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ENT/Ophthalmology > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Which 4 muscles of the eye does the oculomotor nerve supply?

A

Superior rectus
Medial rectus
Inferior rectus
Inferior oblique

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2
Q

Which eye muscle does the trochlear nerve supply?

A

Superior oblique

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3
Q

Which eye muscle does the abducens nerve supply?

A

Lateral rectus

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4
Q

Define cataracts

A

Clouding of the lens which develops gradually with age

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5
Q

How does cataracts affect vision?

A

Blurred vision for distance and near

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6
Q

Give 4 risk factors for cataracts

A
  • Age
  • Diabetes
  • Steroid use
  • Congenital
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7
Q

How does cataracts present?

A
  • Gradual painless blurred vision

- Glare at night

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8
Q

How will a cataract appear on examination?

A

Yellow/brown colour

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9
Q

When is cataract surgery carried out?

A

Only when patient is symptomatic and it affects their life

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10
Q

Give 3 post-op cataract surgery complications

A

o Uveitis
o Cystoid macular oedema
o Retinal detachment

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11
Q

Define glaucoma

A

Progressive, degenerative optic neuropathy

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12
Q

What is the difference between primary and secondary glaucoma?

A

Primary: no discernible cause

Secondary: a known causative factor

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13
Q

What is the general mechanism of pathology of glaucoma?

A

High pressure and damage to the optic nerve

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14
Q

Give 3 treatment options for glaucoma

A
  • Drops
  • Laser treatment
  • Surgery
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15
Q

Give 4 important points when taking a loss of vision history

A
  • Pain?
  • Uni or bilateral?
  • Sudden/gradual?
  • complete/partial?
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16
Q

Give 4 causes of sudden vision loss

A
  • Retinal detachment
  • Wet ARMD
  • Retinal artery occlusion
  • Optic neuritis
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17
Q

Give 4 causes of gradual vision loss

A
  • Cataract
  • Glaucoma
  • Dry ARMD
  • Diabetes
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18
Q

Give 4 risks for ARMD

A
  • Age
  • Smoking
  • Fx
  • Female
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19
Q

Define dry ARMD

A

Progressive atrophy with loss of photoreceptors and development of drusen and atrophy

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20
Q

What is the treatment of dry ARMD?

A

Nothing

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21
Q

Define wet ARMD

A

Neovascular growth of capillaries from choroid into subretinal space causing leakage and bleeding

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22
Q

What is the treatment of wet ARMD?

A

Intravitreal anti-VEGF injection

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23
Q

How does retinal detachment present?

A

Sudden vision loss like a curtain coming down

Unilateral and painless

Flashes and floaters

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24
Q

Give 3 risks for retinal detachment

A
  • Age
  • Trauma
  • Previous cataract surgery
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25
Q

Give 3 treatment options for retinal detachment

A
  • Vitrectomy
  • Laser/cryotherapy to seal the hole
  • Gas/oil to tamponade the break
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26
Q

What is usually the cause of retinal artery occlusion?

A

Embolic

27
Q

What are the signs of retinal artery occlusion?

A

Pale/swollen retina

Cherry red spot

28
Q

Which condition is retinal artery occlusion associated with?

A

Giant cell arteritis

29
Q

What is usually the cause of retinal vein occlusion?

A

Atherosclerosis

30
Q

What should also be done in terms of follow-up for patients with retinal artery occlusion?

A

Referral to TIA clinic as usually embolic cause

31
Q

Give 4 signs of retinal vein occlusion

A

o Torturous vessels
o Disc swelling
o “flame” haemorrhages
o Cotton wool spots

32
Q

How does optic neuritis present?

A

Gradual onset reduced vision over 2 weeks

Pain on eye movement

33
Q

Which drug hastens recovery of optic neuritis but doesn’t change outcome?

