Unit 3: Ophthalmology Flashcards by Justin Holmes

L1: Which pathologic process? Conjunctivitis with thick purulent yellow/white-yellow exudate, eyelids almost swollen shut

Bacterial conjunctivitis

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L1: Which pathologic process? More common type of conjunctivitis, watery discharge

Viral conjunctivitis

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L1: Which structure separates the eyelid from the orbit

Septum

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L1: Which wall of the orbit is most susceptible to fracture?

Inferior

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L1: Which wall of the orbit is thickest?

Lateral

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L1: Which wall of the orbit is thinnest?

Medial

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L2: Most common pathogens in bacterial conjunctivitis

Staph aureus, strep pneumoniae

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L2: Name the physical examination finding: fluffy white areas that represent capillary ischemia and small superficial infarcts

Cotton wool spot

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L2: Name the physical examination finding: lipid leaks from retinal vessels

hard exudate

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L2: Name the physical examination finding: yellow subretinal deposits in the macula consisting of lipofuscin and cell waste

Drusen

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L2: Which bones make up the orbital floor?

Zygomatic, maxillary, palatine

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L2: Which bones make up the orbital lateral wall?

Zygomatic, sphenoid (greater wing)

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L2: Which bones make up the orbital medial wall?

ethmoid, maxillary, lacrimal, sphenoid (lesser wing)

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L2: Which bones make up the orbital roof?

Frontal, sphenoid (lesser wing)

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L2: Which cranial nerves are the afferent input and efferent output in the oculocardiac reflex?

V1; X

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L2: Which pathologic process? Abnormal shape of the cornea causing light to focus in front of or behind the retina

Astigmatism

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L2: Which pathologic process? Acute onset pain, redness, swelling, decrease in vision, white infiltrate in cornea

Corneal ulcer

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L2: Which pathologic process? Associated with extended wearing of contact lenses, risk increased by dry eye or facial nerve palsy

Corneal ulcer

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L2: Which pathologic process? Bilateral optic disc swelling due to increased intracranial pressure, blurring of disc margin

Papilledema

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L2: Which pathologic process? Caused by adenovirus, following URI

Viral conjunctivitis

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L2: Which pathologic process? Cherry red spot

Central artery occlusion

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L2: Which pathologic process? Dilated veins, extensive hemorrhage, often related to hypertension

Central Vein Occlusion

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L2: Which pathologic process? Drusen, hyperpigmentation and atrophy of retinal pigment epithelium, geographic atrophy with large amounts of cell loss

Age-Related Macular Degeneration (AMD) - Non-exudative/Dry

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L2: Which pathologic process? Fatigue, low-grade fever, forehead and upper eyelid rash, unilateral eye symptoms

Herpes Zoster Ophthalmicus

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L2: Which pathologic process? Hypesthesia in cheek and upper lip following trauma

Inferior orbital fracture

L2: Which pathologic process? Increased cup/disc ratio

Glaucoma

L2: Which pathologic process? Infection of lacrimal sac due to nasolacrimal duct obstruction

Dacryocystitis

L2: Which pathologic process? Itching, eyelid swelling, redness, watery discharge

Allergic conjunctivitis

L2: Which pathologic process? Microaneurysms, flame hemorrhages, dot-blot hemorrhages, macular edema, hard exudates

Non-proliferative diabetic retinopathy

L2: Which pathologic process? Neovascularization in the optic disc and retina, complications: vitreous hemorrhage, tractional retinal detachment, neovascular glaucoma

Proliferative diabetic retinopathy

L2: Which pathologic process? Nerve fiber layer and optic disc injury resulting in visual field loss, elevated IOP

Glaucoma

L2: Which pathologic process? Occurs following uncontrolled orbital cellulitis, causing cranial nerve palsies and altered mental status

Cavernous Sinus Thrombosis

L2: Which pathologic process? Ocular/periorbital eye pain, photophobia, blurry/cloudy vision, irregularly shaped pupil

Iritis

L2: Which pathologic process? One of the most frequent causes of vision loss, unilateral eye redness, photophobia, epithelial branching on fluoroscein stain

Herpes keratitis

L2: Which pathologic process? Optical power of the eye is too large, causing light to focus in front of the retina

