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AMC MCQ > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Cataracts: risk factors

A
  • Ageing / Senility
  • Corticosteroid therapy
  • Diabetes
  • Hypoparathyroidism
  • Dystrophia myotonia
  • Trauma (may be delayed)
  • Ocular disease (e.g. glaucoma)
  • Smoking
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2
Q

Cataracts features

A

– Reading Difficulty
– Difficulty in recognising faces
– Problem with driving especially at night
– Difficulty with television viewing
– Reduce ability to see in bright light (glaring)
– May see haloes around light

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3
Q

Traumatic cataract features

A
  • under 45 years of age
  • injury to the lens by foreign body or direct impact
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4
Q

Cataracts management

A
  • Intraocular lens
    -phaecoemulsification to replace intraocular lens
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5
Q

Hyphaema causes

A

Trauma (squash ball, rugby)
- Blood clotting disturbances
- Medications (anticoagulants)
- Neovascularisation (diabetic retinopathy, previous eye surgery0
- melanoma or retinoblastoma
- abnormal vasculature

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6
Q

Hyphaemia features

A
  • presence of blood in the anterior chamber
  • ## impaired visual acuity
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7
Q

Hyphaemia management

A
  • Urgent referral to the ophthalmologist
  • bed rest with the head elevated 30 to 45° with eye shield
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8
Q

Unilateral cataract features

A

– A progressive blurring of vision.
– Glare, especially in bright light or when driving at night
– Monocular double vision

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9
Q

Nasolacrimal duct obstruction features

A
  • Clear eye discharge & crusting of the eyelashes
  • No redness or irritation
  • 6 to 20% of newborns
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10
Q

Nasolacrimal duct obstruction management

A
  • resolves spontaneously
  • requires antibiotics only when
    complicated conjunctivitis or dacryocystitis
  • Ophthalmologic consultation if persists past 12 months of age or earlier if complicated by recurrent infection
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11
Q

Diabetic retinopathy screening

A

2 yearly by either optometrist or ophthalmologist unless:

  • Aboriginal and Torrens Islanders
  • Non-English-speaking backgrounds
  • Visual loss
  • Poor diabetic control
  • hypertension
    -hyperlipidaemia
  • anaemia
  • renal disease
    -long duration of diabetes
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12
Q

Diabetic retinopathy predictors

A
  1. Non-English-speaking backgrounds
  2. Duration of diabetes
  3. Control of diabetes
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13
Q

Diabetic retinopathy screening in diabetic pregnant women

A

1st trimester

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14
Q

Diabetic retinopathy screening in children

A

Puberty

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15
Q

Diabetic retinopathy screening in gestational diabetes

A

diabetes persists after pregnancy

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16
Q

Diabetic retinopathy screening in Non proliferative diabetic retinopathy

A

Screen every 3–6 months

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17
Q

Diabetic retinopathy risk factors

A

-Poor glycemic control.
-Longer duration diabetes.
-Poor lipid or blood pressure control.
-Aboriginal and Torrens Islanders

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18
Q

Diabetic retinopathy management

A

Prophylactic photocoagulation

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19
Q

Base orbital fracture features

A
  • Damage to infraorbital nerve failing to “push” the eyeball up
    1. Diplopia when gazing upwards
    2. enophthalmos (eye receding into the orbit)
    3. Numbness (cheek, upper lip, or upper gingiva)
  • Blurry vision
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20
Q

Superior orbital fracture features

A
  • vertical diplopia when gazing downwards
  • no numbness
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21
Q

Zygomatic fracture features

A
  • horizontal diplopia
  • Mallar flattening
    -difficulty in opening mouth
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22
Q

Hyphaemia complications

A
  • recurrent bleeding
  • glaucoma
  • blood staining of the cornea
  • all leading to permanent vision loss
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23
Q

Nasal bone fracture features

A
  • horizontal diplopia
  • cerebrospinal fluid leakage
  • epistaxis
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24
Q

Glaucoma risk factors

A

-The family history of glaucoma.
-Myopia.
-Diabetes Mellitus.
– Migraine.
– History of trauma to the eyes
– Abnormal blood pressure

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25
Q

Tripod fracture features

A
  • vertical/horizontal/oblique diplopia
  • difficulty in mastication
26
Q

Open angle glaucoma treatment

A
  • STAMP
    -Supine Position
  • Timolol topical (carteolol)
  • Acetazolamide IV
  • Mannitol
    -Pilocarpine topical
27
Q

Long term treatment of acute closed-angle glaucoma

A

Laser iridotomy

28
Q

Long term treatment of chronic open-angle glaucoma

A

Laser trabeculectomy

29
Q

Difference between hypermetropia & presbyopia

A

Age 40 and is completed at 60

30
Q

Contraindication to timolol

A

– severe hypotension
– chronic obstructive airways disease
– Moderate to severe asthma
– uncontrolled cardiac failure
– bradycardia or second or third-degree atrioventricular block

31
Q

Eye corticosteroid side- effects

A

– Microbial keratitis
– Corneal thinning
– Delayed corneal healing
– Corneal perforation
– Cataract formation
– Raised intraocular pressure
– Glaucomatous optic neuropathy

32
Q

Acute closed angle glaucoma features

A
  • rapidly increased IOP
  • pain
  • nausea
  • blurred vision
  • eye redness
  • hazy cornea
    -pupils partially or fully dilated and unresponsive to light (anisocoria)
  • NO photophobia
33
Q

