ISS Opthalmology Tutorial Flashcards
intracranial pain sensitive structures?
blood vessels
meninges
cranial nerves
what are meninges?
tissue covering brain and spinal cord
what muscles of the extracranial area are pain sensitive
scalp
paraspinal
what joint capsules of the head are particularly pain sensitive?
cervical
TMJs
what is a primary headache syndrome
headache with no cause
what is a secondary headache syndrome
headache caused by an underlying condition
q to ask in the history to consider sinusitis as a differential
Hx of sinus problems
what would pain in the eye break down a general headache differential to?
an inflammatory condition of the eye
why ask about earache in someone with headache?
TMJ dysfunction can cause earache as it is near the ear canal
how to exclude raised ICP in a headache patient?
fundoscopy to exclude papilloedema
if the veins of the eye are pulsating does this indicate papilloedema?
no it excludes it
what causes the loss of vision in giant cell arteritis?
infarction of anterior part of optic nerve
if a patient is unable to open their eye for an examination what should you do?
use topical local anaesthetic eg lignocaine
55 year old woman with proptosed, painful eyes with weight loss?
thyroid eye disease
blood tests for suspected thyroid eye disease?
TSH
free T3/4
what should the patient use if she is allergic to chloramphenicol and how often
fucithalmic 2x per day
what should be done to test the eye in order?
- visual field test
- pupillary reflex test
- slit lamp
- fundoscopy
immediate management of CRAO?
ocular massage
rebreath into paper bag
bolus of IV acetazolamide
decompress ant chamber surgically
risk factors for CRAO and CRVO?
HT
diabetes
high cholesterol
smoking
main visual problem associated with CN6 palsy?
horizontal diplopia that is worse when looking to the affected side
management of horizontal diplopia?
temporary prism or patch
usually res
Tx of idiopathic intracranial hypertension?
weight loss
acetazolamide
repeated lumbar punctures
