Brainscape's Knowledge GenomeTM

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


See full index

Medicine > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Glaucoma

A

refers to the optic nerve damage that is caused by a significant rise in intraocular pressure.
The raised intraocular pressure is caused by a blockage in aqueous humour trying to escape the eye. There are two types

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

Most common form of glaucoma

A

Open- angle

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

open-angle glaucoma

A

gradual increase in resistance through the trabecular meshwork. This makes it more difficult for aqueous humour to flow through the meshwork and exit the eye. Therefore the pressure slowly builds within the eye and this gives a slow and chronic onset

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

cupping of the optic disc

A

happens due to increased pressure
it is a small dent in the centre of a normal optic disc,usually less than half the size of the optic disc
when pressure increased, this indent becomes larger as the pressure in the eye puts pressure on that indent making it wider and deeper
optic cup greater than 0.5 the size of the optic disc is abnormal.

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

Risk Factors open angle glaucoma

A

Increasing age
Family history
Black ethnic origin
Nearsightedness (myopia)
hypertension
diabetes mellitus
corticosteroids

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

Clinical features of open-angle glaucoma

A
  1. asymptomatic at first
  2. affects peripheral vision
  3. peripheral vision closes in ( scotomata) until they experience tunnel vision
  4. Gradual onset of fluctuating pain, headaches, blurred vision, haloes around lights, particularly at night time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ix for glaucoma

A

Goldmann applanation tonometry is the gold standard for intraocular pressure
Fundoscopy assessment to check for optic disc cupping and optic nerve health
Visual field assessment to check for peripheral vision loss

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

Management of Open-Angle Glaucoma

A

Treatment is usually started at an intraocular pressure of 24 mmHg or above
1. Prostaglandin analogue eye drops (e.g. latanoprost) are first line (increase uveoscleral outflow)
2. Beta-blockers (e.g. timolol) reduce the production of aqueous humour
3. Carbonic anhydrase inhibitors (e.g. dorzolamide) reduce the production of aqueous humour
4. Sympathomimetics (e.g. brimonidine) reduce the production of aqueous fluid and increase uveoscleral outflow
Trabeculectomy surgery may be required where eye drops are ineffective

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

side effects Prostaglandin analogue eye drops (e.g. latanoprost)

A

eyelash growth, eyelid pigmentation and iris pigmentation (browning)

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

Pathophysiology of acute angle-closure glaucoma

A

iris bulges forward and seals off the trabecular meshwork from the anterior chamber preventing aqueous humour from being able to drain away.pressure builds up particularly in the posterior chamber

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

risk factors Acute angle closure

A

Increasing age
Females
Family history
Chinese and East Asian ethnic origin
Shallow anterior chamber
Hypermetropia

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

Which medications precipitate acute angle-closure glaucoma

A

Adrenergic medications such as noradrenalin
Anticholinergic medications such as oxybutynin and solifenacin
Tricyclic antidepressants such as amitriptyline, which have anticholinergic effects

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

Clinical presentation of acute angle-closure glaucoma

A

patient will generally appear unwell
Severely painful red eye
Blurred vision
Halos around lights
Associated headache, nausea and vomiting
Symptoms may worsen at night as the pupil dilates, closing the iridio-corneal angle even more.

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

Acute angle closure O/E

A

Red-eye
Teary
Hazy/cloudy cornea
Decreased visual acuity
Dilatation of the affected pupil
Fixed pupil size, mid dilated
Firm eyeball on palpation

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

Management of acute angle closure glaucoma in primary care

A

Lie patient on their back without a pillow
Give pilocarpine eye drops (2% for blue, 4% for brown eyes) miotic /constrictive agent
Give acetazolamide 500 mg orally
Given analgesia and an antiemetic if required

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

Management of acute angle closure glaucoma in secondary care

A

Pilocarpine
Acetazolamide (oral or IV)
Hyperosmotic agents such as glycerol or mannitol increase the osmotic gradient between the blood and the fluid in the eye
Timolol is a beta-blocker that reduces the production of aqueous humour
Dorzolamide is a carbonic anhydrase inhibitor that reduces the production of aqueous humour
Brimonidine is a sympathomimetic that reduces the production of aqueous fluid and increase uveoscleral outflow

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

definitive treatment of acute angle-closure glaucoma

A

Laser iridectomy

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

Myopia

A

(Nearsightedness)
you can see objects near to you clearly,but objects farther away are blurry.
It occurs when the shape of your eye causes light rays to bend (refract) incorrectly, focusing images in front of your retina instead of on your retina

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

Hypermetropia

A

(long-sightedness)
nearby objects appear blurred, but your vision is clearer when looking at things further away.

