Eye Pathology Flashcards
What can conjunctivitis be cause by?
Bacterial or viral infection
What are some of the symptoms of conjunctivitis?
Red watery eye
Discharge
What is the treatment for conjunctivitis?
ABI eye drops
If a stye is present externally, what does it affect?
Sebaceous glands on eyelash
What is another name for a stye?
Hordeolum
What does a stye affect on the inner surface of eyelid?
Meibomian gland
Name an inflammatory condition of the cornea
Corneal ulcers
Name a non-inflammatory condition of the cornea
Dystrophies
What are some of the causes of corneal ulcer?
Infectious - bacteria, fungal, viral infect of cornea
Corneal dystrophies usually present with:
Bilateral presentation
Opacifying
Non-inflammatory
What is the most common cause of blindness?
Cataracts
What is the pathology of cataracts?
Lens opacification
What is the main cause of cataract?
UV light - damages lens fibres
What surgery can be used to treat cataracts?
Phacoemulsification - plastic lens replaces new one
What is the usual intraocular pressure?
21mmHg
How is pressure in the eye maintained?
By constant drainage of AH via the Schlemms canal
What is glaucoma defined as?
Raised IOP
What is the 2nd most common cause of blindness?
Glaucoma
What is the most commonly seen form of glaucoma?
Primary Open Angle Glaucoma (POAG)
What are some consequences of raised IOP?
Pressure on nerve fibres results in death of optic nerve head
In glaucoma, what does the optic nerve head appear like?
Pale, unhealthy & cupped
What happens to the visual field in glaucoma?
Loss of peripheral vision
What are the triad of signs observed in glaucoma?
Raised IOP (painless) Visual field defects Optic disc changes on ophthalmoscopy
What can be used to treat POAG?
Eye drops to decrease IOP - prostaglandin analogues, Beta blockers
Laser trabeculoplasty
How does angle closure glaucoma present?
Sudden onset, painful loss of vision & headaches
What does the eye appear like in AC glaucoma?
Red eye
Cornea opaque
What is the pathology of AC glaucoma?
Closure of anterior angle resulting in problems with AH drainage
What are the different ways in which angle closure can occur?
Functional block - small eye, large lens
Mid-dilated pupil - outflow obstructed by iris dilation
What is the management for AC glaucoma?
Decrease IOP - carbonic anhydrase inhibitors
Constrict pupil - pilocarpine
Antiemetics & analgesics
Iridotomy - laser
What usually leads to POAG?
Blockage of trabecular meshwork
Which type of glaucoma, usually occurs in an emergency?
Angle closure glaucoma
Which layer is also called the uvea?
Vascular layer: choroid, ciliary body & iris
What is uveitis?
Inflammation of the uvea, can occur anteriorly, intermediate or posteriorly
What does anterior uveitis affect?
Iris inflammation
What is affected in intermediate uveitis?
Ciliary body
What is affected in posterior uveitis?
Choroid inflammation
What area of the eye does acute red eye conditions affects?
Anterior segment
What examinations would you used in acute red eyes?
Fundoscopy & slit lamp
Staining with fluroscene (abrasion of cornea)
What are some of the signs of infective conjunctivitis?
Gritty
Red
Discharge (purulent/watery)
What are some of the symptoms of allergic conjunctivitis?
Itchy Red Discharge Acute presentation Lid swelling
What can be used to treat allergic conjunctivitis?
Topical antihistamines
Avoid allergen
What are some of the symptoms associated with corneal abrasion?
Pain
Watering
Blurred vision
Epithelial defect
How can you treat corneal abrasion ?
Analgesia
Topical ABIs
What is the pathology associated with cornea abrasion?
Epithelial layer damage
What are some of the symptoms associated with anterior uveitis?
Pain Watering Photophobia Blurred vision Floaters Red
What is a hypopyon?
Pus in the anterior chamber
How do you treat anterior uveitis?
Topical steroids
Dilating drops
What is scleritis?
Inflammation of the sclera
What are some of the symptoms associated with scleritis?
