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Ophthalmology > Clinical > Flashcards

Clinical Flashcards

1
Q

Why do we treat Strabismus?

A

1- To restore stereopsis.
2- To prevent Amblyopia.
3- To prevent confusion and diplopia.
4-Appearance.

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2
Q

What is Amblyopia (lazy eye) ?

A

It is the unilateral decrease of vision caused by form vision deprivation for which there is no obvious cause found by physical examination of the eye.

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3
Q

What are the main types of Amblyopia?

A

1- Strabismic amblyopia.
2- Anisometropic amblyopia.
3- Deprivation Amblyopia.

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4
Q

What is Anisometropia?

A

It’s an unequal refractive power in the two eyes.

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5
Q

what’s the definition of Esotropia ?

A

Inward deviation of the eye.

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6
Q

What’s Accommodative Esotropia?

A

It is a physiological response to excessive hypermetropia and is beyond the patient’s fusional divergence amplitude.

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7
Q

What is the difference between Fully Accommodative Esotropia and Partially Accommodative Esotropia?

A

1- Fully accommodative: completely eliminated by correction of the hypermetropic refractive error.

2- Partially accommodative: partially eliminated by correction of hypermetropic refractive error.

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8
Q

What’s an Infantile Esotropia?

A

It’s an esotropia that develop within the first 6 months of birth in an otherwise normal infant.

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9
Q

What is Duane syndrome “Duane Retraction Syndrome (DRS) ?

A

It is a group of eye muscle disorders that cause abnormal eye movements. People with DRS have difficulty rotating one or both eyes outward (abduction) or inward (adduction).

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10
Q

What is Moebius syndrome?

A

It is a rare neurological condition that primarily affects the muscles that control facial expression and eye movement..

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11
Q

What’s the differential diagnosis for infantile esotropia?

A 
1-Congenital sixth nerve palsy.
2-Sensory Esotropia.
3-Nystagmus blockage syndrome.
4-Duane syndrome types I and III.
5-Mobius syndrome.
6-Strabismus fixus.
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12
Q

What is the treatment of Strabismus in general?

A

1- Glasses.
2-Surgery.
3- Botox Injection.

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13
Q

What are the most common causes of Leukokoria?

A

1-Congenital Cataract.
2-Retinoblastoma.
3-Retinopathy of Prematurity.

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14
Q

What is Leukokoria?

A

White pupillary reflex.

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15
Q

What is Congenital cataract ?

A

Opacification of the crystalline lens.

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16
Q

why congenital cataract occur in newborns ?

A 
1-Inherited tendencies.
2-Infections.
3-Metabolic problems.
4-Diabetes.
5-Trauma.
6-Inflammation.
7-Drug reaction.
8- During pregnancy: mother developing infections "ToRCHeS"
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17
Q

What are the signs and symptoms of congenital cataract?

A 
symptoms:
1- poor fixation.
2-Strabismus.
Signs: 
1-Leukocoria.
2-Opcification of the lens.
3-Hazy view of the retina.
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18
Q

What is Aphakia ?

A

Absence of crystalline lens.

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19
Q

What is the most common clinical presentation of Retinoblastoma?

A

1- Leukocoria 60%.

2- Strabismus 20%.

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20
Q

What is retinopathy of prematurity ROP ?

A

It is a retinal vascular disease of preterm newborns, especially those with a birth weight below 1,500 grams and 32 weeks gestational age.

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21
Q

What is Blepharitis?

A

Inflammation of the eyelid margin.

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22
Q

What are the symptoms of Blepharitis?

A 
1- Burning sensation.
2- Foreign body sensation.
3- Sense of dryness.
4- Redness.
5- Frequent blinking.
6- Itching.
7-Photophobia.
8- Sticky eyelids.
9- Tearing.
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23
Q

What is Punctate Keratitis ?

A

It is the death of small groups of cells on the surface of the cornea.

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24
Q

What is the treatment of Blepharitis?

A 
If it's Anterior:
1- Lid hygiene.
2- Topical broad spectrum antibiotic.
3-Artificial tears.
If it's Posterior: 
1- Warm compressors.
2-Oral Doxycycline.
3- Artificial tears.
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25
Q

What is the sequel of Blepharitis?

A 
Anterior: 
1-Loss of eyelashes.
2- dry eye.
Posterior: 
1-chalazion.
2-Punctate keratitis.
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26
Q

What is Chalazion?

A

It’s a foreign body granulomatous inflammation of the meibomian gland secondary to blockage of the orifice.