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

Amaurosis Fugax symptoms

A

Monocular visual loss that usually lasts seconds to minutes, but may last 1-2 hours.
Vision returns to normal. It is most commonly a negative visual phenomenon, described as a blackout, or ‘greying out’ of vision

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

Mx Amaurosis Fugax

A

Start 300g aspirin, referral to neurology/cardiology or vascular surgery as appropriate

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

Migraine with aura symptoms

A

bilateral
when eyes are closed
flickering, scintillating, or bright geometric shapes
last 10-60 mins
associated/followed by headache

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

Vitreous haemorrhage

A

occurs as a result of bleeding into the vitreous humour, most often from unstable retinal neo-vasculature. Therefore, any condition which risks the formation of retinal neo-vasculature is a risk factor for vitreous haemorrhage

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

Risk factors for Vitreous haemorrhage

A

diabetic retinopathy and hypertensive retinopathy. anti-coagulant use and trauma,posterior vitreous detachment

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

Vitreous haemorrhage symptoms

A

dark spots obscuring vision/ complete loss of vision if the bleed is large enough.
The bleed can also cause a red hue and potentially loss of red reflex if large enough
This condition will resolve with time.

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

Posterior vitreous detachment symptoms

A

Painless
Spots of vision loss
Floaters (Weiss ring)
Flashing lights

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

Central Retinal Occlusion symptoms

A

Sudden and painless loss of vision.

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

Central Retinal Vein Occlusion signs

A

Flame and blot haemorrhages
Optic disc oedema
Macula oedema
dilated tortuous veins, cotton wool spots

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

Management of Central Retinal Vein Occlusion

A

Management in secondary care aims to treat macular oedema and prevent complications such as neovascularisation of the retina and iris and glaucoma
Laser photocoagulation
Intravitreal steroids (e.g. a dexamethasone intravitreal implant)
Anti-VEGF therapies (e.g. ranibizumab, aflibercept or bevacizumab)

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

Central Retinal Artery Occlusion

A

where something blocks the flow of blood through the central retinal artery which supplies the blood to the retina.
most common cause is atherosclerosis, also giant cell arteritis
far less common than retinal vein occlusion, and vision deteriorates faster

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

Central retinal artery occlusion signs

A

Relative Afferent Pupillary Defect (RAPD)
pale retinal (abnormal and asymmetrical red reflex) cherry red spot-area of cilioretinal sparing
- retina is pale due to a lack of perfusion with blood.
- The cherry-red spot is the macula, which has a thinner surface that shows the red coloured choroid below

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

Management Central Retinal Artery Occlusion

A

Urgent (same day) ESR and CRP to exclude Giant Cell Arteritis,and temporal artery biopsy
Ocular massage
Removing fluid from the anterior chamber to reduce intraocular pressure.
Inhaling carbogen (a mixture of 5% carbon dioxide and 95% oxygen) to dilate the artery
Sublingual isosorbide dinitrate to dilate the artery

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

Retinal detachment

A

separation of sensory retina from the retinal pigment epithelium
often due to predisposing retinal hole tear – often associated with myopia but may follow trauma
Tear allows vitreous fluid to get under the retina and fill the space between the retina and the choroid.

It is a reversible cause of visual loss, provided it is recognised and treated before the macula is affected.

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

Retinal detachment symptoms

A

painless loss of vision/ Blurred or distorted vision
ecent history of increased number of visual floaters and/ or visual flashes.
dark shadow/ curtain coming down in the vision of the affected eye/ Peripheral vision loss.

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

Retinal detachment signs

A

grey area of retina which is where it is detached, vision reduced if retina detaches and involves the macula

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

Mx retinal detachment

A

urgent (same day) referral to ophthalmologist.Requires urgent fixation usually with laser.
It is a reversible cause of visual loss, provided it is recognised and treated before the macula is affected.

