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Stage 3: FOCP > Eye > Flashcards

Eye Flashcards

1
Q

List some systemic diseases that result in eye problems

A
  • diabetes
  • hypertension
  • carotid disease
  • autoimmune diseases (ankylosing spond, Crohn’s/UC, HIV, sarcoidosis)
  • TB
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2
Q

List some causes of loss of red reflex

A
  • retinal blastoma

- congenital cataracts

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3
Q

Best drug to use for pupil dilation + its MoA

A

Tropicamide. Anti-ach

lasts 2-4h. Don’t use atropine as effects last about 1 week

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4
Q

3 C’s to look for in optic disc exam

A
  • colour
  • cup
  • contour
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5
Q

The rods/cones are found in the macula/peripheral retina

A

Cones: macula
Rods: peripheral retina

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6
Q

Causes of blurred optic disc

A

inflammation/ infiltration causing swelling of CN2 fibres

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7
Q

Causes of optic disc cupping

A

Advanced glaucoma (loss of nerve fibres)

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8
Q

What is RAPD/Marcus Gunn pupil

A

Defect in direct response (damaged CN2)

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9
Q

Causes of RAPD

A
  1. Optic neuritis
  2. Ischaemic optic disease/ retinal disease
  3. Severe glaucoma causing trauma to CN2
  4. Direct CN2 damage (trauma, radiation, tumour)
  5. Retinal detachment
  6. Very severe macular degeneration
  7. Retinal infection (CMV, herpes)
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10
Q

What is aniscoria. Is this alarming

A

Asymmetrical pupil size

normal variant in 1/5 population. Dangerous if manifestation of Horner’s or CN3 damage

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11
Q

What is Adie’s pupil. What causes it

A

Absent/slow response to light (direct + consensual response)

Denervation in postganglionic parasym N. Benign.

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12
Q

What is Argyll Robertson pupil. Is it alarming.

A

Pupils constrict with accommodation, but WON’T constrict to light (usually both pupils involved)

Hallmark of tertiary neurosyphilis

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13
Q

What are the 3 hallmarks of Horner’s syndrome

A

ptosis
miosis
anhydrosis

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14
Q

Causes of Horner’s syndrome

A
  1. Carotid artery dissection
  2. Pancoast tumours, nasopharyngeal tumours
  3. Lymphoproliferative disorders
  4. Brachial plexus injury
  5. Cavernosus sinus thrombosis
  6. Fibromuscular dysplasia
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15
Q

Describe 3 steps in pathology of diabetic retinopathy

A
  1. Breakdown of capillary tight junctions leading to leakage of blood, proteins
  2. Loss of rigidity of vessel way leading to micro-anurysms.
  3. Capillary occlusion leading to ischaemia, release of VEGF leading to formation of new blood vessels (proliferative stage)
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16
Q

Negative/red numbers on fundoscope focus on items that area near/far

A

Negative/red: far

Positive/green: near

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17
Q

What does visual acuity refer to

A

Central vision for corrected eyesight (with glasses)

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18
Q

How to do corneal reflection test

A

Shine light in middle of patient’s nose with their eyes looking at the torch

19
Q

How to do cover reflection test

A

Cover 1 eye, look at other eye

20
Q

How to do alternate cover test

A

Cover each eye for about 1s, then uncover that eye and look at it

21
Q

How to assess ocular movements

A
  • Ask patient to follow the light whilst keeping head still in the primary position
  • Move torch in the direction of action of each muscle in turn, returning to the primary position after each excursion.
22
Q

What is manifest strabismus/ heterotropia

A

Condition in which one or other visual axis is not directed towards the fixation point

23
Q

What is latent strabismus/ heterophoria

A

Tendency for eyes to want to drift

Both visual axis are directed towards same fixation point but deviate on dissociation (when 1 eye is covered)

24
Q

Define

o Esotropia
o Exotropia
o Hypotropia
o Hypertropia

A

o Esotropia: convergent squint
o Exotropia: divergent squint
o Hypotropia: eye goes down
o Hypertropia: eye goes up

25
Q

CN 3 palsy sign

A

eye down and out, pupil dilated

26
Q

CN 4 palsy sign

A

head tilts away.

eye goes up (hypertropia)

27
Q

CN 6 palsy sign

A

eye unable to look out

28
Q

Differentiating Duane’s and CN6 palsy

A

Both have no LR movement

Duane’s also has:

  • globe retraction
  • widening of lids on abduction
  • narrowing of lids on adduction
29
Q

What might cause the following features on opthalmic examination:

  • Abnormal red reflex
  • Grey & wrinkled detached retina
A

Acute retinal detachment

30
Q

What might cause the following features on opthalmic examination:

  • Retinal haemorrhages
  • Tortuous dilated retinal veins
  • Macular oedema
  • Cotton wool spots
A

Retinal vein occlusion

31
Q

What might cause the following features on opthalmic examination:

Pale retina with central macular cherry red spot

A

Retinal artery occlusion

32
Q

What might cause the following features on opthalmic examination:

Swollen optic disc

A

Acute optic neuropathy

33
Q

What might cause the following features on opthalmic examination:

Decreased red reflex

A

Vitreous haemorrhage

34
Q

What might cause the following features on opthalmic examination:

  • Macular oedema
  • Subretinal haemorrhages
  • Hard exudates
A

Wet age-related macular degeneration

35
Q

What might the following history indicate:

  • Flashing lights
  • Floating spots (black or red)
  • Painless visual field loss
A

Acute retinal detachment

36
Q

What might cause sudden painless vision loss

A
  • Retinal vein or artery occlusion
  • Vitreous haemorrhage
  • Retinal detachment
  • Non arteritic ischaemic optic neuropathy
  • Giant cell arteritis
37
Q

What might the following history indicate:

  • Elderly
  • Sudden distortion/ blurring of vision
A

Wet age-related macular degeneration

38
Q

What diseases are most commonly associated with acute optic neuropathy

A
  • MS
  • nerve ischaemia due to atherosclerosis
  • SLE
  • neurosarcoidosis
  • B12 deficiency
  • infection
  • hyperkaelemia
39
Q

Causes of red eye requiring urgent referral

A
  • Uveitis (iritis)
  • Acute glaucoma
  • Keratitis (corneal inflammation)
  • Scleritis
  • Endophthalmitis (eyeball infection after surgery, injury)
40
Q

Causes of non-urgent red eye

A
  • Conjunctivitis
  • Subconjunctival haemorrhage
  • Episcleritis
41
Q

Causes of vision loss that quickly returns on its own

A
  • TIA

* Ocular migraine

42
Q

Causes of painful vision loss

A
  • Optic neuritis

* Angle-closure glaucoma

43
Q

Difference between miosis and mydriasis

A

Miosis: pupil constriction

Mydriasis: pupil dilation

44
Q

Differentiating Horner’s and CN3 palsy

A

Horner’s will have miosis (pupil constriction)

CN3 palsy will have mydriasis (pupil dilation)

Stage 3: FOCP (47 decks)

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