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GP > Ophthal > Flashcards

Ophthal Flashcards

1
Q

How to manage bacterial conjunctivitis

A

Mild: saline irrigation, antiseptic eye drop
Severe: chloramphenicol eyedrops 1-2hrly first 4 days, then 4x a day for 7 days

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2
Q

Managing vital conjunctivitis

A 
Limit cross infection by hygiene 
Cool compress 
Topical lubricants 
Naphazoline
Vasoconstrictors 
Saline bathing 
Watch for secondary infection 
NO steroids or padding
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3
Q

What is a very important feature of vital conjunctivitis

A

Subconjunctival hemorrhage

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4
Q

Managing allergic conjunctivitis

A 
Topical antihistamines/vasoconstrictors 
Chromoglycate 2% eye drops 
Combination of 1 and 2 
Topical steroids 
Artificial tear prep
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5
Q

How to treat herpes simplex keratitis

A

Eye hygiene
Acyclovir 3% ointment, 5x a day for 14 days
Atropine 1% drop 12 hourly for duration of treatment
Debriedement by consultant

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6
Q

How to manage blepharitis

A

Anterior:
- Wash eyelashes frequently with baby shampoo
- If infected, antibiotic ointment chloromycetin
Posterior:
- eye hygiene also but with eye massage
- Ocular lubricants of dry eyes
- control scalp seborrhoea
- If persists, topical corticosteroid
- antibiotic ointment like chloramphenicol
- avoid makeup and contacts

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7
Q

Tests for acute glaucoma

A 
Full eye Examination
Fundoscopy 
Slit lamp tonometry 
Gonioscopy
Optic nerve imaging
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8
Q

Management of acute glaucoma

A

Refer to ophthal urgently
Analgesia
Acetazolamide/pilocarpine
Need to do iridotomy, under local anesthesia

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9
Q

What to rule out when taking history for red painful eye

A 
Glaucoma
Uveitis 
Conjunctivitis 
Corneal ulcer 
Herpes simplex keratitis 
Herpes zoster 
Penetrating injury 
Orbital cellulitis
Foreign body 
Blepharitis 
Sclerosis 
Drugs/hyperthyroid
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10
Q

Questions to ask for eye presentation

A
  • itch
  • irritation
  • pain
  • loss of vision
  • eye movements
  • discharge
  • contact
  • URTI
  • contact lenses
  • trauma to the eye
  • drops/ointments/cosmetics
  • photophobia (uveitis, keratitis)
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11
Q

Clinical features of chronic glaucoma

A

no early signs and symptoms
central vision usually normal
progressive restriction of visual field resulting in tunnel vision

do tonometry

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12
Q

Treatment for chronic glaucoma

A

Timolol/betaxolol drops
Pilocarpine
Acetazolamide
Surgery/laser if failed pharmaco

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13
Q

Corneal ulcer diagnosis and treatment

A

Slit lamp and fluorescein stain, check for foreign body

Chloramphenicol 1% +/- homatropine 2%
Double eye pad if not infected
Review in 24 hours
Refer early if not healed

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14
Q

Causes of corneal ulceration

A 
Trauma 
Contact lens 
Infection 
Neurotrophic 
Immune-related 
Spontaneous 
Chronic blepharitis 
Overexposure
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15
Q

Keratitis management

A

Refer urgently to ophthal
Can destroy cornea very fast with perforation
Give topical ciprofloxacin 0.3%

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16
Q

What to do if eye struck with a fragment/doubt about trauma

A

X-ray the eye

17
Q

What to do if eye struck with a fragment/doubt about trauma

A

X-ray the eye

18
Q

Retinal detachment clinical features and management

A

Sudden onset of floaters/flashes/black spots
Blurred vision in one eye becoming worse
Curtain coming down over the eye
Partial or total loss of visual field

Immediate referral for sealing of retinal tears, if true detachment need surgery

19
Q

Clinical features of macular degeneration and management

A

Sudden fading of central vision
Distortion of vision
Straight lines seem wavy and objects distorted
Amsler chart shows distorted lines
Central vision eventually completely lost
Peripheral vision normal

Wet - refer urgently for treatment for injection of VEGF
Dry - treatments with vit A C E zinc, and stop smoking

20
Q

Features and investigation of cataracts

A 
Reading difficulty 
Difficulty recognizing faces 
Problem driving esp at night 
Reduced ability to see in bright light 
Haloes around lights

Absence of red reflex on fundoscopy and diminished visual acuity

21
Q

Features of iritis/anterior uveitis

A 
Dull aching painful eye 
Mild photophobia 
Red eye (limbal flush) 
Constricted pupil 
Posterior synechiae
22
Q

Management of anterior iritis/uveitis

A

Topical steroid drops to reduce inflammation

Topical atropine to dilate pupil and break down posterior synechiae

23
Q

Episcleritis is

A

Segmental redness of eye, moderate ache can treat with topical steroids

24
Q

Scleritis features and management

A

Diffuse pattern, severe deep pain, loss of vision, tender

Urgent referral, corticosteroids/NSAIDS

GP (20 decks)

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