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

Optic neuritis

A

presenting feature of multiple sclerosis,can also be linked to diabetes and syphilis
most common in women between 18-50 years old and in Caucasian populations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Optic neuritis symptoms

A

Painless unilateral loss of vision over hours to days.
Orbital pain usually associated with eye movement
Impaired colour vision in the affected eye, typically red desaturation, Central scotoma. This is an enlarged blind spot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Optic neuritis signs

A

reduced visual acuity and colour vision
RAPD on affected side
Visual field defects: commonly central but can be any pattern, central scotoma, optic disc may look normal (retrobulbar neuritis) or be swollen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Mx optic neuritis

A

urgent (same day) referral to ophthalmologist may be indicated for further MRI investigation and intravenous steroid treatment may be required.
Vision starts to recover within a month without treatment.
Following recovery ,clinical findings such as RAPD, red desaturation, and optic nerve pallor (atrophy) commonly persist and there is Gradual loss vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Cataract

A

lens in the eye becomes cloudy and opaque. This reduces visual acuity by reducing the light that enters the eye.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Cataract risk factors

A

Increasing age
Smoking
Alcohol
Diabetes
Steroids
Hypocalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Cataract symptoms

A

usually asymmetrical
Very slow reduction in vision
Progressive blurring of vision
Change of colour of vision with colours becoming more brown or yellow
“Starbursts” can appear around lights, particularly at night time
myopic shift : patient becomes more short sighted due to the increased refractive index of the cataract.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Cataract key sign

A

loss of the red reflex. The lens can appear grey or white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Mx cataracts

A

If the symptoms are manageable then no intervention may be necessary.
Cataract surgery involves drilling and breaking the lens into pieces, removing the pieces and then implanting an artificial lens into the eye.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Risk factors for Age related macular degeneration

A

Age
Smoking
White or Chinese ethnic origin
Family history
Cardiovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Age related macular degeneration symptoms

A

Gradual worsening central visual field loss
Reduced visual acuity
Crooked or wavy appearance to straight lines
Wet age-related macular degeneration presents more acutely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Age related macular degeneration O/E

A

Reduced acuity using a Snellen chart
Scotoma (a central patch of vision loss)
Amsler grid test can be used to assess the distortion of straight lines
Fundoscopy. Drusen are the key finding.
- yellow deposits of proteins and lipids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Dx AMD

A

Slit-lamp biomicroscopic fundus examination
Optical coherence tomography
Fluorescein angiography involves giving a fluorescein contrast and photographing the retina to look in detail at the blood supply to the retina. It is useful to show up any oedema and neovascularisation. It is used second line to Optical coherence tomography

50
Q

Management of wet AMD

A

Medications such as ranibizumab, bevacizumab and pegaptanib block VEGF and slow the development of new vessels.

51
Q

Management Dry AMD

A

no specific treatment
Management focuses on lifestyle measure that may slow the progression:
Avoid smoking
Control blood pressure
Vitamin supplementation has some evidence in slowing progression

52
Q

Retinitis pigmentosa

A

primarily affects the peripheral retina resulting in tunnel vision
night blindness is often the initial sign
fundoscopy: black bone spicule-shaped pigmentation in the peripheral retina, mottling of the retinal pigment epithelium

53
Q

Red flag eye symptoms

A

Sudden onset
Visual loss
Photophobia
Fever
Recent trauma
Vomiting
Associated red eye
Contact lens wearer
History of malignancy
History of flashers or floaters

54
Q

Serious and potentially sight-threatening causes of red eye include

A

Acute glaucoma.
Anterior uveitis.
Corneal ulcer, contact lens-related red eye and corneal foreign body.
Neonatal conjunctivitis.
Trauma, such as penetrating eye injury or high-velocity foreign body.
Chemical injuries.
Scleritis.
Endophthalmitis.

55
Q

Blepharitis

A

Very common non specific generalised inflammation of the eyelids caused by staphylococcal infection, seborrhoeic dermatitis, meibomian gland dysfunction, or all of above
It can lead to styes and chalazions.

56
Q

Blepharitis symptoms

A

sore eyes, itching, burning
Eyelids may stick together on waking.
crusty appearance at the base of the eyelashes
Symptoms are bilateral
dry eye syndrome: watery eyes, blurred vision, dry eyes and intolerance of contact lenses.
associated seborrhoeic dermatitis: dandruff, oily skin, facial rashes.
associated rosacea: facial flushing, redness or telangiectasia.

