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MBChB YR2: Opthalmology > Disease Profiles: Other Visual Defects > Flashcards

Disease Profiles: Other Visual Defects Flashcards

1
Q

What is sympathetic opthalmia?

A

Penetrating injury to one eye results in exposure of intra-ocular antigens results in an auto-immune reaction in both eyes

Inflammation in both eyes may lead to bilateral blindness (from a unilateral injury)

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2
Q

Name 4 sight-threatening complications of ocular trauma

A

Tearing of intra-ocular structures

Dislocated lens

Retinal detachment

Commotio retinae (bruised retina)

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3
Q

Describe the management of a corneal abrasion

A

Remove any foreign bodies

Consider the need for analgesia or ocular lubricants

Consider prescribing chloramphenicol if risk of infection

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4
Q

Define anisometrophia

A

Significant difference between right and left ametropia

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5
Q

Describe the clinical presentation of cataracts

A

Gradual visual loss (‘hazy’/’blurred’)

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6
Q

What causes a subconjunctival haemorrhage?

A

Often appear after episodes of strenuous activity such as heavy coughing, weight lifting or straining when constipated

It can also be caused by trauma to the eye

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7
Q

An inward movement of the uncovered eye during a cover test indicates what type of strabismus?

A

Exotropia

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8
Q

Describe the management of hyperophia

A

Glasses with convex (positive) lenses

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9
Q

Name 3 risk factors for the development of cataracts

A

Hypertension, steroids, metabolic disorders e.g. diabetes

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10
Q

Which ocular muscle is most at risk of entrapment following an orbital blowout fracture?

A

Inferior rectus muscle - results in diplopia

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11
Q

Describe the clinical signs of a patient with a penetrating foreign body in their eye

A

Irregular pupil

Shallow anterior chamber

Localised cataract

Gross inflammation

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12
Q

What is traumatic uveitis?

A

Inflammation of the iris caused by eye trauma

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13
Q

What is a corneal abrasion?

A

Trauma resulting in the removal of a focal area of epithelium on the cornea

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14
Q

Name two risk factors for the development of glaucoma

A

Raised intraocular pressure is currently the only modifiable risk factor

Increased incidence with age

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15
Q

What can fluorescein help with in regards to a corneal abrasion?

A

Fluorescein stain can be used to aid in viewing of the abrasion through opthalmosope/slit lamp

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16
Q

What causes presbyopia?

A

Age-related degeneration of structures responsible for accomodation of the lens

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17
Q

Describe the management of astigmatism

A

Correction with cylindrical lenses

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18
Q

Describe the management of primary open-angle glaucoma

A

First line - prostanoids e.g. latanoprost (‘xalatan’)

Second line - β blockers, carbonic anhydrase inhibitors

Others - ⍺2 adrenergic agonist, parasympathomimetics, combination eyedrops

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19
Q

What is the definitive management of closed-angle glaucoma?

A

Laser peripheral iridotomy

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20
Q

Describe the clinical presentation of open-angle glaucoma

A

Usually asymptomatic, screened for by optometrists

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21
Q

Define ametrophia

A

Retractive error present, light focussed in front of retina or behind retina

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22
Q

What causes glaucoma?

A

Glaucoma occurs when there is a blockage in the drainage through the trabecular meshwork or in the Canal of Schlemm

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23
Q

What causes a corneal abrasion?

A

Abrasions usually occur when the eye is accidently poked with a finger, a foreign body flies into the eye or something brushes against the eye

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24
Q

An outward movement of the uncovered eye during a cover test indicates what type of strabismus?

A

Esotropia

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25
Q

What causes astigmatism?

A

Eye has unequal refractive powers at different meridians of curvature

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26
Q

Describe the management of acutely presenting closed-angle glaucoma

A

Lower IOP quickly with drops/oral medication to prevent the patient from going blind

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27
Q

How would you prevent an infant with strabismus from developing amblyopia (cortical blindness, ‘lazy eye’)?

A

Cover infant’s good eye with a patch for a few hours each day so that the brain must rely on signals from the bad eye

Helps the brain develop properly to process signals coming from both eyes until infant is old enough for surgery

28
Q

Describe the clinical presentation of astigmatism

A

Causes distorted vision at all distances

29
Q

What is a refractive error?

A

Refers to any abnormality in the focusing mechanism of the eye

30
Q

Define cataracts

A

Opacifications within the lens

31
Q

Describe the clinical signs of open-angle glaucoma

A

Visual field defect, may or may not have high IOP

32
Q

A downward movement of the uncovered eye during a cover test indicates what type of strabismus?

A

Hypertropia

33
Q

What causes hyperophia (far-sightedness)?

A

Abnormally decreased axial length of eye means light focuses in behind the retina

34
Q

Describe the management of myopia

A

Glasses with concave (negative) lenses

35
Q

At what age is strabismus most likely to develop?

