misc (eyelid, trauma, pupil defects)

Question 1

what can squints lead to if uncorrected

Answer 1

ambylopia (brain favours other eye, one eye becomes lazy eye)

Question 2

what is concomitant squint

Answer 2

imbalance of extracocular muscles // convergent > divergent

Question 3

what is paralytic squint

Answer 3

paralysis of extraocular muscles

Question 4

invx squint

Answer 4

corneal light reflex (asymmetrical) // cover test (focus on subject + cover eye)

Question 5

mx squint

Answer 5

refer to ophthalmology (maybe eye patch)

Question 6

what is a RAPD

Answer 6

swinging light test –> when shone in bad eye both eyes dilate // when shone in good eye it contracts but bad eye stays dilated

Question 7

causes RAPD

Answer 7

retinal detachment // optic neuritis

Question 8

symptoms + signs argyll roberston pupil

Answer 8

small, irregular pupils // does not react when light shone in (pupil reflex absent) but does react when light in other eye (accommodation)

Question 9

causes argyll Robertson pupil

Answer 9

diabetes // syphilis

Question 10

what is a holmes-adie pupil + symptoms

Answer 10

benign condition in women // unilateral dilated pupil // slowly reactive to accommodation, poorly reactive to light // once pupil constricted slow to dilate again

Question 11

systemic symptoms holmes-adie pupil

Answer 11

absent ankle + knee refelx!!!

Question 12

causes of mydriasis

Answer 12

(dilated pupil) // CNIII palsy // holmes adie // phaemochromocytoma // congenital

Question 13

drug causes mydriasis

Answer 13

topical mydiatics eg topicamide, atropine // sympathetic drugs eg amphetamine, cocaine // anticholinergics eg TCA

Question 14

symptoms horners

Answer 14

small pupil (miosis) // ptosis (droopy eye) // sunken eye // no sweating one side!!! (anhidrosis)

Question 15

what does anyhidrosis on face, arms, trunk in horners indicate

Answer 15

central lesion = stroke, syringiomyelia, MS

Question 16

what does anyhidrosis on face only in horners indicate

Answer 16

pre-ganglionic eg pancoast tumour, thyroidectomy, trauma, cervical rib

Question 17

what does no anyhidrosis on in horners indicate

Answer 17

carotid dissection, carotid aneurysm, cavernous sinus, cluster headache

Question 18

what is seen in congenital horners

Answer 18

heterochromia (different coloured pupils)

Question 19

invx horners

Answer 19

apraclonidine drops (alpha agonist) cause dilation in affected pupil, but little affect in normal pupil

Question 20

what causes posterior blepharitis

Answer 20

meibomian gland dyfunction

Question 21

what causes anterior blepharitis

Answer 21

seborrhoeic dermatitis / staph infection

Question 22

symptoms blepharitis

Answer 22

bilateral // gritty + uncomfortable around eyelids // sticky eyelids // (swollen in staph infection) // can progress to conjunctivitis

Question 23

who commonly gets blepharitis

Answer 23

rosacea

Question 24

mx blepharitis

Answer 24

hot compress 2x day // artificial tears

Question 25

what is a stye

Answer 25

infection of the eyelid glands

Question 26

what is a chalazion

Answer 26

meibomian cyst (firm, painless lump)

Question 27

what is orbital cellulitis

Answer 27

infection affecting the fat and muscles posterior to the orbital septum

Question 28

what usually precedes orbital cellulitis

Answer 28

spreading URTI

Question 29

RF orbital cellulitis

Answer 29

age 7-12 // sinus infection // no H influe (Hib) vaccine // recent periorbital cellulitis // ear or face infection

Question 30

symptoms orbital cellulitis

Answer 30

redness or swelling in eye // ocular pain // visual disturbance eg decreased acuity // proptosis // opthalmoplegia // eyelid eodema

Question 31

invx orbital cellulitis

Answer 31

FBC // CT with contrast // blood culture

Question 32

mx orbital cellulitis

Answer 32

admit + IV abx (ceftriazone)

Question 33

what is preseptal cellulitis

Answer 33

infection in soft tissue anterior to orbital septum eg eyelids, skin

Question 34

organisms preseptal cellulitis

Answer 34

staph A and staph epid

Question 35

difference between orbital vs preseptal cellulitis

Answer 35

preseptal has swollen red, painful eye, fever// orbital = reduced acuity, proptosis (bulging), pain on movement

Question 36

mx preseptal cellulitis

Answer 36

refer + oral abx usually co-amox

Question 37

what is a hyphema

Answer 37

blood in ant chamber (usually from trauma)

Question 38

risk of hyphema

Answer 38

raised intraocular pressure –> sight threatening

Question 39

mx hyphema

Answer 39

bed rest and keeping as still as possible to not redisperse blood

Question 40

what is orbital compartment syndrome

Answer 40

secondary to trauma, retrobulbar haemorrhage, emergency

Question 41

symptoms orbital compartment syndrome

Answer 41

eye pain and swelling // proptosis (bulging) // rock hard eyelid // RAPD

Question 42

mx orbital compartment syndrome

Answer 42

lateral canthotomy (before imaging) to decompress

Question 43

symptoms corneal foreign body

Answer 43

eye pain // foreign body sensation // photophobia // watery eye // red eye

Question 44

referal with trauma

Answer 44

penetrating injury (eg drilling, lawn mowing) // sharps // chemical injury // organic material eg seeds, soil // red flags

Question 45

what medications can cause cataracts

Answer 45

steroids

Question 46

what medications can cause corneal opacity

Answer 46

amiodarone / indomethacin

Question 47

what meds cause optic neuritis

Answer 47

ethambutol // amiodarone // metronidazole

Question 48

what meds cause retinopathy

Answer 48

chlouroquinine, quinine