Ophthalmology Flashcards
How does central retinal vein occlusion present?
sudden painless loss of vision
RAPD
fundoscopy shows widespread hyperaemia and severe retinal haemorrhages - ‘stormy sunset’
How does central retinal vein occlusion present?
sudden painless loss of vision
RAPD
fundoscopy shows widespread hyperaemia and severe retinal haemorrhages - ‘stormy sunset’
What is the key feature of age-related macular degeneration?
degeneration of the central retina (macula) with changes usually bilateral
what are the symptoms and signs of macular degeneration?
Gradual worsening central visual field loss
Reduced visual acuity
Crooked or wavy appearance to straight lines
Examination:
Reduced acuity using a Snellen chart
Scotoma - central patch of vision loss
Amsler grid test can be used to assess distortion of straight lines
Fundoscopy - drusen are the key finding
What are the typical symptoms of cataract?
reduced vision
faded colour vision: makes it more difficult to distinguish different colours
glare: lights appear brighter than usual
halos around lights
what sign can be seen in people with cataract?
defect in the red reflex
what are the risk factors for retinal detachment?
- diabetes mellitus
- myopia
- age
- previous surgery for cataracts
- eye trauma e.g. boxing
what is the treatment for herpes simplex keratitis?
topical aciclovir
What are the causes of optic neuritis and how does it present?
causes: MS, diabetes, syphilis
features:
- unilateral decrease in visual acuity over hours to days
- poor discrimination of colours - ‘red desaturation’
- pain worse on eye movement
- RAPD
- central scotoma
What are the features of anterior uveitis?
acute onset
ocular discomfort and pain
pupil may be small +/- irregular due to sphincter muscle contraction
photophobia - often intense
blurred vision
red eye
lacrimation
ciliary flush - a ring of red spreading outwards
hypopyon - pus and inflammatory cells in the anterior chamber
what is the management of anterior uveitis?
urgent review by ophthalmology
cycoplegics - dilates the eye which helps relieve pain and photophobia e..g. atropine, cyclopentolate
steroid eye drops
What is the treatment for open angle glaucoma?
prostaglandin analogue e.g. latonoprost - reduced uveoscleral outflow
what is endophthalmitis?
infection inside the globe and most commonly occurs after surgery
most commonly presents a few days after the surgery but may present greater than 6 weeks later (chronic post-operative endophthalmitis)
What is herpes zoster ophthalmicus?
reactivation of varicella zoster virus in the area supplied by the ophthalmic division of the trigeminal nerve - accounts for around 10% of shingles
presents with a vesicular rash around the eye, which may or may not involve the actual eye itself
Hutchinson’s sign: rash on the tip or side of the nose - indicates nasociliary involvement and is a strong risk factor for ocular involvement
What are the complications of herpes zoster ophthalmicus?
conjunctivitis, keratitis, episcleritis, anterior uveitis
ptosis
post-herpetic neuralgia