57
Q

Mx Blepharitis

A

daily lid hygiene,hot compresses , lubrication as required with routine referral

58
Q

Ectropion

A

Lid turning outwards with exposure of conjunctival sac.
Eye may be sore and watery
It usually affects the bottom lid
Can cause exposure keratopathy as the eyeball is exposed

59
Q

Entropion

A

Lids turning inwards and eyelashes may abrade cornea.This results in pain and can result in corneal damage and ulceration

60
Q

Mx entropion

A

Definitive management is with surgical intervention. When the eyelid is taped down it is essential to prevent the eye drying out by using regular lubricating eye drops.
A same-day referral to ophthalmology is required if there is a risk to sight.

61
Q

Trichiasis

A

Ingrowing eyelashes. This results in pain and can result in corneal damage and ulceration. - epilate eyelash when touching cornea, lubricate with routine referral.Recurrent cases may require electrolysis, cryotherapy or laser treatment to prevent the lash regrowing.

62
Q

Stye

A

infection of the glands of Zeis or glands of Moll (hordeolum externum) or infection of the Meibomian glands (hordeolum internum)

63
Q

Mx stye

A

treated with hot compresses and analgesia. Consider topic antibiotics (i.e. chloramphenicol) if it is associated with conjunctivitis or persistent.

64
Q

Chalazion/Meibomian cyst

A

Meibomian gland becomes blocked and swells up
presents with a swelling in the eyelid that is typically not tender
Treatment is with hot compress and analgesia. Consider topic antibiotics (i.e. chloramphenicol) if acutely inflamed

65
Q

Corneal foreign body and ocular trauma presentation

A

foreign body sensation, pain, and photophobia
Visual acuity and pupil reflexes are usually normal.

66
Q

Mx Chemical burns

A

ophthalmic emergency and should be immediately irrigated before any steps are taken. Common agents include cement, plaster powder and oven cleaner, all of which are alkaline. Refer once pH has stabilised.

67
Q

Subconjunctival haemorrhage

A

hx of rf such as straining with coughing or constipation,may be associated with hypertension.
usually unilateral, localised and sharply circumscribed. Underlying sclera not visible. No inflammation, pain or discharge. Vision unchanged. Possible association with minor injuries including rubbing. Common with use of antiplatelet agents and anticoagulants.
Reassure and routine referral only if condition worsens or pain develops

68
Q

Common causes of corneal abrasion/erosion

A

Contact lenses ( can be associated with infection with pseudomonas)
Foreign bodies
Finger nails
Eyelashes
Entropion (inward turning eyelid)

69
Q

Signs of Corneal abrasian/erosion

A

eye red and watery, area where corneal epithelium not intact stains with fluorescein

70
Q

Mx Corneal abrasian/erosion

A

check no foreign body, topical antibiotics (i.e. chloramphenicol) and can pad the eye although this does not help healing
Antibiotics to prevent infection because of the break in corneal epithelium. Ointment provides a barrier so that when they sleep eyelid sticks to ointment and not to healing scab.
Uncomplicated corneal abrasions usually heal over 2-3 days.

71
Q

Microbial Keratitis

A

infection of the cornea that can be caused by a range of non-viral pathogens
characterised by an sub/acute onset of pain, conjunctival injection, and corneal ulceration with a stromal inflammatory infiltrate. gritty sensation in the eyes, vision may be impaired depending on location
RF include history of contact lens wear, foreign travel, Poor lens hygiene, swimming

72
Q

Herpes simplex keratitis

A

sore red eye , not sticky
abnormal corneal epithelium in dendrite pattern which stain with fluorescein
Topical aciclovir

73
Q

Bacterial corneal infection symptoms

A

eye sore and red , often in contact lens wearer ulcers or infections, monthly disposable lens its most often seen with. Pain, photophobia, vision may be affected
Signs: white area on cornea, maybe peripheral or central

74
Q

Viral conjunctivitis symptoms

A

often recent eye/URT infection
Burning sensation and watery discharge
rapid spread to the other, often pre-auricular lymphadenopathy, swelling

75
Q

Mx viral conjunctivitis

A

Will resolve on own and treatment aimed at comfort. Cool compresses, regular lubricants (without preservative). Antibiotic drops if indicated. Resolution may take weeks. Refer if photophobia and decrease in visual acuity, severe disease lasting longer than 3 weeks.