Indications for referral of Ophthalmologist

A

– Penetrating eye injury or intraocular foreign body
– Incomplete removal or practitioner uncertainty
– Persisting foreign body symptoms
– Persisting rust ring
– Persisting vision loss
– Keratitis
– Endophthalmitis
– Paediatric or uncooperative patients that may require examination under anaesthesia

34
Q

Features of retinal detachment

A
  • Hx of trauma, diabetic retinopathy, myopia and cataract surgery
  • sudden onset of floaters, flashes and field defects
  • painless loss of vision
  • dark shadow (curtain closing) of affected eye
35
Q

Features of Posterior Vitreous detachment

A
  • Age >70 years (66%)
    -Vision acuity preserved
36
Q

Unilateral exophthalmos features

A
  • most common Graves’s disease (Thyrotoxicosis)
  • orbital pseudotumor
  • orbital cellulitis
  • cavernous sinus
  • thrombosis
  • retrobulbar
  • retro-orbital tumours
  • Congenital glaucoma
    Nasopharyngeal tumours
37
Q

Retinal artery occlusion fundoscopic features

A
  • Cherry red spot
  • Retinal whitening
38
Q

Chronic simple glaucoma fundoscopic features

A
  • increased ratio of the optic cup to the
    optic disc
  • retinal vessels seem to be cut/ broken upon entering optic disk
39
Q

external hordeolum (stye) pathogen

A

Staphylococcus aureus

40
Q

external hordeolum (stye)

A

Warm compresses

41
Q

Strabismus cut-off point

A
  • 5 to 6 months to align by itself
  • Correcting strabismus before 4-6 years
42
Q

dacryocystitis management

A
  • flucloxacillin
  • amoxicillin
  • clavulanate
  • cephalexin
43
Q

Macular degeneration features

A
  • blurry centre of her vision
  • distortion of objects (straight lines wavy)
44
Q

Types of age related macular degeneration

A

Dry
- slow progression
- 90% of AMD cases
- drusen, pigmentation and
sometimes haemorrhages at macula

Wet
- rapid deterioration
- abnormal vessels grow from the choroid into the neurosensory retina &leak macula
- rapid deterioration

45
Q

Hypertensive retinopathy features

A
  • papilloedema
  • straightening of the vessels
  • thickened opacified vessel walls
  • arteriovenous nicking
46
Q

Bacterial conjuctivitis treatment

A

Chloramphenicol

47
Q

inflammation of meibomian glands

A

Internal hordeolum

48
Q

Features of viral conjunctivitis

A
  • adenovirus
  • watery eyes
  • uni or bilateral affection
  • contact lenses
  • usually painless
  • vision preserved
49
Q

Features of allergic conjunctivitis

A
  • can be watery
  • bilateral
    -history of contact hypersensitivity (changing contact lenses), hay fever
  • usually painless
  • vision preserved
50
Q

Features of keratitis

A
  • herpes simplex/zoster infection
  • circumcorneal dendritic ulceration
  • eye pain and redness
  • grittiness (foreign body)
    -photophobia
  • lacrimation
  • vision and pupillary reflex normal
51
Q

Features of acute uveitis (iritis)

A
  • eye pain and redness
  • visual acuity may be decreased
  • photophobia
  • hypopyon (white cells precipitating in anterior chamber)
    -irregular constricted pupil (reflex abnormal)
    -history of prior surgery (phacoemulsification)
  • also associated with seronegative arthropathies (ankylosing spondylitis, RA, IBD)
52
Q
A
53
Q

Traumatic cataract features

A
  • under 45 years of age
  • injury to the lens by foreign body or direct impact
54
Q

Conditions that require urgent referral to Ophthalmologist

A
  • Significant eye trauma, burns, embedded foreign body in cornea, intraocular foreign body
  • Hyphaemia (>3mm)/hypopyon
  • Corneal ulcer
  • Severe conjunctivitis
  • Uveitis/ acute iritis
  • Behcet syndrome
  • acute glaucoma
  • giant cell arteritis
  • acute dacryocystitis
  • endophthalmitis
  • herpes zoster ophthalmicus
55
Q

features of retinal artery occlusion

A

unilateral + sudden onset of significant vision loss
- preceded by transient monocular blindness

56
Q

Types of retina artery occlusion

A

attach pics

57
Q

Hypopyon

A

sign not diagnosis
indicates uveitis

58
Q

Management of subconjunctival haemorrhage

A
  • red discolouration NOT crossing the limbus = warm compress
  • red discoloration CROSSING the limbus = find underlying cause (Orbit CT)
  • AVOID NSAID’s
59
Q

Management of episcleritis

A
  • Hypromellose (artificial tears) 4-6 times/day
  • Topical NSAID’s diclofenac
    NOTE: Topical steroids (prednisolone) if all above not helping
60
Q

Difference between subconjunctival haemorrhage & episcleritis

A

Subconjunctival haemorrhage:
- micro tears in the sclera that cause haemorrhages, eyes appears dark red due to the accumulation of blood, but could also turn blue/purple/yellow after
- no discomfort with the exception of trauma
Episcleritis:
- Patchy pinkish/redness of the eye usually found in the corner
- no discharge, itchiness
- mild discomfort
-

61
Q

Difference between episcleritis & scleritis

A
  • If a patient’s eye redness improves after phenylephrine instillation = episcleritis
  • scleritis is painful

AMC MCQ (56 decks)

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