Ophthalmology Flashcards
Mx of Stye (hordeolum)
Warm compress to speed up process of bursting. If non resolving, do curettage
Dendritic ulcers are seen in?
Viral keratitis
Treatment for acute closed angle glaucoma
Apraclonidine, timolol, pilocarpine, azetazolamide. Laser iridotomy is definitive.
Two ways to investigate closed angle glaucoma. Mention what they measure
Tonometry (pressure), gonioscopy (corneal angle)
Relief of Shoulder pain when place hand on head…. Diagnostic of what
Cervicle radiculopathy.
Tx of cervicle radiculopathy
Conservative
First Signs of macular degeneration, and contrast this for dry and wet
For dry, our central scotoma . For wet, it’s more straight line distortion
Halos at night, is a sign of what?
Cataracts
When to treat cataracts
When it affects life
In strabismus is it normal to have one eyes red reflex more intense
Yes
General Mx for open angle glaucoma
Topical latanoprost first. Then add topical timolol as a step up. If that doesn’t work consider laser therapy. (Tim and his Latino)
Patient has impact to eye/branch in eye etc…. What’s the best invx and why
Flouresin stain…. To Dx abrasion, but also to rule out open globe laceration!!
What are boxcar retinal vessels, where do we see them
In central retinal artery occlusion. Essentially segmentation of the vessels
Tx for retinal detachment
Laser Tx and cryo Tx. To adhere the neursensory retina and RPE
Tremorlous iris with movement of eye left and right, is a sign of?
Lens dislocation
Intial Mx of corneal pH burn. (Bleach for eg.)
Irrigate with normal saline… use litmus to ensure pH normal
What is blepharitis . Some of the causes
Inflam of the eye lid margin. Due to seb derm, HSV, staph, rocasea, allergy, dermodex
What is dacryostenosis. Mx?
Stenosis of the nasolacrimal duct in infants. Massage the duct
Differences in presentation between viral conj and allergic conj
Viral conj : bilateral or unilateral, usually prodrome before, and has 5 days of continuous symptoms
Allergic conj : always bilateral, often atopic and has exposure, intermittent for longer
Strabismus, cover test? And Tx. Significance of 4 month old mark. Red reflex sign.
Where you cover normal eye and see the bad eye move medially . Tx with corrective lenses if bad eye has low visual acuity, and patch cover the good eye to strengthen the bad eye to prevent ambylopia. Only Dx at >4 mo old. Red reflex will be present but greater in the bad eye
How to distinguish between vitreous hemorrhage and optic nerve injury after head injury
Red reflex remains in optic nerve injury, whereas it’s gone in vitreous hem
Invx and Tx for optic nerve injury scodanry to head injury
Ct orbit. Then do conservative therapy, and some may need surgical decompression
Two ways a patient can get traumatic optic nerve damage
Penetrative (usually surgery) or in head injury where the shearing forces transmit to optic canal
What is neonatal chemical conjunctivitis and what causes it? Mx?
Often from silver nitrate being given for gonorrhoea prophylaxis. This is banned in the US though. Presents in first 24 hours, Tx with eye lubrication
Periorbital echymosis (raccoon eyes) suggests?
Orbital fracture
Acute corneal opacification is a sign of what
Acute closed angle glaucoma
Signs of acute global perforation
Fixed teardrop pupil, low acuity, low IOP, extrusion of AH (seen on floruensin), RAPD,
Causes of subconj hem and Tx
Sneeze, cough, HTN, rubbing eye, coagulopathy. Just observe (very benign)
Young patient has strabismus… what needs to be ruled out
Rb…. Do a dilated fundo exam
Hordeolum vs charlazion
H - granulomatous inflam on eye lid. Painless but uncomfortable nodule
C - abscess on eye, localised