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Ophthalmology for Finals > High yield exam cram > Flashcards

High yield exam cram Flashcards

1
Q

What does Mydriasis mean?

A

Dilated pupils

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2
Q

What does mitosis mean?

A

Constricted pupil

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3
Q

Which gives colour vision, rods or cones?

A

Cones (cones for colour)

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4
Q

What is the function of Timolol (Beta blocker)?

A

Reduces the production of aqueous humour

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5
Q

What is the function of Dorzolamide (carbonic anhydrase inhibitor)?

A

Reduces the production of aqueous humour

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6
Q

What is the function of Acetazolamide (carbonic anhydrase inhibitor)?

A

Reduces the production of aqueous humour

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7
Q

What is the function of Brimonidine (sympathomimetics)?

A

Reduce production of aqueous humour and improve uveoscleral outflow

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8
Q

What is the function of Lantoprost (prostaglandin analogues)?

A

Increase uveoscleral outflow

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9
Q

What is the function of Pilocarpine (muscarinic agonist)?

A

Pupil constriction and ciliary muscle contraction

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10
Q

What is the function of Anti VEG-F?

A

Targets VEG-F which stimulates formation of new blood vessels

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11
Q

What is the function of Chloramphenicol eye drops?

A

Antibiotic

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12
Q

What is the function of Fusidic eye drops?

A

Antibiotic (Used instead of chloramphenicol in pregnancy)

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13
Q

What is the function of Sodium cromoglicate?

A

Mast-cell stabiliser, reduces allergic response

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14
Q

What is the function of Cyclopentolate?

A

paralyses and dilates the pupil to relieve ciliary spasm

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15
Q

What is the function of Atropine (eye drops?)

A

paralyses and dilates the pupil to relieve ciliary spasm

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16
Q

What is the function of Phenylephrine eye drops?

A

Differentiates scleritis and episcleritis (doesn’t have any effect in scleritis)

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17
Q

Describe the layers of the eyeball from most superficial to deepest

A
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18
Q

What is the most common bacterial cause of corneal infection (keratitis)

A

S. Aureus

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19
Q

What is the most common viral cause of corneal infection (keratitis)

A

Herpes

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20
Q

How should corneal infection (keratitis) be managed?

A

Antibacterial/viral/fungal eye drops. Stop using contact lenses until healed

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21
Q

What are the two main causes of conjunctivitis?

A

infective or allergic

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22
Q

How long does an episode of conjunctivitis usually last?

A

1-2 weeks (usually self limiting)

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23
Q

How should conjunctivitis be managed?

A

Chloramphenicol antibiotic drops (fusidic acid if preg), hygiene, no lenses, no towel sharing!

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24
Q

What is anterior uveitis?

A

Inflammation of the iris/ciliary body or chorioid

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25
Q

How does anterior uveitis present?

A

Pain, photophobia, epiphora (excessive tears), redness, small & irregular pupil, hypopyon

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26
Q

What causes anterior uveitis?

A

idiopathic

or

secondary to systemic autoimmune diseases (ulcerative colitis), sarcoidosis, infections, trauma, or drug reactions

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27
Q

How is anterior uveitis managed?

A

Topical corticosteroids & cycloplegic agents (tropicamide or homatropine) to reduce ciliary spasm

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28
Q

What causes episcleritis?

A

Who knows (unknown aetiology)

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29
Q

What diseases have an association with episcleritis?

A

rheumatoid arthritis and IBD

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30
Q

How does episcleritis present?

A

Localised, red area on the white part of the eye

PAINLESS!

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31
Q

How is episcleritis managed?

A

Leave it alone to self resolve within a few weeks

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32
Q

What causes scleritis?

A

autoimmune disease (rheumatoid arthritis and vasculitis) and infection

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33
Q

How does scleritis present?

A

Severe pain (Scleritis = Sore), swelling and redness

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34
Q

What happens if scleritis is left untreated?

A

Vision loss

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35
Q

How are scleritis and episcleritis differentiated?

