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Year 2- CNS > Common Conditions of the Eye > Flashcards

Common Conditions of the Eye Flashcards

1
Q

In which conditions can there be hypertrophy of orbital fat?

A

Thyroid diseases
Autoimmune diseases

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2
Q

What happens when the orbital fat hypertrophies?

A

Pushes eyeball out and gives a staring appearance

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3
Q

Proptosis?

A

Eyeball is protruding out of orbit more than normal

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4
Q

When you ask a patient to look up and out, which muscle is this testing?

A

Superior rectus

->these questions can help in OSCE stations

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5
Q

When you ask a patient to look outwards, which muscle is this testing?

A

Lateral rectus

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6
Q

When you ask a patient to look down and out, which muscle is this testing?

A

Inferior rectus

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7
Q

When you ask a patient to look down and in, which muscle is this testing?

A

Inferior oblique

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8
Q

When you ask a patient to look medially, which muscle is this testing?

A

Medial rectus

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9
Q

When you ask a patient to look up and in, which muscle is this testing?

A

Inferior oblique

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10
Q

You check the eye movements of a patient and soon see that their right eye does not move over the midline and only works medially.
Which muscle is likely affected and why?

A

Lateral rectus, sixth nerve palsy

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11
Q

If the LPS muscle is affected, it can cause dropping of the eyelid. Which type of nerve palsy would this be?

A

3rd nerve palsy

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12
Q

Which nerve do the efferent fibre of the pupillary reflex travel with?

A

Third nerve

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13
Q

Which long-term condition can increase risks of a third nerve palsy?

A

Diabetes

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14
Q

Which muscle is affected in a fourth nerve palsy?

A

Superior oblique

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15
Q

What are some common causes of absent pupillary reflexes?

A

Diseases of retina
Diseases of optic nerve
Disease of CN III

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16
Q

RECAP- which muscle of facial expression helps to close the eyes and what innervates it?

A

Orbicularis oculi
Innervated by CN VII (facial nerve).

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17
Q

Which nerve may be affected if there is ptosis (drooping of eyelid)?

A

Third nerve

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18
Q

Which nerve may be affected if a patient cannot properly close their eye?

A

CN VII

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19
Q

If you are unable to close your eye, it can cause drying of the cornea leading to what?

A

Exposure keratopathy

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20
Q

What is a collection of pus on or in the eyelid called?

A

Stye

->can be either external or internal

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21
Q

What is the treatment for an external/internal stye?

A

Warm compress, eyelid hygiene

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22
Q

What is the treatment for styes if they don’t resolve after warm compresses and eyelid hygeine?

A

Surgical incision and curettage

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23
Q

Which glands are blocked in someone with an external stye?

A

Sebaceous glands

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24
Q

Why would an external stye occur?

A

Due to infection of the hair follicle of the eyelash and sebaceous glands.

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25
Q

Why would an internal stye occur?

A

Due to blockage and infection of Meibomian glands

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26
Q

What is conjunctivitis?

A

Self limiting infection of conjunctiva.

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27
Q

What type of infection can cause conjunctivitis?

A

Usually bacterial or viral

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28
Q

What are the symptoms of conjunctivitis?

A

Red, watery eyes, discharge

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29
Q

When would there be loss of vision in a patient with conjunctivitis?

A

If infection spread to cornea

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30
Q

What is the treatment for conjunctivitis?

A

Antibiotic eyedrops if likely to be bacterial

31
Q

Give an example of a virus which can cause conjunctivitis.

A

Adenovirus

32
Q

What is the treatment for opacification of the cornea?

A

Corneal transplant- keratoplasty

33
Q

What may cause corneal ulcers?

A

Viral/bacterial/fungal infection

34
Q

Why do corneal ulcers need aggressive management?

A

To prevent spreading and scarring.
Also aggressive as avascular

35
Q

What are some non-infectious causes of corneal ulcers?

A

Trauma
Corneal degenerations or dystrophy

36
Q

Why do cateracts develop?

A

Damaged lens fibres become opaque and cause cataract

37
Q

Why does a cataract form in the middle of the eye?

A

Old fibres get pushed into centre as newer fibres grow inwards

38
Q

How does UV rays affect the lens?

A

sacrifice

Absorbs harmful rays to prevent them damaging retina but damages itself in the process

39
Q

Do cataracts usually affect sight when the pupil is dilated or constrcited?

