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Eye ENT Patho > Eye > Flashcards

Eye Flashcards

1
Q

Anterior segment components (5)

A

Cornea, conjunctiva, iris, ciliary body, crystalline lens

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2
Q

Posterior segment components (5)

A

Retina, choroid, sclera, vitreous humour, optic nerve

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3
Q

Corneal transplant now transplants the ___ layer of the cornea

A

endothelial layer (endothelial keratoplasty)

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4
Q

What forms the angle of the anterior chamber? What lies within the angle?

A

Corner between cornea, sclera, iris and ciliary body

Trabecular meshwork

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5
Q

Accommodation reflex of the lens

A

Far distance: ciliary muscles relax, suspensory ligaments become taut, lens become less convex

Near distance: ciliary muscles contract, suspensory ligaments become loose, lens become more convex

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6
Q

__ are for light vision, ___ for colour vision

A

rods
cones

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7
Q

Fovea
- highest density of __
- no ___

A

cones, rods

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8
Q

Optic disc is more __, macula is located __ to optic disc

A

nasal
temporal

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9
Q

Fibres of optic radiation in the ___ lobe (aka ___ loop) represent the superior visual field. (pie in the sky)

A

temporal lobe
Meyer’s loop

contralateral superior homonymous quadrantanopia

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10
Q

Fibres of optic radiation in the ___ lobe (aka ___ loop) represents the inferior visual field. (pie on the floor)

A

parietal lobe
Baum’s loop

contralateral inferior homonymous quadrantanopia

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11
Q

Homonymous hemianopia is caused by ___ lesions. The ___ the lesion from the chiasm, the more ___ the hemianopia.

A

retrochiasmal lesions

further from chiasm, more congruent lesion (VF defect looks the same on both sides)

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12
Q

Name the parts of the visual pathway

A

Optic nerve -> optic chiasm -> optic tract -> lateral geniculate body -> optic radiation -> occipital lobe

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13
Q

What defect causes bitemporal hemianopia

A

Chiasmal lesions

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14
Q

What defect causes homonymous hemianopia with macular sparing?

A

Defect in the occipital lobe from PCA infarct with MCA intact

Tip of occipital lobe serves central visual field. Supplied by both MCA and PCA

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15
Q

Patients with defect in superior visual field -> suspect ___ -> check for concomitant ___

A

pituitary adenoma
hyperprolactinemia (galactorrhea, gynaecomastia, amenorrhea)

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16
Q

Snellen chart 6/20 means?

A

At 6 metres, patient can see what a normal person can see at 20m

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17
Q

What is the pinhole effect?

A

focuses light by blocking peripheral light rays, corrects refractive errors up to -4D or +4D but cannot overcome organic/structural disease

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18
Q

Eyelid turn inwards: ___
eyelid turn outwards: ___

A

entropion
ectropion

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19
Q

Use ___ in ___ light to highlight corneal epithelial defects

A

Fluorescein strips in cobalt blue light

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20
Q

What is hyphema

A

Collection of blood in anterior portion of iris

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21
Q

what is hypopyon

A

Collection of leukocytic exudate in anterior portion of iris

seen in inflammatory conditions (eg uveitis) or infections (endopthalmitis)

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22
Q

What is the eclipse sign?

A

Shine light from temporal aspect of cornea towards nose to see width of shadow of iris in nasal area

Shadow broad = anterior chamber shallow = angle may be narrow = risk of angle closure glaucoma

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23
Q

What are the pupillary reflexes

A

Direct light reflex
Consensual
Relative afferent pupillary defect (RAPD)
Light near dissociation

24
Q

Do the ___ to check for strabismus

A

Hirschberg corneal light reflex

25
Q

What to look out for when checking optic disc

A

Colour: pink
Cup-disc ratio: normal = 0.3
Contour: edges
Margins: clear, blurred

26
Q

Myopia = eyeball ___
hypermetropia = eyeball ___
astigmatism =
presbyopia =

A

myopia - eyeball long, light rays focused in front of retina

hypermetropia - eyeball short, light rays focus behind retina

astigmatism = inequality in refractive surface of the eye along 1 axis (rugby ball shape)

presbyopia = loss of lens elasticity and convexity due to aging, loss of accommodative ability

27
Q

Prescription

Spherical = degree of ___
Cylinder = degree of ___
Axis =

A

myopia/hypermetropia
astigmatism
axis at which astigmatism power lies

28
Q

Causes of acute visual loss (media opacity causes)

A

Media opacity
- painful, red: corneal ulcer, endopthalmitis, uveitis, acute angle-closure glaucoma

  • painless, not red: vitreous haemorrhage
29
Q

Causes of acute visual loss (retinal disease)