A

Differentiate with phenylephrine eye drops (scleritis doesn’t react to the drops)

Scleritis is sore

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36
Q

What is the difference between periorbital cellulitis and orbital cellulitis and how are they differentiated from one another?

A

Periorbital cellulitis = around the eye

Orbital cellulitis = behind orbital septum

Differentiate with a CT scan

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37
Q

How does Subconjunctival Haemorrhage present?

A

Bright red patch of blood

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38
Q

What is glaucoma?

A

optic nerve damage caused by a rise in intra-ocular pressure

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39
Q

What is a normal intra-ocular pressure?

A

10-21 mmHg

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40
Q

At which intraoccqular pressure is treatment for glaucoma started?

A

24mmHg

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41
Q

What is considered to be an abnormal cup:disc ratio?

A

> 0.5 is abnormal

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42
Q

What is the gold standard test for diagnosing glaucoma?

A

Goldmann applanation tonometry

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43
Q

Briefly explain the flow of aqueous humour

A

Aqueous humour exits anterior compartment via TM ➡️

Schlemm’s canal ➡️

aqueous veins ➡️
eventually ends up in internal jugular vein

44
Q

Which demographic typically gets:
A) Open angle glaucoma
B) Acute closed angle glaucoma

A

A) Open angle glaucoma = black people

B) Acute closed angle glaucoma = East Asian people

45
Q

Describe the difference between the presentation of Open angle glaucoma vs Acute closed angle glaucoma

A

Open angle = slow, small increase in pressure, painless, tunnel vision

Acute closed angle = sudden, painful, cloudy vision, red eye, N&V

(both get halos around lights)

46
Q

How is open angle glaucoma managed in the first instance?

A

Topical prostaglandin analogues 1st line = improve uveoscleral outflow

Beta-blockers & carbonic anhydrase inhibitors 2nd line to reduce production of aqueous humour

47
Q

What is the definitive treatment for open angle glaucoma?

A

Trabeculotomy

48
Q

What is used to definitively diagnose closed angle glaucoma?

A

Gonioscopy

49
Q

What is the acute management of closed angle glaucoma in primary care?

A

call an ambulance
lie on back without pillow
pilocarpine eye drops
acetazolamide
analgesia and antiemetic

50
Q

What is the acute management of closed angle glaucoma in secondary care?

A

beta-blockers, alpha agonists
prostaglandin analogues
carbonic anhydrase inhibitors.

51
Q

What is the definitive management of closed angle glaucoma?

A

Laser peripheral iridotomy (LPI)

52
Q

What is vitreous attachment associated with?

53
Q

What causes vitreous haemorrhage?

A

retinal detachment or retinal vein occlusion

54
Q

How are severe cases of vitreous haemorrhage managed?

A

Vitrectomy

55
Q

What causes retinal artery occlusion?

A

an atheroma related carotid artery thrombus.
or
vasculitis.

56
Q

How does retinal artery occlusion present?

A

sudden onset, painless monocular visual loss

57
Q

How does retinal artery occlusion look on fundoscopy?

A

‘cherry-red’ spot at the centre of the macula and pale retina.

58
Q

How is central retinal artery occlusion managed?

A

Reperfusion therapy

59
Q

What causes central retinal vein occlusion?

A

Thrombus in the retinal vein

60
Q

how does central retinal vein occlusion present?

A

Flame haemorrhages and cotton wool spots

61
Q

How is central retinal vein occlusion managed?

A

Intravitreal anti-VEGF therapy to stop over proliferation of blood vessels

dexamethasone implant for the oedema

laser photocoagulation to treat the new vessels.

62
Q

explain what diabetic retinopathy is

A

progressive damage to the retina’s blood vessels caused by hyperglycaemia

63
Q

What are the two stages of diabetic retinopathy?

A

proliferative (early and mild) and non-proliferative (late and severe)

64
Q

Explain how diabetic retinopathy presents

A

initially no symptoms

blurred vision, floaters, dark areas in their visual field, and eventually, significant vision loss.

