Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Med school finals > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Recall the features of optic atrophy

A

Mnemonic: Optic Atrophy Can Reduce Sight
Optic disc pale
Acuity reduced
Colour vision reduced (especially red)
RAPD (relative afferent pupil defect)
Scomata centrally

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

What are the 2 most common causes of optic atrophy?

A

MS
Glaucoma

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

Recall 4 red flags when assessing red eyes

A

Photophobia
Poor vision
Fluorescein staining reveals foreign material
Abnormal pupil

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

Is photophobia more likely to be present in acute glaucoma or anterior uveitis?

A

Anterior uveitis

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

What are the typical signs and symptoms of acute closed angle glaucoma?

A

Reduced acuity
Nausea and Vomiting
Haloes around lights
Severe pain

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

What may be seen on examination in acute closed angle glaucoma?

A

Cloudy/red cornea
Fixed and dilated pupil

Photo source: https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/acute-angle-closure.html

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

What are some risk factors for acute closed angle glaucoma?

A

Hypermetropia is the key one
Female
Family history
Old age

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

What sort of examination can examine fluid drainage from the eye?

A

Gonioscopy with slit lamp

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

What are the general principles of management of acute closed angle glaucoma?

A

Refer
Medicate
Laser peripheral iridiotomy
Lens extraction

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

What drugs can be used to treat acute closed angle glaucoma?

A

IV:
Carobonic anhydrase inhibitor (reduces aqueous formation)
Top:
Carobonic anhydrase inhibitor
Beta blocker (also reduces aqueous formation)
Alpha-2 agonist (miosis opens blockage)

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

How does anterior uveitis usually present?

A

Acute pain, photophobia, reduced acuity, hypopyon

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

How does the eye appear in anterior uveitis?

A

Irregular and small pupil, hypopyon

Photo source: https://www.researchgate.net/figure/Hypopyon-and-nasal-synechiae-in-the-left-eye-of-a-young-patient-suffering-from-acute_fig1_333459995

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

What medications can be useful in anterior uveitis?

A

Prednisolone
Cyclopentolate drops

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

What is episcleritis?

A

Inflammation below the conjuctiva in the episcleral layer

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

How does episcleritis usually present?

A

Asymptomatic

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

What is scleritis and what conditions is it associated with?

A

Vasculitis of sclera:
Granulomatosis polyangiitis
Rheumatoid arthritis
Systemic Lupus Erythematous
Vasculitis

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

What is the main symptom of scleritis?

A

Severe pain worse on eye movement

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

What can be seen on examination in scleritis and how can it be differentiated from episcleritis?

A

Conjunctival oedema
Scleritis much more diffuse than episcleritis
If you add phenylephrine drops the sclera goes white in episcleritis but stays red in scleritis

photo source: https://www.msdmanuals.com/professional/eye-disorders/conjunctival-and-scleral-disorders/scleritis

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

How should you manage scleritis as a junior dr?

A 
Urgent referral (\<24 hours) 
Cortisosteroids/ immunosuppressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can viral vs bacterial vs allergic conjunctivitis be differentiated by appearance?

A

Viral: waterey and unilateral
Bacterial: sticky and unilateral
Allergic: pruritic, bilateral

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

Why do contact-lens wearers need urgent referral if they get conjunctivitis?

A

Difficult to distinguish between cojunctivitis and microbial keratitis which requires prompt treatment

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

How does the management of viral vs bacterial vs allergic conjunctivitis differ?

A

Viral: nil
Bacterial: chloramphenicol drops
Allergic: antihistamine drops

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

What classifies as a “corneal abrasion”?

A

Epithelial breech without keratitis

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

How can corneal abrasion be investigated?

