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1
Q

Viral pathogen in viral conjunctivitis

A

Often adenovirus 3

8 day incubation period

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2
Q

Conjunctivitis + follicles/papillae

A

Papillae - have central blood vessel - bacterial + allergic

Follicles - no central blood vessel - White cell collections - viral + chlamydial

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3
Q

What is cycloplegia and what is it used to treat?

A

Cyclopentolate eye drops - dilate the pupil

Help avoid posterior synechiae with anterior uveitis

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4
Q

Acute onset of grittiness, red eye, normal visual acuity or mild blurring
No FB

A

Episcleritis

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5
Q

What is scleritis associated with?

Symptoms

A

Systemic diseases - autoimmune and inflammatory

Dull deep severe pain

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6
Q

What is not affected in preseptal cellulitis?
Difference with orbital cellulitis

Management of both

A

Ocular muscles and visual acuity
Reduced eye movement and possible diplopia with orbital cellulitis

Systemic antibiotics

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7
Q

Which arteries affected in non-arteritic anterior ischaemic optic neuropathy

A

Short posterior ciliary arteries

Leads to infarction of optic nerve head

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8
Q

What causes optic disc pallor?

A

Loss of neural tissue due to infarction

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9
Q

What two features are present in giant cell arteritis that are not present with non-arteritic anterior ischaemic optic neuropathy

A

Pain

Raised ESR AND CRP

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10
Q

Treatment of giant cell arteritis

A

High dose systemic steroids

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11
Q

Hypermetropia is a risk factor for

A

Acute angle-closure glaucoma (smaller eyes)

Non-arteritic anterior ischaemic optic neuropathy

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12
Q

Pain with acute angle-closure glaucoma

Other features

A

Yes
Halos around lights
Oval unreactive pupil

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13
Q

Treatment of acute angle-closure glaucoma

A

Acetazolamide
Timolol eye drops - beta-adrenergic receptor antagonist
Apraclonidine - alpha agonist

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14
Q

Risk factor for retinal detachment

A

Myopia - short-sited

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15
Q

Symptoms of retinal detachment

A

Flashing lights - photopsia in peripheries

Floaters

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16
Q

The effect of cataract on lens refractive power

A

Thicker do more powerful therefore refractive index increases - increasing myopia

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17
Q

Symptom of cataract

A

Glare

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18
Q

What are Drusen

A

Small yellow accumulations of extra cellular waste material from the photoreceptors
- accumulate under neuroretina
Wet Age related macular degeneration

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19
Q

Wet macular degeneration

A

Haemorrhages

New vessels - grey/green lesions

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20
Q

When do you do fluorescein angiography

A

Wet macular degeneration - to see microvascular lesion areas

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21
Q

Open angle glaucoma

A

Peripheral visual field loss
Myopia risk factor
Disc cupping

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22
Q

Upper left quadrantanopia

A

Inferior optic radiations - temporal lobes

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23
Q

Lower/inferior left quadrantanopia -

A

Upper optic radiation in parietal lobe

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24
Q

3rd nerve palsy gaze

A

Down and out (may have dilated pupil)

