Ophthalmology Flashcards
What is the definitive management of acute closed angle glaucoma?
Laser peripheral iridotomy
What fundoscopy signs are seen in chronic glaucoma?
Disc cupping Disc notching Disc haemorrhages Disc pallor Bayonetting of vessels
What is the management of retinal detachment?
Urgent ophthalmology review
What is a Holmes-Adie pupil?
Unilateral dilated pupil
Sluggish to react to light and sluggish to re-dilate
What is Horner’s syndrome?
- Miosis
- Ptosis
- Anhidrosis
How can you determine the lesion in Horner’s syndrome?
S, T, C
Face + trunk CENTRAL LESION – stroke, spyringomyelia
Face only PRE-GANGLIONIC – pancost tumour, trauma, thyroidectomy
No anhidrosis POST-GANGLIONIC – cluster headache, carotid artery dissecton
How can you differentiate between episcleritis and scleritis?
Phenylephrine drops
If redness reduces = episcleritis
If redness persists = Scleritis
Which organisms are most common in keratitis?
Staph aureus = most common
In contact lens wearers = Pseudomonas
If been swimming (esp if contact lens wearer) - Acanthoemoba
Which type of retinitis is common in HIV patients and what is seen on fundoscopy?
How is it managed?
CMV retinits
Fundoscopy = pizza retinitis
Intravitreal Ganciclovir
What is retinitis pigmentosa? How does it present and what is seen on fundoscopy?
Congenital condition – degeneration of rods and cones
Night blindness + loss of peripheral vision
Fundoscopy = Bone-spicule pigmentation
Management = ophthal referral
What is seen on slit lamp examination in anterior uveitis?
Conjunctival injection
Keratic precipitates
Anterior chamber cells
Posterior synechiae
What are signs of optic neuritis?
Central scotoma Reduced colour saturation esp red RAPD Pain on eye movement Reduced visual acuity
What is seen on fundoscopy in optic neuritis?
Pale optic disc
Optic disc swelling
What is seen on fluorescin staining in herpes keratitis?
Dendritic ulcer
How is papilloedema seen on fundoscopy?
Venous engorgement
Loss of venous pulsation
Blurring of optic disc margin
Elevation of optic disc
What risk are children at risk of if you do not correct their childhood squint?
Amblyopia
What is herpes zoster ophthalmicus?
Reactivation of varicella zoster in ophthalmic division of the trigeminal nerve
Vesicular rash around the eye
What is Hutchinson’s sign?
Rash on the tip or side of nose
Indicates risk of anterior uveitis
urgent ophthalmology review needed
How is herpes zoster opthahlmicus managed?
Oral Aciclovir
How to manage bacterial conjunctivitis in pregnant women?
Topical fusidic acid
What is a Marcus-Gunn pupil?
RAPD
What do cotton wool spots on fundoscopy represent?
Areas of retinal infarction
What are the four types of cataracts?
Nuclear
Polar
Subcapsular (associated with steroid use)
Dot (associated with diabetes)
How is herpes simplex keratitis managed?
Topical aciclovir
How is Ramsay Hunt syndrome managed?
Oral acyclovir + Oral prednisolone
How does age related macular degeneration present?
Gradual worsening of central field loss (Central scotoma)
Reduction of visual acuity (particularly near field objectives)
Difficulty seeing at night
Flashing lights
Distortion of line perception (crooked/wavy appearance)
Difficulty recognising faces
How can primary open angle glaucoma be investigated?
Applanation tonometry - measures pressure
Slit lamp examination
Fundoscopy
Gonioscopy
What is the emergency management of acute angle closure glaucoma? What is the definitive management?
Emergency management
Pilocarpine eyedrops - 2% for blue eyes and 4% for brown eyes
Beta blocker eyedrops - Timolol
IV Acetazolamide
Definitive management= laser peripheral iridotomy
What is a cataract and how does it present?
Lens of the eye becomes cloudy Gradual loss of Generalised reduced vision Faded colour vision Glare Haloes around light
What are the four stages of hypertensive retinopathy?
Stage 1 = arteriolar narrowing, increased light reflex (silver wiring)
Stage 2 = Arteriovenous nipping
Stage 3 = Cotton wool spots, flame haemorrhages, blot haemorrhages
Stage 4 = Papilloedema
What is endopthalmitis and how is it managed?
Inflammation of the interior cavity of the eye, usually caused by infection
Complication of intraocular surgery
Red eye, pain and vision loss after intraocular surgery
Managed with intravitreal vancomycin
How to investigate primary open angle glaucoma?
Gonioscopy
Slit lamp exam
Applanation tonometry
How to investigate age related macular degeneration?
Amsler grid testing - wavy lines
Fundoscopy
Gonioscopy
How is wet ARMD managed?
Flourescin angiography
