Brainscape's Knowledge GenomeTM

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


See full index

Opthalmology > ophthalmological conditions > Flashcards

ophthalmological conditions Flashcards

1
Q

what is the sign when blood can be seen forming a layer in the anterior chamber of the eye?

A

hyphaema

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

if a subconjunctival haemorrhage is recurrent or there is bleeding/bruising elsewhere what should be measured?

A

blood pressure and clotting

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

what is mydriasis?

A

a fixed, mid-dilated pupil

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

what is the initial management of acute angle glaucoma?

A

IV acetazolamide, topical steroids, pilocarpine drops, referral for laser iridotomy

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

what are four causes of optic disc swelling?

A

papilloedema, severely raised blood pressure, optic neuritis, anterior ischaemic optic neuropathy (like GCA)

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

although papilloedema does not usually affect visual acuities but what visual disturbances could a patient get?

A

transient visual obscurations (transient blurring of vision lasting a few seconds)

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

what is the pathophysiology of diabetic retinopathy?

A

chronic hyperglycaemia causing changes to retinal capillaries leading to capillary occlusion and leakage. this then causes retinal ischaemia and formation of new fragile vessels

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

what are some symptoms of diabetic retinopathy?

A

floaters/dark spots in vision, blurred vision, difficulty seeing at night and sudden loss of vision

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

what are causes of hypopyon?

A

bacterial keratitis, anterior uveitis and endophthalmitis

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

do all people with open angle glaucoma have increased intraocular pressure?

A

no

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

at which pupil position is the anterior chamber angle at its narrowest?

A

mid dilated

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

what is normal range of IOP?

A

10-21mmHg

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

what are risk factors foracut angle closure glaucoma?

A

increasing age,female, east asian ethnicity, hyperopia, pupil dilators (topical and systemic)

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

where is the anterior chamber?

A

between the cornea and iris

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

where is the posterior chamber?

A

between iris and lens

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

what symptoms does acute glaucoma present with?

A

red painful eye with a semi-dilated fixed pupil, with associated vision loss, halos around lights, hazy cornea, firm on palpation, headache and N+V

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

what investigations are done for suspected acute glaucoma?

A

tonometry, gonioscopy (allows asessment of anterior chamber and drainage system), opthalmoscopy/slit lamp assessment

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

who is able to receive free eye tests for glaucoma?

A

over 60s every 2 years, over 70s every year
over 40 with affected first degree relative every year

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

what is the initial management of acute glaucoma?

A

IV acetazolamide (carbonic anhydrase inhibiitor)
topical beta blocker like timolol
pupil constrictor like pilocarpine
topical sympathomimetics like brimonidine
analgesia and antiemetics may be needed

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

what is the definitive management of acute glaucoma?

A

laser peripheral iridotomy- this allows drainage from posterior to anterior chamber stopping pressure build up behind the iris pushing it forward

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

why is definitive treatment for acute glaucoma often done bilaterally even though it is mostly a unilateral presentation?

A

40-80% of patients will have an episode in the other eye in the following 5-10 years

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

what is blepharitis?

A

inflammation of the eyelid margins

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

what medications can increase risk of acute glaucoma?

A

adrenergic medications, anticholinergic and tricyclic antidepressants

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

what can be done for a patient with acute angle-closure glaucoma while waiting for an ambulance?

A

lay them on their back, oral acetazolamide, pilocarpine drops, analgesia and antiemetic

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

what are common symptoms of blepharitis?

A

gritty or burning sensation in both eyes, crusted eyelashes, red eyes, and swollen or greasy eyelids

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

what is the management of blepharitis?

A

avoid eye makeup or contact lenses
gentle cleaning of eyelid margins with diluted baby shampoo and cotton bud, warm compress and massage
ocular lubricants

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

what age patients are most commonly affected by blepharitis?

A

middle aged- average presentation at 50

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

what are the types of blepharitis?

A

anterior: two predominant types of staphyloccus and seborrhoeic blepharitis (associated with seborrhoiec dermatitis)
posterior: meibomian gland dysfunction

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

what are some clinical signs specific to anterior blepharitis?

A

trichiasis (inturning of eyelashes)
poliosis (eyelash depigmentation)
madarosis (eyelash loss)

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

if there is localised eyelash loss what differential should be considered?

A

sebaceous gland carcinoma

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

what are some specific sign of posterior blepharitis?

