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clinical opthalmology > IOD opthalmology notes > Flashcards

IOD opthalmology notes Flashcards

1
Q

Episcleritis - simple

A

hyperaemia
viewed threw trans conj
vasidilation
confined to one area of diffuse
mild discomfort
no pain
vision affected

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2
Q

Episcleritis - nodular

A

Minority of cases
raised lump with area of hyperaemia
conjucntiva buldges forward
displaces slit lamp beam

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3
Q

Episcleritis - symptoms

A

acute onset
unilateral
redness

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4
Q

episcleritis - management

A

self limiting
reassurance
recurrent condition
cold compress for vasodilation

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5
Q

scleritis - pain

A

pain can be moderate to severe and interfere with sleep.
radiates to temple and brow
worsens with eye movement and touch

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6
Q

scleritis - symptoms

A

unilateral or bilateral (equall split)
redness
pain
vision may be affected
gradual onset - develops over afew days

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7
Q

scleritis signs

A

anterior scleritis (90%)
- non necrotising (75%) - nodular or diffuse
- necrotising (15%) - with and without inflammation
posterior scleritis (10%)

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8
Q

scleritis management

A

emergency same day referral
emphasise urgency - best outcomes are with early tratment
anti - inflammatory meds: topical steroids, systemic oral NSAIDs and systemic steroids
systemic investigation

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9
Q

chalazion signs

A

well defined solid nodule in tarsal plate
lid evertion - excessive conjunctival granulomas
induced astigmatism and hyperaemia
associated with blepth

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10
Q

chalazion symptoms

A

painless lump
can be recurrent
after infection
gradual increase in size
blurred vision

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11
Q

chalazion management

A

hot compress
lid massage

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12
Q

Horedeolum signs

A

tender inflammed area
can be entire lid
point through skin

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13
Q

hordeolum symptoms

A

tender lump
sometimes painfull
sticky discharge
redness of eye lids

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14
Q

Horedeolum management

A

nothing can be done

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15
Q

intermediate uveitis signs

A

tender inflamed area
can be entire lid
point through the skin

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16
Q

intermedaite uveritis symptoms

A

reduced vision
floaters

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17
Q

intermediuate uveritis management

A

urgernt referral - sight threatening
prompt treatment needed- measure IOP and carry out a dilated fundus exam
mydriatic drugs used to treat usually anti inflammatory steroids

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18
Q

Anterior uveitis signs

A

redness
reduced VA
lacrimation
hyperaemia
circumbrial flush
miosis
aqueous flare
hypopyon

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19
Q

anterior uveitis symptoms

A

generally unilateral
pain
sudden onset
recurrent disease
more gradual onset

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20
Q

anterior uveitis complications

A

posterior synachae
secondary open angle glaucoma

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21
Q

anterior uveritis management

A

same as intermediate uveritis

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22
Q

cortical cataracts symptoms

A

slow development
bilateral
clear nucleus
VA normal
Glare
monocular diplopia

23
Q

cortical cataracts signs

A

mid-peripheral opacities- nucleus clear
cortical spokes
direct viewing
radial pattern
opacities shown as shaddows

24
Q

nuclear cataracts signs

A

dense opacities in center of lens
yellow in colour
turn deep brown
reduced VA

25
nuclear cataracts symptoms
slow development bilateral painless increase onm refractive index distance vision worsens
26
posterior and anterior sub capsular cataracts - signs
Direct view opacities center of pupil rough granulomatous textures dense plaques
27
posterior and anterior sub capsular cataracts - symptoms
profound affected vision center location close nodule point glare poor vision in bright light
28
Acquired cataracts - myopic distrophy
macular dystrophy progressive muscle weakness develops at any age 20-30y - refractive cortical steroids 40-50y - wedge shaped opaticies
29
acquired cataracts - steroid use
posterior subcapsular cataracts tropical - anterioer uveitis, scleritis, inhaled - asthma systemic - inflammed bowel disease topical - systemic lupus
30
acquired cataracts diabetes
early development of nuclear cataracts recent referral rare snowflake opacities in cortex resolves spontaneously
31
Acquired cataracts - atoptic dermatitis
atoptic exzema itchy skin, red and inflammed anterior suncapsular sheild cataracts severe atoptic dermatitis
32
Wet amd signs
dpends on subtype Metamorphosia Reduced VA induced hyperopia band of pigment Dome shaped elevation on macula
33
Wet AMD signs
Sudden onset reduced vision unilateral metamorphosia positive scotoma
34
Wet AMD management
Most health boards have rapid access scemes for urgent cases Treated with anti-VEGA by opthalmologist
35
Dry AMD signs
reduced VA intermediate / Large drusen RPE pigment changes Drusenoid REP changes Enlarged area of atrophy on OCT- 1. druse 2. outer retinal tubulation RPE changes Loss of RPE and atrophic
36
Dry AMD symptoms
Bilateral impairment of central vision Vision better in bright light metamorphosia
37
Dry AMD management
Prophylactic use of antioxidants modifiyed lifestyle Amsler Grid monitor regularly no effective treatment options
38
VKC signs
palp conj has cobblestone appearance limbal papilla and hyperetropia cornea:- - loss of epi cells - detected with fluroscein - papillae releases chemicals toxic to corneal epithelium
39
VKC symptoms
Bilaterla Year rounf but worsens in spring itchy eyes redness lacrimation white mucoid sticky discharge
40
VKC management
Cold compress mast cell stabilisers uegent referral topical steroid eye drops powerful anti-inflammatory drugs pred acetate (1%)
41
atopic keratoconjunctivitis
lids - inflammed - thickededd - cracks and fissures - excubated by eye rubbing - hyperaemia - skin dry and scally conjunctiva - inflammed - hyperaemia - papillary reaction - chronically inflammed - conjunctival scarring Cornea - superficial punctate conjunctivitis - plaque sheild ulcer - sub-epi scarring - neovascularisation
42
atopic keratoconjunctivitis symptoms
BIlateral itchy eyes redness lacrimation white mucoid sticky discharge all year round corneal involvement:- - pain - photophobia - Blurred vision
43
atopic Keratoconjucntivitis management
corneal involvement - urgent milder cases - routine cold compress mast cell stabilaisers systemic antihistamines
44
Giant pupillary conjunctvitis signs
superior papillary conj hyperaemia papillary conjunctivitis
45
Giant pupillary conjunctivitis symptoms
Bilateral itchy irritated eyes increased contact lens movement decreased tollerance to contacts white mucoid sticky discharge
46
Giant Pupillary conjunctivitis management
remove mechanical trigger to inflammation surgical artefacts
47
Bacterial keratitis signs
lid oedema epiphoria discharge conj hyoeraemia peripheral corneal lesions anterior chamber activity
48
bacterial keratits symptoms
acute onset unilateral pain redness discharge blurred vision
49
bacterial keratitis management
emergency referral to HES Contact lens wearers keep clases for cultures
50
HSK signs
Highly variable corneal sensitivity dendritic ulcer corneal stroma
51
HSK symptoms
Px may have recurrent attacks usually unilateral pain, photophobia, redness and decreased VA Severity of symptoms varies
52
HSK management
Treat with topical antivirals contact lens wearers go to HES
53

clinical opthalmology (5 decks)

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