65
Q

How does diabetic retinopathy look on fundoscopy?

A

microaneurysms, blot haemorrhages, hard exudates, cotton-wool spots & neovascularisation (new blood vessel formation)

66
Q

How is diabetic retinopathy managed?

A

Laser photocoagulation and anti VEG-F to stop over proliferation of blood vessels

67
Q

what is hypertensive retinopathy?

A

Damage to retinal blood vessels due to high blood pressure

68
Q

How does hypertensive retinopathy present on fundoscopy?

A

Copper/silver wiring” (thickened and scleroses arteriole walls reflect more light on examination)
AV nipping (arterioles compress veins where they cross)
cotton wool spots
hard exudates (damaged vessels leak lipids)
retinal haemorrhages.

69
Q

How is hypertensive retinopathy managed?

A

Control BP and manage risk factors

70
Q

How does retinal detachment present?

A

Sudden loss of vision - curtain coming down
Flashes and floaters

71
Q

How is retinal detachment managed?

A

Laser treatments
cryotherapy
vitrectomy
scleral buckling
pneumatic retinopexy to reattach

72
Q

What is macular degeneration?

A

Degeneration of the central retina (macula).

73
Q

What are the two types of macular degeneration and how do they differ?

A

Dry = no new neovascularisation
wet = new neovascularisation.

74
Q

What is used to diagnose and monitor macular degeneration?

A

Optical coherence tomography

75
Q

What is the typical finding on fundoscopy in macular degeneration?

A

Drusen (yellow deposits under the retina)

76
Q

How is dry macular degeneration managed?

A

zinc & vitamins A,C and E

77
Q

How is wet macular degeneration managed?

A

Anti VEG-F to stop over proliferation of blood vessels

78
Q

Which nervous system causes pupil constriction, sympathetic or parasympathetic?

A

Parasympathetic

79
Q

What is the triad of Horner’s syndrome?

A
  • Ptosis
  • Miosis
  • Anhidrosis
80
Q

What causes a Holme’s - Adie pupil and how does it present?

A

Damage to post-ganglionic parasympathetic fibres

Dilated & sluggish

81
Q

What causes argyll-robertson pupil and how does it present?

A

Neurosyphillis

Irregular shaped pupil which accommodates but does not react to light

82
Q

What happens to the pupil in anterior uveitis?

A

Irregular pupil (due to adhesions)

83
Q

What happens to the pupil in Acute angle closure glaucoma?

A

Vertical oval pupil due to ischaemic damage

84
Q

What is Trichiasis?

A

Eyelashes grow in the way

85
Q

Diagnosis? (patient is a contact lens user)

A

Keratitis (corneal infection)

86
Q

Diagnosis?

A

Conjunctivitis

87
Q

Diagnosis?
Patient has ulcerative colitis

A

Anterior uveitis

88
Q

Diagnosis?
Painless

A

episcleritis

89
Q

Diagnosis?
Painful

90
Q

Diagnosis?

A

Cellulitis

91
Q

Diagnosis?

A

Subconjunctival haemorrhage

92
Q

Diagnosis?

A

Increased ocular pressure (glaucoma)

93
Q

Diagnosis?

A

vitreous detachment

94
Q

Diagnosis?

A

Vitreous haemorrhage

95
Q

Diagnosis?

A

Central Retinal Artery Occlusion

96
Q

Diagnosis?

A

Central Retinal Vein Occlusion

97
Q

Diagnosis?

A

Diabetic Retinopathy

98
Q

Diagnosis?

A

Hypertensive Retinopathy

99
Q

Diagnosis?

A

Retinal Detachment

100
Q

Diagnosis?

A

dry macular degeneration

101
Q

Diagnosis?

A

wet macular degeneration

102
Q

diagnosis

A

Horner’s syndrome

103
Q

Diagnosis

A

trichiasis

104
Q

Diagnosis

105
Q

Diagnosis

Ophthalmology for Finals (1 decks)

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