76
Q

Bacterial conjunctivitis symptoms

A

red sticky eyes with purulent discharge

77
Q

Mx bacterial conjunctivitis

A

regular hygiene to minimise secretion buildup, topical antibiotics for 5 days. Eg chloramphenicol. Refer if needs

78
Q

Acute Anterior uveitis

A

inflammation of the anterior segment of the eye. It may be associated with other inflammatory disorders, such as ankylosing spondylitis

79
Q

Acute Anterior uveitis symptoms

A

Gradual onset, photophobia, eye red and sore, blurred vision, , headache, pain on accommodating, increased lacrimation, ibd history

80
Q

Acute Anterior uveitis signs

A

VA may be reduced, redness more localised around the corneal edge (ciliary injection), pupils may be constricted or irregular due to adhesions between the lens and iris (termed synechiae).
anterior chamber appears cloudy from cells and flare
When severe, white cells precipitate on the corneal endothelial surface

81
Q

Scleritis symptoms

A

severe eye pain which radiates to head or jaw and wakes them at night, purple hue , pain despite adequate analgesia

82
Q

Scleritis signs

A

Eye is red , may have nodules and necrotic patch, sclera may be discolored and is tender to palpation. Progressive onset of photophobia and visual impairment, gradual decrease in vision

83
Q

Hypopyon

A

Visible accumulation of white cells inferiorly seen in severe uveitis,located in the anterior chamber.
Can be due to inflammation or infection
If no recent surgery more likely to be inflammation
Urgent (same day) referral for investigatio

84
Q

Hyphaema

A

Red cells in anterior chamber

85
Q

Management hyphaema

A

Bed rest,keep patient upright so only bottom of cornea will have rbc and will have better vision than if it was spread over,eye pad. Urgent (same day) assessment by ophthalmologist.
Steroids to prevent inflammation
Sleep upright too to prevent conrea being stained and to help blood drain away
Keep eye on pressure too

86
Q

Endophthalmitis

A

post-operative infection that occurs within the first 2 weeks of surgery and can rapidly cause blindness

87
Q

Endophthalmitis symptoms

A

hx eye surgery, reduced vision, significant pain/headache, hypopyon.
Red eye, decreasing visual acuity, and pain

88
Q

Mx Endophthalmitis

A

Urgent/immediate referral for intravitreal and systemic antibiotics
reatment is intravitreal vancomycin as the most common causative organisms after surgery are gram positive

89
Q

Periorbital Cellulitis

A

an eyelid and skin infection in front of the orbital septum (in front of the eye). It presents with swelling, redness and hot skin around the eyelids and eye.CT to make sure it isn’t orbital cellulitis

90
Q

Orbital Cellulitis

A

infection around the eyeball that involves tissues behind the orbital septum.
Key features that differentiate this is pain on eye movement, reduced eye movements, changes in vision, abnormal pupil reactions and forward movement of the eyeball (proptosis).

91
Q

Pupil Constriction

A

stimulated by the parasympathetic nervous system using acetylcholine as a neurotransmitter.
The fibres of the parasympathetic system innervating the eye travel along the oculomotor (third cranial) nerve.

92
Q

Pupil Dilation

A

dilator muscles are stimulated by the sympathetic nervous system using adrenalin as a neurotransmitter

93
Q

Causes of Mydriasis (Dilated Pupil)

A

Third nerve palsy
Holmes-Adie syndrome
Raised intracranial pressure
Congenital
Trauma
Stimulants such as cocaine
Anticholinergics

94
Q

Causes of Miosis (Constricted Pupil)

A

Horners syndrome
Cluster headaches
Argyll-Robertson pupil (in neurosyphilis)
Opiates
Nicotine
Pilocarpine

95
Q

Holmes Adie Pupil

A

unilateral dilated pupil that is sluggish to react to light with slow dilation of the pupil following constriction. Over time the pupil will get smaller. This is caused by damage to the post-ganglionic parasympathetic fibres.

