Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OST interviews > Ophthal Clinical > Flashcards

Ophthal Clinical Flashcards

1
Q

closure of eyelids

opening of eyelids

A

orbicularis oculi, 7th nerve

levator muscles, 3rd nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

limbus

A

where the cornea meets the slcera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

scleral and corneal thickness

A

sclera 1mm, cornea 0.5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

tear film components

A

lipid from meibomian glands in eyelid, aqueous from superotemporal lacrimal gland, conjunctiva have goblet cells which secrete mucin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ciliary body roles

A

makes aqueous humour for the anterior chamber, anchors the lens via attached zonules and modulates its convexity, also connects the iris to the choriod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

in between sclera and retina…

A

choriod, provides nutrition to the retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

presbyopia

A

loss of accomodation secondary to aging, caused by reduction in lens capsule elasticity and decreased lens deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

anterior chamber/posterior chamber

A

corneairis/irislens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

vitreous humour gel like consistency

A

99% water but contains collagen fibriles and hyalouron, cushions retina from trauma, as you age it can pull on retina cuasing detachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

cones vs rods

A

cones for fine vision and colour in the macula

rods for light and movement in the peripheral retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

bones of orbit

A

sphenoid
zygomatic nose/lacrimal bone
maxilla

medial and inferior bones are most vulnerable to #/infection
optic foramen allows entry of the optic nerve and ophthalmic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

rectus muscles arise from..

nerves inervated by…

A

arise from orbital apex
medial - 3rd
lateral - 6th
superior and inferior - oculomotor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

superior and inferior oblique

A

superior - 4th nerve

inferior oculomotor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

topical mydriatics

A

antimuscarinics tropicamide, atropine, cyclopentolate - inhibit parasympathetic
phenylephrine - sympathetic (agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

red eye history

A

glaucoma, hypermetropai
contact lens, trauma
itching (infective), pain, photophobia (iritis)
discharge - watery (viral) or purulent
unilateral or bilateral
ecent disease e.g. herpes, URTI, sarcoidosis,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

visual loss history

A

sudden and profound - arteriol
recurrent - embolic
?raised ICP
distortion (macular disease), central vision loss (macular)
progression from periphery to centra (retinal detachment, retinal artery embolism, migraine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

diplopia history

A

in which direction - side to side (6th)
intermittent - MG, dysthyroid
any trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

stabismus

A

misalignment of the eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

acne rosacea can cause…

A

rosacea keratoconjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

red desaturation in…

A

optic neuritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is a hess chart used

A

by orthoptists, it is a graphical representation of eye movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

visual field testing

A

humfreys visual field, this is called perimetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when is US used

A

for chorioidal tumours, to exclude retinal detachment/viterous haemorrhage when there is a dense cataract or an obscured view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is keratometry

A

measuring the shape of the cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

amsler chart/grid

A

used for measuring macular degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

fundus flourescein angiography

A

hypofluorescence shows ischaemia - dark

hyperfluorescence shows leakage - bright

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

optical coherence tomography

A

anatomical detail to macula oedema, macular holes, choroidal neovascular membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

uvea

A

iris, ciliary body, choriod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

chalazion

A

blockage of the meibomian glands causing chronic inflammatory change, warm compresses for 15minutes 4x a day, may need injected steroids or surgical incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

investigation of intraocular infection

A

endophthalmitis, can do a AC tap for testing aqueous humour or a viterous biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

prostaglandin analogues

A

treatment of glaucoma, increase aqueous outflow via the uvoscleral route

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

reduce aquous secretion by direct action on the ciliary body

A

beta blockers (timolol), alpha2 stimulants (brimonide), carbonic anhydrase inhibitors (acetazolamide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

muscarinic stimulants

A

increases aqueous outflow via trabecular meshwork

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ranbizumab

A

anti VEGF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

topical local anaesthetic

A

oxybuprocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

mebomian gland dysfunction

A

associated with seborrhoeic dermatitis and acne rosacea. Causes inflammation of the eye and evaporative dry eye disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

stye

A

external hordeolum = bacterial eyelash folliculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

internal hordeolum

A

acute meibomian gland dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

causes of ptosis

A

ageing, MG (ab to acetylocholine receptors), 3rd nerve palsy (DM, CVA, aneurysm), Horners (disruption to sympathetic chain), enophthalmos secondary to trauma, mitochondrial myopathies, trauma to levator muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

treatment of myasthenia gravis

A

cholinesterase inhibitors which increase availability of acetylcholine, immunosuppresants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

cicatricial scarring

A

scarring of the conjuctiva, can be caused by trachoma, alkali burns, steven johnsons
causes entropion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

