ophthal Flashcards
argyll-robertson pupil - describe it and causes
small irregular pupil caused by DM or syphilis
superior oblique does what to eyeball
depress and abduct
pathophysiology of acute closed angle glaucome
blocked drainage from anterior chamber via canal of Schlemm
RFs for ACAG
hypermetropia
old age
female
ACAG sx
pain
nausea/vomiting
reduced visual acuity
symptoms worse with mydriasis/dark room
dull/hazy cornea
haloes
ix for ACAG
gold standard is gonioscopy
also tonometry
mx of ACAG
refer ASAP
medical: combination eye drops (pilocarpine + timolol), IV acetazolamide
surgical: laser peripheral iridotomy DONE WHEN ACUTE ATTACK SETTLED
uvea consists of
iris, ciliary body, choroid
anterior uveitis sx
acute pain with acute onset
photophobia
blurred vision
hypopynon - pus in chamber
anterior uveitis associations
IBD
sarcoid
Still’s
seronegative arthropathies
mx anterior uveitis
urgent referral
meds: prednisolone + cyclopentolate drops
episcleritis associations
IBD and rheumatoid
episcleritis sx
commonly painless red eye
watering and photophobia may be present
episcleritis vs scleritis clinically
scleritis more painful
episcleritis blanches vessels on pressure or use of phenylephrine drops
scleritis mx
urgent same day referral
oral NSAIDs mainstay
glucocorticoids used for severe presentations
when does someone with conjunctivitis need to be same-day reviewed by ophthalmologist?
if they are a contact lens wearer
corneal ulcer/abrasion ix
fluorescein staining
keratitis definition
inflammation of cornea
keratitis bacteria
staph aureus
pseudomonas in contact lens wearers
antibiotics for keratitis of assumed bacterial cause?
quinolones are first line
how long aciclovir for HZO
7-10days (oral)
complications of HZO
post-herpetic neuralgia
ptosis
keratitis, conjunctivitis, uveitis
mechanism of sudden vision loss in GCA
anterior ischaemic optic neuropathy
non-arteritic causes of AION
diabetes
HTN
smoking
s/s of optic neuritis
central scotoma
RAPD
acuity loss (central and colour)
pain on movement
optic neuritis drug causes
ethambutol
chloramphenicol