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MBBS Y5 > Medicine - Ophthalmology > Flashcards

Medicine - Ophthalmology Flashcards

1
Q

causes of optic neuritis?

A

NAME?

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2
Q

features of optic neuritis?

A

NAME?

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3
Q

management of optic neuritis? how long does it take to fully recover?

A
  • high-dose steroids| - 4-6 weeks
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4
Q

prognosis of optic neuritis?

A

if >3 white matter lesions seen on MRI, very high risk of developing MS

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5
Q

describe the pathophysiology of (all types of) glaucoma

A

NAME?

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6
Q

which fluid fills the anterior chamber? vitreous chamber?

A
  • aqueous humour| - vitreous humour
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7
Q

which structure produces aqueous humour?

A

ciliary body

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8
Q

what is normal intraocular pressure?

A

10-21 mmHg

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9
Q

pathophysiology of open-angle glaucoma?

A

NAME?

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10
Q

pathophysiology in acute angle-closure glaucoma?

A

NAME?

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11
Q

how does increased intraocular pressure affect the optic disc?

A
  • causes “cupping”| - optic cup in centre of disc gets wider and deeper
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12
Q

risk factors for open angle glaucoma?

A
  • ageing- FHx- Black ethnic origin- myopia (short-sightedness)
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13
Q

presentation of open angle glaucoma?

A
  • often asymptomatic, picked up on screening- loss of peripheral vision first- eventually gives “tunnel vision”- gradual onset- fluctuating pain- headaches- blurred vision- halos around light, esp at night
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14
Q

how can intraocular pressure be measured in suspected glaucoma?

A
  • non-contact tonometry (puff of air, useful for screening)| - goldmann applanation tonometry (gold standard)
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15
Q

investigations and findings in open angle glaucoma?

A

NAME?

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16
Q

at what intraocular pressure should treatment be started in open angle glaucoma?

A

24mmHg or above

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17
Q

management of open angle glaucoma?

A
  • 1st: latanoprost (prostaglandin analogue) eye drops- timelol (BB)- dorzolamide (carbonic anhydrase inhibitor) - brimonidine (sympathomimetic) - trabeculectomy surgery if eye drops fail
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18
Q

notable SEs of latanoprost?

A

NAME?

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19
Q

risk factors for acute angle closure glaucoma?

A

NAME?

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20
Q

which drugs can precipitate acute angle closure glaucoma?

A

NAME?

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21
Q

presentation of acute angle closure glaucoma?

A

NAME?

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22
Q

findings O/E of acute angle closure glaucoma?

A

NAME?

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23
Q

initial management of acute angle closure glaucoma?

A
  • same day ophthalmology assessment - lay on back w/ pillow- pilocarpine eye drops- PO acetazolamide 500mg- analgesia / antiemetics if needed
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24
Q

drug class of acetazolamide?

A

carbonic anhydrase inhibitor

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25
Q

secondary care management of acute angle closure glaucoma? hint: similar to open angle

A

NAME?

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26
Q

definitive treatment of acute angle closure glaucoma?

A

laser iridotomy

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27
Q

most common cause of blindness in the UK?

A

age-related macular degeneration (ARMD)

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28
Q

key finding on fundoscopy in ARMD?

A

drusen

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29
Q

how can ARMD be classified? which type is most common?

A
  • dry (90%)| - wet (10%)
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30
Q

which type of ARMD carries a worse prognosis?

A

wet

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31
Q

feature common to both dry and wet ARMD?

A

drusen on fundoscopy

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32
Q

risk factors for ARMD?

A

NAME?

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33
Q

presentation of ARMD?

A

NAME?

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34
Q

how might wet ARMD present slightly differently to dry ARMD?

A
  • more acute- vision is lost over days- full blindness after 2-3 years
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35
Q

findings O/E of ARMD?

A

NAME?

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36
Q

what is a scotoma?

A

a central patch of vision loss

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37
Q

specialist investigations used in ARMD?

A

NAME?

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38
Q

management of dry ARMD?

39
Q

management of wet ARMD?

A
  • refer to ophthalmology| - anti-VEGFs (ranibizumab, bevacizumab, pegaptanib)
40
Q

describe the pathophysiology and examination findings in diabetic retinopathy

A
  • repeated exposure to hyperglycaemia causes increased vascular permeability of retina, causing:- blot haemorrhages - hard exudates- microaneurysms - venous beading- “cotton wool spots”- neovascularisation
41
Q

how can diabetic retinopathy be classified?

A

based on fundoscopy findings: - proliferative- non-proliferative

42
Q

signs on fundoscopy in mild / moderate non-proliferative diabetic neuropathy?

