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Brief > Eye > Flashcards

Eye Flashcards

1
Q

Leucokoria: Clinical Presentation (Cp)

A

White pupil

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2
Q

Leucokoria: Differential Diagnosis (DD)

A

Congenital cataract, Retinoblastoma

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3
Q

Leucokoria: First Step

A

Refer immediately (vvvvvvvvvvvimp)

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4
Q

Retinopathy : Risk Factor

A

Prematurity

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5
Q

Retinopathy of Prematurity: High Flow Oxygen

A

Vasoproliferative scarring and blindness

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6
Q

Retinopathy of Prematurity: Treatment (TTT)

A

Laser

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7
Q

Retinoblastoma: Incidence

A

Rare, most common malignant intraocular tumor

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8
Q

Retinoblastoma: Clinical Presentation (Cp)

A

Leukocoria, Strabismus

  • most common intraocular tumor in children
  • Leukocoria (white cornea or Cat’s eye)
    -strabismus
  • initial: US (intraocular calcification)
  • best dilated indirect
    ophthalmoscopic examination under anesthesia
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9
Q

Retinoblastoma: Investigation (Inv)

A

CT (NO BIOPSY…SPREAD)

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10
Q

Retinoblastoma: Treatment (TTT)

A

Surgery, good prognosis

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11
Q

Corneal Abrasion: Symptoms

A

Pain, tearing, photophobia, decreased vision

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12
Q

Corneal Abrasion: Investigation (Inv)

A

Fluorescein staining

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13
Q

Corneal Abrasion: Treatment (TTT)

A

Pain relief and antibiotics

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14
Q

Foreign Body: First Step

A

Excessive irrigation with saline

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15
Q

Foreign Body: Metal Foreign Body

A

Emergent removal under anesthesia

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16
Q

Foreign Body: If deeply embedded

A

Refer

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17
Q

Penetrating Eye Injury: Management

A

Urgent referral, X-ray, Tetanus vaccine, Antibiotics

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18
Q

Orbital vs. Periorbital Cellulitis: Common Organism

A

Staph

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19
Q

Orbital vs. Periorbital Cellulitis: Clinical Presentation (Cp)

A

Erythema, Edema, Chemosis

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20
Q

Orbital Cellulitis: Clinical Presentation

A

Cannot move eye, diplopia

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21
Q

Periorbital Cellulitis: Clinical Presentation

A

Normal eye movements, no diplopia

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22
Q

Orbital Cellulitis: Investigation (Inv)

A

CT (vvvvvvvvvvvimp)

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23
Q

Periorbital Cellulitis: Investigation (Inv)

A

FBC and blood culture

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24
Q

Orbital Cellulitis: Treatment (TTT)

A

Admission and IV ceftriaxone and IV flucloxacillin

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25
Q

Periorbital Cellulitis: Treatment (TTT)

A

Mild: Amoxicillin/Clavulanate; Moderate: Flucloxacillin; Severe: Flucloxacillin and Ceftriaxone 50 mg/kg

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26
Q

Aniridia: Definition

A

Defect of the iris

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27
Q

Aniridia: Check for

A

Wilm’s tumor

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28
Q

WAGR Syndrome: Components

A

Wilms tumor, Aniridia, Genitourinary malformation, Retardation

WAGR syndrome is a rare genetic disorder that stands for:

1.	Wilms Tumor: A type of kidney cancer that primarily affects children.
2.	Aniridia: Absence of the iris, the colored part of the eye, leading to visual impairment.
3.	Genitourinary Anomalies: Various abnormalities of the genitals and urinary tract. In males, this might include undescended testes (cryptorchidism) or hypospadias. In females, it might include streak ovaries or other genital malformations.
4.	Intellectual Disability (previously referred to as “mental Retardation”): Developmental delays and intellectual disability of varying degrees.
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29
Q

Congenital Cataract: Most Common Causes

A

Rubella (cataract, deafness, PDA), Galactosemia

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30
Q

Strabismus: Transient

A

Common up to 4 months

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31
Q

Strabismus: Time to Correct

A

1-2 years

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32
Q

Strabismus: Correction Deadline

A

Before 7 years

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33
Q

Neonatal Conjunctivitis: First Day

A

Chemical (silver nitrate)

