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Ophthamology > Ophthalmic Urgencies and Emergencies > Flashcards

Ophthalmic Urgencies and Emergencies Flashcards

1
Q

Acute, painful vision loss in one or both eyes

Typically comes on suddenly

A

Optic Neuritis

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2
Q

This ophthalmic condition may be initial manifestation of
multiple sclerosis

A

Optic Neuritis

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3
Q

What disorder is described below?

Acute visual loss or diplopia

Headache

Scalp tenderness (temporal artery area)

Jaw claudication

A

Giant Cell Arteritis

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4
Q

What is the definitive diagnosis of Giant Cell Arteritis?

A

Temporal artery biopsy

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5
Q

Giant Cell Arteritis is associated with other disorder?

A

Associated with polymyalgia rheumatica

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6
Q

What disorder is described below?

Young adults with subacute monocular loss of vision with pain on movement of eye

Associated with MS

Consider compressive optic neuropathy

A

Retrobulbar Optic Neuritis

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7
Q

What are the other uncommon causes of inflammatory optic nerve
disease?

A

Demyelinating diseases
Viral infections
Systemic infections
Vitamin deficiencies
Toxic
Hereditary
Vascular diseases
Neoplastic diseases

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8
Q

This condition tsually has infectious etiology

A

Corneal Abrasion

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9
Q

In a corneal abrasion, the corneal epithelium tends to
regenerate rapidly, and healing is usually complete within what time frame?

A

24-48 hours

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10
Q

When should you patch a contact lens abrasion?

A

NEVER

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11
Q

Why should you NEVER patch contact lens abrasions?

A

Results in high frequency of severe bacterial infections that may be blinding

Highly susceptible to Pseudomonas (anaerobic)

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12
Q

Why should you NOT USE Topical anesthetics?

A

Inhibit corneal growth and healing of the corneal epithelium

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13
Q

Contact lens abrasions are highly susceptible to infection of what organism?

A

Pseudomonas (anaerobic)

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14
Q

What disorder is described below?

True ocular emergency!

Requires immediate irrigation with nearest source of water

Briefly measure acuity ASAP

A

Chemical Injury

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15
Q

Which type of chemical injury is more dangerous to the eye?

A

alkali burn

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16
Q

Which chemical injury management is described below?

Immediate irrigation

Emergency referral to an ophthalmologist

Have patient go via ambulance to ER to continue to irrigate the eye continuously

A

Alkali

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17
Q

Which chemical injury management is described below?

Immediate irrigation

Manage as corneal abrasion

Prompt referral (EMS not required, patient/buddy can drive them to ER)

A

Acid

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18
Q

What are the only two organisms that can penetrate the intact epithelium to cause an infection?

A

Neisseria and Pseudomonas

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19
Q

This type of corneal ulcer is dendritic – like a tree branch

A

Herpes Simplex Ulcer

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20
Q

What disorder is described below?

True Ocular Emergency!

Vision can be lost in less than a day

Second most common cause of irreversible blindness

A

Acute Angle-Closure Glaucoma

21
Q

What is the second most common cause of irreversible blindness?

A

Acute Angle-Closure Glaucoma

22
Q

Describe the pathophysiology of acute angle-closure glaucoma

A

During ACG, the iris and lens block the flow of fluid into the anterior
chamber (fluid cannot drain)

The intraocular pressure rises and the eye becomes very painful and
inflamed

The eye will feel like a tennis ball – won’t really be able to compress
at all

23
Q

What disorder is described below?

Bleeding inside the eye

A

Hyphema

24
Q

What are the two most common causes of a hyphema?

A

Blunt trauma and diabetes

25
Q

What is a complication of a hyphema?

A

If bleeds long enough, can fill up the eye and lead to an acute
glaucoma attack

26
Q

What disorder is described below?

Bilateral swelling of the optic discs from increased cerebral pressure

Pushes optic nerve into eye and get bilateral swelling

A

Papilledema

27
Q

What disorder is described below?

“curtain” spreading across field of vision or sudden onset of visual
loss in one eye

NO pain or redness

Occurs over hours to days

A

Retinal Detachment

28
Q

What are the two most common predisposing factors for retinal detachment?

A

Nearsightedness and cataract

29
Q

In retinal detachment, once this part is detached vison will never be the same.

A

macula

30
Q

What disorder is described below?

Sudden, persistent catastrophic monocular visual loss that is painless and occurs over a period of seconds

A stroke of the retina

May pass (amaurosis fugax) or may be permanent

Ocular emergency!

A

Central Retinal Artery Occlusion

31
Q

“Cherry red spot” and amaurosis fugax should make you think of what?

A

Central Retinal Artery Occlusion

32
Q

What are the two types of central retinal artery occlusion?

A

Amaurosis Fugax

Permanent

33
Q

What type of central retinal artery occlusion is described below?

Temporary arterial obstruction

Sudden, transient, painless visual loss

Temporary, will clear spontaneously

A

Amaurosis Fugax

34
Q

What type of central retinal artery occlusion is described below?

Will not resolve

Urgent referral

A

Permanent

35
Q

What condition must be referred to ophthalmologist and also
cardiologist and vascular surgeon? Any why?

A

Amaurosis Fugax

in case it is a harbinger of a future ominous event

36
Q

List some causes of Amaurosis Fugax?

A

Retinal emboli
GCA
APL syndrome
Occlusive CAD
Raised ICP

37
Q

What disorder is described below?

Painless vision loss, most often noticed in the mornings after rising (happens usually at night, unlike the other)

Tends to not occur as abruptly or dramatically as the other (some patients may not even notice it at all)

A

Central Retinal Vein Occlusion

38
Q

In central retinal vein occlusion, what two groups are most commonly affected?

A

Diabetics and/or smokers

39
Q

In central retinal vein occlusion, types of patients should you look out for?

A

Older patients with CV disease and HTN
Diabetics
Smokers

40
Q

On examination, you may see a “blood and thunder” fundus - retina appearance

A

Central Retinal Vein Occlusion

41
Q

What condition is described below?

The very thin orbital floor may rupture into the maxillary sinus from blunt impact to the orbit

A

Blowout Fracture

42
Q

Why are we so concerned about a blowout fracture?

A

Orbital contents, including the inferior rectus and inferior oblique
muscles may become trapped, restricting vertical eye movement and
causing double vision

43
Q

What condition is described below?

Defined as infection of orbital contents

Typically starts from a skin infection

Optic emergency

A

Orbital Cellulitis

44
Q

Why are we so concerned about orbital cellulitis?

A

Dangerous because it can easily make its way into the brain

45
Q

What ages do we commonly see cases of orbital cellulitis?

A

Typically occurs in children (usually 10 years old or less)

46
Q

What are the common organisms seen in orbital cellulitis?

A

Staphylococcus aureus

Streptococcus species

Haemophilus influenzae

47
Q

What are the complications of orbital cellulitis?

A

Meningitis

Cavernous sinus thrombosis

48
Q

How can you tell apart orbital cellulitis from eyelid edema?

A

Eyelid edema - will have normal visual acuity, pupils, and motility; and no proptosis

Orbital cellulitis - Fever, eye motility may be impaired and painful, proptosis: (globe displaced forward, decreased eye movement), If optic nerve involvement: decreased vision, afferent pupillary defect, disc edema

49
Q

What condition is described below?

Life threatening complication of infections of face, sinuses, middle
ear, teeth

A

Cavernous sinus thrombosis

Ophthamology (6 decks)

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