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Opthalmology > Common Conditions of the Eye > Flashcards

Common Conditions of the Eye Flashcards

1
Q

What is the bony orbit closely related to?

A

Air sinuses

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2
Q

Which parts of the bony orbit have very thin walls?

A

Everywhere except the orbital rims, lateral wall and superior walls

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3
Q

What can thin walls of the orbit lead to?

A

Herniation of contents into surrounding tissues

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4
Q

What is the conjunctiva?

A

Thin vascular membrane that covers the inner surface of the eyelids and loops back over the sclera

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5
Q

What is a blow out fracture?

A

The walls of the orbit can fracture (floor of medial wall usually) and contents can herniate out into e.g. maxillary sinus
The outer orbit remains fine

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6
Q

What is found when there is a blow out fracture, the orbital floor is fractured and there is herniation into the maxillary sinus?

A

Tear drop sign

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7
Q

What is the limbus?

A

The junction between the cornea and the sclera

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8
Q

What is found at the corneoscleral junction?

A

Lower eyelid

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9
Q

What appearance does a coloboma give?

A

Keyhole appearance

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10
Q

What causes coloboma?

A

An embryological anomaly due to choroid fissure not fusing

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11
Q

How can a retinal tear occur from blunt trauma?

A

Peripheral retina tears
Vitreous gel gets liquified
Liquid vitreous pushes through retinal tear and detaches it

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12
Q

What is the main function of vitreous gel?

A

Keep the retina in position

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13
Q

How does retinal attachment commonly occur?

A

Fluid getting into the “potential” space between the 9 inner layers of the retina and the outer 10 layers

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14
Q

What is conjunctivitis?

A

Self limiting bacterial or viral infection of the conjunctiva

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15
Q

Symptoms of conjunctivitis

A 
Red eye
Watery eyes 
Discharge
Enlargement of blood vessels in the conjunctiva 
NO loss of vision
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16
Q

Treatment of conjunctivitis

A

Antibiotic eye drops if likely to be bacterial

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17
Q

If conjunctivitis causes loss of vision, what does this mean?

A

The infection has spread onto the cornea

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18
Q

What is damaged if there is an inability to lose the eyelid?

A

Left facial nerve paralysis

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19
Q

What is a phenomenon that also occurs when there is inability to close the eyelid?

A

Eyeball turned upwards

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20
Q

What can inability to close the eyelid lead to?

A

Drying of cornea which can lead to lesions

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21
Q

Two types of stye

A

External stye

Internal stye

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22
Q

Another name for external stye

A

Hordeolum externum

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23
Q

What causes an external stye?

A

Infection of a hair follicle (blockage of sebaceous glands)