Very painful
Redness (deep sclera vessels)
Tender
Nodule
How is scleritis treated?
Systemic steroids
What is orbital cellulitis?
Infection of orbital tissue (usually from sinuses)
What are some of the symptoms of orbital cellulitis?
Very painful Redness Blurred vision Diplopia Malaise Pyrexia Proptosis Reduced eye movements
What are the treatments for orbital cellulitis?
IV ABIs
CT scan
Drainage of pus
What test can be used to assess for macular disease?
Amsler chart
What test can be used to visualise vessels in the eye?
Fluorescein angiography
What test can be used to visualise the layers of retina?
Optical coherence tomography (OCT)
What are some of the risk factors associated with vascular loss of vision?
Smoking
Hypertension
Hyperlipidaemia
Name a vascular event that can result in complete sudden loss of vision
Central retinal artery occlusion
What will blood flow through retinal arteries look like in central artery occlusion?
Weak & segmented
What is the management for central retinal artery occlusion?
Treat risk factors: BP, cholesterol
Intravitreal anti Vegf
What are the 2 types of anterior ischaemic optic neuropathy?
Arteritic: Giant cell arteritis
Non-Arteritic
What are some of the symptoms associated with giant cell arteritis?
Loss of vision headache loss of appetite scalp tenderness pain on chewing
What are some of the signs of giant cell arteritis?
Raised inflammatory markers
tenderness over superficial temporal artery
What is the management for giant cell arteritis?
High dose steroids
What are some of the symptoms of non-arteritic ischaemic neuropathy?
Painless visual loss (usually altitudinal)
What are the 4 most common causes of visual loss?
Cataract
Glaucoma
Age related macular degeneration
Diabetic retinopathy
What are some of the symptoms of cataract?
Gradual visual loss
Dazzle/ glare with bright light
In chronic glaucoma or POAG, what are the symptoms?
Assymptomatic
Loss of peripheral field
What are some of the symptoms associated with AMD?
Distorsion of images
Loss of central vision
What are some of the signs of AMD?
Distorsion of amsler chart
Pigment epithelial changes (fundoscopy)
Spots called - drusen
What are the different types of AMD called?
Dry AMD (90%) Wet AMD (10%) - neovascular
What is the characeristic sign of dry AMD?
Drusen present at macula
Atrophy of epithelium
What are drusen?
Spots that appear around macula.
Waste products of photoreceptors which accumulate under pigment epithelium
What is treatment for dry AMD?
Low vision aids
Registration (visually impaired)
Does dry AMD affect one or both eyes?
Both
What is the pathology of wet AMD?
Growth of new choroidal vessels
What type of imaging is gold standard for diagnosing wet AMD?
Optical coherence tomography (OCT)
What is the management for wet AMD?
Intravitreal Vegf
Low vision aids
Registration
What are some of the signs of diabetic retinopathy?
Microaneurysms
Retinal haemorrhage & exudates
Neovascularisation
What investigators can be used to assess for diabetic retinopathy?
Fluorescein angiography
OCT
What management is used in diabetic retinopathy?
Intravitreal Vegf
Laser -panretinal photocoagulation
Low vision aids
Registration
What symptoms are observed in cavernous sinus thrombosis?
Red, painful swollen eye
No movement
Loss of vision
Previous infection which could spread intracranially
What type of cranial nerve palsy presents with ptosis, eye down & out and pupil dilated?
3rd nerve palsy
What conditions are associated with IIIn palsy?
Diabetes (parasympathetic spared)
Cerebral artery aneurysm (no pupillary reflex)
What cranial nerve palsy is associated with a medially deviated eye?
Abducent (VI) nerve palsy
What cranial nerve palsy is associated with in & up movement of eye?
Trochlear (IV) nerve palsy
What is a characteristic sign of retinal detachment?
A curtain coming down across visual field
What nerve palsy results in inability to open eyelid?
IIIn palsy
What nerve palsy results in inability to close eyelid?
VIIn palsy
What is the treatment for a hoerdolum?
Warm compress
Eyelid hygiene