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27
Q

What is the treatment of Chalazion?

A

1- Warm compressors.
2- Incision and curettage.
3- Intra-lesional injection of steroid.

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28
Q

What is the meaning of curettage ?

A

It’s a surgical scraping or cleaning.

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29
Q

What is the difference between Chalazion and stye?

A

1- Location:
C:Away from the eyelashes.
S: Near the eyelashes.

2- Cause:
C:Blocked Meibomian gland.
S:Bacterial infection of lash follicles/zies glands.

3- Rx:
C:Warm compressors-Incision and curettage-Intralesional injection of steroid.
S:Warm compressors-Topical antibiotics.

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30
Q

What is Entropion ?

A

It is an inward rotation of the lid margin.

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31
Q

What is the etiology and management of congenital entropion?

A

Etiology: Defect in parts of the lower lid layer.
Management: Spontaneous resolution/ surgical repair.

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32
Q

What is the etiology and management of Involutional Entropion?

A

Etiology:Medial and Lateral canthal tendon laxity.
Management: Surgical repair.

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33
Q

What is the etiology and management of Entropion Cicatricial?

A

Etiology: Conjunctival scarring:
- Infections (Trachoma, Herpes Zoster).
- Post-Surgery.
- Autoimmune Diseases (Cictricial pemphigoid)
- Trauma (Thermal, Chemical burns).
-Chronic use of topical glaucoma drops (miotics).
Management: Surgical repair.

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34
Q

What is Ectropion ?

A

It’s the outward rotation of the lid margin.

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35
Q

What is the etiology of Paralytic ectropion?

A

7th cranial nerve palsy —> Orbicularis oculi muscle weakness.

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36
Q

What is the etiology of Involutional ectropion?

A

Canthal tendon laxity.

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37
Q

What is the etiology of Cicatricial ectropion?

A

1-Burns.
2-Trauma.
3- Skin conditions like Atopic dermatitis, Rosacea, Eczema and HZ infection.

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38
Q

What is Ptosis?

A

Drooping of the upper eyelid.

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39
Q

What is the etiology and management of congenital ptosis?

A

Etiology: Defective development of levator muscle.
management: prevent Amblyopia/ surgical repair.

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40
Q

What is the etiology of Aponeurotic ptosis?

A

Etiology: Aging- levator aponeurosis dehiscence from insertion site.

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41
Q

What is the etiology of Neurogenic ptosis?

A

3rd nerve palsy due to either Ischemia “DM” or Compression “aneurysm”.

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42
Q

What is the etiology of Myoneural junction ptosis?

A

Myasthenia gravis.

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43
Q

What is Myasthenia gravis ?

A

It’s a chronic autoimmune disease marked by muscular weakness without atrophy, and caused by a defect in the action of acetylcholine at neuromuscular junctions.

44
Q

What is the etiology of Mechanical ptosis?

A

Eyelid swelling or mass.

45
Q

What is the etiology of Traumatic ptosis?

A

a trauma which causes a tear in the levator muscle.

46
Q

What is the differential diagnosis of lid retraction?

A 
1-Thyroid eye disease.
2-Contralateral ptosis.
3-Aberrant 3rd CN regeneration.
4-Parkinson's disease.
5-Bell's palsy.
6- Large filtering blebs.
47
Q

What is the clinical presentation of Acquired nasolacrimal duct obstruction?

A

1-constant tearing.

2-dacryocystitis.

48
Q

What is dacryocystitis ?

A

Inflammation of the lacrimal sac.

49
Q

What is the management of Acquired nasolacrimal duct obstruction?

A

dacryocystorhinostomy.

50
Q

What is the management of dacryocystitis?

A

1- warm compressions.
2-Oral/IV broad spectrum antibiotics.
3-drainage of the abscess.
4-dacryocystorhinostomy “DCR”.

51
Q

What’s an Orbital septum?

A

it’s a fibrous tissue that originate from the periosteum of orbital rim and acts as a barrier between eyelid skin and orbit.

52
Q

What is Preseptal cellulitis?

A

It’a an Inflammation above the orbital septum.

53
Q

How to manage Preseptal cellulitis?

A

1- Oral antibiotics.

2- close monitoring as it can convert to orbital cellulitis.

54
Q

What is Orbital cellulitis?

A

It’s an inflammation deep to the orbital septum.

55
Q

What are the signs of Orbital cellulitis?

A

1- Proptosis.

2-decrease EOM.

56
Q

How to manage orbital cellulitis?