keratoconjunctivitis sicca

A

deficiency of the aqeous component of the tear film, pure KS due to only lacrimal gland, KS can be a part of sjogrens which involves other glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

xerophthalmia

A

absence of mucin in tear film causing dryness of eye caused by scarring or vit A deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

dacrocystitis

A

infection of the lacrimal sac causing swelling at the medial canthus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

thyroid eye disease treatment

A

caused by humoural and cell mediated autoimmune reaction to orbital antigens, has a 2-3 acute phase where symptoms can be intermittent followed by a stable chronic phase, manage with prisms, lubrication, radiotherapy, systemic immunosuppression, surgical orbital decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

paediatric tumours

A

capillary haemangiomas, optic nerve gliomas, retinoblastoma, dermoid cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

chemosis

A

conjunctival swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

erythema multiforme major

A

steven johnstons syndrome, causes target like lesions, can affect conjunctiva causing bullae and necrosis leading to scarring
young adults, can be idiopathic, caused by drugs such as sulphonamides, caused by infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

ocular cicatricial pemphigoid

A

chronic relapsing/remitting condition of the conjunctiva causing scarring.
redness, grittiness and watering of the eye, contraction

50
Q

herpes simplex virus

A

primary: ulcer, blepharoconjunctivitis
secondary: anterior uveitis, virus reactivated along nerve, can cause dendritic ulcer

51
Q

varicella zoster virus (shingles)

A

herpes zoster ophthalmicus in 10% of shingles, can cause conjunctiitis and rarely an ulcer, can cuase keratitis and anterior uveitis
post herpetic neuralgia

52
Q

adenovirus conjunctivitis

A

can cause keratitis with white opacities causing blurring of vision

53
Q

hypophyon

A

suggesting of endophthalmitis, treat with a quinolone such as vancomycin

54
Q

how does rheumatoid arthritis causes corneal melting

A

secondary sjogrens/keratoconjunctivitis sicca causing decreased aqeous content of tear film which leads to dry eyes and erosion of corneal epithelium

55
Q

keratoconus

A

disorder of the shape of the cornea leading to a cone like protusion, it has a gradual onset, first noted with visual deterioration and proved with computed corneal topography, can be fixed with riboflavin UVA cross linking or corneal transplant

56
Q

pterygium

A

can cause astigmatism and encroach visual axis, surgical removal with repair using patch of patients own conjunctiva

57
Q

band keratopathy

A

corneal deposition in subepithelium in the interpalpebral region

58
Q

glaucoma findings

A

optic disc cupping, visual field loss, raised intraocular pressure
cup:disc ration of >0.6
Arcuate scotoma

59
Q

primary open angle glaucoma

A

most common type 1/3, does not present with symptoms until central vision is affected

60
Q

gonioscope

A

to measure angle of AC

61
Q

treatment of glaucoma

A

decrease aqueous humour formation: drops such as beta blockers, lasers to ciliary body
increased aqueous outflow: drops such as prostaglandin analogues for uvoscleral or muscarinic antagonists (pilocarpine), can also laser iridiotomy if closed angle or into TM, can use trabeculoplasty

62
Q

side effects of prostaglandin analgues

A

increased iris pigmentation, increased eyelash length, red eye

63
Q

angle closure glaucoma

A

present with pain, nausea, loss of vision (due to corneal oedema, also causes loss of red reflex), halos, oval non reactive pupil . more likely in hypermetropic individuals and following mydriatics

64
Q

management of angle closure glaucoma

A

lie flat
Reverse pupil block with pilocarpine (miotic, cholinergic)
oral acetozolamide
analgesia/antiemetics
laser iriotomy
long term prostaglandin analogues and surveillance

65
Q

causes of secondary glaucoma

A 
long term topical steroids
chronic uveitis
inflammation
pseudoexfoliation (deposition of proteins in TM)
lens abnormalities
aphakia
66
Q

non pharmacological treatment of glaucoma

A

trabeculectomy with mitogen c
laser to the ciliary body
tube drainage

67
Q

buphthalmos

A

enlarged eye in child, can occur in glaucoma in children

68
Q

anterior uveitis

A

pain, redness, photophobia, watering, blurred vision

signs: miosis, keratic precipitates, inflammatory cells on slit lamp

69
Q

causes of anterior uveitis/iritis

A 
Ocular:
viral HSV/VZV
Trauma
Sympathetic ophthalmitis
Fuchs heterochromic cyclitis
Systemic:
Seronegative spondyloarthropathies
anklyosing spondylitis
reactive arthritis
Psoriatic arthritis
crohns/UC
sarcoidosis
juvenile idiopathic arthritis
Behcets
syphilis
TB
70
Q

posterior uveitis

A

inflammation of the choriod, can cause floaters, decreased vision, inflammatory cells in the vitreous, cotton wool spots, macular oedema, optic disc swelling
Causes of PU: toxoplasmosis, sarcoidosis, syphillis, TB, CMV, candidiasis, behcets, HSV, VZV, sympathetic ophthalmitis

