Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neurology > 26 Jan 24 Eye > Flashcards

26 Jan 24 Eye Flashcards

1
Q

RF for orbital cellulitis

A

Local infection:

 Sinusitis 
 Dental infection (maxillary teeth) 
 Skin infection

Orbital trauma

🧇 for orbital cellulitis due to dental abscess always check the side of teeth and eye involvement should be same saide and only maxillary teeth can cause orbital cellulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Orbital cellulitis CF

A

Painful eye movements
Ophthalmoplegia
Proptosis
Visual changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Orbital cellulitis Pathophys

A

Proximity of sinuses to orbital space allows contiguous spread of bacteria (strept. Staph) during episodes of severe sinusitis.
The infection causes inf of extraocular muscles (ophthalmoplegia , painful eye movements) and orbital fat (proptosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

OC management

A

DX :

 Clinical 
 Uncertain cases  CT orbit and sinuses (to identify drainable fluid collections in orbit)

 IV antibiotics 

 Surgical drainage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Preseptal cellulitis cause

A

Preseptal cellulitis is an infection anterior to orbital septum

Cause :

Breaks in skin due to inf (atopic dermatitis )

Trauma (insect bite)

No proptosis , visual change or ophthalmoplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pt with esotropia and asymmetric red reflexes

A

Strabismus / ocular misalignment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Examination of strabismus

A

Asymmetric corneal light reflex
Asymmetric red reflex (more intense in deviated eye)
Cover test: Misaligned eye shifts to refixate on object. Normal maintain same position without moving.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

DIagnostic workup of strabismus….

A

Dilated fundoscopy exam : for secondary causes

 Retinoblastoma

MRI to confirm retinoblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cause of strabismus

A

Idiopathic
Intraorbital mass (retiniblastoma)
Inc ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is it imp to treat strabismus

A

Can cause amblyopia
Dec visual acuity of affected eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Retinoblastoma CF

A

Diagnosed in age <2
Any child with absent red reflex
White pupillary reflex (leukocoria)
Inactivation if RB1 gene
Sporadic is UL
Genetic BL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CF of retinoblastoma

A

Strabismus
Nystagmus
Vision impairment
Ocular inflamation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dx workup of RB

A

MRI of orbits and brain
(Biopsy not done due to risk of seeding )

Immediate Referral to avoid mets to CL eye and brain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Amblyopia

A

Functional reduction in visual acuity in one or both eyes due to vision disturbance in early childhood

UL (most common) : >2 line diff in vision between eyes

BL : vision worse than 20/40 at age >4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of amblyopia

A

Strabismus
Asymmetric Refractive error
Vision deprivation (cataracts , ptosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management of amblyopia

A

▶️ corrective lens
▶️ encourage use of amblyopic eye
Patching eye with better vision
Cycloplegic drops to blur normal eye

▶️ surgery ; cataract removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pathophys of Amblyopia

A

Occurs when visual system is developing
Age <5 . During early childhood dec visual stimuli from one eye results in preferentially enhanced developmentbof visual cortex ass with the other normally functioning eye and further decreased visual acuity of the affected eye.

Because of compensation from normal eye , amblyopia from an uncorrected refractive error maynot present until normal eye is occluded(pirate patch in children)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Ttt of amblyopia

A

Corrective lens

Envourage use of amblyopic eye
Patching eye with better vision
Cycloplegic drops to blur normal eye
Surgery
(Remove cataract )
Without ttt vision loss becomes permanent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Myopia (near sightedness) pathophys

A

Causes by inc axial length of eye (most common) or corneal protrusion

Refracted image is focused anterior to retina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Myopia incidence

A

New onset incidence highest in adolescents

Severity typically stabilizes by early adulthood

RF: positive FH ,
East Asian descent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Myopia CF

A

Blurred distant vision
Normal near vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ttt of myopia

A

Prescription lenses with diverging (concave) lens , refocusing the refracted image onto retina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Examination of Myopia

A

Dec visual acuity
Normal peripheral field testing
Fundoscopy normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Complication in uncorrected or refractory myopia

A

Progressive myopia leads to high myopia
Needing >6 diopters of correction to achieve normal visual acuity

High myopia stretches and thins retina choroid and sclera
These changes causes RETINAL detachment and macular degeneration ➡️ vision loss.

Retinal detachment➡️ retinal tear that allows vitreous fluid to accumulate between retina and choroid