A

dilated or obstructed meibmoian glands, telangiectasia, chalazion

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

what is cataracts?

A

opacification of the lens

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

what are the different parts of the lens?

A

the capsule, epithelium, nucleus and cortex

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

what holds the lens in place?

A

suspensory ligaments that are attached to the ciliary body

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

what are some non-age related causes of cataracts?

A

steroid use in the eye, trauma, anterior uveitis, scleritis, radiation, systemic diseases like DM, smoking

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

what are the different types of cataracts?

A

the different types depend on location of lens affected: nuclear, cortical and posterior subcapsular

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

which type of cataracts is caused by corticosteroid use and diabetes?

A

posterior subcapsular

38
Q
A
39
Q

what are the clinical features of cataracts?

A

slowly progressive vision loss, blurred vision, poor night vision, halos around lights, reduction in colour intensity (mainly blues)

40
Q

what is myopic shift’ which can be seen in cataracts?

A

increasing ofacification means the lens cant refract light as well, making a slight improvement in nearsightedness but deterioration in longsightedness

41
Q

what are signs of cataracts?

A

snellens chart shows reduced visual acuity, loss of red reflex, whitish/grey pupil, nystagmus

42
Q

what are the two main techniques for cataracts surgery?

A

phacoemulsification-
standard extracapsular cataract extraction- slightly bigger incision used

43
Q

what is most common cause of central retinal artery occlusion?

A

atherosclerotic disease

44
Q

what are some non atherosclerotic vascular and inflammatory causes of CRAO?

A

vascular: Fabry’s disease, carotid artery dissection, fibromuscular dysplasia (causes narrowing of arterial lumen)
inflammatory: vasculitis like GCA

45
Q

where does the central retinal artery supply?

A

the surface of the optic nerve and inner retina

46
Q

why might some patinets with CRAO have a central area of visual sparing?

A

some individuals have the macula and a small area of the inner retina supplied by the ciliary arteries not the retinal arteries

47
Q

what is prognosis of CRAO?

A

generally poor even if presenting early with main short term complication of visual loss which can be profound

48
Q

what are the symptoms of CRAO?

A

acute, painless, monocular loss of vision

49
Q

what is seen on pupil reactions and fundoscopy?

A

RAPD as blood supply to surface of optic nerve affected
pale retina with a cherry red spot at the fovea which has a thinner surface and shows red coloured choroid below it

50
Q

although diagnosis of CRAO is usually clinical what investigation can be done?

A

fluorescein angiography which shows a slowed flow or filling defect
CRP and ESR to assess for GCA

51
Q

what is the management of CRAO and how quickly should this be started?

A

treatment should be started within 6 hours of presentation
-vigorous ocular massage
-anterior chamber paracentesis, IV acetazolamide/mannitol (change in pressure hopes to dislodge embolus)
-arterial dilators
-intra-arterial thrombolysis (catheter directed delivery of tissue plasminogen activator)
- high dose IV steroid if suspecting GCA

52
Q

what are key differentials for sudden painless loss of vision?

A

retinal detachment, central retinal vein/artery occlusion, vitreous haemorrhage

53
Q

does episcleritis progress to scleritis?

A

no

54
Q

what eye drops can help differentitate between scleritis nd episcleritis?

A

phenylephrine eye drops- causes blanching of episcleral vessels but wont affect scleral vessels

55
Q

management of episcleritis?

A

usually self limiting in 1-2 weeks
simple analgesia for mild pain e.g ibuprofen and
lubricating eye drops

56
Q

what are some red flags that require urgent ophthamological assessment in suspected conjuctivitis?

A

reduced visual acuity, copious purulent discharge, red sticky eye in neonate, marked eye pain headache or nausea, history of trauma or foreign body, infection with herpes virus, contact lens use with corneal symptoms (photophobia, watering)

57
Q

what is the conservative management of uncomplicated conjuctivitis?

A

cool compress, lubricating eye drops, cleaning of eye with sterile water, good hand hygiene and separate towels to others, safety netting advice and do not wear contact lens until condition resolves

58
Q

if a bacterial conjuctivitis is suspected, what can be given alongside conservative management?

A

chloramphenicol drops/ointment
fusidic acid eye drops

59
Q

what can be seen with diabetic retinopathy?