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25
Painful unilateral 3rd nerve palsy
Posterior communicating artery aneurysm
26
What does CN 4 supply - trochlear nerve
Superior oblique - rotation of eye in towards nose
27
What does CN 6 supply
Lateral rectus | Horizontal diplopia
28
Neonatal conjunctivitis 2-5 days after birth and 5-12 days after birth
Chylmadia - 5-12 days after with creamy white discharge Gonorrhoea - 2-5 days after Staphylococcus- yellow discharge
29
Shaken baby syndrome triad
Encephalopathy Sub dural haemorrhage Retinal haemorrhage
30
Phoria versus tropia
Phoria - misalignment usually suppressed Tropia - eyes deviate - can't be controlled
31
Ocular problems associated with prematurity
Retinopathy - wide range of complications Retinal detachment Screening if before 32 weeks gestation
32
Pathological anisocoria vs physiological
Physiological is same in all light levels | Pathological varies between light and dark
33
Causes of large pupil
3rd nerve palsy Holmes adie pupil - large with poor reaction to light and reduced accommodation or delayed mydriasis after going from near to far
34
Causes of Small pupil
Horner's syndrome | Uveitis
35
Facial nerve palsy and eyelids
Failure of closure - widened eye
36
Parts of eye affected by diabetes
``` Retinopathy Maculopathy Extra ocular muscle palsy (3rd nerve usually spares pupil) Cataract Retinal vascular occlusion a ```
37
Iris in diabetes
Iris rubeosis - new vessels at iris - can block trabecular network and cause glaucoma
38
Treatment of diabetic macular oedema and of new vesel formation
Macular oedema - focal macular laser | New vessels - pan retinal photocoagulation
39
Mild non-proliferative DR
At least one micro aneurysm
40
Moderate non-proliferative DR
Haemorrhages or microaneurysms - retinal And/or Cotton wool spots, venous beading, intraretinal microvascular anomalies
41
Severe non-proliferative DR
Haemorrhages or microaneurysms - all 4 quadrants VB in 2 Or Microvascular anomalies in 1
42
Non high risk proliferative DR
New vessels anywhere but not criteria for high risk
43
High risk proliferative DR
``` Vessels at disc >1/3 of area Or At disc and haemorrhage Or Elsewhere >1/2 of disc area and haemorrhage ```
44
Advanced proliferative DR
Tractional Retinal detachment
45
Lids in thyroid eye disease
Retracted and lid lag | Lahophthalmous - can't shut kid properly
46
CN often affected in MS
6th nerve
47
What is mollescum contagiosum
small nodule on eyelid or lid margin | Caused by pox virus in HIV
48
Panvascular retinal opacification from retinitis with associated haemorrhage
CMV retinitis
49
Grade 1 hypertensive retinopathy
Arteriolar narrowing (see narrowed arteries generally)
50
Grade 2 hypertensive retinopathy
Focal arteriolar narrowing and AV nipping
51
Grade 3 hypertensive retinopathy
Haemorrhages Exudates Cotton wool spots
52
Grade 4 hypertensive retinopathy
Grade 3 + disc swelling
53
What are cotton wool spots
Small areas of retinal ischaemia and swelling
54
Exudates
Vascular leakage
55
Restricted eye movement with orbital fracture
Floor blow out can trap inferior rectus and restrict elevation
56
What is keratoconjunctivitis sicca?
Dry eye Tear deficiency - systemic such as sjogrens, rheumatoid and sarcoid Causes mildly reduced vision, discomfort and photophobia bilaterally Also bilateral punctuate fluorescein staining of inferior cornea
57
Most common pathogen in bacterial conjunctivitis
Staph aureus or strep pneumoniae
58
Hypromellose
Artificial tears
59
Schirmers test
Measures rate at which a strip of filter paper suspended from lower eyelid is wetted with tears- positive test means reduced tear production Treated with artificial tears
60
AntaZoline
Topical antihistamine
61
Most common ocular manifestation of RA
Keratoconjunctivitis sicca Then episcleritis Then scleritis also get corneal ulceration and keratitis
62
Risk factors for acute open angle glaucoma
``` Myopia Afro-caribbean HTN Diabetes Family history ```
63
What is horner syndrome?
Combination of symptoms that arise following damage to the sympathetic trunk
64
Symptoms of Horner syndrome
``` Miosis (small pupil) Ptosis Enophthalmos (sunken eye) Possible anhidrosis (loss of sweating on one side) Unilateral symptoms ```
65
What is an additional feature of Horner syndrome if congenital
Heterochromia
66
First line treatments for glaucoma (open angle)
Lantanoprost (brown pigmentation of iris) or timolol (not asthma or heart block)
67
Stroke with right sided hemiparesis - where will visual defect be?
Right side also!!! (both vision and motor neurons cross over) Left cortex lesion
68
Common visual defect with pituitary tumour
Inferior chiasmal compression - upper quadrant defect
69
Common visual defect with a craniopharyngioma
Upper chiasmal compression - lower quadrant defect
70
Difference between hordeolum externum (stye) and chalazion
Chalazion is blocked gland, firm and painless | Stye is infected and is painful

Opthalmology (6 decks)

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