A

Dilated as prevents light getting into retina- often complaints of driving in dim light

40
Q

Cataracts can develop as a complication from use of which drugs?

A

Steroid eye drops

41
Q

What is the name of the condition in which only the nucleus of the cataract become opaque?

A

Nuclear sclerosis

42
Q

Why may cataracts develop in childhood?

A

Periods of malnutrition in utero.

43
Q

What is the treatment of cataracts?

A

Surgery

->eye drops do not treat cataracts!!!

44
Q

Describe a cataract operation.

A

Day case- small incision made and the lens capsule opened.
Lens affected by cataracts removed by emulsification and replaced by a capsular bag

45
Q

Checking you were reading- which process removes the cataracts lens?

A

Emulsification (phacoemulsification).

46
Q

Which type of lens is implanted in cataract surgery?

A

Posterior Chamber Intra Ocular Lens

PCIOL

47
Q

RECAP- where is aqueous humor produced?

A

Ciliary body

48
Q

What is one of the most common causes of raised intra-ocular pressure?

A

Glaucoma

49
Q

What is the most commonly seen form of primary glaucoma?

A

Primary Open Angle Glaucoma

(POAG)

50
Q

Is glaucoma usually unilateral or bilateral?

A

Usually bilateral

51
Q

What can raised intraocular pressure cause?

A

Pressure on nerve fibres on the surface of retina meaning they die out and cause visual field defects.

52
Q

List the triad of signs for the diagnosis of glaucoma.

A
  1. Raised intra ocular pressure
  2. Visual filed defects
  3. Optic disc changes on ophthalmoscopy
53
Q

What is the management for primary open angular glaucoma?

A

Eye drops to decrease IOP
Laser trabeculoplasty
Trabeculctomy surgery

54
Q

Which types of drugs may be used in the form of eye drops to reduce IOP in those with POAG?

A

Prostaglandin analogues
Neta-blockers
Carbonic anhydrase inhibitors

55
Q

Which part of the eye is not functioning in POAC?

A

Trabecular meshwork

56
Q

Why does angle closure glaucoma occur?

A

Aqueous humor cannot reach trabecular meshwork as angle of the anterior chamber is blocked

57
Q

What are some symptoms of angle closure glaucoma?

A

Sudden onset, painful, vision lost/blurred, headaches

->this can often be confused with migraines

58
Q

What are the signs of angle closure glaucoma?

A

Red eye
Cornea often opaque

59
Q

Why is the cornea often opaque in those with closed angle glaucoma?

A

Increased IOP which drives fluid into the cornea

60
Q

How do you treat closed angle glaucoma?

A

Decrease IOP- primary treatment
Iridotomy (laser) to both eyes to bypass blockage- secondary treatment

61
Q

List some ways to decrease IOP in those with closed angle glaucoma.

A

IV infusion +/- oral therapy
Analgesics, antimetrics
Constrictor eye drops
Beta-blocker drops
Steroid eye drops e.g. dexamethasone

62
Q

TEST TIME!!!

Which is painful-
Primary Open Angle Glaucoma
Closed Angle Glaucoma
?

A

Closed Angle Glaucoma

63
Q

TEST TIME!!!

Which condition is there an increased in IOP?
Primary Open Angle Glaucoma
Closed Angle Glaucoma
?

A

Both:)

64
Q

What is the other name for the vascular coat of the eye?

A

Uvea

65
Q

RECAP- what makes up the uvea of the eye?

A

Ciliary body, choroid, iris

66
Q

Uveitis?

A

Inflammation of uvea

67
Q

Which part of the uvea is inflamed in anterior uveitis?

A

Iris +/- ciliary body

68
Q

Which part of the uvea is inflamed in intermediate uveitis?

A

Ciliary body

69
Q

Which part of the uvea is inflamed in posterior uveitis?

A

Choroid

70
Q

Give a non-infectious cause of uveitis.

A

Autoimmune causes e.g. presence of HLA-B27

71
Q

Which type of uveitis does presence of HLA-B27 lead to?

A

Anterior uveitis

72
Q

Give an example of an infectious cause of uveitis.

A

Chronic diseases like TB

73
Q

Give an example of a systemic disease which is associated with uveitis.

A

Ankylosing spondylosis

74
Q
A

Year 2- CNS (49 decks)

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