71
Q

CMV retinitis

A

immunosuppresed individuals, presents with painless visual loss, pizza appearance

72
Q

sarcoidosis in the eye

A

Intraocular: anterior and posterior uveitis
Extraocular: conjunctivitis, keratitis secondary to keratoconjunctivitis sicca
Chronic: leads to glaucoma, cataract etc
check ACE, CXR and lysozyme levels
treat with topical steroids can use periocular depot steroids and intravitreal injections
vitreous cells, venous sheathing and perivenous exudates

73
Q

systemic causes of cataract vs ocular causes

A

Systemic:
DM, ageing, corticosteroids, galactosaemia, hypocalcaemia
Ocular:
Trauma, UV light, topical steroids, recurrent uveitis, radiation, high myopia

74
Q

how does diabetes cause retinopathy

A

poor glycaemic control causes glycosylation of tissues, small vessl occlusion leads to ischaemia and then neovascularisation more like to cause haemorrhage. also increased permiability of blood retinal barrier

75
Q

exudates vs cotton wool spots

A

exudates are lipid deposits, cotton wool spots are areas of ischaemia

76
Q

background diabetic retinopathy

A

microaneurysms
blot haemorrhages
exudates

77
Q

preproliferative diabetic retinopathy

A

cotton wall spots

venous bleeding

78
Q

proliferative diabetic retinopathy

A

new vessels at disc and new vessels elsewhere

79
Q

rubeosis

A

neovascularisation of the iris

80
Q

sudden painless loss of vision

A 
retinal detachment
retinal vein occlusion
vitreous haemorrhage
retinal artery occlusion
macular haemorrhage
81
Q

causes of retinal vascular occlusion

A

DM, HTN, IHD, Emboli (vegetations, calcific, cholesterol), clotting disorders (smoking, pregnant, COCP), vessel wall (sarcoidosis, SLE, polarteritis nodosa)

82
Q

hypertensive retinopathy

A

cotton wool spots, flame haemorrhages, vessel occlusions, macro and microaneurysms, exudates, optic disc swelling

83
Q

retinopathy of prematurity

A

normal retinal vascularisation is not complete until term, increased risk with high O2 can lead to retinal detachment characteristic purse string, screening is done in babies <31 weeks

84
Q

sickle cell retinopathy

A

due to occlusion and ischaemia, may have proliferative retinopathy in sea fan distribution, sunbutest scars and salmon patches

85
Q

age related macular degeneration

A

most common cause of blind registration in western world, deposition of drusen between the retinal pigment epithelium and the photoreceptors, occurs at the macula causing central visual loss
Wet causes profound central visual loss causing haemorrhages, drusen, RPE atrophy and can later develop a large scar
Ix with fundus flourescein angiography
manage with antioxidents, low vision aids, fi wet then antiVEGF

86
Q

cystoid macular oedema

A

cysts in the macula, due to fluid within retina

87
Q

retinitis pigmentosa

A

night blindness, decreased peripheral vision, glare, bone spicule pigment, waxy optic disc
take FHx, genetic counselling, low vision aids, optimise cataract if present, known associated genetic metabolic conditions

88
Q

choroideraemia

A

progressive night blindness then peripheral loss then central loss in young males. it is a x linked recessive retinal disorder

89
Q

rhegmatogenous

A

when there is a tear or retinal break - leads to retinal detachment rfs: high myopia, FHx, cataract surgery, ocular trauma

90
Q

non rhegmatogenous retinal detachment causes

A

tractional e.g. advanced DM or exudative e.g. tumout

posterior vitreous detachment causes flashes and floaters

91
Q

surgical management of retinal detachment

A

vitrectomy to remove traction
indenting of wall to remove traction
drainage of subretinal fluid
laser to reattach vitreous

92
Q

optic nerve disease causes

A

eye: uveitis, glaucoma, retinal vein occlusion, retinal ischaemia
nerve: gliomas, neuritis
Tumours: meningiomas, gliomas, pituitary gland compression

93
Q

consequences of papilloedema

A

true papilloedema is a swollen optic nerve head due to raised intracranial pressure, this can lead to optic disc swellin and optic atrophy causing a central scotoma. raised ICP can also cause a 6th nerve palsy

94
Q

optic neuritis presentation

A

rapidly progressive loss of vision, worse with eye movement, central scotoma, RAPD
vision often improves within a few weeks, 60% have MS in 5yrs

