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402: Ophthalmology > Anterior disorders > Flashcards

Anterior disorders Flashcards

1
Q

Define cataracts

A

Opacity of the lens due to deposits of proteins by epithelial surface.

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2
Q

Risk factors/ associations for cataracts

  • Demographics
  • Diseases/ conditions
  • Lifestyle
  • medications
A

Demographics:
- Increasing age

Diseases:

  • Diabetes
  • Uveitis
  • Down’s syndrome
  • Retinal pigmentosa
  • High myopia

Lifestyle:

  • Smoking
  • Alcohol

Medication
- Steroids

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3
Q

Types of cataracts and their associations [3]

A

Nuclear
- Central, typically due to aging

Cortical

  • Affects outer layer and moves inwards
  • Associated with diabetes

Posterior subcapsular

  • Affects posterior lens
  • Associations: younger age, steroids, diabetes, trauma,
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4
Q

Complications of cataract surgery

A

Lens displacement

Endophthalmitis

  • Infection of the inner eye contents
  • Management: intravitreous injection of antibiotics.
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5
Q

Presentation of cataracts

A
  • Gradual onset
  • Reduction of visual acuity
  • Discolouration of vision= yellow/ brown hue
  • Starbursts/glare around lights, particularly at night

Signs

  • Reduced visual acuity (Snellen)
  • Reduced/ absent red reflex
  • Opacification of lens in slit lamp
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6
Q

Management of cataracts

A

Mild cataracts
- Correct visual acuity with lens

More severe cataracts= surgery
- Removal of opaque lens and implant of new lens.

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7
Q

Causes of corneal abrasions

A

Foreign bodies

Contact lens

Fingernails

Eyelashes

Entropion

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8
Q

Presentation of corneal abrasion

A

Red, painful eye

Watering eyes, no purulent discharge

Grittiness to eye/ foreign body sensation

Blurred vision

Photophobia

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9
Q

First line examination for corneal abrasion

A

Slit lamp ophthalmoscopy with fluorescein stain

  • Shows yellow/orange lesions of abrasion
  • Can show foreign bodies.
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10
Q

First line examination for corneal abrasion

A

Slit lamp ophthalmoscopy with fluorescein stain

  • Shows yellow/orange lesions of abrasion
  • Can show foreign bodies.
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11
Q

Contact lens corneal abrasion is associated with infection by…

A

Pseudomonas

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12
Q

Management of corneal abrasions

A

Pain management= simple analgesia

Infection prevention
- Chloramphenicol drops

Lubricating drops

Photophobia relief= cyclopentolate

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13
Q

Features of herpes keratitis

A

Dendritic corneal ulcers seen via fluorescein stain

Presentation

  • Red, painful, watery eye.
  • Blurred vision
  • Grittiness, foreign body sensation
  • Photophobia
  • Vesicles
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14
Q

Management of herpes keratitis

A

Topical antivirals

  • Aciclovir topical
  • Ganciclovir gel

Steroids for stromal keratitis

Corneal transplant for scarred cornea.

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15
Q

Anterior uveitis

  • Definition
  • Causes
A

Inflammation of the iris, typically due to systemic autoimmune/ inflammatory disorders.

Causes:

  • Acute= ankylosing spondylitis, IBD, reactive arthritis.
  • Chronic= Sarcoidosis, TB, Lyme disease
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15
Q

Anterior uveitis

- Presentationc

A

Acutely= painful, red eye

Reduced visual acuity/ blurred vision

Floaters/ flashes (cells in anterior chamber)

Photophobia

Lacrimation/ watery eye

16
Q

Anterior uveitis

- Diagnosis

A

Slit lamp examination of anterior eye

  • White cells in anterior chamber
  • Hypopyon (accumulation of cells, forming white fluid)
  • Posterior synechiae (adhesion of iris to lens)
  • Ciliary flush (redness from cornea outwards)
17
Q

Management of anterior uveitis

A

Topical/ oral steroids

Cycloplegic-mydriatic drops

  • Cyclopentolate/ atropine
  • Dilates pupils, reduces pain from ciliary spams

Treatment of underlying disease via immunosupressants

18
Q

Causes of acquired ptosis

A

NMJ:
- Myasthenia gravis

Demyelination
- Multiple sclerosis

Nerve lesions

  • Horner’s syndrome
  • Bell’s palsy
  • Cerebrovascular accident

Anatomical

  • Exophthalmos
  • Meibomian cyst
  • Atopic dermatitis
19
Q

Vortex keratopathy (corneal verticillata)

  • Definition
  • Causes
A

Deposition of asymptomatic grey opacities in a vortex pattern on the corneal epithelium

Causes

  • Fabry disease
  • Medications
20
Q

Medications that cause vortex keratopathy

A

Amiodarone

Chloroquines (malaria)

Indomethacin (NSAID)

Phenothiazine (D2-receptor action)

21
Q

_______ is given in anterior uveitis to for pain and to treat muscle spasms

A

Cyclopentolate/ atropine (cycloplegic-mydriatic)

22
Q

First line imaging for orbital cellulitis

A

CT with contrast

23
Q

Orbital cellulitis presentation

A

Painful, red eye

  • Painful eye movements
  • Ophthalmoplegia

Reduced acuity

Proptosis

Abnormal pupil light reflex

24
Q

Contact lens users have an increased risk of keratitis caused by…

A

P. aeringosa

402: Ophthalmology (7 decks)

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