusion)
blockage of the central retinal artery eg amaurosis fugax ~ TIA of the eyes usually from the carotids and thromboembolic disease
40
describe vision loss in amaurosis fugax
vision loss like a curtain coming down
41
what is CRVO (central retinal vein occlusion)
blockage of the central retinal vein eg GCA vasculitis eg atherosclerosis of neighbouring artery impinging on vein
42
in which neurological condition can optic neuritis be seen | what is a sign of this
MS | RAPD
43
what is a cause of ischaemic optic neuropathy
GCA
44
what investigations are used to monitor signs in glaucoma
IOP - tonometry visual fields - perimetry optic disc - fundoscopy
45
risk factors for open angle glaucoma
age raised IOP afro-carribean FH
46
what is the name of surgery for open angle glaucoma
trabeculectomy
47
patient with which refractive error have an increased risk of closed angle glaucoma
hypermetropes
48
management of closed angle glaucoma
reduce IOP medically | peripheral iridotomy
49
what is the pathogenesis in wet ARMD
eye grows new blood vessels within the macula to 'repair' dry ARMD new vessels are leaky and so bleed into retinal tissue
50
CRAO treatment is only effective if presentation is within 12-24 hours, true or false
true
51
management of CRAO
ocular massage paper bag breathing IV diamox anterior chamber paracentesis
52
management of CRVO
no signs of ischaemia - observe every 3 months ischaemia but no neovascularisation - observe every 4-6 weeks ischaemia + neovascularisation - urgent PRP
53
what is Horner's syndrome
paralysis of sympathetic supply to the eye - mild ptosis - constriction of pupil - anhydrosis
54
risks of corneal transplant
``` rejection astigmatism glaucoma uveitis retinal detachment ```
55
risk factors for retinal detachment
myopia previous eye trauma / surgery FH
56
complications of lens replacement surgery
endophthalmitis | unexpected refractive error
57
pathophysiology of thyroid eye disease
inflammatory changes in the EOM and hypertrophy of orbital fat leading to ocular dysmotility, diplopia and proptosis
58
indications for corneal transplant
keratoconus | corneal scarring following infection or trauma
59
what is keratoconus
progressive thinning and bulging of the cornea into a conical shape
60
how can you prevent corneal graft rejection
long term use of topical corticosteroids
61
what is the surgical treatment for glaucoma
trabeculectomy | laser iridotomy
62
what are sight threatening complications of BRVO
macular oedema | rubeotic glaucoma

Year 4 - Ophthalmology (12 decks)

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