A

Fluorescein stains the defect green

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How can corneal abrasion be managed?
You just use antibiotic infection prophylaxis (chloramphenicol ointment)
26
How does a corneal ulcer/keratitis appear?
visible defect and white corneal opacity Photo source: lhttps://thesgem.com/2021/01/sgem315-comfortably-numb-with-topical-tetracaine-for-corneal-abrasions/
27
Why is corneal ulcer/keratitis an emergency?
It can cause scarring and vision loss
28
What is the cause of ophthalmic shingles?
CN VI reactivation of shingles
29
What is Huntchinson's sign?
Nose-tip zoster (nasocilliary branch) --\> ophthalmic involvement
30
How should ophthalmic shingles be managed?
Oral aciclovir +/- topical corticosteroids
31
Recall 2 possible complications of ophthalmic shingles?
Post-herpetic neuralgia Ptosis
32
Which artery is involved in anterior ischaemic optic neuropathy?
Posterior ciliary artery
33
What is the cause of arteritic anterior ischaemic optic neuropathy?
Giant cell arteritis
34
What are the 4 main symptoms of optic neuritis?
CRAP Central scomata RAPD Acuity loss Pain on movement
35
What is the most common cause of optic neuritis?
Multiple sclerosis
36
How should optic neuritis be managed (immediately and ongoing)?
72 hours IV methylprednisolone 11 days prednisolone PO
37
Recall the signs and symptoms of vitreous haemorrhage
Small bleeds --\> small black dots in vision and ring floaters Large bleeds --\> loss of red reflex, retina not visualised Fundal photo source: https://www.glycosmedia.com/education/diabetic-retinopathy/diabetic-retinopathy-features-of-diabetes-vitreous-haemorrhage/
38
What is the most common cause of vitreous haemorrhage?
Diabetes - causes angiogenesis
39
What is the best investigation for vitreous haemorrhage?
Brightness scan ultrasonography
40
How should small vitreous haemorrhages be managed?
They should resorb spontaneously
41
How should large vitreous haemorrhages be managed?
Vitrectomy
42
What is the aetiology of retinal detachment?
Holes in retina allow fluid to separate retina from the pigmented epithelium
43
What is the most common cause of retinal detachment?
Diabetes
44
Recall the 4 main signs and symptoms of retinal detachment
Floaters Flashes Field loss Fall in acuity
45
Describe the appearance of the retina in retinal detachment
Grey, opalescent retina, ballooining forwards Photo is of retinal detatchment secondary to horseshoe retinal tear - source: https://geekymedics.com/retinal-detachment/
46
On the other side of the card is a fundal photo of a central retinal vein occlusion for reference
Photo source: https://www.glycosmedia.com/education/diabetic-retinopathy/diabetic-retinopathy-features-of-diabetes-vitreous-haemorrhage/
47
On the other side of this card is a fundal photo of branch retinal vein occlusion for reference
Photo source: https://en.wikipedia.org/wiki/Branch\_retinal\_vein\_occlusion
48
How should retinal detachment be managed?
Urgent vitrectomy and gas tamponade with laser coagulation
49
Differentiate the symptoms of central retinal vs branch retinal vs cilioretinal artery occlusion
Central RAO: sudden painless total loss of vision + RAPD Branch RAO: sudden painless partial loss of vision with NO RAPD Ciliretinal AO: painless central vision loss
50
Recall 3 things that must be done to investigate possible retinal artery occlusion
1. CVS RF history 2. Temporal artery biopsy 3. ESR
51
Recall some ways of managing retinal artery occlusion
First thing to do is an eyeball massage (?!) Then options include: - Carbogen therapy (inhalation of 95% O2 and 5% CO2) - Haemodilution - Vasodilators - Measures to decrease IOP
52
Recall three possible causes of retinal vein occlusion
DM HTN Glaucoma
53
How does the nature of vision loss in retinal vein occlusion indicate whether it is ischaemic or non-ischaemic in nature?
If it is sudden total vision loss = ischaemic If it is subacute partial vision loss = non-ischaemic If RAPD = ischaemic
54
What is the best investigation for imaging retinal vein occlusion?
Fluorescin angiography
55
How can retinal vein occlusion be managed?
Can only be managed actively if ischaemic cause Mx = panretinal photocoagulation
56
