Random key facts Flashcards by shreya Arun

In acute angle glaucoma which eye condition predisposes you to it

long sited

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tool used to measure intraocular pressure

tono metry

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tool to measure the angle between the iris and cornea

gonio scopy (the angle between the cornea and the iris is GON! in acute angle glaucoma)

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what is the redness on the eye seen In uveitis

usually around the cornea
will see all the other features on slit lamp
- anterior chamber flare
- anterior chamber cells
- hypopyon
- keratinic precipitate

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what is the redness seen in conjunctivitis

redness diffuse all over
Discharge, irritation, itchy/burning, no photophobia, vision usually normal

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what redness seen in scleritis

Deep, violaceous red eye (often sectoral or diffuse)
Severe boring eye pain, worse on movement, may affect vision, globe tenderness

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redness seen in Acute Angle-Closure Glaucoma

Diffuse redness + corneal haze
Sudden vision loss, fixed mid-dilated pupil, headache, nausea, very high IOP

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redness seen in Subconjunctival Hemorrhage

Bright red patch, sharply demarcated
Painless, no vision change, often incidental or after trauma/straining

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what is the difference between scleritis and episcleritis

scleritis is very painful
episcleritis is not supposed to be painful and is also is self limiting

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what are the three features of keratitis

inflammation of the cornea
red eye, photophobia, gritty eye

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two meds for acute angle glaucoma

pilocarpine
acetazolamide

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how to tell which blood vessel has been occluded in the retina

branch retinal vein - red patches of haemorrhage confined to certain areas of the retina
branch retinal artery - cotton wool spots and some pallor
CRAO - cherry red spot and some retinal pallor
CRVO - multiple patches of haemorrhage not confined to one place

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how does age related macular degeneration affect vision vs open angle glaucoma

ARMD - affects central vision (facial recognition, visual acuity)
open angle - affects peripheral vision

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congenital cataracts vs retinoblastoma

retinoblastoma - malignant tumour of the retinal cells, from RB1 gene (emergency)
cataracts - cloudy haze over the lens of the eye

Investigations
Retinoblastoma -> fundoscopy can see a mass in the retina
Cataracts - lens opacification
US - calcifications in the retinoblastoma, none in the cataracts
genetic testing will show RB1 tumour

Treat:
Retinoblastoma - lifelong chemo, surgical resection
cataracts -> remove lens aspiration, posterior capsulotomy
In infants <6 months, many surgeons leave the eye aphakic (without a lens) and correct vision with contact lenses or glasses until secondary IOL implantation is safer.

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what is Amblyopia

“lazy eye” when the eye doesn’t develop properly in childhood
The brain favours the stronger eye and reduces input into the weaker eye as it gives blurry / unequal images to the brain
develops usually before the age of 7

TREAT:
patch
glassess to fix refractive error
surgery if caused by cataracts

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most common cause of amblyopia

Strabismic Amblyopia Caused by a squint (misalignment of eyes); brain ignores the deviated eye.
Deprivation Amblyopia Caused by something blocking vision (e.g., congenital cataract, ptosis).

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what is the fundoscopy looking at

Retina -> contains rods and cones, light sensitive layer of the eye
Optic disc -> where the optic nerve enters
Macula -> has a high number of cones and rods in the periphery
retinal blood vessels

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what are some signs a fundoscopy can show

retinoblastoma - mass on the retina
-papilledema - swollen optic disc
-diabetic retinopathy
hypertensive changes
diabetic retinopathy

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what does a slit lamp show

the patient rests their chin and forehead on a support
then a small beam of light enters the eye

It looks at front of eye
Eyelids and lashes
Conjunctiva (thin layer covering the white of your eye)
Cornea (clear front surface)
Iris (colored part)
Lens (just behind the iris)
Sometimes the vitreous and retina (with additional lenses)

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what are some conditions a slit lamp may be used to diagnose

Cataracts
Corneal injuries or infections
Dry eye
Glaucoma
Macular degeneration
Retinal detachment
Uveitis

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what are 4 conditions that must be ruled out with ocular pain

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Acute angle closure glaucoma
Anterior uveitis
Scleritis
Corneal ulcer

what are the main causes for papillodema

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Unilateral:
- glaucoma
- optic neuritis (MS)
-diabetic retinopathy
-CRVO

Bilateral:
- Raised ICP - tumour, Brain haemorrhage
-hydrocephalus
-malignant HTN

key signs and symptoms of papillodema

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symptoms :
Headache (worse on coughing or standing)
longsightedness
Transient vision loss (particularly when standing)

signs
-Blurring of optic disc margin
- Absent venous pulsation on fundoscopy, Haemorrhages over or near to the optic disc,
- Increase in size of the blind spot, - – -Diplopia (if there’s a sixth nerve palsy)

what is the common bacteria of bacterial keratinitis in contact lens wearers

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pseudomonas aeruginosa

this is a sight threatning emergency

Pain on eye movement → think Pain worsened by light (photophobia) → Pain + red eye + sudden vision loss Pain + proptosis/swelling