A

1-Admission to hospital.

2- IV antibiotics.

57
Q

What is Proptosis ?

A

It’s a forward projection or displacement of the eyeball “Bulging eyes”.

58
Q

What is the clinical presentation of orbital fractures ?

A

1- Enophthalmos.
2-Echymosis.
3- Limitation of ocular movement.
4- Diplopia “muscle entrapment”.

59
Q

What is the management of orbital fractures ?

A 
1- Observation until edema subside.
2-Surgical intervention IF:
- Diplopia on looking straight or down.
- Severe enophthalmos..
- Very large orbital floor fracture.
60
Q

What is enophthalmos?

A

It’s the sinking of the eyeball into the orbital cavity.

61
Q

What is ecchymosis ?

A

It’s the escape of blood into the tissues from ruptured blood vessels marked by a livid black-and-blue or purple spot or area.

62
Q

What is Thyroid eye disease?

A

It’s an autoimmune condition in which the auto-antibodies attack on the eyelid and orbital tissue.

63
Q

What is the clinical features of the Thyroid eye disease?

A 
1- Exophthalmos "Esoptosis".
2- Lid retraction.
3- Lid lag.
4- Conjunctival chemosis.
5- EOM myopathy.
6- High IOP.
7- Optic nerve compression.
64
Q

What is a Lid lag ?

A

Delay in moving the eyelid as the eye moves downwards. It is a common finding in thyroid disease when it is known as Graefe’s sign.

65
Q

what is the meaning of chemosis ?

A

It is the swelling/edema of the conjunctiva.

66
Q

What is the management of thyroid eye disease ?

A

1- Regular eye examination.
2- Medical.
3- Radiotherapy.
4-Surgical.

67
Q

What is the Medical management of thyroid eye disease?

A

1- Lubrication.
2-Systemic Steroids.
3- Ritoximab :chemptherapy”.

68
Q

What is the Surgical management of thyroid eye disease?

A

1- Decompression.
2- Strabismus surgery.
3- Lid lengthening.
4- Blepharoplasty.

69
Q

What is the risk factors of Diabetic Retinopathy ?

A 
1- Duration of Diabetes.
2- Poor metabolic control "raised HbA1C".
3- Pregnancy.
4- HTN.
5-Nephropathy.
6- Hyperlipidemia.
70
Q

Name the stages of Diabetic Retinopathy.

A

1- Non-proliferative Diabetic Retionopathy NPDR.
2- Pre-Proliferative Diabetic Retinopathy PPDR.
3- Proliferative Diabetic Retinopathy PDR

71
Q

When do we treat Diabetic Retinopathy with PPV?

A

1- Severe persistent vitreous hemorrhage.

2- Tractional retinal detachment involving the macula.

72
Q

What is Retinal Detachment ?

A

It’s the separation of neurosensory retina from the retinal pigment epithelium by sub-retinal fluid.

73
Q

What are the causes of Rhegmatogenous RD ?

A

1- Acute Posterior Vitreous Detachment “PVD”.
2- Myopia.
3- Trauma.

74
Q

What is Acute Posterior Vitreous Detachment ?

A

It’s the separation of cortical vitreous from the internal limiting membrane of the sensory retina posterior to the vitreous base.

75
Q

What are the causes of Tractional Retinal Detachment?

A

1- Proliferative Diabetic Retinopathy “PDR”.
2- Retinopathy of prematurity “ROP”.
3- Penetrating Posterior segment trauma.

76
Q

What are the causes of Exudative Retinal Detachment?

A

1- Choroidal Tumors : melanomas - metastases.

2- Inflammation: Harda disease - Posterior scleritis.

77
Q

What are the symptoms of Rhegmatogenous Retinal Detachment?

A

1- Floaters.
2- Photopia “flashes”.
3- Visual field defect “black curtains”.

78
Q

What are the signs of Rhegmatogenous Retinal Detachment?

A

1- Elevation of the retina and flap tear/break in retina.
2- RAPD.
3- IOP lower than normal.
4-Tobaco dust in anterior vitreous.

79
Q

What is the treatment of Rhegmatogenous RD ?

A

1- Pneumatic Retinopexy.
2-Scleral buckling.
3- PPV

80
Q

What is the most common cause of irreversible visual loss?

A

Age-related Macular Degeneration “AMD”.

81
Q

What are the causes of Chronic visual loss ?

A

1- Cataract.
2- Glaucoma.
3- Age-related Macular Degeneration.

