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MB2: Ophthalmology > Eye disease > Flashcards

Eye disease Flashcards

1
Q

in who is eye trauma more common

A

males 25-36 in machinery or assault

females >60 who have fallen

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2
Q

how many with poor outcome due to eye trauma have no light perception?

A

50%

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3
Q

what parts of eye should be examined in trauma

A 
lids 
conjunctiva 
cornea 
anterior segment 
pupils
fundus 
fluroscien
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4
Q

golden rules of eye trauma?

A 
hx key 
take visual acuity 
fluroscein drops 
handle globe rupture with care 
Xray or CT IORB
irrigate chemical injuries
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5
Q

what may cause blowout fracture and what is a consequence

A

trauma to globe or to orbital rim may transmit to orbital plates
can trap inferior rectus and patient may not be able to look up
may cause subconjunctival haemorrhage

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6
Q

what is hyphaemia

A

blood in ant chamber or in vitreous cavity leaking in

can circulate around but if enough then will settle

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7
Q

describe the process of traumatic retinal detachment

A

slight tear of retina causes vitreous to get behind and cause total detachment

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8
Q

how can a corneal lateration or penetrating injury present

A

aqueous leaking out, ant chamber flat/shallow

iris may be pulled into wound to cause irreg pupil

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9
Q

what is siedels test

A

use of fluroscein to determine corneal penetration as it is diluted by aqueous

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10
Q

what is sympathetic ophthalmia

A

injury to one eye leads to AA uveitis in both eyes due to systemic exposure of intraocular antigens
can lead to bilateral blindness

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11
Q

what may cause small particle corneal damage

A

hammer and chisel

machinery

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12
Q

management of corneal abrasion or small particle in eye

A

slit lamp/local anaesthetic
use edge of needle to scrape out
chloramphenicol ointment 4x daily for 1 week

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13
Q

what may raise suspicion of anterior chamber penetrating injury

A

irreg pupil
shallow ant chamber
localised cataract
gross inflammation

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14
Q

what may cause intra-ocular penetrating trauma and what must be done

A

hammer and chisel or other fast moving objects

always X ray/CT

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15
Q

what is the china white sign

A

ischaemia and white areas caused by alkali destruction of blood vessels

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16
Q

alkali damage can cause corneal vascularisation - what is this?

A

blood vessels growing over cornea following alkali damage

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17
Q

true/false - acid burns are more penetrating than alkali

A

false - alkali generally have better penetration and can cause corneal/conjunctival scarring

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18
Q

management of chemical burns to the eye

A 
quick Hx with nature of chemical 
check its not cement or lime 
check toxbase and pH 
irrigate with 2L saline or until pH normal 
assess at slitlamp
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19
Q

prevention of eye trauma?

A

safe practice
eyewear
education

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20
Q

what is papilloedema

A

optic disc swelling in response to raised ICP

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21
Q

what should optic disk swelling be suspected as

A

always suspect as SOL until proven otherwise

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22
Q

what is a consequence of increase in volume in intercranial cavity

A

herniation of brainstem through foramen magnum

may lead to cord compression, brainsrem compression and death

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23
Q

common vascular cause of papilloedema

A

malignant hypertension

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24
Q

functions of CSF

A 
maintains stable extracellular environment 
buoyancy 
mechanical protection 
waste removal 
nutrition
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25
Q

what happens in chronic optic disk swelling

A

swelling subsides and disk becomes atrophic and pale

may lead to lost visual function and blindness

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26
Q

what is idiopathic intercranial hypertension

A

common cause of bilateral disc swelling in young females

may be due to blocked CSF absorption or obstructed CSF circulation

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27
Q

what may cause CSF blockage to absorption in IIH

A

vitamin A

microemboli in superior sagittal sinus

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28
Q

what may cause obstructed CSF circulation in IIH

A

increased intra abdo pressure - ie obesity

stenosis of transverse cerebral sinuses

29
Q

what is ischaemic optic neuropathy, how does it present and what is an associated condition

A

occlusion of posterior ciliary arteries causing occlusion of optic nerve head circulation
sudden, painless visual loss with swollen optic nerve
associated with temporal arteritis

30
Q

cause of CRAO

A

carotid artery disease

emboli from heart

31
Q

presentation of CRAO

A

painless sudden visual loss
RAPD
pale, oedematous retina with thread like vessels

32
Q

other forms of CRAO

A

branch retinal artery occlusion

amaurosis fugax

33
Q

what is amaurosis fugax

A

painless vision loss lasting around 5 mins
nothing on examination
refer to stroke clinic