96
Q

Argyll-Robertson Pupil

A

pecific finding in neurosyphilis. It is a constricted pupil that accommodates when focusing on a near object but does not react to light.ften irregularly shaped

97
Q

mononuclear vision loss

A

lesion before chiasm

98
Q

Causes of monocular vision loss

A

optic neuritis, optic atrophy, glaucoma, trauma, central retinal occlusion, retinal detachment

99
Q

bitemporal hemianopia

A

loss of temporal part of the visual field in both eyes esulting in central tunnel vision. It is usually caused by a lesion in the midline which is exerting pressure effects on the optic chiasm.

100
Q

Causes of bitemporal hemianopia

A

pituitary tumour
craniopharyngoma
Meningioma
Chiasmatic glioma
Aneurysm or ectatic carotid artery
Epidermoid cyst
Dermoid cyst

101
Q

Homonoymous hemianopia

A

lesion after chiasm,contralateral optic tract lesion
causes by middle cerebral artery occlusion

102
Q

Homonymous inferior quadrantanopia

A

contralateral pariental upper optic radiation lesion
caused by parietal tumour or stroke

103
Q

Homonumous superior quadrantanopia

A

Contralateral parietal lower optic radiation lesion
caused by temporal stroke or tumour

104
Q

Homonymous hemianopia with macular sparing

A

contralateral occipital visual cortex lesion
caused by posterior cerebral artery occlusion

105
Q

Diabetic retinopathy

A

blood vessels in the retina are damaged by prolonged exposure to high blood sugar levels (hyperglycaemia) causing a progressive deterioration in the health of the retina.

106
Q

Features of Diabetic retinopathy

A

blot haemorrhages
hard exudates
microaneurysms and venous beading
cotton wool spots
Intraretinal microvascular abnormalities (IMRA) is where there are dilated and tortuous capillaries in the retina
Neovascularisation

107
Q

Mx diabetic retinopathy

A

Laser photocoagulation
Anti-VEGF medications such as ranibizumab and bevacizumab
Vitreoretinal surgery (keyhole surgery on the eye) may be required in severe disease

Primary prevention
annual monitoring

108
Q

Signs of hypertensive retinopathy

A

Silver wiring or copper wiring
Arteriovenous nipping
Cotton wool spots
Hard exudates
Retinal haemorrhages
Papilloedema

109
Q

Silver wiring or copper wiring

A

is where the walls of the arterioles become thickened and sclerosed causing increased reflection of the light.

110
Q

Arteriovenous nipping

A

is where the arterioles cause compression of the veins where they cross, due to sclerosis and hardening of the arterioles.

111
Q

Cotton wool spots

A

are caused by ischaemia and infarction in the retina causing damage to nerve fibres.

112
Q

Hard exudates

A

are caused by damaged vessels leaking lipids into the retina.

113
Q

Retinal haemorrhages

A

are caused by damaged vessels rupturing and releasing blood into the retina.

114
Q

Papilloedema

A

is caused by ischaemia to the optic nerve resulting in optic nerve swelling (oedema) and blurring of the disc margins.

115
Q

Keith-Wagener Classification of hypertensive retinopathy

A

Stage 1: Mild narrowing of the arterioles
Stage 2: Focal constriction of blood vessels and AV arteriovenous nicking
Stage 3: Cotton-wool patches, exudates and flame haemorrhages
Stage 4: Papilloedema

116
Q

causes of squint

A

Refractive errors, especially hypermetropia.
causes of poor visual acuity in one or both eyes, including occular malformations, optic neuropathy, amblyopia (lazy eye) which can also be a complication of a squint, congenital cataract, and retinoblastoma
cerebral palsy and downs syndrome
brain tumour

117
Q

Squint is sig after age of

A

3m
Normal binocular coordination is established at about 3 months

118
Q

Squint having underlying cause red flags

A

Limited abduction.
Double vision.
Headaches.
Nystagmus (involuntary, repetitive, side-to-side oscillation of the eyes).

119
Q

Secondary care treatments for squint

A

Glasses to correct any refractive error.
Occlusion or penalization therapy to treat amblyopia-
Surgery (or in some cases injection of botulinum toxin) to correct misalignment of eyes

120
Q

Retinoblastoma presentation

A

leukocoria (white pupil)
deteriorating vision, strabismus or failure to thrive
In developing countries, the tumour often presents as eye enlargement.

Medicine (72 decks)

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