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Questions based on lectures Flashcards

1
Q

Risk factors for diabetic retionpathy

A 
Young-onset diabetes
Duration of diabetes
Hypertension
Dramatically improved diabetic control
Hypercholesterolaemia
Pregnancy
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2
Q

What does OCT stand for

A

Optical coherence tomography

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3
Q

What does IRMA stand for

A

intra-retinal microvascular abnormality

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4
Q

In summary, why do people with diabetic retinopathy lose their vision?

A

Retinal haemorrhage affecting the fovea
Vitreous haemorrhage
Scarring/tractional retinal detachment

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5
Q

What are cotton wool spots?

A

Nerve fibre degeneration

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6
Q

Raised intraocular pressure
Characteristic field defects
Optic disc cupping

A

Glaucoma

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7
Q

Three things to look for/measure to diagnose and monitor glaucoma

A
  • pressure
  • fields
  • optic disc
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8
Q

Methods of testing: glaucoma (3)

A
  • pressure (tonometry)
  • fields (perimetry)
  • optic nerve - clinical exam
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9
Q

Normal eye pressures

A

Under 20mmHG
20-30 - pretty sure you teach this
Above 30mmHg definitely treat

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10
Q

Classic pattern of visual field loss in glaucoma

A

Arcuate

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11
Q

Second most common cause of blindness in the UK

A

Primary open angle glaucoma

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12
Q

How is POAG usually detected

A

Most detected by optometrist at routine examination

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13
Q

Risk factors for primary open angle glaucoma

A
  • age
  • raised IOP
  • afro-carribean origin
  • family origin
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14
Q

Which disease is more common in afro-carribean people

A

Primary open angle glaucoma

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15
Q

Treatment for acute glaucoma

A

1) need to give acetazolamide and mannitol first (to lower pressure and make cornea less cloudy)
2) give all three types of eye drops (beta blockers, prostaglandin analogues and carbonic anhydrase inhibitors)
3) Iridotomy

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16
Q

Sudden painless loss of all or part of visual field

A

Retinal vessel occlussions

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17
Q

Horizontal and vertical field loss, which is in front and which is behind chiasm?

A

Horizontal - in front of chiasm

Vertical - behind chiasm

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18
Q

Which condition might colour vision be reduced in first?

A

Optic neurities

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19
Q

Gradual loss in vision over a couple of weeks, colour vision reduced

A

Optic neuritis

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20
Q 
Over 50
Scalp tenderness
Weight loss
Proximal myalgia (polymyalgia rheumatica)
Jaw claudication
Raised PV/ESR/CRP
A

Giant cell arteritis

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21
Q

How do you treat giant cell arteritis?

A

Steroids

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22
Q

Causes of retinal vein occlusion

A
  • hypertension
  • raised cholesterol
  • increased viscosity e.g. myeloma
  • inflammation
  • Virchows triad (circulatory stress, endothelial injury, hypercoagulable state)
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23
Q

Why is vascular endothelial growth factor bad?

A
  • leaky vessels (oedema)
  • new vessels, which could cause vitreous haemorrhage
  • new vessels, which could cause neovascular glaucoma
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24
Q

How does dry macular degeneration present

A

Gradual loss of central vision

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25
Treatment for age-related ARMD
Anti-VEGF intravitreal injections
26
Cells in the anterior chamber Synechiae Keratitic precipitates Hypopyon if severe
Anterior uveitis
27
Entropion
Eyelid folds inwards
28
Ectropion
Eyelid droops outwards
29
Purulent vs watery discharge
Purulent - think bacterial | Watery - think viral
30
Mild chemosis
Bacterial conjunctivitis
31
Moderate chemosis
Viral conjunctivitis
32
Treatment for bacterial conjunctivitis
Topical antibiotic e.g. chloramphenicol | fusidic acid may also be used
33
Treatment for viral conjunctivitis
Supportive - cool compress/lubricants
34
Young patient, unilateral, FOLLICULAR CONJUNCTIVITIS
Chlamydia | do chlamydia PCR swab
35
Risk factors for bacterial corneal ulcers
Corneal abrasion Contact lens wearer Dry eye Iatrogenic
36
Treatment for bacterial corneal ulcers
Topical antibiotics e.g. ofloxacin hourly
37
Which drugs could cause cataract
Steroids
38
Cataract treatment
Phaco-emuslfication with intra-ocular lens insertion
39
Most common cause of blindness in western world in the over 65s
Age related macular degeneration
40
Investigations for wet ARMD
Optic coherence tomography | Fundus fluoroscene angiography
41
Sudden, profound visual loss (<6/60) Relative afferent pupillary defect (RAPD) Pale swollen retina with cherry red spot at macula
Central retinal artery occlusion
42
CRAO treatment
Ocular massage Paper bag breathing IV diamox (acetazolamide) Anterior chamber paracentesis
43
Who is most likely to get anterior ischaemic optic neuropathy?
45-65 years Hypermetropes with small crowded optic discs Smokers
44
Treatment for anterior ischaemic optic neuropathy?
No active treatment, assess and treat risk factors
45
Persisting flashing lights Burst of new floaters Dark shadow in peripheral vision, increasing in size
Retinal detachment
46
Is retinal detachment more common in myopes or hypermetropes?
Myopes (short-sighted)
47
Symptoms: Variable loss of vision, usually over few days Washed out colours Dull ache on eye movements ``` Signs: Decreased VA RAPD Decreased colour vision Enlarged blind spot Optic disc swelling (not in retrobulbar neuritis) ```
Optic / retrobulbar neuritis
48
Optic/retrobulbar neuritis and steroids?
IV steroids may hasten recovery but not affect final visual acuity Oral steroids may worsen outcome
49
When might you see a RAPD?
Anterior ischaemic optic neuropathy Optic neuritis CRVO CRAO No RAPD in macular disease
50
Swollen optic disc with hyperaemia - pale disc later
Anterior ischaemic optic neuropathy
51
What does a RAPD test?
Test of optic nerve function
52
Lesions anterior to what are associated with a RAPD?
Lesions anterior to the lateral geniculate are associated with optic atrophy and RAPD
53
Paralysis of sympathetic nerve supply to the eye
Horner's syndrome
54
Causes of Horner's
``` Pancoast tumour Carotid/aortic aneurysms Lesions of neck Congenital Idiopathic ```
55
Really bad side effect of chloramphenicol
Aplastic anaemia
56
Why would you use Rose Bengal stain?
Will stain devitalised areas
57
Why would you use fluoroscein?
Shows up de-epithelialised areas
58
Dilating drops and how long they last for
Tropicamide (shortest duration but least effective) Cyclopentolate (lasts 1 day) Atropine (lasts up to 3 weeks) Phenylephrine - stimulates dilator pupillae
59
Paediatrics: | Sticky and red eye within first 10 days of birth
Chlamydial conjunctivitis
60
Paediatrics: | Sticky and white uninflamed eye
Blocked nasolacrimal gland

Opthalmology (7 decks)

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