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Yr5 Ophthalmology > Cataracts > Flashcards

Cataracts Flashcards

1
Q

What are cataracts?

A

Opaque protein deposits onto lens

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2
Q

What are the risk factors for cataracts?

A 
↑Age 
Smoking
DM
Corticosteroids
Female
Malnutrition
Acute dehydration 
Inflammatory eye disease
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3
Q

What are the causes of congenital cataracts?

A 
TORCH:
Toxoplasmosis
Other
Rubella
CMV
HSV
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4
Q

How do cataracts present?

A 
Gradual onset
Blurred vision: Difficulty reading/see TV
TROUBLE W/NOCTURNAL VISION
Dazzle/glare
haloes 
Opacity
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5
Q

What are signs of a cataract in a child

A

Squint
White pupil
Nystagmus
Amblyopia

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6
Q

How are cataracts investigated?

A

Fundoscopy

Slit lamp: Red reflex, lens appears brown/white

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7
Q

What are the different types of cataracts?

A

Nuclear (elderly): Refractive index varies
Cortical: Spoke-like shape, mild acuity affect
Post sub capsular: Clasic glare from sunlight/nocturnally, fast progression

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8
Q

How are cataracts treated?

A

Conservative: Mydriatic drops
Surgery: Phaecoemulsion + Intra-ocular lens implant

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9
Q

How soon should congenital cataracts be acted upon?

A

4weeks

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10
Q

What are the indications for cataract surgery?

A

QoL↓

Unable to read number plate @ 20m

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11
Q

What should be done in pre-op for cataract surgery?

A

Ocular biometry to measure curvature of cornea & length of eye for lens size

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12
Q

Why are cataracts a big deal?

A

Leading cause of blindness worldwide

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13
Q

What are complications of cataract surgery?

A

Anterior uveitis
Retinal detachment
Glaucoma

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14
Q

How do corneal ulcers occur?

A

Inflammation/infection of cornea
Disruption of epithelial layer
Leads to ulcer formation

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15
Q

What is the function of the cornea?

A

1) Protects the eye

2) Refracts light

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16
Q

Does the cornea have a blood supply?

A

No-avascular

17
Q

How does a corneal ulcer present?

A 
VERY painful eye causes a SQUINT
Red eye
Tearing & watering
Photophobia
↓Visual acuity
18
Q

How are corneal ulcers investigated?

A

URGENT referral to ophthalmology
HIV test
Slit lamp w/1% Fluorescein

19
Q

Why is fluorescein used when studying corneal ulcers?

A

Differentiate between keratin & dendritic ulcers

20
Q

How are corneal ulcers treated?

A

Gram +ve: Chloramphenicol drops
Gram -ve: Ofloxacin
Other: Cefuroxime drops + Gentamicin drops

21
Q

What are HSV dendritic ulcers?

A

HSV1 infection
Acute pain, watering & photophobia
Can lead to blindness!
Tx: TOP Aciclovir 3% drops x5/day

22
Q

What are the Sx of a corneal abrasion?

A 
Red + painful eye
Worse on movement
Sensation of FB
Blurred vision
Conjunctival/ciliary injection
Epithelial defects on staining
23
Q

What are Sx of a penetrating corneal injury?

A

Sudden onset pain after incident
Distorted iris/pupil
Air bubbles under cornea

24
Q

What actions are risk factors for a penetrating corneal injury?

A 
Welding 
Grinding
Bottled
Mowing
Hamering
25
Q

How is a corneal injury investigated?

A

Functional Ex
Slit lamp: Measure IOP
Orbit & lid Ex
Seidel’s test: 10% fluorescein check if aqueous fluid is leaking = Globe injury

26
Q

What are red flags to look for in a corneal injury?

A

Evidence of open globe injury: Distorted globe, leaking humor, subconjunctival haemorrhage

  • Evidence of deep eyelid laceration
  • Hyphaema
  • Irregular pupil
  • ↓↓IOP (FB in ant chamber)
27
Q

What are the indications for an urgent ophthalmology referral in a corneal injury?

A
  • All high-velocity injuries caused by sharp objects
  • Chemical injury
  • FBs
  • ↓visual acuity
  • Large abrasion (>60% cornea)
  • Corneal opacity
  • Rust ring
  • Distorted pupil
  • Retinal damage
  • Deep laceration of orbit
28
Q

How is a corneal abrasion treated?

A

TOP Chloramphenicol/ Fusidic acid

Re-evaluate in 24hours

29
Q

How is a corneal foreign body treated?

A

Remove FB under TOP anaesthetic

Irrigate eye w/water

30
Q

How is a penetrating corneal injury treated?

A

DO NOT TOUCH/MANIPULATE/PAD EYE
Give rigid eye shield
Refer IMMEDIATELY
Tetanus injection

Yr5 Ophthalmology (5 decks)

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