Near-sightedness

L2: Which pathologic process? Optical power of the eye is too low, causing light to focus behind the retina

Far-sightedness

L2: Which pathologic process? Pain, erythematous lid swelling, tenderness to palpation, extraocular muscle restriction, late vision loss and increased IOP

Orbital Cellulitis

L2: Which pathologic process? Pain, redness, foreign body sensation, tearing

Corneal foreign body

L2: Which pathologic process? Pink eye of a few day's duration, eye pain, discharge, blurred vision, mattering of the eylids in the morning

Conjunctivitis

L2: Which pathologic process? Plugged Meibomian gland causing accumulation of oil within tarsus

Chalazion

L2: Which pathologic process? Progressive disease of the optic nerve associated with increased intraocular pressure

Open Angle Glaucoma

L2: Which pathologic process? Reactivation of VZV

Herpes Zoster Ophthalmicus

L2: Which pathologic process? Retinal hemorrhage, macular edema and exudate, papilledema

Acute Hypertensive retinopathy

L2: Which pathologic process? Risk factors: Caucasian, female, tobacco smoking

Age-Related Macular Degeneration (AMD)

L2: Which pathologic process? Severe eye pain or foreign body sensation with acute onset, tearing, redness blurred vision, irregularly-shaped corneal epithelium

Corneal abrasion

L2: Which pathologic process? Sluggish mid-dialated pupil, hazy cornea, shallow anterior chamber, hardness upon palpation

Angle Closure Glaucoma

L2: Which pathologic process? Top cause of blindness in older individuals

Age-Related Macular Degeneration (AMD)

L2: Which pathologic process? Top cause of blindness in working age adults

Diabetic Retinopathy

L2: Which pathologic process? Unilateral severe eye pain, nausea, redness, blurred vision, halos around lights

Angle Closure Glaucoma

L2: Which pathologic process? Vasoconstriction, arterioslcerosis, arteriovenous nicking,

Hypertensive retinopathy

L2: Which pathologic process? Vision loss, choroidal neovascularization into the retinal pigment epithelium, subretinal hemorrhage

Age-Related Macular Degeneration (AMD) - Exudative/Wet

L3: Indications for repair of inferior orbital fracture within 2-4 weeks (3)

Exophthalmos, incarcerated muscle or orbital tissues, >50% fractured

L3: What treatment/management? Allergic conjunctivitis

Avoid triggers, mast cell stabilizer, antihistamine

L3: What treatment/management? Angle Closure Glaucoma

Laser peripheral iridotomy, lower IOP

L3: What treatment/management? Bacterial Conjunctivitis

3rd/4th fluoroquinolones, tobramycin, sulfacetamide

L3: What treatment/management? Dacryocystitis

antibiotics, surgical bypass surgery

L3: What treatment/management? Diabetic retinopathy

Glycemic/BP control, Anti-VEGF injections

L3: What treatment/management? Dry eye

Antihistamines (systemic causes), artificial tears/eye drops, punctal plugs

L3: What treatment/management? Exudative AMD

Anti-VEGF injections

L3: What treatment/management? Herpes Keratitis

Topical trifluridine, Oral acyclovir/valacyclovir

L3: What treatment/management? Herpes Zoster Ophthalmicus

Acyclovir/Valacyclovir

L3: What treatment/management? Iritis

Steroid drops, systemic workup for recurrent infections

L3: What treatment/management? Mild corneal abrasion

Artificial tears, topical antibiotic ointment

L3: What treatment/management? Non-exudative AMD

Antioxidant vitamins

L3: What treatment/management? Orbital cellulitis

Broad-spectrum antibiotics

L3: What treatment/management? Small corneal ulcer

Fluoroquinolone

L3: What treatment/management? Viral Conjunctivitis

Usually self-limiting, steroid drops in severe cases

L3: Which pathologic process? Large corneal ulcer

Cultures, vancomycin or tobramycin, corneal implant

L3: Which pathologic process? Moderate-Severe corneal abrasion

antibiotic ointment, patch/contact lens, oral pain management

L4: Layers above the skin crease (7)

skin > orbicularis muscle > septum > fat > Levator aponeurosis > Muller's muscle > conjunctiva

L4: Layers below the skin crease (4)

skin > orbicularis muscle > tarsus > conjunctiva