A

retinal detachment

painless:
- retinal vein occlusion
- retinal artery occlusion

30
Q

Causes of acute visual loss (optic nerve disorders)

A

inflammatory:
- pain with ocular movement: optic neuritis

ischemic:
- painless: ischemic optic neuropathy

compressive optic neuropathy

31
Q

Causes of chronic visual loss

A

Glaucoma - peripheral vision loss

age related macular degeneration - central vision loss

cataracts - general blurring

32
Q

10 differentials for red eye

A

1) Allergic conjunctivitis
2) Infection: blepharitis, cellulitis, conjunctivitis, keratitis, endopthalmitis
3) Inflammation: episcleritis, scleritis, uveitis
4) Trauma: FB, chemical injury
5) Glaucoma

33
Q

papillae vs follicles

A

papillae: fibrovascular mounds with central vascular tuft

follicles: small translucent, avascular mounds of plasma cells and lymphocytes

34
Q

Only ___ and ___ problems causes RAPD

A

retina
optic nerve

35
Q

Methods to assess visual acuity in preverbal children

A
  • Observe fixation and following
  • Fixation preference: getting upset when good eye is occluded
36
Q

__ cards to test forced preferential looking in children 6mo-2yo

A

Teller

Striped patterns on one side appeal more to child, child looks at stripe over plain

37
Q

Snellen chart used in children more than __

A

4yo

38
Q

Pathophysiology of amblyopia?

A

Abnormal visual stimulation -> disruption in development of lateral geniculate nucleus and primary visual cortex

Unilateral: difference in BCVA is 2 or more Snellen lines

Bilateral: BCVA of 6/12 or less

39
Q

Causes of amblyopia

A

1) Strabismus
- child’s brain suppresses image from non-fixating eye to avoid diplopia
- cortical suppression of sensory input from eye

2) Stimulus deprivation
- occlusion of visual axis

3) Refractive error
- anisometropia (difference in 2 eyes): hyperopia >1.5D, myopia > -3-4D, astig >1.5D
- ametropia (both eyes high deg): hyperopia >5D, myopia <-8D

40
Q

Tx of amblyopia

A

1) Occlusion therapy
- Gold standard
- Cover good eye to force fixation by amblyopic eye

2) Provide clear retinal image
- identify and correct refractive error with spectacles
- remove obstacles in vision (eg. ptosis, cataracts)

41
Q

Treatment of amblyopia is critical before __ years old

A

8 years old
Best to correct during infancy/childhood

42
Q

Inward deviation of eye known as ___

Outward deviation known as ___

A

esotropia

exotropia

43
Q

___ most common strabismus in children

A

Intermittent exotropia
- more apparent when child is tired/daydreaming

44
Q

How to assess strabismus

A

1) Hirschberg corneal light reflex
- 1mm deviation = 7 degree squint

2) Cover-uncover

3) Alternate cover

4) Stereopsis - depth perception

45
Q

Cx of strabismus

A

1) Amblyopia - deviated eye

2) Poor binocular vision - ability to appreciate depth or stereovision

3) Abnormal head posture

46
Q

Comitant vs incomitant strabismus

A

Comitant
- non-paralytic
- congenital, accomodative, intermittent

Incomitant
- paralytic, eye movement limited from EOM paralysis

47
Q

What is leukocoria

A

White reflex - needs urgent referral

Absent red reflex also needs to be referred

48
Q

Causes of leukocoria

A

1) Retinoblastoma
2) Congenital cataracts
3) Retinopathy of prematurity

49
Q

Features of retinoblastoma

A
  • Presents ~18 months
  • RB1 gene on chr 13q14
  • Features: leukocoria, strabismus, reduced vision, change in eye appearance, eye pain
50
Q

Secondary cause of cataracts in children

A

TORCH infections
Trauma
Drug exposure
RB
Radiation

51
Q

What is retinopathy of prematurity? Risk factors

A

Abnormal vascularisation of retina in premature child

RF:
- early gestational age, low birth weight
- Supplemental O2
- Unstable clinical course post delivery

52
Q

Triad seen in congenital glaucoma

A

Blepharospasm - squeezing of eyes

Epiphora - tearing

Photophobia

53
Q

Causes of ophthalmia neonatorum

A

1) Neisseria gonorrhea (3-5 days after birth)
- can cause corneal perf

2) Chlamydia trachomatis (5-14 days after birth)

3) HSV (1-2 weeks)

54
Q

Trichiasis vs distichiasis

A

Trichiasis - normal eyelashes growing posteriorly towards eye

Distichiasis - eyelashes growing at abnormal positions

55
Q

The Valve of ___ fails to open in congenital nasolacrimal duct obstruction

A

Hasner - closed at birth and opens by 1st month of life

56
Q
A

Eye ENT Patho (1 decks)

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