- optic neuritis - consider uveitis or corneal issues - be alert for glaucoma or scleritis - orbital cellulitis

ocular pain vs periocular pain

ocular - pain from the eye itself, often dull, sharp or stabbing periocular - around the eye—in the eyelids, orbit, or surrounding structures. Often a dull ache or deep pressure sensation

what is the key feature to look out for on a herpes keratinitis

An acute painful red eye with a dendritic corneal ulcer on slit-lamp examination is characteristic of herpes simplex keratitis. This is caused by HSV 1, which commonly infects the face, lips and eyes.

if your suspecting a patient has a penetrating eye injury and you want to do imaging what would be the best

CT orbits

afferent vs efferent

afferent is input from eye into the brain Light hits the retina → photoreceptors convert it into a signal Signal travels via the optic nerve (CN II) → to the optic chiasm → then to the pretectal nucleus in the midbrain efferent: response from the brain to the eye eg causing dilation or constriction From the Edinger–Westphal nucleus (in midbrain) → via oculomotor nerve (CN III) → to the ciliary ganglion → then to the sphincter pupillae muscle, causing pupil constriction

what is a A relative afferent pupillary defect (RAPD) (prompts urgent CT of orbit)

asymmetric or unilateral optic nerve dysfunction or severe retinal disease as they are not relaying the signals to the brain properly it is shown when

test for relative afferent pupillary defect

How do you test for RAPD? Using the Swinging Flashlight Test: Shine a light in the normal eye → both pupils constrict (normal consensual response). Swing the light to the affected eye: If there’s an RAPD, both pupils dilate slightly, because the brain receives less afferent input from that eye.

if pupils are different in size what are you dealing with

efferent pathway issue usually due to oculomotor nerve palsy Is the larger pupil abnormal? If yes, the problem is likely in the parasympathetic system → think CN III palsy more obvious in bright light eye is down and out 👇 Is the smaller pupil abnormal? If yes, the problem is likely in the sympathetic system → think Horner’s syndrome more obvious in dim light

If a patient presents with a red, painful eye after recent intraocular surgery, and there’s vision loss think

endophthalmitis until proven otherwise. this is an infection inside the eye either within the aqueous or vitreous humor Decreased visual acuity (rapid onset) Severe eye pain Red eye Hypopyon (pus in anterior chamber — white fluid level) Swollen eyelids Vitreous haze (cloudy view on fundoscopy) Photophobia, floaters

why would Fluorescein angiography be used

useful in evaluating the retinal vasculature and identifying areas of neovascularisation, ischaemia, or other abnormalities in cases of proliferative diabetic retinopathy. can also do OCT but not in situation when the retina is blocked due to a vitreous haemorrhage

Bilateral optic neuritis is caused by

Neuromyelitis Optica over MS

Endophthalmitis

usually after a cataracts surgery infection inside the patient's eye. This patient also has a hypopyon, described in the stem as a 'white fluid level', which is a collection of pus in the anterior chamber and indicates intraocular inflammation

A 55-year-old woman presents with a sudden onset painful blurring of vision in her left eye. On examination, the eye appears normal, with normal appearances of the cornea, conjunctiva and pupils. On fundoscopy, she has a left-sided pale and swollen optic disc. Given the most likely diagnosis, what is the most appropriate therapy?

vasculitic subtype of anterior ischaemic optic neuropathy. high dose steroids

2 key meds for anterior uveitis

Topical cyclopentolate and topical corticosteroids

what is a KEY feature of orbital cellulitis that warrants further investigations like a CT orbit

proptosis need hospital admission

visual loss seen in optic nerve damage

Monocular vision loss - Complete loss of vision in the affected eye

visual loss seen at the optic chiasm

Bitemporal hemianopia Loss of peripheral (temporal) vision in both eyes; commonly due to pituitary tumors.

visual loss seen in an Optic tract lesion

Loss of the same side of the visual field in both eyes (e.g., right visual field loss from left optic tract lesion).

visual field loss seen in a Temporal lobe lesion

Contralateral superior quadrantanopia ("pie in the sky") Loss of upper quadrant of the visual field on the opposite side of the lesion.

vision loss seen in a parietal lobe lesion

Contralateral inferior quadrantanopia ("pie on the floor") Loss of lower quadrant of the visual field on the opposite side of the lesion.

if IOP is raised above which number does surgery need to be done for open angle glaucoma

above 24

what is a main side effect of treatment for panretinal laser photocoagulation (treatment for proliferative diabetic retinopathy)

they can experience peripheral vision loss, laser burns are given to the peripheral retina

how does timolol work

reduces the production of aqueous humour in the ciliary body

does central retinal vein occlusion cause painless or painful LOSS of vision

it causes painless LOSS of vision

imaging for optic neuritis

MRI of the brain and orbits with gadolinium contrast is the investigation of choice highlights areas of tissue where there is more leaking from blood vessels

what position does the eye need to be in for the superior oblique to move the eye down

adducted

why might surrounding structure of the eye be red

- herpes zoster keratitis - shingles - rosacea - orbital cellulitis

what is a key part of social history in eye conditions

driving, learn about their occupation

Random key facts Flashcards

(52 cards)