Fundoscopy Flashcards
What are 3 side effects to using dilating eye drops?
Temporary blurred vision
Temporarily more sensitive to light
Temporarily unable to drive
What do you assess the eyelids and lashes for?
Lids: lumps (benign or malignant), oedema, cellulitis + entropion/ectropion.
Lashes: loss of lashes (malignant lesions) or trichiasis (inturning of lashes).
What should you assess the cornea for?
Abrasion: redness, pain, watering + photophobia. Defects stain brightly with fluorescein drops + a cobalt blue light.
Ulcer: pain, watering, photophobia + a staining epithelial defect with associated haziness (infiltrate: may appear fluffy + irregular)
What is diffuse conjunctival injection? What is it caused by?
Redness: dilated inflamed blood vessels across most of the conjunctiva
Bacterial, viral + allergic conjunctivitis.
What is Circumciliary injection? What is it caused by?
Dilated inflamed blood vessels affecting the conjunctiva in a circular pattern around the cornea suggesting intraocular inflammation.
Keratitis, acute angle-closure glaucoma + uveitis.
What are watery and purulent discharge from the eye associated with?
Watery: allergic conjunctivitis, viral conjunctivitis or normal physiological production (e.g. reaction to a corneal abrasion/foreign body).
Purulent: bacterial conjunctivitis.
What is Hyphema? What is it the result of?
inferior settled layer of blood in the anterior chamber Trauma.
What is Hypopyon? What usually causes it?
inferior settled layer of ‘pus’ in the anterior chamber. Severe corneal ulcers or endophthalmitis
Can occur secondary to anterior uveitis.
What is Periorbital erythema and swelling a feature of?
Preseptal cellulitis (anterior to the orbital septum) Orbital cellulitis (posterior to the orbital septum).
What do you assess the pupil for?
Size: varies + depends on lighting conditions
Shape: abnormal shapes can be congenital or due to pathology. Peaked pupils in the context of trauma: globe injury.
Asymmetry in size: anisocoria May or may not be pathological
Which pupil is abnormal:
If a pupil is more pronounced in bright light?
If pupil is more pronounced in dark?
Light: Large pupil= abnormal e.g. Oculomotor nerve palsy
Dark: small pupil= abnormal e.g. Horner’s syndrome
What do you assess the lids for?
Position: ptosis: Horner’s syndrome (subtle) + oculomotor nerve palsy (partial to complete ptosis).
Margins: crusting + inflamed in blepharitis.
List 4 causes of painless red eye
Conjunctivitis
Subconjunctival haemorrhage
Episcleritis
Dry eye
List 6 causes of painful red eye
Scleritis Uveitis Corneal abrasion Corneal ulcer Acute angle-closure glaucoma (AACG) Foreign bodies
What does absence of the red reflex suggest in children and adults?
Adults: cataracts in lens blocking light, vitreous haemorrhage + retinal detachment.
Children: congenital cataracts, retinal detachment, vitreous haemorrhage + retinoblastoma.
What may be seen in the anterior segment of the eye?
Fluorescein dye fluoresces yellow unde blue cobalt light filter if there is damage to corneal or conjunctival epithelium (e.g. an abrasion).
White opacities on the cornea suggest a corneal ulcer.
Which 3 C’s are assessed when looking at the optic disc?
Contour: borders should be well defined
Colour: a healthy = orange-pink doughnut with a pale centre (well-perfused neuro-retinal tissue)
Cup: the pale centre of the orange-pink doughnut, due to absence of neuroretinal tissue. A cup-to-disc ratio of 0.3 is normal
What do blurred borders of the optic disc suggest?
Optic disc swelling (papilloedema) secondary to raised intracranial pressure.
What does a pale optic disc suggest?
Optic atrophy which can occur as a result of optic neuritis, advanced glaucoma + ischaemic vascular events.
What does an increased cup to disc ratio suggest? When can this occur?
Reduced volume of healthy neuro-retinal tissue
Glaucoma.
List 9 types of retinal pathology
Arteriolar narrowing Arteriovenous nipping/nicking Dot + blot haemorrhages Flame haemorrhages Cotton wool spots Hard exudates Neovascularisation Pan-retinal photocoagulation Branch retinal vein occlusion
Describe the appearance of the macula
Temporal to the optic nerve head
Yellow
Central part = “fovea” is darker than the rest of the macula
List 3 types of macula pathology
Hard exudates
Drusen
Cherry-red spot
