4th Year Additions Flashcards
sub-types of cataracts
- cortical (spoke-like pattern)
- nuclear sclerotic (most common - progressive brown/green appearance)
- posterior sub-capsular
- mature (white)
what is retrobulbar neuritis?
inflammation that occurs behind the optic nerve head
presentation of retrobulbar neuritis
vision drops then gradually improves
optic nerve is spared so there is no disc swelling
what is neuroretinitis?
sub-type of optic neuritis
with inflammation of the retina and optic nerve
what is seen on fundoscopy in neuroretinitis?
macular start
where are forniceal injections given?
around the edge
to what age are children’s eyes developing?
6
diagnosis of squints?
corneal reflections
cover test
logMAR test
causes of squint
hypermetropia congenital nerve palsies orbit problems e.g. blow-out fracture muscle problems= MG, Daune's, Brown's or fibrosis
management of squint
correct refractive error
treat ambylopia
surgery
management of ambylopia
patching or atropine in good eye
what is a phoria?
latent squint, often symmetrical whereas manifest squint is unilateral
causes of an absent red reflex?
neuroblastoma
cataract
coloboma
what is a coloboma?
failure to fuse into a circle, such as iris, choroid, etc. Hole in the eye
cat eye?
what is ophthalmia neonatorum?
conjunctivitis of the neonate
presentation of blocked nasolacrimal duct?
presents every2 months with sticky eyes + white uninflamed
diagnosis of blocked nasolacrimal duct?
fluorescein dye
management of blocked nasolacrimal duct
most resolve spontaneously
classification of amblyopia
- strabismus
- anisometropic
- stimulus deprivation
- ametropic
what is anisometropic?
unequal refractive error
what is stimulus deprivation causes?
congenital cataracts
ptosis
what is ametropic?
bilateral refractive error (very high prescription)
what vision does glaucoma affect first?
peripheral vision (tunnel vision)
methods for measuring IOP
- non-contact tonometry
2. Goldmann applanation tonometry
what is non-contact tonometry?
involves shooting a puff of air at the cornea and measuring response
what is Goldmann applanation tonometry?
mounted on a slit lamp a device makes contact with the cornea and applies different pressures
neurotransmitter in pupil constriction
ACh
neurotransmitter in pupil dilation
adrenaline
what is a tadpole pupil?
spasm of the iris causes a misshapen pupil, usually temporary
what is tadpole pupil associated with?
migraines
what vascular complications can compress the 3rd cranial nerve?
cavernous sinus thrombosis
posterior communicating artery aneurysm
what does a 3rd nerve palsy with sparing of the pupil indicate?
microvascular cause with sparing of the parasympathetic fibres including diabetes, hypertension, ischaemia
what is a surgical thrid?
full 3rd nerve palsy which can be caused by tumour, trauma, cavernous sinus thrombosis, PCA aneurysm or raised ICP
pre-ganglionic causes of Horner’s syndrome (4T’s)
tumour (Pancoast)
trauma
thyroidectomy
top rib (cervical rib)
central causes of Horner’s syndrome (4S’s)
stroke
swelling (tumour)
MS
syringomyelia
post-ganglionic causes of Horner’s syndrome (4C’s)
carotid aneurysm
carotid artery dissection
cavernous sinus thrombosis
cluster HA
what is congenital Horner’s syndrome associated with?
heterochromia
what is Holmes-Adie pupil?
unilateral dilation that is sluggish to react to light
cause of Holmes-Adie pupil
damage to post-ganglionic parasympathetic fibres (viral usually)
what does Holmes-Adie syndrome present with?
absent ankle and knee reflex
diagnosis fo Holmes-Adie pupil?
pilocarpine
what is Argyll-Robertson pupil?
neurosyphilis - constricted pupil that does not react to light but accommodates
what is hordeolum externum?
infection of the glands of Zeis (sebaceous glands at the base of eyelashes) or glands of Moll (sweat glands at the base of the eyelashes)
what is hordeolum internum?
infection of the meibomian glands
what is a chalazion?
meibomian gland becomes blocked and swells, often called meibomian cyst
causes of painless red eye?
conjunctivitis
episcleritis
subconjunctival haemorrhage
causes of painful red eye?
glaucoma anterior uveitis scleritis corneal abrasion/ ulceration keratitis foreign body traumatic or chemical inury
what does a horseshoe tear precede?
retinal detachment
what is microbial keratitis?
acanthamoeba keratitis (associated with contact lenses)
which short-acting mydriatic assists fundoscopy?
tropicamide
what does a pizza-like appearance of the retina indicate?
CMV retinitis (HIV associated)
management of CMV retinitis?
IV ganciclovir
complication of cataract surgery?
posterior capsule opacification
endophthalmitis
define emmetropic?
no refractive error
what is gonioscopy?
mirror measures the drainage angle
what is pachymetry?
measures corneal thickness
