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SSs > Ophthal > Flashcards

Ophthal Flashcards

1
Q

HPC of an eye history

A

Site: whole eye, lid, localised, wear contacts
Onset: gradual, sudden
Character: Foreign body sensation, headache
Radiation: behind eye, midline, head, side of face, ear, jawline
Associated symptoms: nausea/vom, headache
Time: Constant/intermittent
Exac/relieve
Severity.

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2
Q

Why is it importance to ask about illicit drugs?

A

Poppers - loss of central vision

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3
Q

Importance factors in social history:

A

Driving.
Home situation.
Smoking (macula degen, cataracts, diabetic retinopathy, thyroid eye disease, healing)

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4
Q

Vision questions

A

How is your vision? Compared to other eye? What was it like before? Anything missing?

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5
Q

What condition can cause a brow ache?

A

Glaucoma - feel bruise pain of bone

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6
Q

What symptom presents with pressure?

A

Scleritis

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7
Q

Curtain?

A

TIA

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8
Q

How can a detached retina present?

A

Curtain, flashes and floaters

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9
Q

What is the likely differential if the patent has sudden, painful visual loss?

A

Vascular

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10
Q

What underlying cause if pain for days-weeks compared to hours

A

infection - inflammatory for less time

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11
Q

How does a piece of metal look on close inspection of the eye?

A

Circular lesion on cornea, often brown with a yellow halo

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12
Q

What condition occurs as a result of the iris and lens blocking the angle through the trabecular meshwork causing sudden severe symptoms?

A

Angle closure glaucoma.

Intense eye pain, red eye, headache, halos, blurred, nausea

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13
Q

What are the risk factors of AC glaucoma?

A

HLA-B27. Dry eyes. Sjogren’s. RA. Scleritis. Rheumatoid arthritis.

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14
Q

Define Entropion

A

Lid rolled in, lashes scratch eye - ulcers

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15
Q

What are signs of allergic disease of conjunctiva?

A

Follicular, both eyes. Sticky coating on eye lashes, itchy and watering

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16
Q

What is the term for a constricted pupil?

A

Miosis

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17
Q

What condition is suggested by gradual onset of blurred hazy vision with associated glare, halos and monocular diplopia? What other signs would be present?

A

Cataracts - opacification of lens:

Reduced acuity, red reflex and poor fundus view.

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18
Q

What is glaucoma? How does it present?

Signs present on optic disk?

A 
Degenerative disease of the option nerve, eye drainage canals become blocked over time. At end stage - peripheral field loss (nasal defect first). Linked to raised intraocular pressure. 
Optic disk:
Cupping 
Pallor
Splinter haemorrhage
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19
Q

Red flags of Giant Cell Arteritis?

A 
Weight loss
Headache
Malaise
Pain on chewing 
Scalp Tenderness
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20
Q

Red flags of retinal tear or detachment?

A

Flashing lights
Floaters
Shadow over vision

21
Q

Red flags of double vision?

A

Headache.
Vomiting.
(would indicate intracranial pathology)

22
Q

Red flags with eye pain? Excluding AC Glaucoma

A

Haloes

Triggered by low illumination

23
Q

When would you get painful visual loss?

A

Secondary to inflammatory events: uveitis, AC glaucoma, keratitis, neurtis

24
Q

When would you get painless visual loss?

A

Secondary to vascular events: vitreous haemorrhage, occlsions, artertic, ARMD

25
Q

Would visual loss with vascular events, retinal detachment, and angle closure glaucoma be gradual or sudden?

A

Sudden

26
Q

Would visual loss with cataracts, ARMD, uveitis and keratitis be gradual or sudden?

A

Gradual

27
Q

Term for long sightedness

A

Hypermetropia

28
Q

Discharge and conjuctivitis - likely causes.

  1. purulent - yellow and sticky
  2. Mucoid - white and stringy
  3. Serous-Watery
A
  1. Bacterial chlamydial
  2. Allergic
  3. Viral/toxic
29
Q

What does pain from shining a light in good eye or asking patient to follow a target suggest?

A

Iris inflammation (iritis or anterior uveitis)

30
Q

Signs of acute glaucoma?

A

Severe pain.
Fixed, mid-dilated pupil.
Hazy view of iris.

31
Q

How can anterior uveitis present?

A

Miosis (constricted pupil). irregular pupils due to iris and pupil adhesions

32
Q

Does papilloedema occur unilaterally or bilaterally?

A

Bilateral

33
Q

What is giant cell arteritis and how is it treated?

A

Inflammation of medium and large arteries in head and neck.

Urgent treatment with steroids and temporal biopsy within one week of commencing steroids.

34
Q

What chemicals cause more damage to the eye? How are they treated?

A

Alkali - can penetrate more rapidly (lipophilic)

Restore pH with irrigation. Recover corneal epithelium.

35
Q

How is scleritis treated?

A

Urgent referral, NSAID, immunosuppressants required.

36
Q

Is posterior vitreous detachment common? What symptoms does it cause?

A

Yes occurs in 75% of those of 65.

Floaters & flashing lights.

37
Q

When may a patient experience cobweb effect of floaters?

A

Retinal detachment

Flashes of light, black curtain

38
Q

What is a severe complication of retinal detachment?

A

Blindness due to the lack of blood supply. URGENT

39
Q

What condition occurs when retinal blood vessels are atherosclerosed?

A

Amaurosis fugax

40
Q

What is the difference between dry macular degeneration and wet?

A

Dry is damage caused by build up deposit - drusen.

Wet is damage from the abnormal formation of blood vessels underneath the macula.

41
Q

Is wet or dry AMD more serious?

A

Wet: vision can deteriorate over days.

42
Q

What condition causes central vision loss?

A

Macula degeneration

43
Q

What are the symptoms of optic neuritis?

A

Painful eye movements and dull ache behind the eye.
Unilateral temporary visual loss.
Loss of colour vision and visual fields.

44
Q

What may indicate a painful third nerve palsy?

Why is it important to CT?

A

Pain.
Ptosis
Eye lateral and downwards
Diplopia.

Sign of a berry aneurym

45
Q

What is the concern with painful horner’s syndrome?

A

Carotid dissection until proven otherwise

46
Q

What is the term for near-sightedness? What do they have difficulty seeing?

A

Myopia

Distant objects

Correct with concave lens

47
Q

Term for lazy eye.

A

Amblyopia

48
Q

Types of squint:

A

Esotropia: eye turning inwards
Exotropia: eye turning outwards
Hypertropia: eye turning upwards
Hypotropia: eye turning downwards

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