82
Q

What is Glaucoma?

A

It’s a group of diseases characterized by chronic progressive optic neuropathy mainly secondary to increase IOP.

83
Q

What are the common types of Glaucoma?

A

1- Primary Open Angle Glaucoma “POAG”.
2- Primary Angle Closure Glaucoma “PACG”.
3- Congenital Glaucoma “CG”.

84
Q

How to diagnose Glaucoma ?

A

1- Measurement of IOP.
2- Assessing cup/disc ratio.
3- Assessing Visual field.

85
Q

What is the Pathophysiology of Congenital Glaucoma “CG”?

A

Arrest of angle development.

86
Q

What is the Pathophysiology of Primary Open Angle Glaucoma “POAG”?

A

Narrowing of the Trabecular Meshwork.

87
Q

What is the Pathophysiology of Primary Angle Closure Glaucoma “PACG”?

A

Iris cover Trabecular Meshwork.

88
Q

What is the definition of Uveitis?

A

It’s the inflammation of the Uveal tract : Iris - Ciliary body- Choroid.

89
Q

What is the anatomical classification of Uveitis?

A

1- Anterior Uveitis: Inflammation of the Iris or iris with ciliary body.
2- Intermediate Uveitis: Inflammation of the Ciliary body.
3- Posterior Uveitis: Inflammation of the Choroid.
4- Pan Uveitis: Inflammation of all areas.

90
Q

What are the causes of Uveitis?

A

1- Idiopathic.
2- Infection.
3- Systemic diseases.
4- Autoimmune Disease.

91
Q

What are the symptoms of Uveitis ?

A

1- Pain.
2- Floaters.
3- Redness.
4- Blurring of vision.

92
Q

What is Hypopyon ?

A

It’s an accumulation of white blood cells in the anterior chamber of the eye.

93
Q

What is the treatment of Uveitis?

A

1- Topical/Sub-conjunctival/Oral Steroids.
2- Non-steroidal Anti-inflammatory Medications.
3- Cycloplegic drops.
4- Immunosupressive Therapy.

94
Q

What is the side effects of Topical and Sub-conjunctival steroids?

A 
1- Cataract. 
2- Glaucoma.
3- Ptosis.
4- Reactivation of HSV keratitis.
5- Reactivation of Toxoplasmosis Retinitis.
6-Increased risk of eye infection.
7- Corneal melt.
95
Q

What is Episcleritis ?

A

It’s an inflammation of the superficial layers of the sclera.

96
Q

What is the treatment of Scleritis?

A

1- Steroids.
2- non- steroidal anti-inflammatory.
3- Immunosuppressive agents.

97
Q

What are the signs and symptoms of Corneal ulcer?

A 
1- Pain. 
2-Redness.
3- Decrease in vision.
4- Hypopyon.
5- White localized corneal opacity with overlying epithelial defect.
98
Q

What is the treatment of corneal ulcer?

A

1- Aggressive Antibiotic treatment.

2- Never Patch an eye with corneal ulcer.

99
Q

What is Dry Eye Disorder ?

A

It’s a disorder characterized by either quantitative decrease or qualitative change in the precorneal tear film.

100
Q

What is Keratoconjunctivitis Sicca ?

A

It’s a chronic Disease caused by Autoimmune Inflammatory damage to the lacrimal gland resulting in decreased aqueous tear secretion.

101
Q

What is Primary Sjögren’s syndrome ?

A

It’s a chronic autoimmune -Lymphocytic infiltration of lacrimal and salivary glands - xerostomia - KCS.

102
Q

What is Secondary Sjögren’s syndrome ?

A

It’s a chronic autoimmune - xerostomia - KCS - Autoimmune systemic disease.

103
Q

What are the symptoms of Dry Eye Disorder ?

A 
1- Pain.
2- Itching.
3- Foreign Body Sensation.
4- Blurred Vision. 
5- Burning.
6- Photophobia.
7- Ropey Discharge.
104
Q

What are the causes of Cataract ?

A 
- Primary:
1- Congenital and infantile.
2- Senile.
3- Trauma.
- Secondary.
1- Drugs - Steroids - Phenothiazines - Amiodarone.
2- Radiation.
3- Chemical injuries - Alkali. 
4- DM.
5- Uveitis.
105
Q

What are the symptoms of Cataract ?

A 
1- Blurry vision.
2- Diplopia. 
3- Poor night vision.
4- Glare.
5- Sudden change in glasses prescription.

Ophthalmology (2 decks)

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