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Y4 Eyes > Emergencies > Flashcards

Emergencies Flashcards

1
Q

what is examined in the anterior segment of the eye?

A 
lid
conjunctiva
cornea
iris
pupil (RAPD)
lens
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2
Q

what is examined in the posterior segment of the eye?

A

vitreous
optic disc
macula
retinal vasculature

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3
Q

what are some causes of subconjunctival haemorrhage?

A

spontaneous
trauma
coagulative disorder
valsalva pressure

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4
Q

what is the difference between a subconjunctival haemorrhage and scleral rupture?

A

can’t see the posterior limit of a scleral rupture and is more severe

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5
Q

is episcleritis or scleritis more severe?

A

scleritis

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6
Q

what are the signs of episcleritis?

A

pain. discomfort, patch of redness

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7
Q

what is the treatment of episcleritis?

A

NSAIDs, topical steroids, lubricants

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8
Q

what additional symptoms are experienced with scleritis compared to episcleris ?

A

severe pain
photophobia
decreased vision

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9
Q

what are the three different types of scleritis ?

A

localised
nodular
diffuse

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10
Q

what is scleritis associated with?

A

systemic autoimmune diseases

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11
Q

what investigation can be done for foreign bodies/corneal abrasion in the eye?

A

fluorescein staining

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12
Q

what are the symptoms of corneal abrasion?

A

pain, watering, photophobia, conjunctiva injection, swollen lids

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13
Q

what do cycloplegics do?

A

paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation.

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14
Q

what is the management of corneal abrasions

A 
evert eye lid 
wash 
topical antibiotic 
cycloplegics 
pressure pad and patch
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15
Q

what could cause a corneal ulcer?

A

excessive contact lens

wearing contact lens while swimming, sleeping, showering

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16
Q

what are the symptoms of corneal ulcers?

A

pain, redness, photophobia, watering, discharge

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17
Q

what is a sign of viral keratitis?

A

epithelial dendrites

stromal keratitis

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18
Q

what is the treatment for viral keratitis ?

A

aciclovir 3% ointment for 3 weeks

topical cyclolplegics

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19
Q

what are some signs of iritis ?

A 
circumcorneal redness 
keratic precipitates on corneal endothelium 
cells in anterior chamber 
hypopyon 
posterior synaechiae 
peripheral anterior synchiae 
miosis
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20
Q

what is hypopyon?

A

leukocytic exudate, seen in the anterior chamber

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21
Q

what is miosis ?

A

excessive constriction of pupil

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22
Q

what is the treatment for iritis ?

A

topical steroids

cycloplegics

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23
Q

do myopic or hypermetropic people get acute angle closure glaucoma and why?

A

hypermetropic because the eye ball is smaller than normal so the image is projected behind the retina

24
Q

what are symptoms of acute angle closure glaucoma ?

A

nausea, vomiting
coloured halos around light
red eye
painful

25
Q

does acute angle closure glaucoma have a deep or shallow anterior chamber ?

A

shallow anterior chamber

26
Q

what type of necrosis does acid produce?

A

coagulative necrosis

27
Q

what type of necrosis does alkali produce?

A

liquefactive necrosis

28
Q

what ocular burn is worse?

A

alkali burn because its liquefactive

penetrates cornea faster and rapidly damages intraocular structures

29
Q

what is hyphema?

A

bleeding in the anterior chamber of the eye

30
Q

what blood system supplied the fovea centralis?

A

choroid blood supply

31
Q

what is a contraindication of mannitol?

A

heart failure

32
Q

what retinal sign is present with retinal vein occlusion?

A

blot haemorrhage

33
Q

what is the management of hyphema?

A 
bed rest 
head elevation 
analgesia 
topical steroids 
topical cycloplegic
34
Q

what % of pts rebleed in the first 5 days after hyphema ?

A

30%

35
Q

what does the cornea look like after an ocular burn?

A

cloudy

36
Q

once an ocular burn has been irrigated with 2 litres what medication can be given?

A 
topical antibiotics 
lubricants 
cycloplegics 
steroids 
Vitamin C
37
Q

what is the presentation of central retinal artery occlusion ?

A

sudden painless loss of vision

38
Q

what is the presentation of central retinal vein occlusion ?

A

sudden painless loss of vision

- not as sudden as central retinal artery occlusion

39
Q

what does the retina look like after central retinal artery occlusion ?

A

pale retina with attenuated (thin) vessels with cherry red spot on fovea

40
Q

what is the management of central retinal artery occlusion ?

A 
ocular massage (to try dislodge emboli)
reduce intraocular pressure 
hypoventilate 
anterior chamber paracentesis 
infusion of tPA in ophthalmic artery
41
Q

what ocular problem does GCA cause?

A

anterior ischaemic optic neuropathy

42
Q

what visual field defect is seen in GCA?

A

altitudinal field defect (vision superior to horizontal axis is absent due to inferior retinal defect)
blurry vision

43
Q

what signs are seen on retina for central retinal vein occlusion ?

A

blot haemorrhages in all 4 quadrants
dilated tortuous vessels
swollen optic disc
cotton wool spots

44
Q

what is the presentation of retinal detachment ?

A

black curtain coming down over visual field
sudden onset of floaters
flashing lights

45
Q

what are risk factors of retinal detachment ?

A

myopia

ocular surgery

46
Q

what is the presentation of vitreous haemorrhage ?

A

sudden painless loss of vision

sudden onset of floaters

47
Q

what are some risk factors for vitreous haemorrhage ?

A

HTN, DM, proliferative diabetic retinopathy (PDR)

anti coagulant treatment

48
Q

what is the normal ESR meant to be?

A

male - half of age

females - age +10 divided by 2

49
Q

does orbital cellulitis have RAPD?

A

yes

50
Q

what are the signs of orbital cellulitis ?

A 
severe pain
periorbital and lid oedema 
proptosis 
chemosis 
RAPD 
reduced visual acuity 
restricted movements 
fever
51
Q

what is a complication of orbital cellulitis ?

A

meningitis

cavernous sinus thrombosis

52
Q

what is the treatment for orbital cellulitis ?

A

IV antibiotics

53
Q

what are some risk factors for endophthalmitis ?

A

post operative patients and history of ocular trauam

54
Q

what is the treatment for endophthalmitis?

A

intravitreal antibiotics and vitrectomy

55
Q

what causes endogenous endopthalmitis ?

A

sepsis

immunocompromised patients

Y4 Eyes (3 decks)

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