What is the phrase 'cherry red macula' usually associated with?
Central retinal artery occlusion Photo source: https://en.wikipedia.org/wiki/Cherry-red\_spot
57
What is the most common cause of blindness in \>60yo?
Age-related macular degeneration ARMD
58
What are the 2 types of age-related macular degeneration?
Wet and dry Dry = geographic atrophy Wet = subretinal neovascularisation
59
What are drusen?
White fluffy spots around macula caused by fat deposits under retina Seen in dry ARMD Photo source: https://morancore.utah.edu/basic-ophthalmology-review/wet-versus-dry-macular-degenerative-changes/
60
What is the timeline of decline of vision in wet vs dry ARMD?
Dry: 1-2 years Wet: days to weeks
61
What is the relative prevalence of wet vs dry ARMD?
``` Wet = 10% of ARMD Dry = 90% of ARMD ```
62
What is the aetiology of wet ARMD?
Aberrant vascular growth into the retina from the choroid that leads to haemorrhage
63
What test is used during eye examiation to identify macular degeneration?
Amsler grid
64
How can wet ARMD be managed?
Photodynamic therapy VEGF inhibitors
65
How should ARMD be investigated?
Urgent referral to ophthalmology 1st = slit lamp microscopy to identify pigmentory, haemorrhage, exudative changes If wet ARMD --\> fluorescin angiography as this detects abnormal neovascularisation All pts should get a high-res image of retina = Optical Coherence Tomography
66
What lifestyle measure is most useful for slowing the progression of ARMD?
Smoking cessation
67
How can dry ARMD be managed?
Antioxidant vitamins (ACE) and zinc
68
What is tobacco-alcohol ambylopia?
Toxic effects of cyanide radicals combined with thiamine deficiency
69
Recall 3 signs and symptoms of tobacco-alcohol ambylopia
Optic atrophy Loss of red/green discrimination Scomata
70
Recall 5 drugs used to manage chronic glaucoma
Those that reduce aqueous production = ABC Alpha 2 antagonists Beta blockers Carbonic anhydrase inhibitors Those that Increase uveoscleral outflow: Prostaglandin analogues Pilocarpine
71
What IOP counts as 'increased'?
\>21mmHg
72
Describe 2 features of the optic disc in chronic OA glaucoma?
Atrophy Cupping Photo source: https://www.glaucomaassociates.com/glaucoma/what-is-glaucoma/
73
Recall 2 RFs for chronic open angle glaucoma
Myopia FHx
74
What is the main symptom of chronic open angle glaucoma?
Peripheral vision loss
75
When does glaucoma screening begin for people with a strong family history of glaucoma?
40 years old
76
What are the first and second line options for treating chronic open angle glaucoma?
First line: one, then the other, then both: - timolol/ betaxolol - Latanoprost Second line: - Brimonidine tartrate (alpha-2 antagonist) - acetazolamide (carbonic anhydrase inhibitor) - pilocarpine (topical miotic)
77
What is the surgical option for managing chronic open angle glaucoma?
Laser trabeculoplasty
78
What does annual eye screening involve for diabetic patients?
Fundus photography Fluorescin staining
79
Recall the stages of diabetic retinopathy and their features on fundoscopy
Background: hard Exudates, Microaneurysms and blot Haemorrhages (it's the lowkey one so it's MEH) Pre-proliferative: cotton wool spots and soft exudate Proliferative: angiogenesis Maculopathy: hard exudates near the macula Photo source: https://www.ophthalytics.com/our-technology/diabetic-retinopathy/
80
How should diabetic proliferative retinopathy be managed?
Pan-retinal photocoagulation
81
How should diabetic maculopathy be managed?
Focal retinal photocoagulation
82
Recall the types of hypertensive retinopathy and their features on fundoscopy
Grade 1: silver wiring and arteriole tortuosity Grade 2: AV-nipping Grade 3: flame haemorrhages and cotton wool exudates Grade 4: papilloedema Photo source: https://www.sciencedirect.com/science/article/pii/S093336571730427X
83
Describe the typical symptoms of cataracts
Dazzling bright lights, haloes, night vision loss
84
Recall some risk factors for cataracts
Age Steroids Diabetes Smoking Hypocalcaemia
85
How is the red reflex affected by cataracts?
It is darkened
86
How can cataracts be medically managed?
Mydriatic eye drops (tropicamide)
87
What is the most common complication of cataract surgery?
Posterior capsular opacification
88
