Misc Ophthal Flashcards
Principles of ANALGESIA in eyes:
Cycloplegic
Artificial tears
Shield to avoid light
Topical anaesthetic
–> eg. Tetracaine 0.5%
Principles of REDUCING IOP in eyes:
Sit up
Control pain/ cough/ vomit
Avoid val salva
Hyperventilate
Reduce aqueous production
–> Timolol 0.5%
–> Acetazolamide 500mg
Increase aqueous outflow
–> Miotic to open angle: Pilocarpine 2%
Reduce volume
–> Mannitol 10%
Reduce inflammation
–> Prednisolone 1%
Paracentesis
CYCLOPLEGIC meds:
AKA Mydriatics/ Dilators. They are anticholinergic
Tropicamide 1%
Atropine
Scoplamine
Cyclopenolate
MIOTIC meds (and indication):
Pilocarpine 2%
What is normal intraocular pressure:
10 - 21 mmHg
Red flags for eyes:
Severe pain
Ciliary flush (vs. perilimbic sparing)
Pupil irregularity
Reduced extraocular movements
Decreased VA
RAPD
Contact lense use
Trauma
Why beware the opthal patient with sickle cell?
In setting of raised IOP, they can’t have acetazolamide (increases sickling(
DDx anisocoria:
If anisocoria in light: larger one is abnormal. If in dark, smaller is abnormal
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IRIS PHYSIOLOGICAL
Physiological
3rd nerve palsy
–> Cav sin, PCOM, pituitary
Horner’s
Use of cycloplegic/ mydriatic/ miotic
IRIS MECHANICAL
Traumatic mydriasis (iris concussion)
Trauma to iris
Iritis (anterior uveitis)
Acute angle closure
LIGHT PERCEPTION
Severe retinal disease
Optic neuritis/neuropathy
–> Incl. retrobulb haemor, orbital cell, GCA
List 5 causes of Horner’s Syndrome:
Interruption of sympathetic supply to face/eye
Upper chest/neck
- Aortic dissection (Type A- into int. carotids)
- Apical lung lesion (ie. Pancoast tumour)
- Cervical rib
- Goitre
- Cervical trauma
Cavernous sinus
- Cavernous sinus thrombosis
- ICA aneurysm/ dissection
- Pituitary tumour
In brain
- Wallenberg syndrome (PICA)
- Hypothalamic stroke
+ Iatrogenic, trauma, cluster headache, Herpes Zoster opthalmicus
