D2 - Ocular Conditions Flashcards
Iritis:
Signs (4)
Irregular shaped pupil
Unilateral inflammation of the iris
Limbal injection
Usually bilateral
Iritis (acute):
Symptoms (4)
Pain
Reduced VAs
Lacrimation
Photophobia
Iritis (chronic):
Symptoms (1)
Very few symptoms
Iritis:
History (3)
Arthritis
AIDS
TB
Iritis:
Treatment (2)
Mydriatic drops
Systemic steroids
Iritis:
Referral (4)
Urgent A&E - phone ahead
Keratitis:
Signs (7)
Red eye
Corneal lesion
Inflammation of cornea
Lacrimation
Discharge
Visible corneal ulcer
Usually bilateral
Keratitis:
Symptoms (5)
Pain
Blurred vision
Photophobia
Reduced VA if ulcer central
Foreign body sensation
Keratitis:
History (4)
Corneal trauma
Contact lens wear
Dry eye - elderly
Herpes sim[lex
Keratitis:
Treatment (3)
Antibiotic drops
Steroids
Antiviral drops
Keratitis:
Referrals (1)
Urgent to A&E
Hypopyon:
Signs (1)
White blood cells deposited in lower anterior chamber
Hypopyon:
Symptoms (1)
None
Hypopyon:
History (3)
Linked with bacterial keratitis
In severe or long standing cases, hypopyon may be present
May lead to acute secondary glaucoma
Hypopyon:
Treatment (2)
Antibiotic drops
Subconjunctival injections
Hypopyon:
Referral (1)
Urgent to A&E
Hyphaema:
Signs (1)
Blood in anterior chamber
Hyphaema:
Symptoms (3)
Pain
Blurred vision - especially if lens displaced
Possible visual field loss if retinal attachment
Hyphaema:
History (2)
Blow to eye or orbital region, eg blow out fracture
May lead to secondary glaucoma
Hyphaema:
Treatment (2)
Miotics to reduce IOPs
Surgery may be required to remove blood clot or lens
Hyphaema:
Referral (1)
A&E
Malignant Melanoma of Iris:
Signs (4)
Darker iris area
May appear thicker
May cause distorted pupil
May cause hyphaema
Malignant Melanoma of Iris:
Symptoms (1)
None unless causes secondary glaucoma
Malignant Melanoma of Iris:
History (2)
Increased uncontrolled growth of melanocyst
Common in over 60s
Malignant Melanoma of Iris:
Treatment (3)
None if no bleeding or pupil distortion
Surgical if enlargements occurs
Removal of tumour, possibly eye
Malignant Melanoma of Iris:
Referral (1)
GP - urgent
Acute Glaucoma:
Signs (3)
Red eye
Cloudy cornea
Oval shaped pupil
Acute Glaucoma:
Symptoms (4)
Severe pain
Frontal headaches
Blurred vision
Vomiting due to pain
Acute Glaucoma:
History (1)
Haloes around lights
Acute Glaucoma:
Treatment (1)
Miotics to reduce IOPs
Acute Glaucoma:
Referral (1)
A&E - phone ahead and email referral
Orbital Cellulitis:
Signs (3)
Inflammation of orbital connective tissue
Red and swollen lids
Swollen and inflamed conjunctiva
Orbital Cellulitis:
Symptoms (4)
Moderate to severe orbital pain
Possible diplopia
Reduced VAs
Feverish
Orbital Cellulitis:
History (1)
Bacterial infection spread from sinus or tooth
Orbital Cellulitis:
Treatment (2)
Immediate hospitalisation - can lead to optic neuritis or meningitis
Antibiotics or surgery to drain orbit and infected sinus
Orbital Cellulitis:
Referral (1)
A&E
Episcleritis:
Signs (3)
Inflamed sclera
Redness and swelling of sclera
Can be diffused or defined area near limbus
Episcleritis:
Symptoms (4)
Slight discomfort
Gritty
Sensation
Photophobia
Episcleritis:
History (2)
Commonly affects young people
Associated with shingles or gout
Episcleritis:
Treatment (3)
Often disappears without treatment
Steroid drops for discomfort
Defer contact lens wear
Episcleritis:
Referral (1)
GP if recurring
Scleritis:
Signs (3)
Inflamed sclera
Redness and swelling
Diffuse bulbar injection
Scleritis:
Symptoms (3)