A
  • mild: microaneurysms| - moderate: microaneurysms, blot haemorrhages, hard exudates, cotton wool spots and venous beading
43
Q

signs on fundoscopy in severe non-proliferative diabetic retinopathy?

A
  • blot haemorrhages- microaneurysms in 4 quadrants- venous beading in 2 quadrants - IRMA in any quadrant (intraretinal microvascular abnormality)
44
Q

signs on fundoscopy in proliferative diabetic retinopathy?

A
  • neovascularisation| - vitreous haemorrhage
45
Q

signs on fundoscopy in diabetic maculopathy?

A
  • macular oedema| - ischaemic maculopathy
46
Q

complications of diabetic retinopathy?

47
Q

management of diabetic retinopathy?

48
Q

how could hypertensive retinopathy develop?

A

2 ways:- very slowly from chronic HTN- quickly in malignant HTN

49
Q

signs on retina on fundoscopy in hypertensive retinopathy?

50
Q

how can hypertensive retinopathy be classified?

A

keith-wagener classification

51
Q

management of hypertensive retinopathy?

52
Q

what is a cataract?

A
  • when the lens becomes cloudy and opaque| - causes loss of visual acuity
53
Q

how are congenital cataracts picked up?

A

screened for using red reflex in NIPE

54
Q

risk factors for cataracts?

55
Q

presentation of cataracts?

A
  • asymmetrical- very slow vision loss - progressive blurring - change of colour vision (more yellow / brown)- “starbursts” in light, esp at night
56
Q

finding O/E of cataracts?

A
  • loss of red reflex| - might be picked up in flash pics
57
Q

management of cataracts?

A
  • if asymptomatic, nothing| - surgically breaking less and replacing with artificial lens
58
Q

why might someone get cataract surgery and still have poor visual acuity afterwards?

A

cataracts can mask other eye conditions (e.g. macular degeneration, DM retinopathy)

59
Q

important complication of cataract surgery?

A

endophthalmitis, secondary to infection

60
Q

management of endophthalmitis?

A

intravitreal ABx

61
Q

causes of abnormal pupil shape?

62
Q

what is the difference between rubeosis iridis and coloboma?

63
Q

key associated condition of tadpole pupil?

64
Q

causes of mydriasis (dilated pupil)?

65
Q

causes of miosis (constricted pupil)?

66
Q

how does CN3 palsy affect the eye?

A
  • ptosis- dilated, non-reactive (mydriasis) pupil- divergent squint - “down and out” position
67
Q

which unique feature is found in congenital horner syndrome?

A

heterochromia (different coloured irises)

68
Q

how can you test for horner syndrome?

69
Q

describe the holmes-adie pupil

70
Q

features of holmes-adie syndrome?

71
Q

describe the argyll-robertson pupil

72
Q

what is blepharitis? what does it predispose to?

73
Q

management of blepharitis?

74
Q

what is a stye?

A

infection of the sebaceous / sweat glands at base of eyelashes

75
Q

management of a stye?

76
Q

what is a chalazion? how does it present?

A
  • blocked meibomian gland| - non-tender swelling
77
Q

management of chalazion?

78
Q

what is an entropion? does it hurt?

A
  • eyelid turns in on itself and eyelashes touch the eyeball| - painful
79
Q

complications arising from entropion?

A
  • corneal damage| - ulceration
80
Q

management of entropion?

81
Q

what is an ectropion?

A
  • eyelid turning outwards, exposing inner eyelid mucosa| - usually bottom lid affected
82
Q

complication of ectropion?

A

exposure keratopathy, due to dryness

83
Q

management of ectropion?

84
Q

what is trichiasis?

A
  • inward growth of eyelashes| - causes pain
85
Q

complications of trichiasis?

A
  • corneal damage| - ulceration
86
Q

management of trichiasis?

87
Q

what is periorbital cellulitis?

A

infection of eyelid and skin in front of eye

88
Q

presentation of periorbital cellulitis?

89
Q

key differential of periorbital cellulitis? how can these be distinguished?

A
  • orbital cellulitis| - CT
90
Q

management of periorbital cellulitis?

A
  • PO / IV systemic ABx| - admit and observe if severe
91
Q

what is orbital cellulitis?

A

infection around eyeball involving tissue behind orbital septum

92
Q

features of orbital cellulitis NOT found in peri-orbital cellulitis?

93
Q

management of orbital cellulitis?

A
  • emergency!- admit- IV ABx- surgical drainage if abscess present

MBBS Y5 (27 decks)

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