Ophthalmology Flashcards
What is a cataract?
Opacification of lens
Sx cataracts
Painless loss of vision
Haloes around light
Difficulty reading
Blurry vision
treatment of cataracts
replace lens
pathophys of diabetic retinopathy
Continuous hyperglycaemia damages blood vessels and leads to symptoms
symptoms of diabetic retinopathy
- Hard exudates
- Microaneurysms
- Blot haemorrhages
- Cotton wool spots
pathophys of retinal artery occlusion
ophthalmic artery occlusion by atherosclerosis
sx retinal artery occlusion
pale retina
cherry red spot
RAPD
Sudden painless loss of vision
tx retinal artery occlusion
urgent referral to ophthalmology
optic vein occlusion pathophys
thrombus blocks optic vein drainage of eye = sudden, painless loss of vision
optic vein occlusion sx
sudden, painless loss of vision
haemorrhages
neovascularisation
macular/optic disc oedema
tx optic vein occlusion
ophthalmology referral
what is posterior vitreous detachment
vitreous gel comes away from retina as we age
sx posterior vitreous detachment
painless loss of spots of vision, floaters and flashes
pilocarpine function
pupillary constriction
tropicamide function
pupillary dilatation
what is retinal detachment?
retina separates from choroid allowing jelly to get behind it
sx retinal detachment
curtain falling = sudden loss of vision
floaters/flashes
pale grey area of retina ballooning forwards
tx retinal detachment
surgeeu
pathophys vitreous haemorrhage
bleeding into vitreous humour
sx vitreous haemorrhage
cobwebs
floaters
invisible retina if severe
treatment vitreous haemorrhage
treat cause
pathophys optic neuropathy
optic nerve loses blood supply
sx ischemia optic neuropathy
monocular vision loss, colour blindness and pale optic disc if chronic
treatment ischaemic optic neuropathy
treat cause
macular degeneration
age-related degeneration of macula
sx macular degeneration
Drusen = dry
well-demarcated red patches = wet
both have decreased visual acuity, loss of central vision and straight lines appear wavy
treatment macular degeneration
dry: ophthalmology
wet: anti-VEGF
herpes keratitis pathophy
HSV infects cornea
sx herpes keratitis
vesicles around eye
photophobia
fluorescein stain
tx herpes keratitis
ophthalmology and aciclovir
Sx sclerosis
abnormal pupil reaction to light
watery eyes
photophobia
tx scleritis
treat cause
NSAIDs
anterior uveitis
Inflammation of uvea (iris + ciliary body + choroid) → autoimmune (HLA-B27) associations
sx anterior uveitis
- Hypopynon
- Flashes
- Floaters
- Abnormally-shaped pupil
corneal abrasion
Foreign body sensation + fluorescein stain
subconjunctival haemorrhage
Blood vessel rupture causing painless red eye
Episcleritis
Inflammation of episclera - associations with RA and IBD
Sx:
- Patches of redness
- Foreign body sensation
Tx:
- Normally self-resolves
conjunctivitis sx
- Itching
- Red eyes
- Discharge
conjunctivitis tx
chloramphenicol
hypertensive retinopathy sx
- Silver wiring
- Hard exudates
- Papilloedema
periorbital cellulitis sx and tx
Skin infection in the skin overlying orbital septum
Sx: swollen, red eye skin
Tx is ABx
orbital cellulitis
nflammation around eyeball and painful eye movements
Refer to ophthalmology
stye sx and tx
Infection of glands of Zeis
Sx:
- Red, hot raised lump and pain
Tx: hot compress and analgesia
what is retinitis pigmentosa
Autosomal dominant degeneration of rods > cones = night blindness
sx retinitis pigmentosa
- Night blindness
- Peripheral > central loss of vision
- Bone-spicule pigmentation
argyll-robertson pupil
- Neurosyphilis
- Constricted pupil accommodates when focussing on object but no reaction to light
- Irregularly shaped pupils
holmes adie pupil
- Damage to post-ganglionic parasympathetic fibres
- Slow constriction in bright light
open angle glaucoma
iris bulges forward and seals off anterior chamber - optic cup >0.5 size of optic disc
sx open angle glaucoma
loss of peripheral vision
haloes around light
Goldmann tanometry
sx open angle glaucoma
loss of peripheral vision
haloes around light
Goldmann tanometry
tx open angle glaucoma
latanoprost
timolol
trabeculectomy
closed angle glaucoma
increased pressure in posterior chamber pushes iris forward = closed angle
sx closed angle glaucoma
haloes around light
dilated, non-reacting pupils
tx closed angle glaucoma
refer to ophthalmology
lie pt back without a pillow
pilocarpine
most common cause of painless vision loss
retinal vein occlusion
flame haemorrhages
retinal vein occlusion
is orbital or peri orbital cellulitis worse
orbital - ophthalmological emergency, pain on eye movement
what is a stye?
infected gland of Zeis - red, hot, raised lump and pain
what would ‘cobwebs and floaters’ indicate?
vitreous haemorrhage
reasons for sudden, painless LOV
vitreous haemorrhage
vitreous detachment
retinal detachment
RA occlusion
RV occlusion
ischaemic optic neuropathy
what is ischaemic optic neuropathy?
optic nerve damaged due to ischaemia
sx ischemia optic neuropathy
sudden, monocular vision loss
colour blindness
mx ischaemic optic neuropathy
treat cause
lots of haemorrhages and stormy sky appearance on fundoscopy
ventral retinal vein occlusion
how long does subconjunctival haemorrhage take to resolve?
2 week
‘patches of well-demarcated haemorrhage in one eye with a history of consdtipation’
subconjunctival haemorrhage
history of ankylosing spondylitis/ HLA B27
anterior uveitis
straight lines appear bendy
age macular degeneration
erythematous injected sclera with a bluish hue
scleritis
latanoprost side effect
eyelash growth