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34
Q

Neonatal Conjunctivitis: 2-5 Days

A

Gonococcal infection

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35
Q

Neonatal Conjunctivitis: Gonococcal Treatment

A

Single dose IV ceftriaxone

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36
Q

Neonatal Conjunctivitis: 5-14 Days

A

Chlamydia (more common)

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37
Q

Neonatal Conjunctivitis: Associated Condition

A

Pneumonia

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38
Q

Neonatal Conjunctivitis: Investigation

A

Swab for PCR

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39
Q

Neonatal Conjunctivitis: Treatment (TTT)
Chlamidya

A

Oral azithromycin 3 days

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40
Q

Nasolacrimal Duct Obstruction: Clinical Presentation (Cp)

A

Excessive watery secretions

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41
Q

Nasolacrimal Duct Obstruction: Treatment (TTT)

A

Massage

The appearance differs from conjunctivitis in that the child will not have any discomfort and the conjunctiva remains white. Gentle massage of the lacrimal sac may cause expression of mucus.

90% of nasolacrimal duct obstructions will spontaneously resolve by 12 months of age. Due to this, referrals should wait until the child is 1 year of age.

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42
Q

Nasolacrimal Duct Obstruction: Prognosis

A

Majority heal spontaneously

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43
Q

Children Conjunctivitis: Most Common Cause

A

Viral

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44
Q

Children Conjunctivitis: Most Common Virus

A

Adenovirus

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45
Q

Children Conjunctivitis: Symptoms

A

Running nose, red eye, clear discharge 2-3 weeks, follicular response, preauricular lymphadenopathy

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46
Q

Children Conjunctivitis: Management

A

Cool compression, no pad

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47
Q

Photophobia Differential Diagnosis: Look at the Pupil

A

Normal: Keratitis

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48
Q

Photophobia Differential Diagnosis: Constricted Pupil

A

Iritis/Uveitis

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49
Q

Iritis/Uveitis: Treatment (TTT)

A

Steroids

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50
Q

Photophobia Differential Diagnosis: Dilated Fixed Pupil, No Light Reflex

A

Acute glaucoma

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51
Q

Acute Glaucoma: Symptoms

A

Sudden onset red painful eye, halos, fixed semi-dilated pupil

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52
Q

Acute Glaucoma: Management

A

Immediate referral to ophthalmology, IV or oral acetazolamide or pilocarpine

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53
Q

Photophobia Differential Diagnosis: No Photophobia

A

Conjunctivitis (bacterial or viral)

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54
Q

Herpes Simplex Infection: Clinical Presentation (Cp)

A

Dendritic ulcer vesicles, gritty watery green, pain, photophobia, lacrimation

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55
Q

Herpes Simplex Infection: Treatment (TTT)

A

Initial management is with topical acyclovir eye ointment administered five times daily.
, refer to ophthalmology

56
Q

Herpes Zoster Ophthalmicus: Clinical Presentation (Cp)

A

Rash involving trigeminal nerve distribution, dendritiform ulcer

57
Q

Herpes Zoster Ophthalmicus: Treatment (TTT)

A

Acyclovir

58
Q

Subconjunctival Hemorrhage: Causes

A

Trauma, severe cough and sneezing

59
Q

Subconjunctival Hemorrhage: Symptoms

A

Painless, uniform redness

60
Q

Subconjunctival Hemorrhage: Management

A

Usually none, reassure
If doesn’t cross limbus

61
Q

Acute Glaucoma: Risk Factors

A

Old age, Female, Hypermetropia, Prolonged time in dark area

62
Q

Acute Glaucoma: Clinical Presentation (Cp)

A

Sudden severe unilateral pain, halos around lights, dilated fixed pupil, photophobia, lacrimation, blurring of vision, eye injection

63
Q

Acute Glaucoma: Investigation (Inv)

A

Tonometry

64
Q

Acute Glaucoma: Treatment (TTT)