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24
Q

Another name for an internal stye

A

Hordeolum Internum

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25
What causes an internal stye?
Blockage and infection of the Meibonium gland (stuck inside the tarsal plate)
26
Treatment of a stye
Warm compress Eyelid hygiene May need surgical incision and curettage
27
Two types of corneal pathologies
Inflammatory e.g. corneal ulcers | Non-inflammatory e.g. dystrophies
28
What do corneal pathologies frequently lead to?
Opacification of the cornea
29
What is another name for a corneal transplant?
Keratoplasty
30
Causes of corneal ulcers
``` Inflammatory Infection - viral - bacterial - fungal Trauma Corneal degeneration Corneal dystrophy ```
31
Features of corneal dystrophies and degenerations
``` Bilateral Opacifying Non inflammatory Most genetically determined Sometimes due to accumulation of substances such as lipids in the cornea ```
32
When do corneal dystrophies and degenerations present?
First to fourth decade
33
Most common symptom of corneal degenerations and dystrophies
Decreased vision
34
Pathology of cataracts
Older (embryological, foetal) fibres never shed - and are compacted in the middle No blood supply to the lens Absorb harmful UV rays preventing them from damaging the retina but in the process, get damaged themselves Damaged lens fibres become opaque leading to cataracts
35
Types of cataracts
Immature cortical cataracts Mature cataracts Nuclear sclerosis Sutural and zonular cataract
36
Pathology of immature cortical cataracts
Seen as spoke like opacities | Outer cortical fibres that get opaque
37
Presentation of immature cortical cataracts
Usually fine during the day due to bright light but for example have stopped driving at night as too hazy
38
Treatment of cataracts
Surgery
39
How does the surgery work to treat cataracts?
``` Small incision Lens capsule opened Cataractous lens removed by emulsification (phacoemulsification) Plastic lens placed in capsular bag Lens implant after surgery ```
40
What is the lens called that is inserted after cataracts surgery?
Posterior chamber intra ocular lens (PCIOL)
41
What is glaucoma?
Raised intraocular pressure (IOP)
42
Two types of glaucoma
Open angle glaucoma | Angle closure glaucoma
43
Most common type of glaucoma
Primary Open Angle Glaucoma (POAG)
44
What are the consequences of raised IOP?
Pressure on nerve fibres on surface of the retina -> die out -> visual field defects Pressure on the optic nerve head as the nerve fibres die out - optic disc on ophthalmoscopy appears unhealthy, pale and cupped Results in an altered field of vision Ultimately all nerve fibres are lost, which results in blindness
45
The triad of signs for the diagnosis of glaucoma
1. Raised IOP 2. Visual field defects 3. Optic disc changes on ophthalmoscopy
46
Treatment of PAOG
``` Eye drops to decrease IOP - prostaglandin analogues - betablockers - carbonic anhydrase inhibitors Laser trabeculoplasty Trabeculectomy surgery ```
47
Presentation of open angle glaucoma
Bilateral Can be asymptomatic for a long period of time Picked up on routine eye exams
48
Presentation of angle closure glaucoma
``` Sudden onset Painful - ocular or headache Vision lost/blurred Headaches (often confused with migraine) Red eye Hard eye Cornea often opaque as raised IOP drives fluid into the cornea Pupil mid dilated and non reacting Haloes around lights IOP severely raised Systemic upset - N + V - abdominal pain ```
49
Features of the AC in angle closure glaucoma
AC shallow | Angle is closed
50
Pathology of angle closure glaucoma
1. Functional block in a small eye - large lens 2. Mid dilated pupil - periphery of iris crowds around angle and outflow is obstructed 3. Iris sticks to pupillary border (synechia) which prevents reaching AC. Leads to iris ballooning anteriorly and obstructing angle
51
Treatment of an acute episode of angle closure glaucoma
``` Decrease IOP - IV infusion +/- oral therapu (carbonic anhydrase inhibitors) - Analgesics - antiemetics - constrictor eye drops (pilocarpine) - beta blocker e.g. timolol - steroid eye drops e.g. dexamethasone Iridotomy (laser) ```
52
Pathology of primary open angle glaucoma (POAG)
The drainage through the trabecular meshwork is blocked (in most cases) Leads to a gradual, painless build up on IOP
53
Pathology of angle closure glaucoma
Some event on a predisposed eye leads to the peripheral iris blocking the angle, therefore the aqueous cant drain So SUDDEN increase in IOP
54
In angle closure glaucoma, what does the patient usually present as?
An emergency
55
What is the vascular layer of the eye called?
Uvea
56
Function of the choroid
Supplies blood to the outer layers of the retina
57
Function of the ciliary body
Suspends the lens | Produces aqueous humour
58
Function of the iris
Controls diameter of the pupil and therefore controls the amount of light rays entering the eyeball
59
What is uveitis?
Inflammation of the uvea
60
Types of uveitis
Anterior uveitis Intermediate uveitis Posterior uveitis
61
What does anterior uveitis involve?
Iris with or without ciliary body inflamed
62
What does intermediate uveitis involve?
Ciliary body inflamed
63
What does posterior uveitis involve?
Choroid inflamed
64
Causes of uveitis
Isolated illness Autoimmune causes e.g. presence of HLA-B27 predisposes to anterior uveitis Infection e.g. chronic diseases such as TB Assosiated with systemic diseases e.g. ankylosing spondylitis
65
Pathology of anterior uveitis
An inflamed uvea (iris) leaks plasma and white blood cells into the aqueous humor
66
When is anterior uveitis seen? What is seen?
During slit lamp examination - a hazy anterior chamber and cells deposited at the back of the cornea Cells in the AC may settle inferiorly - hypopyn
67
Presentation of anterior uveitis
Red eye Painful Visual loss
68
Pathology of intermediate uveitis
Ciliary body is inflamed and leaks cells and proteins leading to hazy vitreous
69
Presentation of intermediate uveitis
Patient complains of "floaters" or hazy vision
70
Pathology of posterior uveitis
Choroid inflamed | Since the choroid sits under the retina the inflammation frequently spreads to the retina and can cause blurred vision
71
Is there lymphatics in the eyeballs?
No
72
Is there lymphatics in the eyelids?
Yes
73
What is the treatment for proliferative vessels?
Laser treatment
74
Features of the eye in diabetic retinopathy
``` Usually no symptoms Usually fine vision in both eyes Hard exudates - yellow and waxy looking Blot haemorrhages Microaneurysms Cotton wool spots ```
75
Types of diabetic retinopathy
Proliferative | Non-proliferative
76
Main feature of proliferative diabetic retinopathy
New vessels can grow
77
Main feature of non proliferative diabetic retinopathy
No new vessels grow
78
Which type of diabetic retinopathy is more aggressive?
Proliferative
79
What are cotton wool spots a sign of?
Ischaemia
80
What do new vessels typically look like?
Small | Grow in places they shouldn't
81
Where do new vessels often grow?
Optic disc
82
Where can new vessels grow?
Optic disc | Vitreous
83
What is the result of new vessels growing into the vitreous?
They can bleed and scar - this can pull the retina
84
Types of maculopathy
Exudative | Ischaemic
85
Treatment of exudative maculopathy
anti VegF | Steriods
86
Features of ischaemic maculopathy
Look normal | Vision down
87
Treatment for ischaemic maculopathy
No treatment
88
Predisposing factors for acute closed angle glaucoma
Hypermetropia Pupillary dilatation Lens growing with increased age

Opthalmology (8 decks)

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