AMK day 14/10/23 Flashcards
sclera
white part of eye - fibrous layer that protects and shapes the eye.
HWere EO msucles attach
Choriod
is a vascualr layer that provides oxygen and nuritents to the retina
fovea
where visual acuity is highest and is repsonsible for sharp vision
features of Auveiits ( iritis)
pinful red eye
ciliary flush
hypopyon - whote cell collection in eye
pain on eye movement
miosis
abnromally shaped pupil
reduced visual acuity
usually due to autoimmune causes
infection
trauma
ischaemia
malignancy
Mx of ant uveitis
ophthalmology referral
steroid eye drops
mydriatics for sx relief - cyclopentolate ( 6-8hrs of blurry vision) or atropine ( will have blurry vision for a white) most use tropacamide)
immunosuppressants
eye pain and blurry. dendritic ulcer in cornea - most likely organ
herpes simplex 1( face lips and eyes)
contact lenses in tap water - treatment for this
acanthamoeba - chlorine is treatment
herpes simplex 2 affects
genitals
keratitis sx
inflamamtion of cornea
painful red eye
photphobia - hence wearing sunglasses
dendritic ulcers
BF sensation
epiphora - watery eyes
reduced visual acuity
keratitis mx
same day opthalmolog assessment
acyclovir
blurred vision, cannot drive at night due to glare for cars. T2DM , COPD
catarcts
difference bwteen viral and bacterial conjuctivits
bacterial - Purulent discharge(thick and pus like)
Eyes may be ‘stuck together’ in the morning)
viral - Serous discharge((clear and thin; may be present in a healthy,)
Recent URTI
Preauricular lymph nodes
cataracts sx
slow redution in vision
blurring
halos
glare
abnromal red relfex
RF cataracts
Increasing age - biggest RF
Smoking
DM
steriod use
alcohol
metabolic disorders - hypocalcaemia
women
need surgery
4 days post cataract surgery - painful red eye, hypopyon, reduced vision, photophobia, floaters what is tx
intravitreal abx ( vancomycin)
central vision worse. T2DM. vessels and haemorrhages around fovea. fatty deposits across the retina and around the macula what is the answer
wet ARMD
how is hypothyroidism linked to blephairits
hypothyroidism has been linked to blepharitis due to its association with meibomian gland dysfunction.
mx of chronic open angle glaucoma
NICE guidelines
offer 360° selective laser trabeculoplasty (SLT) first-line to people with an IOP of ≥ 24 mmHg NICE
360° SLT can delay the need for eye drops and can reduce but does not remove the chance they will be needed at all
a second 360° SLT procedure may be needed at a later date
prostaglandin analogue (PGA) eyedrops should be used next-line NICE
the next line of treatments includes:
beta-blocker eye drops
carbonic anhydrase inhibitor eye drops
sympathomimetic eye drops
surgery in the form of a trabeculectomy may be considered in refractory cases.
acue angle closure glaucoma what is
angle between iris and cornea is clsoed off as the iris bulges forward and seals off(closure) the trabeuclar meshwork and then aqueosu humour cannot drain away therefore icnrease IOP and causing pain and then down teh line optic nerve damage
sx of acute angle closure glaucoma
sudden onset
peripheral vision loss
severly painful red eye
blurred vision
cornea looks hazy to others
halos in vision/around lights
fixed dilated pupil
firm pupil on palpation
assoicated headache/ NandV
decreased visual acuity
why does the cornea look hazy in glaucoma
build u aqueous humour getting pushed into the cornea causing the cloudiness
rf for acute angle closure glauocma - from lorena teach will in
adreneregic medication
hypermetropia
pathology of open angle glaucoma
graudual onset with increased reisitance due to decrease in aqueous humour outflow through trabecula mesh network leadign to increased IOP and more optic nerve damage - angle between the iris and cornea is normal
presentation of open angle glaucoma
gradual
loss of perioherla vision
haloes
fluctuaitng pain headahce sand blurred v
rf of open angle
icnreasing age
fmaily hisotry
myopia
black
ix for open angle
fundoscop shows cupping of optic nerve - increased cup to disc ratio
goldmann applanation tonometry - measures IOP - note IOP can be normal - gold
mx of open angle
AMK - treatment start over 24mmHg
prostaglandin first line
bb or alpha 2 antaognist - brimonidien
carbonic anhydrase i
trabeculectomy
normal intraocular pressure
10-21mmHg
what is a stye and tx
infected abscess within follicle - hordeolum
staph
painful
warm compress and analgesia
chalazion
cyst due to obstruction of emibomian gland on inside of eye
non fluctuant and painless
entropion
inwards turning of eyelid causing lashes to brush against eyeball
painful
corneal damaeg
need to tape eylid down and lubricating eye drops
ectorpion
bacterial keratitis most comkon ause in contac tlens
peseudomonas
acanothomeoba - unproportionate pain
pus within the anterior chamber.
hypopyon
As her anisocoria is worse in the light, her right pupil which is more dilated than her left, is most likely to be the abnormal pupil. This is because an anisocoria worse in the light suggests an inability of the eye to constrict in response to light, hence the pupillary asymmetry becoming more apparent as the normal eye constricts.
means different in pupil size
where is the problem
right ciliary gnaglion
exotropia can lead to what
Amblyopia, also known as ‘lazy eye
why is a CT scan with contrast should be done if orbital cellulitis is suspected
to assess the posterior spread of infection
tx for corneal abrasion like accidently scratching your eye
Corneal abrasion: topical antibiotics should be given to prevent secondary bacterial infection
complication of pan-retinal laser photocoagulation for diabetic retinopathy
decrease in night vision
Which one of the following features is not present in diabetic pre-proliferative retinopathy?
Microaneurysms
Blot haemorrhages
Cotton wool spots
Venous beading
Neovascularisation
neovascularisation
treat proliferative diabetic retinopathy
Intravitreal VEGF inhibitors + pan-retinal photocoagulation laser
. This patient has stage 3 proliferative diabetic retinopathy, and so will benefit from a combination of both an anti-vascular endothelial growth factor (VEGF) injection and pan-retinal photocoagulation laser.
segmented areas of redness and dilated episcleral vessels
episcleritis
A 26-year-old woman presents to her GP practice with a painful lump on the edge of her left eyelid. She is otherwise well and has no past medical history. On examination it appears that she has a small pus-filled abscess in the area. Her visual field is not affected. Given the likely diagnosis, which of the following treatments should be advised?
Advise regular warm steaming as first line treatment for stye
