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Ophthalmology > Bits & Pieces > Flashcards

Bits & Pieces Flashcards

1
Q

Define Accommodation

A 
Focussing CLOSE UP
So:
-> Parasympathetic Innervation
-> Contraction of ciliary muscle
-> Relaxes suspensory ligaments
-> Less tension on lens
-> Lens shortens and fattens
-> Greater bending of light
-> Focusses close up
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2
Q

What lens would be used to correct hyperopia vs myopia?

A

Hyperopia (longsightedness)

  • Image focusses behind retina
  • > Convex lens to increase bending of light

Myopia (Shortsightedness)

  • > Image focusses in front of retina
  • Concave Lens to reduce bending
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3
Q

What type of neuron is involved in sight?

A

Bipolar

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4
Q

Papilloedema
Define [1]
Unilateral or bilateral?
Other signs on fundoscopy [5]

A

Optic disc swelling caused by increased ICP
Almost always bilateral

Other signs on fundoscopy:
- venous engorgement: usually the first sign
- loss of venous pulsation: although many normal patients do not have normal pulsation
- blurring of the optic disc margin
- elevation of optic disc
loss of the optic cup
- Paton’s lines: concentric/radial retinal lines cascading from the optic disc

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5
Q

Dislocated lens is common in 2 condtions

A

Marfans

Homocysteinuria

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6
Q

Retinitis pigmentosa associations [3]

A
  • Rare systemic conditions
  • Heart block
  • Laurence-Moon-Biedl syndrome
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7
Q

Blue sclera is seen in what condition?

A

Osteogenesis imperfecta

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8
Q

What is Kayser-Fleischer ring seen in?

A

Wilsons disease

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9
Q

Adverse ocular reactions of drugs

Lid pigmentation

A

Phenothiazine - antipsychotic, antiemetic`

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10
Q

Adverse ocular reactions of drugs

What is practolol syndrome? [2]

A

Oculomucocutaneous syndrome

  • keratoconjunctivitis sicca
  • scarring, fibrosis, metaplasia, and shrinkage of the conjunctiva.
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11
Q

Adverse ocular reactions of drugs

Corneal opacification [3]

A
  • Chloroquine
  • Amiodarone
  • Indomethacin
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12
Q

Adverse ocular reactions of drugs

What drugs affect pupils and accommodation? [3]

A
  • Atropine
  • Tricyclic antidepressants
  • Others with anti-cholinergic activity
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13
Q

Adverse ocular reactions of drugs

What drugs can cause cataracts?

A
  • Corticosteroids

* Busulphan

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14
Q

Adverse ocular reactions of drugs

Retina pigment epithelium drug deposits [2]

A
  • Chloroquine

* Thioridizine

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15
Q

Adverse ocular reactions of drugs

Ganglion cell swelling and death [3]

A
  • Digoxin
  • Quinine
  • Interferon
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16
Q

Adverse ocular reactions of drugs Topiramate

A

Acute angle closure glaucoma

17
Q

Adverse ocular reactions of drugs

Oculogyric crisis [2]

A
  • Phenothiazines

* Metoclopramide

18
Q

Systemic toxicity from ocular treatments
Pilocarpine (cholinergic) [2]

What are allergic reactions from this drug? [2]

A

• Nausea and malaise if drops used in excess

  • Miosis
  • Accommodative spasm
19
Q

Systemic toxicity from ocular treatments

Phospholine (cholinesterase inhibitor) [2]

A
  • Nausea

* Suxamethonium apnoea (beware)

20
Q

Systemic toxicity from ocular treatments

Phenylephrine (stimulant) [2]

A
  • Hypertension (babies and elderly)

* Beware when concomitant MOAI therapy

21
Q

Systemic toxicity from ocular treatments

Beta blockers [3]

A
  • Bradycardia
  • Bronchospasm, reduced exercise tolerance
  • Timolol > Carteolol
22
Q

Systemic toxicity from ocular treatments

Acetazolamide (carbonic anhydrase inhibitor) [4]

A
  • Depression
  • Nausea
  • Potassium depletion
  • Renal stones
23
Q

Systemic toxicity from ocular treatments
Chloramphenicol (antibiotic) [2]
Prostaglandins [1] What are allergic reactions from this drug? [1]

A
  • Rare side effects compared with systemic use
  • Bone marrow suppression

Prostaglandins can cause abortion. Allergic reaction: • Hyperpigmentation of the conjunctiva and iris and skin around the eyes

24
Q

Allergic reactions from eye drops: preservatives [3]

A
  • Follicular conjunctivitis
  • Corneal epithelial toxicity
  • Accumulation in soft contact lenses
25
Q

Allergic reactions from eye drops: atropine [3]

A
  • Cycloplegia
  • Mydriasis
  • Angle closure glaucoma
26
Q

Allergic reactions from eye drops: adrenaline [3]

A
  • Reactive conjunctival deposits in conjunctival sac (adrenochrome)
  • Cystoid macular oedema (in aphakia)
  • Hyperaemia pigmented conjunctiva
27
Q

Allergic reactions from eye drops: idoxuridine [2]

A
  • Epithelial toxicity

* Punctual stenosis

28
Q

Allergic reactions from eye drops: CCS [3]

A
  • Recurrence of herpes simplex keratitis
  • Chronic open angle glaucoma
  • Lens opacities
29
Q

Papilloedema definition

A

Papilloedema describes optic disc swelling that is caused by increased intracranial pressure. It is almost always bilateral.

30
Q

Signs of papilloedema on fundoscopy [6]

A
  • venous engorgement: usually the first sign
  • loss of venous pulsation: although many normal, patients do not have normal pulsation
  • blurring of the optic disc margin
  • elevation of optic disc
  • loss of the optic cup
  • Paton’s lines
31
Q

Patons lines

A

concentric/radial retinal lines cascading from the optic disc

32
Q

Causes of papilloedema [5]

A
  • space-occupying lesion: neoplastic, vascular
  • malignant hypertension
  • idiopathic intracranial hypertension
  • hydrocephalus
  • hypercapnia
33
Q

Rare causes of papilloedema [2]

A

hypoparathyroidism and hypocalcaemia

vitamin A toxicity

Ophthalmology (10 decks)

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