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MBBS - Year 3 > Neuro & Opthal - Ophthalmology > Flashcards

Neuro & Opthal - Ophthalmology Flashcards

1
Q

Role of blinking

A

Spreads a thick film of tears across the eyes and replenishes moisture

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2
Q

Disorders of tear film

A

Low quantity of tears
Poor quality tears
Disturbance of blink reflex
Increased evaporation through exposure

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3
Q

Causes of low quantity of tears

A

Age
Eye surgery
Damage to tear gland

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4
Q

Cause of poor quality tears

A

Blepharitis

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5
Q

When might you see disturbance of blink reflex

A

After surgery

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6
Q

Causes of increased tear evaporation through exposure

A

Post-surgery
VII palsy
Thyroid eye disease
Poor obicularis tone (ageing/ VII palsy)

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7
Q

What does exposure in the eye cause

A

Drying of ocular surface

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8
Q

Sx of exposure

A

Irritation
Stinging
Burning
Red, sticky eye in morning

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9
Q

Complications of exposure

A

Microbial keratitis
Loss of vision

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10
Q

Lagophtalmos

A

Incomplete eye lid closure

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11
Q

What is chalaza often associated w/

A

Blepharitis

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12
Q

How may chalzion px initially

A

Diffuse, swelling ‘stye’

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13
Q

Mx of chalazioon

A

Often resolves spontaneously
Hot lid massage and incision & curettage
Lid hygiene for underying blepharitis

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14
Q

Main cause of lid malposition

A

Lid laxity/ ageing
Other causes incl congenital, spastic, cicatricial

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15
Q

Entropion

A

Eyelid rolls inward

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16
Q

Sx of eyelid malposition - entropion

A

Irritation
Watering
Grittiness
Stickiness
Recurrent infections

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17
Q

Entropion mx

A

Usually conservative
Lubricants
Taping lower eyelid
Botox
Surgery - definitive

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18
Q

Why would botox be given as mx of entropion

A

Combat blepharism - lasts 3/12

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19
Q

Possible surgery for entropion

A

Everting sutures
Lid tightening

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20
Q

Ectropion

A

Eyelid rolls outwards from ocular surface

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21
Q

Causes of ectropion

A

Lid laxity/ ageing
Paralytic - VII nerve palsy
Cicatricial

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22
Q

Sx of ectropion

A

Watering
Red appearance to eyes
Discharge
Blurred vision
If exposure - stinging and pain

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23
Q

Tx of ectropion

A

Lubrication
Surgery

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24
Q

What is ptosis

A

Malposition of upper eyelid
Sign and NOT a dx

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25
Q

Hx for ptosis

A

Recent or gradual onset (sudden onset requires referral)
Associated sx - diplopia, variability (day to day), visual loss
Eye hx
Fhx
Systemic disease - neurology, myasthenia

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26
Q

Examination and ix for ptosis

A

Lid heights and variability
Lid movements
Ocular surface dryness
Obicularis tone and function
Risk of exposure?
Extraocular motility
Pupil reactions
VA

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27
Q

Why is VA important to test for in children w/ ptosis

A

Amblyopia is a risk

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28
Q

Congenital causes of ptosis

A

Dystrophic muscle

29
Q

Acquired causes of ptosis

A

Aponeurotic/ senile
Traumatic
Neurogenic
Myogenic
Mechanical

30
Q

Treating aponeurotic ptosis

A

Levator advancement

31
Q

Dermatochalasis

A

Excess skin in upper eyelid, causing eyelid to be pushed down

32
Q

Features of malignant lid lesions

A

Recent onset
Rapid growth
Bleeding
Pigmented

33
Q

Examination findings of malignant lid lesions

A

Ill-defined borders
Loss of lashes
Destruction of lid architecture
Bleeding
Ulceration
Diplopia