A

Emergency room: IV Acetazolamide; Long term: Iridotomy

65
Q

Acute Glaucoma: Drug to Avoid

A

Atropine

66
Q

Open Angle Glaucoma: Clinical Presentation (Cp)

A

Bilateral loss of peripheral vision

67
Q

Open Angle Glaucoma: Risk Factors

A

DM, Myopia, Elderly

68
Q

Open Angle Glaucoma: Fundus Exam

A

Cupping of optic disc

69
Q

Open Angle Glaucoma: Tonometry

A

Increased IOP

70
Q

Open Angle Glaucoma: Treatment (TTT)

A

Timolol; Long term: Trabeculectomy

71
Q

Sudden Unilateral Loss of Vision Differential Diagnosis (DD)

A

CRAO, CRVO, Amaurosis fugax, Retinal detachment

72
Q

Central Retinal Artery Occlusion (CRAO): Cause

A

Emboli

73
Q

CRAO: Source

A

Ipsilateral carotid artery

74
Q

CRAO: Clinical Presentation (Cp)

A

Sudden painless unilateral loss

75
Q

CRAO: Ophthalmoscopy

A

Cherry red spot

76
Q

CRAO: First Step

A

Breathing in a bag (increase CO2), Massage (only first 90 minutes)

Ocular massage using a contact gonioscopy lens was performed. Intravenous acetazolamide and topical medications were given to lower the intraocular pressure. An anterior chamber paracentesis was performed, in which 0.1 mL of aqueous humour was removed using a 25 gauge needle via a limbal approach.racgp

77
Q

CRAO: Treatment if >3 hours

A

IV acetazolamide (vvvvvvvv imp)

78
Q

Central Retinal Vein Occlusion (CRVO): Clinical Presentation (Cp)

A

Sudden unilateral painless loss of vision

79
Q

CRVO: Fundoscopy

A

Disk swelling and venous dilatation

80
Q

CRVO: Treatment (TTT)

A

No specific treatment

81
Q

Retinal Detachment: Main Risk Factors

A

Myopia, DM, Macular degeneration

82
Q

Retinal Detachment: Clinical Presentation (Cp)

A

Flashes of light (key word), curtain coming down (vvvvvvv imp), floaters, loss of vision

83
Q

Retinal Detachment: First Aid

A

Tilt the head back (vvvv imp)

84
Q

Retinal Detachment: Treatment (TTT)

A

Laser photocoagulation

85
Q

Amaurosis Fugax: Cause

A

Emboli

86
Q

Amaurosis Fugax: Source

A

Ipsilateral carotid artery

87
Q

Amaurosis Fugax: Sign of

A

Impending stroke

88
Q

Amaurosis Fugax: Clinical Presentation (Cp)

A

Sudden painless unilateral loss of vision, curtain falls down, then sees well again

89
Q

Amaurosis Fugax: Examination

A

Murmur over carotid

90
Q

Amaurosis Fugax: Investigation (Inv)

A

US for carotid

91
Q

Amaurosis Fugax: Drug of Choice

A

Aspirin

92
Q

Curtain Falling Down Differential Diagnosis (DD)

A

Retinal detachment (flashes of light), Retinal emboli (murmur over carotid)

93
Q

Macular Degeneration: Most Common Cause of Blindness

A

Elderly

94
Q

Macular Degeneration: Clinical Presentation (Cp)

A

Slowly bilateral loss of central vision, see lines wavy

95
Q

Macular Degeneration: Treatment (TTT)

A

Better to refer

96
Q

Macular Degeneration: Dry

A

No treatment

97
Q

Macular Degeneration: Wet

A

Laser

98
Q

Diabetic Retinopathy: Stages

A

Non-proliferative: control DM; Proliferative: Laser photocoagulation

99
Q

Diabetic Retinopathy: Screening Frequency

A

Every 1-2 years

100
Q

Cataract: Most Important Risk Factor

A

Age

101
Q

Cataract: Other Risk Factors

A

DM, Smoking, Trauma

102
Q

Cataract: Clinical Presentation (Cp)

