Corrections 2 Flashcards
What ethnicity is a risk factor for AACG?
Asian
Typical IOP in AACG?
≥40mmHg
What investigation provides a diagnosis of AACG?
Gonioscopy –> allows assessment of iridocorneal angle
What combination of eye drops are used in AACG?
1) Beta blocker e.g. timolol
2) Alpha agonist e.g. apraclonidine
3) Direct parasympathomimetic e.g. pilocarpine
Effect of pilocarpine on ciliary muscle?
Causes ciliary muscle contraction
Can IOP be normal in 1ary open angle glaucoma?
Yes!
What ethnicity are at risk of POAG?
Black patients
What medication can increase the risk of POAG?
Steroids
Describe visual loss in POAG?
Peripheral visual field loss
Give 2 fundoscopy findings in POAG
1) Optic disc cupping
2) Optic disc pallor (indicating optic nerve atrophy)
How can POAG (and AACG) cause optic nerve atrophy?
The increase in pressure damages the optic nerve by reducing the amount of blood that can get through the tiny blood vessels and by pressing on the nerve itself.
Define endophthalmitis
inflammation of aqueous and/or vitreous humour
What is the most common cause of blindness in the UK?
ARMD
What is the most common cause of curable blindness worldwide?
Cataracts
Describe vision loss in ARMD
Vision loss particularly for near field objects
Features of ARMD?
- Straight lines appear wavy (Amsler grid)
- Reduction in visual acuity, particularly for near field objections
- Deterioration in night vision
- Visual hallucinations (Charles-Bonnet)
Features of retinal detachment?
- Flashes & floaters
- Painless vision loss (like a curtain/shadow) from the periphery to the centre
Mx of patients with new onset flashes and floaters?
Urgent referral (<24 hours) to an ophthalmologist for assessment with a slit lamp and indirect ophthalmoscopy for pigment cells and vitreous haemorrhage.
What can posterior vitreous detachment lead to?
Retinal detachment
1st line mx of HSV keratitis?
Topical antivirals e.g. ganciclovir or acyclovir
Most common bacterial cause of microbial keratitis?
Staph. aureus
Most common bacterial cause of microbial keratitis in contact lens wearers?
Pseudomonas aeruginosa
Mx of contact lens wearers with a painful red eye?
Same day referral for assessment –> rule out microbial keratitis
1st line abx in microbial keratitis?
Topical quinolones e.g. ciprofloxacin
What is a ciliary flush?
What condition is it seen in?
A red ring around the cornea that’s caused by dilated blood vessels. It’s also known as perilimbal redness.
Seen in anterior uveitis.
1st line mx of anterior uveitis?
Topical steroid & cycloplegic agent (e.g. atropine)
Posterior synechiae are a potential complication of anterior uveitis.
What are these?
Adhesions between the iris and lens can lead to pupil distortion, iris bombe, and angle-closure glaucoma.
Cause of an irregular pupil in anterior uveitis?
Posterior synechiae
What are corneal ulcers highly associated with?
Extended contact lens wearers (especially overnight)
What are some ocular complications of herpes zoster ophthalmicus?
conjunctivitis, keratitis, episcleritis, anterior uveitis
Mx of herpes zoster ophthalmicus?
oral antiviral treatment for 7-10 days
Mx of Ramsay Hunt syndrome?
Oral aciclovir + steroids
What is Adie’s tonic pupil due to?
due to ciliary ganglion dysfunction (results in parasympathetic dysfunction –> pupil is dilated).
Anisocoria is WORSE in bright light.
How soon should oral aciclovir be started in herpes zoster ophthalmicus?
Within 72h of onset
What can be seen on fundoscopy following pan-retinal photocoagulation in proliferative diabetic retinopathy?
dark circular scars at the periphery
Describe stage I to IV of hypertensive retinopathy (Keith-Wagener classification)
I - arteriolar narrowing and tortuosity, silver wiring
II - AV nipping
III - cotton wool spots, flame & blot haemorrhages
IV - papilloedema