A

Commonly onset is in childhood, can start in adulthood but this is less common

36
Q

Describe the clinical presentation of closed-angle glaucoma

A

1/3 present as an emergency - acute red eye and visual loss, headache and N+V

37
Q

Name two complications associated with hyperophia

A

Complications related to smaller eyeball size - closed angle glaucoma

38
Q

Describe the management of cataracts

A

Surgical removal with intra-ocular lens implant if patient is symptomatic

39
Q

Define emmetropia

A

No refractive error, light focussed onto retina

40
Q

An upward movement of the uncovered eye during a cover test indicates what type of strabismus?

A

Hypotropia

41
Q

What is a subconjunctival haemorrhage?

A

Occurs when one of the small blood vessels within the conjunctiva ruptures and release blood into the space between the sclera and the conjunctiva

42
Q

Describe the clinical presentation of myopia

A

Clear near vision, blurred far vision

43
Q

Describe the management of presbyopia

A

Requires a supplementary convex or positive lens (i.e. reading glasses) in order to focus light from a near object onto the retina

44
Q

What is an orbital blowout fracture?

A

Occurs when there is a fracture of one of the walls of the orbit but the orbital rim remains intact; typically caused by a direct blow to the central orbit from a fist or a ball

45
Q

Name 3 risk factors for the development of strabismus

A

Premature birth, cerebral palsy and a family history of the condition

46
Q

Describe the immediate management of a chemical burn to the eye?

A

Quick history, check pH, irrigate minimum 2L saline, or until pH normal, then assess using slit lamp

47
Q

What causes strabismus?

A

Can occur due to muscle dysfunction, farsightedness, problems in the brain, trauma or infections

48
Q

Describe the clinical presentation of hyperophia

A

Blurred near vision, clear far vision

49
Q

In a patient with strabismus, corneal reflections will be _________

A

Asymmetrical

50
Q

What causes a globe rupture?

A

More commonly occurs after direct penetrating trauma but if sufficient blunt force is applied to the eye the intraocular pressure can increase enough to rupture the sclera

51
Q

Name two complications associated with myopia

A

Complications related to larger eyeball size - retinal detachment, primary open angle glaucoma

52
Q

What causes myopia (short-sightedness)?

A

Abnormally increased axial length of eye or, less commonly, increased refraction means light focuses in front of the retina

53
Q

Define strabismus (squint)

A

Ophthalmic condition in which the eyes do not properly align with each other when focusing to look at an object (i.e. poor fusion)

54
Q

What causes open angled glaucoma?

A

Result of poor drainage through trabecular meshwork

Slow onset, often asymptomatic and now screened for

55
Q

How do glaucoma drops work?

A

Either decrease aqueous production or increase drainage

56
Q

What causes cataracts?

A

Many different causes, often age-related

57
Q

Describe the fundoscopy findings associated with glaumcoma

A

Cupped disc (increased cup-to-disc ratio) indicates a reduced volume of healthy neuro-retinal tissue, which can occur in glaucoma

58
Q

Define glaucoma

A

A group of chronic diseases characterised by a progressive optic neuropathy resulting in characteristic field defects

59
Q

What causes closed angled glaucoma?

A

Drainage through meshwork is patent

Aqueous humour encounters resistance through iris/lens channel

Increased pressure gradient causes peripheral iris to bow forward, obstructing trabecular meshwork → pressure increases

60
Q

Describe the clinical presentation of strabismus

A

Misalignment of the eyes

Reduced visual acuity

Diplopia

Asthenopia (i.e. eye strain, fatigue or pain), particularly in the afternoon or at the end of the day

61
Q

Describe the management of strabismus

A

Depends on type of strabismus and the underlying cause; may include the use of glasses and possibly surgery

62
Q

What is hyphaemia?

A

Blood in the anterior chamber, sign of fairly significant intra-ocular trauma

63
Q

Describe the clinical presentation of presbyopia

A

Similar to hyperopia - blurred near vision, clear far vision

Preexisting myopia may temporarily compensate presbyopia, leading to better near vision

64
Q

What might a pale optic disc indicate on fundoscopy of a patient with glaucoma?

A

A pale optic disc suggests the presence of optic atrophy, which can result from advanced glaucoma

65
Q

Describe the clinical signs of closed-angle glaucoma

A

Red eye, cloudy cornea, dilated pupil

66
Q

What causes rubeotic glaucoma?

A

New vessel formation in diabetic eye disease forms obstructive angle (rare and late complicatiom

67
Q

How can diabetes predispose to the development of cataracts?

A

Changes to osmotic pressures and altering of fluid content in lens damages epithelial cells and fibres

MBChB YR2: Opthalmology (20 decks)

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