A

Cannot read well at night (key word), cannot see well at daylight (vvvvvv imp)

103
Q

Cataract: Treatment (TTT)

A

Phacoemulsion (imp)
Definite - lens

104
Q

Eye Floaters Differential Diagnosis (DD)

A

Retinal detachment, Trauma (bleeding), DM (most common cause)

105
Q

Eye Floaters: Clinical Presentation (Cp)

A

Black dots moving in front of him

106
Q

Eye Floaters: Investigation (Inv)

A

Fundoscopy

107
Q

Eye Floaters: Treatment (TTT)

A

Usually none

108
Q

Pupil Abnormalities Differential Diagnosis (DD): Constricted Pupil

A

Morphine, Heroin toxicity, Organophosphorus, Intracranial hemorrhage (pontine), Iritis/Uveitis

109
Q

Constricted Pupil: Morphine Treatment

A

Give naloxone

110
Q

Constricted Pupil: Organophosphorus Treatment

A

Atropine and oximes

111
Q

Constricted Pupil: Intracranial Hemorrhage (Pontine) Investigation (Inv)

A

CT is a must

112
Q

Pupil Abnormalities Differential Diagnosis (DD): Dilated Pupil

A

Amphetamine toxicity, Ecstasy toxicity, Cocaine toxicity, LSD toxicity, Alcohol withdrawal

113
Q

Dilated Pupil: Alcohol Withdrawal Treatment

A

IV diazepam

114
Q

Dilated Fixed Pupil Differential Diagnosis (DD)

A

Acute glaucoma, 3rd cranial nerve palsy

115
Q

Trachoma: Organism

A

Chlamydia

116
Q

Trachoma: Most Common Cause of Blindness

A

Aboriginal people

117
Q

Trachoma: Prevention

A

Face wash

118
Q

Trachoma: Spread Prevention

A

<20%: treat only contact with azithromycin; >20%: treat whole community

119
Q

Trachoma: Clinical Presentation (Cp)

A

Inflammation and scarring of the eye flees

120
Q

Trachoma: Best Prophylaxis

A

Wash hands

121
Q

Trachoma: Treatment (TTT)

A

Azithromycin (DOC), Surgery

122
Q

Dacryocystitis: Clinical Presentation (Cp)

A

Infection of the lacrimal sac, pain, redness, swelling over inner aspect of lower eyelid

123
Q

Dacryocystitis: Treatment (TTT)

A

Oral antibiotics, warm compresses; If abscess: incision and drainage

124
Q

Hypopyon: Definition

A

Pus in the anterior chamber

125
Q

Hypopyon: Cause

A

Post-operative

126
Q

Hyphema: Definition

A

Blood in the anterior chamber

127
Q

Episcleritis and Scleritis: Clinical Presentation (Cp)

A

Both conditions present with a red eye which may be painful but no discharge; Think Rheumatoid arthritis, Herpes zoster

128
Q

Episcleritis and Scleritis: Management

A

Topical corticosteroids or oral anti-inflammatory medications

129
Q

Episcleritis and Scleritis: Notable Symptom

A

Painful and no discharge

130
Q

Sudden Loss of Vision in Elderly: First Investigation (Inv)

A

ESR (vvvvvvvvvvvvvvv imp, even before CT)

131
Q

Stye: Clinical Presentation (Cp)

A

Red painful swelling on eyelid margin abscess

132
Q

Stye: Management

A

Hot compression

133
Q

Chalazion: Clinical Presentation (Cp)

A

Granuloma of the meibomian in eyelid, painless lump

134
Q

Chalazion: Management

A

Hot compression with massage; If large: refer for incision

135
Q

Blepharitis: Common Organism

A

Staphylococcus

136
Q

Blepharitis: Symptoms

A

Feels like something is in the eye, crust or scale near baseline of eyelid

137
Q

Blepharitis: Management

A

Hygiene

Blepharitis may be treated with a combination of antibiotic or steroid drops. Lid scrubs to remove any excess crusting will also help.

Brief (1 decks)

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