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Duke Elder > Assorted Concepts > Flashcards

Assorted Concepts Flashcards

1
Q

Collagen type in various ocular structures

A
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2
Q

Driving Criteria

(In order to be eligible for a car/motorcycle license)

A
  1. Read a post-September 2001 number plate at 20m
  2. Visual acuity ≥ 6/12
  3. Horizontal visual field of 120° with 50° of extension in either direction
  4. No visual field defects within 20° of the horizontal meridian

If diagnosis which is unlikely to satisfy these conditions, the DVLA must be notified.

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3
Q

Revise occular structures and their germ tissue of origin

A
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4
Q

How are visual impairments classified

A

The department of health in the UK classifies patients with visual impairments as severe (blind) or partial.

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5
Q

Severe Sight Impairment (blind)

A

One of:

  • VA < 3/60
  • VA 3/60-6/60 AND a severe VFD such as tunnel vision
  • VA ≥ 6/60 with significant VFD, particularly affecting the lower fields
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6
Q

Sight Impaired (partial impairment)

A

One of:

  • VA 3/60-6/60 with full VF
  • VA 6/18-6/24 with moderate VFD or loss of central vision
  • VA ≥ 6/18 with a significant VFD such as hemianopia
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7
Q

Most common cause of blindness in the world

A

Cataract

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8
Q

Most common cause infective blindness in the world

A
  • Trachoma (1st)
  • Onchocerciasis (2nd)
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9
Q

Most common cause of visual impairment in the world

A

Refractive error

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10
Q

Most common type of colour blindness

A

Red-green

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11
Q

Most common cause of nutritional blindness

A

Vitamin A deficiency → nyctalopia

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12
Q

Most common cause of irreversible blindness in the world

A

Glaucoma

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13
Q

Mitochondrial Inheritance

A

Mitochondria are inherited on the X chromosome, meaning a father with mitochondrial disease cannot pass it to his son.

  • Kearns-Sayre syndrome
  • Leber Hereditary optic neuropathy
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14
Q

Kearns-Sayre syndrome

A
  • Increased concentration of mitochondria in muscles
  • Causes to myopathy, ophthalmoplegia, ptosis, salt and pepper retinopathy and cardiac conduction defects
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15
Q

Leber Hereditary optic neuropathy

A
  • Ganglion cell degeneration leads to optic atrophy.
  • Presents in young men with progressive painless vision loss and a fundoscopic triad of pseudo-oedema, telangiectasia and tortuous vessels.
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16
Q

List 4 X-linked Recessive conditions

A

A son can only be affected if the mother is also affected.

  • Congenital Retinoschisis
  • Ocular Albinism
  • Fabry Disease
  • Lowe Syndrome
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17
Q

List 2 Autosomal Recessive conditions

A
  • Oculocutaneous albinism
  • Stargardt’s disease
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18
Q

List 4 Autosomal Dominant conditions

A
  • Congenital Cataracts
  • Corneal Dystrophies
  • Marfan Syndrome
  • Stickler Syndrome: defective collagen 2 syntheses leading to an empty vitreous, RD, deafness and systemic marfanoid and facial abnormalities.
  • Neurocutaneous disorders: tuberous sclerosis, Von-Hippel Lindau and neurofibromatosis
19
Q

Revise diseases associated with specific chromosomes

A
20
Q

Coloboma

A

A coloboma is a hole in the structure of the eye, most commonly the iris. It is uncommon but high-yield in exams.

21
Q

Revise 3 types of colobomas

A
22
Q

Revise organisms and culture mediums

A
23
Q

Classsification of Fungi

A
  • Yeast (unicellular)
  • Filamentous (grow in branches)
  • Dimorphic (features of both yeast and filamentous types)
24
Q

Candida infection

A

The yeast Candida albicans infects the retina of immunocompromised people and it is also the commonest endogenous cause of endophthalmitis.

It typically presents with fluffy white retinal lesions.

25
Q

Aspergillus and Fusarium

A

Both filamentous fungi associated with keratitis following trauma involving soil or bark.

26
Q

Histoplasma

A

A dimorphic soil fungus, endemic to the Mississippi and Ohio river valleys and causes presumed ocular histoplasmosis syndrome (POHS).

27
Q

Protozoa

A

Protozoa are single-celled eukaryotic parasites.

Eg. Acanthamoeba

28
Q

Acanthamoeba

A

Acanthamoeba is found in water and soil. It causes acanthamoeba keratitis (an orphan disease), typically in contact lens wearers who do not remove lenses whilst swimming or are storing lenses incorrectly.

29
Q

Toxoplasma gondii

A

Toxoplasma gondii is transmitted to humans via cats (definitive host). It can also be transmitted vertically by humans and cause congenital toxoplasmosis

30
Q

Helminth

A

Helminths are infection-causing parasitic worms.

Eg. Onchocerca volvulus, Toxocara canii

31
Q

Onchocerca volvulus

A

Onchocerca volvulus causes onchocerciasis (African river blindness) and is the commonest helminth related ocular infection.

It is transmitted by Simulium blackflies and is endemic to Africa

32
Q
A

Ophthalmic excimer laser for refractive surgery

The laser hazard classification (VDE 0837) categorises these therapeutic lasers as class 4, on a scale of 1-4 where 1 is relatively harmless.

33
Q

Explain the application and effect of various lasers

A
34
Q

Medications which raise IOP

A
  1. Topiramate (can result in bilateral acute angle-closure secondary to ciliary body swelling
  2. Steroids
35
Q

Medications which lower IOP

A

Cannabinoids and alcohol can transiently lower IOP

36
Q

Medications which can cause cataracts

A
  • Steroids
  • Amiodarone
  • Allopurinol
  • Busulphan
  • Chlorpromazine (a thiazide): fine yellow-brown granules on anterior lens capsule
  • Gold: innocuous, anterior capsular deposits in 50% of patients
37
Q

Medications which cause Vortex Keratopathy

A
  • Fabry’s disease.
  • Amiodarone
  • Chloroquine
  • Tamoxifen
  • Chlorpromazine
38
Q

What is vortex keratopathy

A

Also known as corneal verticillata

Corneal deposition that has characteristic associations

39
Q
A

Corneal verticillata (whorl-like pattern of cream coloured lines in the cornea) in a patient with Fabry’s disease.

40
Q

Medications Causing Cystoid Macular Oedema

(Retina-related)

A
  • Latanoprost
  • Adrenaline
  • Glitazones
  • Nicotine
41
Q

Medications Causing Bull’s-eye Maculopathy

(Retina-related)

A

Chloroquine (also causes renal toxicity and corneal verticillata)

42
Q

Medications Causing Crystalline Maculopathy

(Retina-related)

A

Tamoxifen

43
Q

Medications which affect the optic nerve

A
  • Ethambutol
  • Chloramphenicol
  • Amiodarone
  • Vigabatrin (also associated with binasal visual field defects)
  • Isoniazid
44
Q

Describe the various sutures used for various ocular structures

A

Duke Elder (12 decks)

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