34
Q

cause of CRVO

A

diabetes
hypertension
cancer
virchow’s triad

35
Q

signs and symptoms of CRVO

A

sudden visual loss
retinal haemorrhage
dilated, tortuous veins
optic disc and macula swelling

36
Q

signs and symptoms vitreous haemorrhage

A 
sudden loss of vision 
floaters 
loss of red reflex 
haemorrhage on fundoscopy 
identify cause
37
Q

cause of vitreous haemorrhage

A

retinal vein occlusion, diabetes lead to angiogenesis with leaky blood vessels
retinal tear leading to disrupted blood vessel

38
Q

presentation of retinal detachment

A

painless loss of vision with flashes/floaters
may have RAPD
tear on fundoscopy

39
Q

what is Wet ARMD

A

new blood vessels grow causing build up of fluid and scarring

40
Q

presentation and management of wet ARMD

A

rapid loss central vision, metamorphopsia, scotoma
haemorrhage, exudate
intra-vitreal VGEF

41
Q

what is closed angle glaucoma

A

aqueous humour encounters increased resistance through iris/lens channel leading to peripheral iris to bow forward and obstruct trabecular meshwork

42
Q

presentation of closed angle glaucoma

A 
painful red eye 
sudden visual loss 
headache 
nausea and vomiting 
cloudy cornea
dilated pupil
43
Q

causes of gradual visual loss

A 
ABCDG
dry ARMD 
Blur - refractive error 
cataract 
diabetes 
glaucoma
44
Q

what is a cataract

A

clouding of lens - often age related

45
Q

management of symptomatic cataracts

A

intra-ocular lens implant

46
Q

presentation and management of dry ARMD

A

gradual vision decline
scotoma
druden, atrophic retina
supportive with low visual aids, social support, registered blind

47
Q

signs/symptoms of open angle glaucoma

A

often none and may be incidental
cupped disc
visual field defect

48
Q

how many layers does the retina have

A

10

49
Q

pathogenesis of diabetic retinopathy

A

diabetes leads to high sorbitol, outpouching of retinal blood vessels to cause microaneurism, haemorrhage, deposition fo exudate
high sorbitol makes blood more viscous so there is slowed flow and ischaemia
VGEF leads to angiogenesis, which can lead to retinal traction

50
Q

features of mild/moderate non-proliferative diabetic retinopathy

A

microaneurism
hard exudates
small intraretinal haemorrhage

51
Q

features of severe non proliferative diabetic retinopathy

A

cotton wool spots

venous bleed

52
Q

how can severe non-proliferative diabetic retinopathy be managed

A

laser therapy

53
Q

management of diabetic macular oedema

A

anti-VGEF

used to be laser

54
Q

consequence of proliferative diabetic retinopathy

A

vitreous haemorrhage and retinal traction

55
Q

findings on fundus of pathological myopia

A 
lacquer crack
subretinal haemorrhage 
fuch's spot 
RPE/ choroid haemorrhage 
cystoid, paving stone, lattice degeneration 
retinal thinning with holes 
scleral thinning
56
Q

diagnostic criteria for pathologic myopia

A

spherical equivalent >-8.00D or axial length >26mm

57
Q

what retinal tears need to be treated in case of retinal detachment

A

horseshoe tears or total dialysis

58
Q

what is a rhegmatogenous PVD

A

retinal break leads to retinal detachment

59
Q

what is a non-rhegmatogenous PVD

A

traction or exudate forms scar tissue or exudative fluid that pushes off the retina

60
Q

cause of traction leading to retinal detachment

A

diabetes

61
Q

cause of exudative retinal detachment

A 
choroid tumours 
post scleritis 
haradas 
toxaemia of pregnancy 
hypoproteinaemia 
RD surgery 
excess retinal photocoag 
choroid neovascularisation 
uveal effusion
62
Q

signs of exudate behind retina?

A

convex, smooth elevation

may be mobile with fluid shift

63
Q

what is central serous chorioretinopathy

A

small, focal RPE leak
young pt, male, healthy, 30-50, executive job
most recover, some recur

64
Q

causes of cystoid macular oedema

A 
postop 
uveitis 
retinal venous occlusive disease 
choroid neovascualrisation 
epiretinal membrane 
retinitis pigmentosa
65
Q

Ia macular hole?

A

foveolar detachment

66
Q

II macular hole?

A

full thickness defect <400mm

67
Q

III macular hole

A

full thickness defect >400mm

68
Q

IV macular hole

A

stage III with PVD

MB2: Ophthalmology (8 decks)

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