🛞 in some children antimuscrinic drops (atropine ) and orthokeratology (rigid contact lens) mayb used to slow progressive myopia and prevent subsequent complications.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Hyphema
Blood in anterior chamber due to bkunt forced trauma
26
Chemical conjuctivitis onset , findings , ttt
Age of onset : <24hrs CF : Mild conjuctival irritation and tearing Uncommon adverse effect of topical erythromycin Ttt: Artificial tears.
27
Gonococcal conjuctivitis onset , Cf , ttt
Onset: 2-5days CF : Profuse purulent discharge Marked conjuctival injection, and eyelid edema Ttt: IM/IV cefotaxime (single dose)
28
Chlamydial conjuctivitis onset , CF , ttt
Onset : 5-14 days CF: Watery , serosanguineous or mucopurulent eye discharge Mild eyelid swelling Ttt: Oral erythromycin 🎱monitor patients for pyeloric stenosis a potent adverse effect of oral macrolides in infants.
29
Dacryocystitis Cause
Infection of lacrimal sac Causes purulent discharge Erythema and swelling and tenderness over lacrimal sac at MEDIAL CANTHUS of affected eye
30
Why we do oral(systemic) macrolides for chlamydia and not topical ?
Chlamydia perinatal transmission leads to colonization of nasopharynx plus conjuctivitis. Topical erythmromycin has high failure rate and colonization if nasopharynx cant be treated. Hence oral erythromycin
31
Congenital Dacryostenosis
NLD obstruction due to incomplete canalization of distal duct in utero leading to persistent membrane that blocks tear drainage from NLD to nose. Tears flow out of lacrimal sac back into eye (inc tearing or mucoid discharge)
32
Congenital dacryostenosis CF
Intermittent or chronic tearing , mucoid discharge Eyelash crusting/matting Absence of conjuctival injection
33
Ttt of Dacryostenosis
Lacrimal sac massages Reassurance (resolution by 6-12mo) Persistent obstruction➡️ NLD probing
34
Complications of Dacrysostenosis
Distension of lacrimal Sac/duct (dacryocystocele) Infection of lacrimal duct/sac (dacryocystitis)
35
Photokeratitis cause and prevention
UV light causes desquamation of corneal epithellium RF: High altitudes , areas with inc UV light reflection(sand,water , snow) Prevention: UV glasses
36
Photojeratitis CF
👀 severe , BL eye pain and phoyophobia 6-12hr after exposure 👀 foreign body sensation in eye 👀 dec vision 👀 conj erythema , chemosis , tearing
37
Photokeratitis Dx
Punctate corneal staining with fluorescein dye
38
Ttt of photokeratitis
Supportive (oral analgesics , topical AB) Symptom resolution in 1-3 days
39
UV radiation related eye dx
Photokeratitis Pterygium Cataracts
40
Fuoresceine dye showing discrete UL linear stain ….dx
Foreign body
41
When should vision be evaluated in child routine evaluation
4years. 3years in co operative children
42
When is autism evaluated in routine?
Age 18months and 2years.
43
When is despression screening done ?
Age 12.
44
Trachoma CF
Stage 1 (active): Inflammation of upper tarsal conjuctiva Follicular conjuctivitis White yellow follicles on inflammed tarsal conjuctiva Pts have mild itchiness , redness or discharge. Stage 2 (scarring): Scarring of upper tarsal conjuctiva and trichiasis Stage 3: As lashes rub the eye ➡️painful ulcerations ➡️eventually Corneal opacity and blindness
45
Trachoma causative agent
Chlamydia trachomatis (A,B,C) 🎗Genital infection serotypes (D , K)
46
DX of trachoma.
Clinical exam of tarsal conjuctiva (Leading cause of blindness worldwide)
47
Ttt of trachoma
Acute infection is self limiting Oral azithromycin for patient and all contacts to limit the dx and limit the spread.
48
Adenoivral keraticonjuctivitis CF
Preceded by URTI Severe ocular pain Photophobia Corneal abrasions on exam
49
Optic nerve injury mechanism and CF
🚑Facial trauma on blow to face shearing forces are transmitted to optic canal causing avulsion of nerve in the optic canal. 🚑Penetrating eye trauma (needle puncture during eye surgery) CF: Acute vision loss (dec visual acuity) Dec color vision RAPD
50
DX of optic nerve injury
CT scan if orbit
51
Ttt of optic nerve injury
Urgent Ophthalmology referral Surgical decompression Poor initial visual acuity (loss of light perception) is ass with worse prognosis.
52
Strabismus (ocular misalignment) CF
⚽️Constant eye deviation at any age Nasal (esotropia) temporal (exotropia) ⚽️Intermittent eye deviation at any age >4mo ⚽️Eye deviation on cover test ⚽️A/S corneal light reflexes ⚽️A/S intensity of red reflexes ⚽️Torticollis or head tilt
53
Ttt of strabismus
Strengthen deviated eye (Patch unaffected eye , cycloplegic drops to blur unaffected eye ) Correct refractive error Surgery
54
Complication of strabismus
Amblyopia Diplopia
55
Strabismus cause in paeds
<4mo due to immature EOM in infants. >4mo is treated to prevent amblyopia Cause ; Idiopathic IO mass (RB) Inc ICP
56
Strabismus screen
Screening is done until 5years at every visit. (Early ttt has best results as Visual cortex is most malleable)
57
CF of optic pathway glioma (NF1)
UL vision loss Proptosis Esotropia Optic disc pallor NF1; Freckling of skinfold Cafe au lait macules Lisch nodules Neurofibromas
58
Lens dislocation(ectopia lentis) cause
🍔detachment of lens from ciliary body 🍔 blunt ocular trauma (forceful projectile) 🍔 genetic condition (marfan)
59
CF of ectopia lentis
Painless vision loss Tremulous iris with eye movement Lens displacement on slitlamp exam
60
Ttt of ectopia lentis
Glasses to correct refractive error Surgical correction Assessment for underlying condition if lens dislocated on mild trauma (marfan) Screen for marfan with Echo for aortic root disease. As it can be first presentation for marfans
61
Ass conditions in ectopia lentis
Hemocytinuria (intellectual diability, thrombotic events) Marfan ( high myopia , marfanoid habitus , ectopia lentis)

Neurology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions