ModC: Ophthalmology Flashcards
Age-related macular degeneration
ARMD
Wet or dry
Wet = rapid deterioration is rapid and distortion is key, tx is anti-VEGF intravitreal injections
Dry = Amsler chart used to monitor progression, no tx
RFs: female, smoking, age
Amaurosis fugax
Ophthalmic artery
Amblyopia
Aka lazy eye - eye is unable to build a strong link to the brain seen in 3% of children
Px: blurred vision & poor depth perception
Results in decreased visual acuity
Blepharitis
dry eye
Cataracts
eye
Chemical eye injury
eye
Conjunctivitis
subtypes: viral, bacterial
Ophthalmia neonanatorum
conjunctivitis
Vernal keratoconjunctivitis
conjunctivitis
Diabetic eye disease
Aka proliferative diabetic retinopathy
Microvascular
Corneal abrasion
cornea
Contact-lens associated keratitis
cornea
Exposure keratopathy
eye
Herpes simplex keratitis
eye
Dry eye
eye
Eyelid tumour
eye
Giant cell arteritis
AKA temporal
Glaucoma
open or closed angle
Horner’s syndrome
CN palsy
CNIII palsy
Occulomotor
CNIV palsy
Trochlear
CNVI palsy
Abducens
Optic neuropathy
eye
Orbital cellulitis
eye
Preseptal cellulitis
eye
Papilloedema
Optic disc swelling from raised intracranial pressure
Results in decreased visual acuity
Idiopathic intracranial hypertension
eye
Myopia
refractive error
Short sighted
RF for retinal detachment (due to longer eyeball length making the retina thinner and more likely to tear and detach)
Hyperopia
refractive error
Astigmatism
refractive error
Presbyopia
refractive error
Retinal artery occlusion
Affects central retinal artery
Retinal detachment
Px: sudden loss of vision, floaters, myopic hx
Strabismus
Abnormal alignment of pupils (either cross-eyed appearance or one eye is more outwards, upwards or downwards)
Due to oculomotor, trochlear or abducens nerve palsy
Thyroid eye disease
eye
Uveitis
Inflammation of middle layer of eye (uvea)
Divided into anterior and posterior uveitis
Causes: infection, injury, autoimmune/inflammatory disease
Non-infectious uveitis tx: Adalimumab and dexamethasone
Photopsia
flashes
Floaters
Eye presentation associated with posterior vitreous detachment
If associated with loss of vision, then floaters are associated with retinal detachment
Posterior vitreous detachment
Px: floaters, no loss of vision
Central serous retinopathy
eye
Painful red eye presentation
Subtarsal foreign body
Corneal foreign body
Subtarsal foreign body
Painful red eye presentation
Corneal foreign body
Painful red eye presentation
Intraocular foreign body
Medical emergency hence requires urgent referral to eye casualty
Panretinal photocoagulation
Tx for diabetic retinopathy
Reduces number of hypoxic peripheral retinal photoreceptors producing VEGF to reduce oxygen consumption of retina and re-establish oxygen supply/demand balance
May cause new blood vessels to regress
SEs: poor peripheral vision, poor night vision (due to rod destruction)
Macular grid laser
laser type used?
Vitrectomy
Surgery
Intravitreal steroid implant injection (Ozurdex)
Implant that gradual releases Dexamethasone (glucocorticoid) over time then implant dissolves
Reduces inflammation of retina and improves visual acuity
Uses: diabetic macular oedema, macular oedema (secondary to retinal vein occlusion), non-infectious uveitis
Intravitreal anti-VEGF injections
Injections given intravitreal for wet age-related macular degeneration, not used for dry ARMD
Blocks VEGF which encourages new blood vessel formation
Can be used for diabetic retinopathy but too expensive hence, not cost effective (not licensed for NHS use)
Retinal vein occlusion
Complication: macular oedema (tx: Ozurdex)
Optical Coherence Tomography
Used to visualise any retinal, or macula impairment
Anisocoria
Unequal pupil size
Causes: direct trauma, concussion, bleeding in skull, optic neuritis, brain tumour, aneurysm, meningitis, seizure
Optic neuritis
Inflammation of optic nerve (CNII)
Results in decreased visual acuity and pain
Commonly seen multiple sclerosis (~50%) - may be 1st sign
Symptoms: diminished vision, blurred vision, abnormal colour vision, eye pain, abnormal reaction to light
Ix: visual acuity, MRI brain
Tx: resolves on its own, or short course of prednisolone
Ptosis
Drooping or falling of upper eyelid