A

damage to vessel walls causing microaneurysms and venous beading
damage to retinal nerve fibres causes cotton wool spots
leaky vessels cause blot haemorrhages and hard exudates
dilated and tortuous capillaries
neovascularisation

60
Q

what is the management of non-proliferative diabetic retinopathy?

A

close monitoring and optimisation of diabetic control

61
Q

what are the management options for proliferative diabetic neuropathy?

A

pan-retinal photocoagulation
intravitreous anti-VEGF injections
surgery e.g vitrectomy in severe cases

62
Q

how can macular oedema be treated in diabetic retinopathy?

A

intravitreal implant containing dexamethasone

63
Q

what are the complications of diabetic retinopathy?

A

vision loss, retinal detachment, vitreous haemorrhage, rubeosis iridis (this can lead to neovascular glaucoma), optic neuropathy, cataracts

64
Q

what are the four stages of hypertensive retinopathy according to the keith-wagner classification?

A

1- mild narrowing of the arterioles
2- focal constriction of blood vessels and AV nicking
3- cotton-wool patches, exudates and blot haemorrhages
4- papilloedema

65
Q

what is the management of hypertensive retinopathy?

A

blood pressure control and managing other vascular risk factors

66
Q

what can cause an abnormal pupil shape?

A

anterior uveitis, tadpole pupil, trauma to sphincter muscles, coloboma, acute glaucoma, rubeosis iridis

67
Q

what is mydriasis?

A

dilated pupil

68
Q

what is miosis?

A

constricted pupil

69
Q

does cocaine constrict or dilate the pupil?

A

dilate

70
Q

does oxybutynin (anticholinergic) constrict or dilate the pupil?

A

dilate

71
Q

does Holmes-Adie syndrome cause a constricted or dilated pupil?

A

dilated

72
Q

does acute angle closure glaucoma cause a constricted or dilated pupil?

A

dilated

73
Q

does horners syndrome cause a constricted or dilated pupil?

A

constricted

74
Q

do cluster headaches cause a constricted or dilated pupil?

A

constricted

75
Q

do opiates cause a constricted or dilated pupil?

A

constricted

76
Q

does nicotine cause a constricted or dilated pupil?

A

constricted

77
Q

does pilocarpine cause a constricted or dilated pupil?

A

constricted

78
Q

does neurosyphillis cause a constricted or dilated pupil?

A

constricted (argyll-robertson pupil)

79
Q

what are different causes of horners syndrome broken into central, pre-ganglionic and post-ganglionic lesions?

A

S- Stroke, MS, Swelling (tumours), Syringomyelia
T- Tumour, Trauma, Thyroidectomy, Top rib (cervical rib)
C- Carotid dissection, Carotid aneurysm, Cluster headache, Cavernous sinus thrombosis

80
Q

what is Holmes-Adie pupil?

A

dilated, slow to react to light, slow to constrict but responsive to accommodation.
caused by damage to post-ganglionic parasympathetic fibres

81
Q

what is Holmes-adie syndrome?

A

holmes-adie pupil with absent ankle and knee reflexes

82
Q

what is an Argyll-Robertson pupil?

A

constricted, accommodates but does not react to light
known as prostitues pupil as associated with neurosyphillis and ‘it accomodates but does not react’

83
Q

how do patients with corneal abrasions present?

A

history of trauma followed by a painful, red, watery eye with photophobia, foreign body sensation and blurred vision

84
Q

what can be used to see corneal abrasions?

A

fluoroscein stain will collect in the abrasions making them yellow, these are more visible under cobalt blue light

85
Q

what are the main symptoms of posterior vitreous detachment?

A

floaters, flashing lights and blurred vision

86
Q

what is a key difference in posterior vitreous detachment compared to retinal detachment?

A

there is no vision loss with vitreous detachment

87
Q

what is retinitis pigmentosa?

A

a gentic condition affected the rod cells in the retina and causing night blindness and peripheral vision loss

88
Q

how will retinitis pigmentosa appear on fundoscopy?

A

bone-spicule pigmentation around the mid-peripheral area of the retina

89
Q

what is most common benign orbital tumour?

A

cavernous venous malformation

90
Q

what are signs of IIH seen on MRI?

A

prominence of CSF around optic nerves
venous sinus narrowing
flattened sella turcica

91
Q
A

Opthalmology (2 decks)

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