95
Q

pseudopapilloedema

A

swollen optic disc not due to raised ICP, can be caused by hypermetropisa

96
Q

retinoblastoma

A

usually rpesents around 18 months due to loss of red reflex, occurs in approximately 1in20,000. investigate with CT/MRI imaging and staging imagine for ?mets, bloods for tumour markers. large tumours require enucleation, can use radiotherapy as an adjunct, if confined to the orbit has a 90% 3yr survival. 10% develop a second primary tumour often a sarcoma

97
Q

neurofibromatosis

A

NF1 - peripheral
NF2 - central
axillary freckling, cafe au lait spots, bone dysplasia, fibroma molluscum, lisch nodules in iris, may have proptosis secondary to tumour
AD inheritance

98
Q

von hippel lindau syndrome

A

haemangiomas, can occur in retinal capillaries, treated with freezing or laser
also liver and kidney cysts

99
Q

stuge weber syndrome

A

cutaneous facial haemangiomas - port wine stain in the trigeminal nerve distribution can also have haemangiomas in the outer sclera
associated with LD and epilepsy

100
Q

tuberose sclerosis

A

ocular lesions in 50%, most commonly astrocytomas

associated with shagreen patches (weird bumpy things), renal cysts

101
Q

causes of childhood cataract

A

1/3 congenital, downs, rubella, metabolic, toxoplasmosis

102
Q

colobomatous iris

A

keyhole iris due to abnormal foetal development

103
Q

assessment of ambylopia

A 
age of onset
?cause: trauma, maternal history/infection, FHx, neurological disease
acuity
cover test
retinal assessment
orthoptic management/patching
can have surgery to extra ocular muscles
104
Q

adult causes of strabismus

A

trauma, nerve palsy (ischaemic, intracranial, nerve disorders, neoplastic), MG, myopathy
in adults strabismus will cause diplopia

105
Q

vertical upgaze pals

A

parkinsons progressive supranuclear palsyu

106
Q

internuclear ophthalmoplegia

A

disruption of medial longitudinal fasciculatus causes failure of convergent gaze due to failure of adduction on affected side and nystagmus of abducting eye

107
Q

pilocarpine

A

constricts the pupil, it is a cholinergic agent

108
Q

third nerve palsy (oculomotor)

A

down and out, unable to react to light and accommodation, failure of medial, superior and inferior rectus muscles
causes: DM, trauma, aneurysm

109
Q

orbital wall fractures

A

thinnest at inferior and medial walls, may see a tear drop sign on facial xray from herniation of soft tissue into the maxillary sinus

110
Q

4th nerve palsy (trochlear)

A

common with head injury, worse on looking up or down

111
Q

6th nerve palsy (abducens)

A

inervated lateral rectus, failure of abduction

112
Q

corneal abrasian management

A

flourescein examination, chloramphenicol drops, can give cyclophenolate for pain if needed, occlusive padding

113
Q

hyphema

A

bleeding into AC, suggests significant trauma, bed rest to avoid secondary haemorrhage

114
Q

ophthalmia neonatorum

A

conjunctivitis in first postnatal month, notifiable disease, most commonly chlamydia, herpes, gonorrhoea but can be s aureus, time of onset can give clues to which bug

115
Q

scleritis

A

very painful (unlike episcleritis which is painless), full thickness of sclera, around anterior chamber, associated with corneal thinning,
causes: herpes, RA, SLE,
treat with topical/systemic steroids, NSAIDs, immunosuppresants if severe

116
Q

astigmatism

A

imperfection in the curvature of the eyeball causing change in refractive index across different meridians

117
Q

photorefractive keratectomy

A

laser eye treatment, complications include corneal haze, regression and under/over correction

118
Q

ranges for low vision and blindness

A

low vision
6/18 - 3/60
blind
<3/60

119
Q

onchocerciasis

A

parasitic infection transmitted by black flies, has a 1 year incubation period and can cause papular rash with pruritis . in the eyes there can be depigmentation, conjunctivits and keratitis, corneal opacification. treated with ivermectin, eosinophilia will be present, prevention is important

120
Q

leprosy

A

skin changes, atrophy of peripheries, nerve palsys, can cause corneal exposure, dry eyes, anaesthesia of the eyes, cataract and glaucoma. treated with dapsone and rifampicin, active blinking encouraged

121
Q

driving

A

as long as you are between 6/9-6/12 and no visual field defect

122
Q

complications of cataracts

A

perioperative - posterior capsule rupture, expulsive haemorrhage
postoperative - endophaltmitis, opacification of PC (treat with a laser capsulotomy), astigmatism, retinal detachment, macular oedema

OST interviews (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions