12. Opthalmology Flashcards
What is BPPV?
Reccurent and brief attacks of positional vertigo
Canalith particles break loose and fall into the wrong part of semi-circular canals of ear
Symptoms of BPPV?
Last less than a minute
Provoked by position
Quick onset
N&V
How do we investigate BPPV?
Hallpike’s manoeuvre
- Sit up, rotate head 45 degrees and then lie patient down and hold at 20 degree at edge of bed
- Positive is nystagmus and vertigo
What is menieres disease?
Inner ear change in fluid volume in labyrinth, causing tinnitus and vertigo.
Idiopathic, menieres syndrome is secondary to another condition e.g. allergy, viral, syphilis etc.
Symptoms of menieres disease?
Minutes to hours
N&V
Tinnitus
May have hearing loss in affected ear
Fukuda’s stepping test - marching and body starts to turn toward affected side
Romberg’s test - eyes closed and body will tilt to affected side
How do we investigate and treat meniere’s?
Clinical diagnosis but sensorineural hearing loss on affected side
No cure
Vestibular suppressant drugs e.g. benzos, antihistamines
Lifestyle to prevent recurrence - limit salt, caffeine, alcohol, smoking and stress.
Exercise for balance.
What is a thyroglossal cyst?
Epithelial-lined cyst between adam’s apple and chin.
Median age 5 y/o
Thryoglossal duct should disappear after 6 weeks but if open, fluid
Thyroglossal cyst symptoms?
Lump that is compressible and moves upward when tongue protruded and on swallowing
What is cataracts?
Opacification of the lens with gradual loss of visual acuity as the lens degrades overtime
Symptoms of cataracts?
Loss of vision over years
Blurred vision
Glare in bright light
Painless
Examination and management for cataract?
Slit lamp reveals a black cataract against red reflect
Normal pupillary response
Reduced red reflex
Control risk factors
What is conjunctivitis?
Inflammation of conjuctiva
Viral most common e.g. EBV
Bacterial e.g. staph a
Symptoms of conjunctivitis?
Eye redness
Discharge
Itchy
Crust formation
How do viral and bacterial conjunctivitis differ?
Viral clear and water discharge, unilateral but then becomes bilateral with redness and conjunctival follicles.
Bacterial is thick purulent discharge, unilateral with diffuse redness
How to manage conjunctivitis?
Viral - self-limiting, antihistamine drops and maybe acyclovis if herpes
Bacterial - abx
Allergic - avoid allergen, cold compress and antihistamine drops