Pain affecting orbital area, forehead, jaw and eyeball]
Photophobia
Lacrimation
Reduced VAs
Scleritis:
History (2)
Associated with systemic conditions eg arthritis or shingles
Often followed by uveitis, and possibly keratitis, glaucoma and cataract
Scleritis:
Treatment (2)
Steroid drugs
Defer contact lens wear
Scleritis:
Referral (1)
A&E
Retinoblastoma:
Signs (3)
White or yellow appearance of pupil
Usually unilateral
Rare tumour found affecting very young children
Retinoblastoma:
Symptoms (3)
Reduced vision
Rarely noticed unless bilateral
Advanced can cause secondary glaucoma
Retinoblastoma:
History (2)
Nuclear layers in retina arise from genetic mutation
Hereditary
Retinoblastoma:
Treatment (2)
Radiation therapy
Removal of eye
Retinoblastoma:
Referral (1)
A&E
Basal Cell Carcinoma:
Signs (3)
Eye or nose lesion
Misaligned eyelashes
‘Pearly’ edge, dipped centre, and red area
Basal Cell Carcinoma:
Symptoms (2)
No pain
Possible discomfort if ulcerated
Basal Cell Carcinoma:
History (1)
Possible previous occurrence
Basal Cell Carcinoma:
Treatment (1)
Surgical treatment
Basal Cell Carcinoma:
Referral (1)
GP - further referral to dermatologist
Foreign Body:
Signs (3)
Red eye
Inflammation
Lacrimation
Foreign Body:
Symptoms (5)
Inflammatory reaction
Pain
Reduced VAs
Photophobia
Blurred vision
Foreign Body:
History (1)
Occupational ot DIY accident
Foreign Body:
Treatment (1)
Remove if possible
Foreign Body:
Referral (1)
Urgent to A&E if embedded
Chemical Burn:
Signs (1)
Inflammation
Chemical Burn:
Symptoms (2)
Pain
Blurred vision
Chemical Burn:
History (1)
Occupational or DIY accident
Chemical Burn:
Treatment (1)
Immediate irrigation
Flush excessively with saline or water
Chemical Burn:
Referral (1)
Urgent to A&E
Trichiasis:
Signs (4)
Misdirected eyelashes - growing inwards
Inflammation
Lacrimation
Ulceration of cornea
Trichiasis:
Symptoms (2)
Pain
Reduced VAs - lashes on cornea
Trichiasis:
History (4)
Eyelash follicles in abnormal position
Entropian
Blepharitis
Congenital
Trichiasis:
Treatment (2)
Lash removal
Bandage contact lens
Trichiasis:
Referral (1)
GP
Macular Degeneration:
Signs (2)
No external signs
Opthalmoscopy shows pale spots on fundus
Macular Degeneration:
Symptoms (4)
Loss of central visual field
Difficulty with near tasks
Straight lines appear wavy
Loss of detail
Macular Degeneration:
History (4)
Hereditary
Smoking
Female
Poor diet
Macular Degeneration:
Treatment (1)
Wet:
Anti VEGF injections
Lucentis injections
Macular Degeneration:
Referral (1)
Urgent GP of sudden onset wet
Detached Retina:
Signs (3)
No external signs
Ophthalmoscopy shows purple-grey area on fundus
Retinal blood vessels in area appear darker
Detached Retina:
Symptoms (4)
Progressive field loss, like shadow or curtain
Flashes of light with movement
Floaters
Reduced VAs
Detached Retina:
History (4)
High myopia
Exertion
Aging
Cataract surgery
Detached Retina:
Treatment (3)
Laser
Cryotherapy - seals retina onto pigment epithelium
Injecting gas in front of detachment to push it back
Detached Retina:
Referral (1)
Urgent to A&E
Acute Glaucoma:
Signs (3)
Red eye
Cloudy cornea
Oval shaped pupil
Acute Glaucoma:
Symptoms (4)
Severe pain
Frontal headaches
Blurred vision
Vomiting due to pain
Acute Glaucoma:
History (3)
Haloes around lights
Types; acute, open angle, closed angle and congenital
Urgent to A&E if IOPs over 34
Acute Glaucoma:
Treatment (1)
Miotics to reduce IOPs
Acute Glaucoma:
Referral (1)
Urgent to A&E, phone ahead and email referral