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Opthalmology > More > Flashcards

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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
Q

Painful unilateral 3rd nerve palsy

A

Posterior communicating artery aneurysm

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26
Q

What does CN 4 supply - trochlear nerve

A

Superior oblique - rotation of eye in towards nose

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27
Q

What does CN 6 supply

A

Lateral rectus

Horizontal diplopia

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28
Q

Neonatal conjunctivitis 2-5 days after birth and 5-12 days after birth

A

Chylmadia - 5-12 days after with creamy white discharge

Gonorrhoea - 2-5 days after

Staphylococcus- yellow discharge

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29
Q

Shaken baby syndrome triad

A

Encephalopathy
Sub dural haemorrhage
Retinal haemorrhage

30
Q

Phoria versus tropia

A

Phoria - misalignment usually suppressed

Tropia - eyes deviate - can’t be controlled

31
Q

Ocular problems associated with prematurity

A

Retinopathy - wide range of complications
Retinal detachment
Screening if before 32 weeks gestation

32
Q

Pathological anisocoria vs physiological

A

Physiological is same in all light levels

Pathological varies between light and dark

33
Q

Causes of large pupil

A

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
Q

Causes of Small pupil

A

Horner’s syndrome

Uveitis

35
Q

Facial nerve palsy and eyelids

A

Failure of closure - widened eye

36
Q

Parts of eye affected by diabetes

A 
Retinopathy
Maculopathy 
Extra ocular muscle palsy (3rd nerve usually spares pupil) 
Cataract
Retinal vascular occlusion a
37
Q

Iris in diabetes

A

Iris rubeosis - new vessels at iris - can block trabecular network and cause glaucoma

38
Q

Treatment of diabetic macular oedema and of new vesel formation

A

Macular oedema - focal macular laser

New vessels - pan retinal photocoagulation

39
Q

Mild non-proliferative DR

A

At least one micro aneurysm

40
Q

Moderate non-proliferative DR

A

Haemorrhages or microaneurysms - retinal
And/or
Cotton wool spots, venous beading, intraretinal microvascular anomalies

41
Q

Severe non-proliferative DR

A

Haemorrhages or microaneurysms - all 4 quadrants
VB in 2
Or
Microvascular anomalies in 1

42
Q

Non high risk proliferative DR

A

New vessels anywhere but not criteria for high risk

43
Q

High risk proliferative DR

A 
Vessels at disc >1/3 of area
Or
At disc and haemorrhage
Or
Elsewhere >1/2 of disc area and haemorrhage
44
Q

Advanced proliferative DR

A

Tractional Retinal detachment

45
Q

Lids in thyroid eye disease

A

Retracted and lid lag

Lahophthalmous - can’t shut kid properly

46
Q

CN often affected in MS

A

6th nerve

47
Q

What is mollescum contagiosum

A

small nodule on eyelid or lid margin

Caused by pox virus in HIV

48
Q

Panvascular retinal opacification from retinitis with associated haemorrhage

A

CMV retinitis

49
Q

Grade 1 hypertensive retinopathy

A

Arteriolar narrowing (see narrowed arteries generally)

50
Q

Grade 2 hypertensive retinopathy

A

Focal arteriolar narrowing and AV nipping

51
Q

Grade 3 hypertensive retinopathy

A

Haemorrhages
Exudates
Cotton wool spots

52
Q

Grade 4 hypertensive retinopathy

A

Grade 3 + disc swelling

53
Q

What are cotton wool spots

A

Small areas of retinal ischaemia and swelling

54
Q

Exudates

A

Vascular leakage

55
Q

Restricted eye movement with orbital fracture

A

Floor blow out can trap inferior rectus and restrict elevation

56
Q

What is keratoconjunctivitis sicca?

A

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
Q

Most common pathogen in bacterial conjunctivitis

A

Staph aureus or strep pneumoniae

58
Q

Hypromellose

A

Artificial tears

59
Q

Schirmers test

A

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
Q

AntaZoline

A

Topical antihistamine

61
Q

Most common ocular manifestation of RA

A

Keratoconjunctivitis sicca
Then episcleritis
Then scleritis
also get corneal ulceration and keratitis

62
Q

Risk factors for acute open angle glaucoma

A 
Myopia
Afro-caribbean 
HTN
Diabetes
Family history
63
Q

What is horner syndrome?

A

Combination of symptoms that arise following damage to the sympathetic trunk

64
Q

Symptoms of Horner syndrome

A 
Miosis (small pupil)
Ptosis
Enophthalmos (sunken eye)
Possible anhidrosis (loss of sweating on one side)
Unilateral symptoms
65
Q

What is an additional feature of Horner syndrome if congenital

A

Heterochromia

66
Q

First line treatments for glaucoma (open angle)

A

Lantanoprost (brown pigmentation of iris) or timolol (not asthma or heart block)

67
Q

Stroke with right sided hemiparesis - where will visual defect be?

A

Right side also!!! (both vision and motor neurons cross over)
Left cortex lesion

68
Q

Common visual defect with pituitary tumour

A

Inferior chiasmal compression - upper quadrant defect

69
Q

Common visual defect with a craniopharyngioma

A

Upper chiasmal compression - lower quadrant defect

70
Q

Difference between hordeolum externum (stye) and chalazion

A

Chalazion is blocked gland, firm and painless

Stye is infected and is painful

Opthalmology (6 decks)

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