A

IV Methylprednisolone

34
Q

Define anterior ischaemic optic neuropathy

A

Interruption of blood supply to optic nerve head

35
Q

Give 4 ways in which anterior ischaemic optic neuropathy may present

A

o Reduced vision
o Reduced colour vision
o Visual field defect
o Disc swelling

36
Q

How is anterior ischaemic optic neuropathy managed?

A

Urgently with IV methylprednisolone

37
Q

Give 3 traumatic causes of red eye

A
  • Abrasion
  • Foreign body
  • Chemical injury
38
Q

Give 3 non-traumatic causes of red eye

A
  • Conjunctivitis
  • Corneal Ulcer
  • Iritis
39
Q

Give 3 causes of conjunctivitis

A
  • Bacterial Infection
  • Chlamydia
  • Allergy
40
Q

What is papillae and how does it appear on examination?

A

A vascular response, cobblestone arrangement of flattened nodules with a central vascular core

41
Q

Define chemosis

A

Swelling/oedema of conjunctiva

42
Q

What does gonococcal infection do to the eye and how is it treated?

A

Severe purulent discharge

Tx: Topical and systemic ABX, GUM referral

43
Q

What affect does chlamydia have on the eye and what is the treatment?

A

Mucopurulent discharge and oedema

Tx: topical and systemic ABX, GUM referral

44
Q

Give 3 risks for a corneal ulcer

A

Trauma
Contact lens user
Dry eyes

45
Q

Give 4 clinical features of a corneal ulcer

A
  • Pain
  • Foreign body sensation
  • Redness
  • Photophobia
46
Q

Which investigation can be used for a corneal ulcer?

A

Corneal scrape if ulcer >1mm

47
Q

What is the management of a corneal ulcer?

A

Topical Ganciclovir ointment

Broad spectrum ABX before cultures back

48
Q

Give 2 features and the treatment of scleritis

A

Acute red eye
Pain on eye movement

Tx: Oral steroid
Investigate for underlying vasculitis

49
Q

What is Uveitis?

A

Inflammation of the uveal tract (iris, ciliary body and choroid)

50
Q

Give 4 causes of uveitis

A
  • Idiopathic
  • Trauma
  • Infection
  • RA
51
Q

In general, what is the treatment of uveitis?

A

Steroids

52
Q

Give 2 risk factors for angle closure glaucoma

A

Older age

Long-sighted

53
Q

Give 3 symptoms of angle closure glaucoma

A
  • Severe pain
  • Headache
  • Photophobia
54
Q

Give 3 management options while waiting for an urgent ENT review in angle closure glaucoma

A

IV mannitol
Topical steroid
Topical pressure lowering drops

55
Q

Define hyphaema

A

Blood in the anterior chamber of the eye

56
Q

Define Age-related macular degeneration

A

Atrophy of retinal pigment epithelium or growth of choroidal vessels due to atrophy

57
Q

What will patient’s with ARMD describe seeing?

A

Loss of central vision and kinks in straight lines

58
Q

What causes amblyopia (lazy eye)?

A

Halting of development of visual axis between eye and brain

59
Q

Give 3 treatment options for amblyopia

A
  • Glasses
  • Patch over good eye
  • Atropine penalization (into good eye which blurs vision of good eye forcing them to use bad eye)
60
Q

What is the treatment for orbital cellulitis?

A

Immediate ABX
CT for abscesses
ENT input

61
Q

Define strabismus

A

Incorrect positioning of the eye due to muscle positioning with no CN involvement

62
Q

Define retinopathy of prematurity

A

<32 weeks or LBW, retina doesn’t fully develop and areas of ischaemia develop, new blood vessels try to grow which causes bleeds and scarring

63
Q

Give 2 management options for retinopathy of prematurity

A
  • Anti VEGF injections

- Surgery

64
Q

Give 2 causes of an absent red reflex at a neonatal check

A
  • Retinoblastoma

- Congenital cataracts

ENT/Ophthalmology (2 decks)

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