What are the most common, best prognostic and worst prognostic inheritance pattern of retinitis pigmentosa (it has variable inheritance)?
Most common: AR Best prognosis: AD Worst prognosis: X-linked
89
What are the signs and symptoms of retinitis pigmentosa?
Night-blindness, tunnel-vision, blindness by mid-30s
90
Recall some fundoscopic findings in retinitis pigmentosa
Pale optic disc Macula-sparing peripheral retinal pigmentation Photo source: https://www.ncbi.nlm.nih.gov/books/NBK11553/figure/ch36clinicalerg.F12b/
91
What mutation is responsible for hereditary retinoblastoma?
RbP gene mutation (a TSG)
92
Recall 2 signs of retinoblastoma
Strabismus Leukocoria Photo source: https://www.aao.org/eye-health/diseases/what-is-retinoblastoma
93
Recall the 2 causes of inflammatory eyelid swelling
Stye (hordeolum externum/internum) Chalazion
94
What is a stye?
Abscess in lash follicle
95
What is a chalazion?
Abscess in Meibomian gland after a hordeolum internum Photo source: https://my.clevelandclinic.org/health/diseases/17657-chalazion
96
What is blepharitis?
Chronic eyelid inflammation
97
Recall 2 causes of blepharitis
Seborrhoeic dermatitis Staphylococcus
98
What are the signs and symptoms of blepharitis?
Red gritty/itchy eyes with scales on the lashes
99
How should blepharitis be managed?
Warm compresses, warm water cleanse BD and topical ABx (chloramphenicol)
100
What is lagophthalmos?
Difficulty closing the eyelid over the globe leading to exposure keratitis
101
Recall the signs and symptoms of orbital cellulitis
Inflammation of the orbit, lid swelling and pain on movement
102
How do the symptoms of periorbital cellulitis differ from orbital cellulitis?
Periorbital cellulitis does not have pain on eye movement or systemic symptoms or vision loss
103
How should you investigate suspected orbital cellulitis?
CT scan with contrast (orbits, sinuses and brain to assess for posterior spread
104
How should orbital cellulitis be managed?
IV cefuroxime, urgent ophthalmology referral
105
What would cause the following eye symptoms?: - engorgement of eye vessels - lid and conjunctival oedema - pulsatile exophthalmos - eye bruit
Carotid cavernous fistula
106
What is the layterm for strabismus?
Squint
107
What are the 2 forms of strabismus, and what is the difference between them?
Concomitant - imbalance of extraocular muscles Paralytic - paralysis of extraocular muscles
108
Describe the appearance of the eyes in CNIII vs IV vs VI palsy
CNIII: ptosis, fixed/dilated pupil, 'down and out' CNIV: diplopia going downwards CNVI: diplopia in horizontal plane
109
What are the 2 most common causes of CN III/IV/VI palsies?
DM Trauma
110
Recall 2 vascular causes of CNIII palsy
Cavernous sinus thrombosis PCA aneurysm
111
Recall 3 central causes of CNIV/VI palsy
MS SOL Vascular
112
What is the most common type of strabismus in children?
Esotropia (towards the nose)
113
Recall the '4 Os' of strabismus management
Ophthalmological review Optical (correct refractive errors) Orthoptic (eye patch to the GOOD eye to prevent ambylopia) Operations (rectus muscle resections)
114
What is the possible serious complication of intra-ocular haemorrhage?
Acute closed angle glaucoma | (Large blood volume may restrict outflow)
115
What is the aetiology of orbital blowout fracture?
Trauma --\> increase in IOP --\> orbital contents herniate into sinuses
116
Recall 5 causes of floaters
Retinal detachment (one of the 4 Fs) Vitrous haemorrhage Diabetes Old retinal branch occlusion Syneresis (degenerative opacities in vitreous)
117
Recall 3 causes of painless haloes in the vision
Cataracts Corneal oedema Acute glaucoma
118
Which pathology typically caues jaggered haloes in the vision?
Migraine
119
What pathology causes haloes with eye pain?
Acute glaucoma
120
What are the 1st and 2nd line options for managing seasonal allergic conjunctivitis
1st line: topical antihistamine 2nd line: mast cell stabiliser eg cromoglycate
121
What tropical eye diseases are spread by flies?
Trachoma (Chlamydia trachomitis) Onchocerciasis (onchocerca volvulus)
122
How is trachoma managed?
Tetracycyline
123
How is onchocerciasis managed?
Ivermectin

Med school finals (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions