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Opthalmology > Investigations and Treatments > Flashcards

Investigations and Treatments Flashcards

1
Q

Treatment of bacterial conjunctivitis

A

Chloramphenicol ointment QDS
(Chloramphenicol drops hourly- less effective)

*Ointment should be avoided or used in both eyes in <7 years to avoid unilateral deterioration in vision

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2
Q

Treatment of allergic conjunctivitis

A

Levocabastine drops QDS (antihistamine)

Lodoxamide QDS (mast cell stabiliser)
*In chronic

Steroids - intense use under ophthalmologist
*Rarely as can cause cataracts

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3
Q

Treatment of adenovirus conjunctivitis

A

None effective

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4
Q

Treatment of bacterial ulcer

A

Sterilisation of cornea:

Ciprofloxacin (4th gen cephalosporin)
Chloramphenicol

  • Hourly for 48hr then 5x per day for 2 weeks
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5
Q

Treatment of dendritic (viral) ulcer

A

Acyclovir 5x per day for 2 weeks

FACT: Constant observation required!! Viral endotoxins can cause opacity..

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6
Q

Treatment of allergic (marginal) ulcer

A

Steroids effective

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7
Q

Treatment of iritis (or uveitis)

A

Steroids

Atropine (relaxes iris muscles)

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8
Q

Treatment of acute glaucoma

A

Opthalmic emergency:

  1. IV Acetazolamide (red. Intraocular pressure)
  2. Pilocarpine 2% (constrict pupil)

Future prevention required:

  1. Laser Iridotomy
  2. Often cataracts are removed
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9
Q

When would a migraine aura be investigated?

What would be used?

A

Increase frequency or long duration means there may be an organic cause.

An MRI would be most appropriate

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10
Q

What would be investigated when central retinal artery occlusion is suspected?

A

Investigate for blood flow or emboli cause:

  • RBC count
  • Clotting screen
  • ECG (AF)
  • Carotid duplex if bruit heated

Investigate for giant cell arthritis:
- CRP (>50 concerning)

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11
Q

What’s the management of CRAO?

Immediate and future.

A

Immediate:

  1. Acetazolamide (red. Intraocular pressure)
  2. 5% CO2 / brown bag (vasodilation)
  3. Pressure on eye then release (ditto 1.)
    * Aimed at moving clot to a branch!

Future:

  1. Smoking cessation and exercise
  2. Lower BP
  3. Aspirin
  4. Statin
    * AKA risk factor management…
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12
Q

What would be investigated if a CRVO was suspected?

A

Investigate possible thrombus causes:

  • blood pressure
  • FBC
  • Lipid profile
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13
Q

What is the management of CRVO and when is it required?

Immediate and future.

A

Immediate:

  • laser therapy
  • Required if evidence of ischaemia. i.e. an APD or round haemorrhages in fundoscopy

Future:

  1. Smoking cessation and exercise
  2. Lower BP
  3. Aspirin
  4. Statin
    * AKA risk factor management… In all cases!
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14
Q

What investigations would be considered if anterior ischaemic optic neuropathy is suspected?

A

Investigate for giant cell arthritis:
- CRP (>50 concerning)

Investigate blood flow or emboli cause:

  • fluorescein angiography
  • RBC
  • Clotting screen
  • ECG (AF)
  • Carotid duplex if bruit heated

…continue with other rarer causes

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15
Q

What is the management of AION and when is it required?

Immediate and future.

A

Immediate:

  • High dose IV the oral steroids
  • If CRP >50 so possible giant cell arteritis

Future:

  1. Smoking cessation and exercise
  2. Lower BP
  3. Aspirin
  4. Statin
    * AKA risk factor management… In all cases!
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16
Q

What investigation would be considered for optic neuropathy and why?

A

MRI

May show evidence of CNS plaques indicating multiple sclerosis. >4-6 significant

17
Q

What is the management of optic neuritis?

A

Should explain links to multiple sclerosis.

No treatment of ON is very effective, although some believe in steroids.

18
Q

What investigations should be performed is vitreous haemorrhage suspected?

A

Investigate for clotting abnormalities:

  • FBC
  • Clotting screen

Investigate for diabetes:

  • blood sugar
  • HBA1C if known sufferer

Visualise for obvious abnormalities:
- ultrasound of retina

19
Q

What is the management of vitreous haemorrhage?

A

Rest.

Vitrectomy if doesn’t settle.

20
Q

What investigations would be done if amaurosis fugax is suspected?

A

Investigate for blood flow or emboli cause:

  • RBC count
  • Clotting screen
  • ECG (AF)
  • Carotid duplex if bruit heated
21
Q

What management would be considered in amaurosis fugax?

A

Future:

  1. Smoking cessation and exercise
  2. Lower BP
  3. Aspirin
  4. Statin
    * AKA risk factor management…
22
Q

What management would be required for retinal detachment?

A

Find and seal holes and reattach retina.

*some fancy surgery e.g. Lasers, bits of silicon and gas bubbles..

Opthalmology (3 decks)

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