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Surgical Specialties > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Does ARMD present with an RAPD?

A

No

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2
Q

What signs will be present of fundoscopy in dry ARMD?

A

Hyper/hypopigmentation of retina

Deposition of drusen

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3
Q

What is the investigations of choice for wet ARMD?

A

Fundus fluorescene angiogram

OCT

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4
Q

What is the treatment for wet ARMD?

A

Anti-VEGF

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5
Q

What 4 conditions cause a gradual visual loss?

A

Cataract
ARMD
Chronic open angle glaucoma
Diabetic retinopathy

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6
Q

What signs will be seen on fundoscopy of a central retinal artery occlusion?

A

Pale swollen retina

Cherry-red spot on macula

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7
Q

What is the treatment for central retinal artery occlusion?

A

Ocular massage
Paper bag breathing - CO2 mediated arteriodilation
IV diamox (CA inhibitor)
Anterior chamber paracentesis

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8
Q

What signs will be seen on fundoscopy for central retinal vein occlusion?

A

Flame haemorrhage
Tortuous vessels
Swollen optic disc
Cotton wool spots

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9
Q

Does RAPD develop in central retinal artery occlusion and central retinal vein occlusion?

A

Yes

Yes

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10
Q

What is ischaemic optic atrophy?

A

A cause of moderate to severe visual loss
Associated with 40-60s, hypermetropes, smokers.
Swollen optic disc with hyperaemia

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11
Q

What is the treatment for retinal detachment?

A

Retinal tears can be lasered

“Full-blown” detachment can utilise vitrectomy

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12
Q

What are 3 causes of painless, sudden visual loss?

A

Vasular occlusion (CRVO, CRAO, ischamic optic atrophy, amaurosis fugax)
Retinal detachment
Vitreous haemorrhage

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13
Q

What are 3 causes of painful, sudden visual loss?

A

Acute angle closure glaucoma
Optic neuritis
Giant cell arteritis

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14
Q

Is RAPD present in optic neuritis?

A

Yes

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15
Q

What is the treatment for optic nueritis?

A

Steroids

Beta-interferon

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16
Q

What is the treatment of giant cell arteritis?

A

2 years of steroids

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17
Q

What visual loss would a left sided parietal lesion cause?

A

Right inferior quadrantanopia

18
Q

What would a visual loss would a right sided temporal lesion cause?

A

Left superior quadrantanopia.

19
Q

Where would a brain lesion allow for sparing of the central vision?

A

If the lesion is in the visual cortex (cortical blindness)

20
Q

What is Horner’s syndrome?

How can the location, and therefore the underlying cause, of Horner’s be identified?

A

Disruption to sympathetic innervation of half of the face - leads to unilateral ptosis, anhidrosis and miosis.

Determined by extent of anhidrosis:

  • head, arm, trunk - central lesion i.e. stroke, syringomyelia
  • face alone - pre-ganglionic i.e. pancoast, cervical rib
  • none - post-ganglionic i.e. carotid pathology
21
Q

What is a unique cause of CNIII palsy?

A

Posterior communicating artery aneurysm

22
Q

What is a unique cause of CNIV palsy?

A

Congenital

Trauma

23
Q

What is a unique cause of CNVI palsy?

A

Raised ICP

24
Q

How may scleritis be differentiated from episcleritis?

A

Localised injection in both

  • episcleritis blanches with phenylephrine, or mild ocular pressure
  • scleritis does not blanch with phenylephrine (injection is a deeper, purple-ish colour)

Scleritis is associated with connective tissue disease, episcleritis is not.

Pain is worse and deep with scleritis. Only mild or no pain in episcleritis.

25
Q

What is the management for episcleritis?

A

Self-limiting
Topical lubricants
NSAIDs

26
Q

What is the management for scleritis?

A

Oral NSAIDs
Systemic steroids
Immunosuppression if necrotic

27
Q

What are the signs and symptoms of anterior uveitis/iritis?

A 
Dull pain
Photophobia 
Lacrimation
Circumcorneal injection
Hypopyon
Small, fixed pupil
28
Q

What is the treatment for anterior uveitis/iritis?

A

Topical steroids

Topical mydriatic - cyclopentolate, atropine

29
Q

What are the symptoms of acute angle closure glaucoma?

A

Unilateral eye pain and headache
Red eye
Cupping
Hazy cornea

30
Q

How do you measure intra-ocular pressure?

A

Tonometry

31
Q

What is the initial management of acute angle closure glaucoma?

A
  1. Pilocarpine - miotic (constricting) agent.
  2. Acetazolamide (Diamox) - CA inhibitor, IV or oral.
  3. Mannitol/Glycerol - hyperosmotic agent.
  4. Timolol - beta-blocker.
  5. Brimonidine - sympathomimetic agent.
32
Q

What is the initial management of open angle glaucoma?

A
  1. Prostaglandin eyedrops - latanoprost, first line.
  2. Second line drugs:
    i. Beta-blockers - timolol.
    ii. CA inhibitors - dorzolamide.
    iii. Sympathomimetics - brimonidine.
33
Q

A patient has blurry vision and photophobia. On examination, a small, fixed, oval pupil with ciliary flush is observed.

What is the likely diagnosis?

A

Anterior uveitis

34
Q

What are side effects of lantoprost drops?

A

Eye lash growth, eyelid and iris hyperpigmentation.

35
Q

What is the definitive management of open angle glaucoma?

A

Trabeculectomy - surgery that opens a hole in the meshwork.

36
Q

What is the definitive management of acute angle closure glaucoma?

A

Laser iridotomy - makes a hole in iris, allowing drainage into posterior chamber.

37
Q

What is the management for a dendritic keratic ulcer?

A

Herpes simplex keratitis - topical aciclovir

38
Q

What is Hutchinson’s sign?

A

Shingles affecting tip of nose - strong risk factor for ocular involvement of HZV infection

39
Q

What is the strongest risk factor for ARMD?

A

Smoking

40
Q

What is the treatment for allergic conjunctivitis?

A

Topical antihistamines

41
Q

What is Argyll-Robertson pupil?

What are the 2 causes?

A

A pupil that is not reactive to light but does accommodate.

Syphilis and diabetes mellitus

Surgical Specialties (2 decks)

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