34
Q

Examples of benign lid lesions

A

Chalazion
Cyst of Moll
Cyst of Zeiss
Papilloma
Xanthelasma

35
Q

Examples of pre-malignant lid lesions

A

Keratoacanthoma
Solar keratosis
Lentigo maligna

36
Q

Examples of malignant lid lesions

A

BCC- nodular, infiltrative
SCC
Merkel cell Ca

37
Q

Risk factors for orbital extension from neglected BCC

A

Previous RT
Previous surgery for BCC
Elderly
Mental health problem e.g. dementia

38
Q

Disorders of lacrimal system

A

Dacrocystitis
Dacryoadenitis
Nasolacrimal duct obstruction

39
Q

Dacryoadenitis

A

Infl of lacrimal gland
Settles on conservative mx w/ anti-infl

40
Q

Sx of lacrimal gland swelling

A

Dry eyes
Reduced vision
Swollen upper lids
S shaped deformity in upper lid

41
Q

Mx of lacrimal gland swelling

A

Conservative mx
If not, lacrimal gland debulking

42
Q

Dacrocystitis

A

Abscess in lacrimal sac

43
Q

Hx of dacrocystitis

A

Watery eye
Recent onset
Painful swelling in medial canthal area

44
Q

Ddx of dacryocystitis

A

Lacrimal sac mass/ tumour - will have blood-stained tears

45
Q

Mx of dacryocystitis

A

Oral abx
Drain
DCR surgery
Bypass nasolacrimal duct obstruction

46
Q

Sx of orbital disease

A

Diplopia
Swelling around the eye
Bulging, prominent eye
Ache behind the eye
Pain on eye movements
Awareness of a ‘lump’

47
Q

Signs of orbital disease

A

Restricted eye movement
Swelling around the eye
Proptosis
Lid retraction
Reduced vision
Reduced colour vision
Pupil abnormalities

48
Q

What is proptosis

A

Eye swelling within orbit
Bulging eyes, pushed forward
May be bilateral

49
Q

Causes of proptosis

A

Usually, thyroid eye disease
Primary orbital tumour - lymphoma, glioma
Metastasis - breast, prostate

50
Q

Sx of proptosis

A

Double vision
Reduced vision if compressing optic nerve
Exposure can result if eye cannot close

51
Q

Swelling of which muscles can lead to esotropia

A

Medial & inferior rectus

52
Q

Signs requiring urgent opthal referral

A

Exposure of the eye - refer urgently
Double vision and ptosis
Reduced vision
Rapidly suspicious eye lid lesion
Proptosis
Swelling in lacrimal gland or sac area
Entropion

53
Q

What does the orbit contain

A

Eyeball and associated structures
Extrinsic and intrinsic muscles of the eye
Fat and periorbital fascia

54
Q

Which CNs pass through or supply structures in the orbit

A

II, III, IV, V and VI

55
Q

Is the optic nerve found anteriorly or posteriorly

A

Posteriorly

56
Q

How many layers in the eye surrounded by

A

3 concentric layers

57
Q

Compartments of the eye

A

Anterior
Posterior

58
Q

Features of anterior compartment of eye

A

Transparent
~1/6th of eyeball
Anterior and posterior chamber
Makes aq humour

59
Q

Features of posterior compartment

A

Opaque
~5/6th of eyeball
Makes vitreous humour

60
Q

Which layers of the eye make up its structure

A

Fibrous outer layer
Vascular middle layer
Neural inner layer

61
Q

Fibrous outer layer of eye

A

Anterior cornea - transparent
Posterior sclera - opaque

62
Q

What does the vascular middle layer of the eye consist of

A

Choroid
Ciliary body and iris

63
Q

What is the neural layer pf the eye

A

Retina - optic and non-visual parts

64
Q

What is the cornea

A

Transparent, anterior continuation of sclera

65
Q

Since the cornea is avascular, how does it receive nourishment?

A

Peripheral capillary beds
Lacrimal gland
Aq humour

66
Q

What is the sclera

A

‘White of the eye’
Tough, opaque fibrous membrane, relatively avascular
Visible anteriorly through the transparent bulbar conjunctiva

67
Q

Function of sclera

A

Maintenance of the eyeball shape
Attachment for extrinsic muscles

68
Q

Anatomical relationship between sclera and optic nerve

A

Optic nerve pierces sclera anteriorly - continuous w/ Dural sheath

69
Q

h

A

MBBS - Year 3 (9 decks)

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