Ophthalmology Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Mx of Stye (hordeolum)

A

Warm compress to speed up process of bursting. If non resolving, do curettage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dendritic ulcers are seen in?

A

Viral keratitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment for acute closed angle glaucoma

A

Apraclonidine, timolol, pilocarpine, azetazolamide. Laser iridotomy is definitive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Two ways to investigate closed angle glaucoma. Mention what they measure

A

Tonometry (pressure), gonioscopy (corneal angle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Relief of Shoulder pain when place hand on head…. Diagnostic of what

A

Cervicle radiculopathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tx of cervicle radiculopathy

A

Conservative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

First Signs of macular degeneration, and contrast this for dry and wet

A

For dry, our central scotoma . For wet, it’s more straight line distortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Halos at night, is a sign of what?

A

Cataracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When to treat cataracts

A

When it affects life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In strabismus is it normal to have one eyes red reflex more intense

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

General Mx for open angle glaucoma

A

Topical latanoprost first. Then add topical timolol as a step up. If that doesn’t work consider laser therapy. (Tim and his Latino)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Patient has impact to eye/branch in eye etc…. What’s the best invx and why

A

Flouresin stain…. To Dx abrasion, but also to rule out open globe laceration!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are boxcar retinal vessels, where do we see them

A

In central retinal artery occlusion. Essentially segmentation of the vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx for retinal detachment

A

Laser Tx and cryo Tx. To adhere the neursensory retina and RPE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tremorlous iris with movement of eye left and right, is a sign of?

A

Lens dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Intial Mx of corneal pH burn. (Bleach for eg.)

A

Irrigate with normal saline… use litmus to ensure pH normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is blepharitis . Some of the causes

A

Inflam of the eye lid margin. Due to seb derm, HSV, staph, rocasea, allergy, dermodex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is dacryostenosis. Mx?

A

Stenosis of the nasolacrimal duct in infants. Massage the duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Differences in presentation between viral conj and allergic conj

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Strabismus, cover test? And Tx. Significance of 4 month old mark. Red reflex sign.

A

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 well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How to distinguish between vitreous hemorrhage and optic nerve injury after head injury

A

Red reflex remains in optic nerve injury, whereas it’s gone in vitreous hem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Invx and Tx for optic nerve injury scodanry to head injury

A

Ct orbit. Then do conservative therapy, and some may need surgical decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Two ways a patient can get traumatic optic nerve damage

A

Penetrative (usually surgery) or in head injury where the shearing forces transmit to optic canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is neonatal chemical conjunctivitis and what causes it? Mx?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Periorbital echymosis (raccoon eyes) suggests?

A

Orbital fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Acute corneal opacification is a sign of what

A

Acute closed angle glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Signs of acute global perforation

A

Fixed teardrop pupil, low acuity, low IOP, extrusion of AH (seen on floruensin), RAPD,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Causes of subconj hem and Tx

A

Sneeze, cough, HTN, rubbing eye, coagulopathy. Just observe (very benign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Young patient has strabismus… what needs to be ruled out

A

Rb…. Do a dilated fundo exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hordeolum vs charlazion

A

H - granulomatous inflam on eye lid. Painless but uncomfortable nodule

C - abscess on eye, localised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does dacryostenosis present, and how is it managed

A

Presents with excess Eye tearing and discharge. May even cause eyelash/eyelid crusty. You can do a fluorescent dye, which will show the fluorescent dripping down the cheek and not draining. Management is to massage daily, and if unresolved in six months surgery

32
Q

What is ambylopia And what are its causes

A

Essentially a reduced vision due to a vision issue in that eye. So either cataracts, strabismus, refractive error will cause cortical changing to enhance the other eyes vision., but will then neglect the bad eye.

33
Q

Quick recap on some of the ophthalmological Checks we do in infants and children

A

Shortly after birth the eyes fixate on stuff. Around three months eyes should be tracking. We should also be doing red reflex testing and strabismus checking. At around 3 to 4 years old we can do visual acuity testing with Snellen chart. 20 out of 40 is concerning for refractive error. Up at five years old 30/40 as concerning

34
Q

If a patient who had cataract surgery starts to get blood vision, what is this most likely

A

Posterior capsule opacification. To get cataracts again after surgery is highly unlikely

35
Q

What is a traumatic hyphema, and what’s the treatment

A

Blood collection between the cornea and the lens. Usually from blunt trauma, rarely penetrative. Use an eye shield, bed rest, elevate head, glucocorticoid eyedrop. And monitor pressure since glaucoma is a complication

36
Q

What is the treatment for a trachoma

A

Azithromycin orally conclude the chlamydial infection. The whole village should be treated in theory. If the patient has trichiasis, then surgery is required of course

37
Q

 Most common cause of vitreous haemorrhage and how does it present

A

Most common course is a diabetic retinopathy. Present with loss of vision in one eye, a decrease perception to light, decrease fundal details (SOS), floaters, and a red glow on fundoscopy

38
Q

How to manage CMV retinitis

A

Must start ganciclovir. Lesions near the surveyor or optic nerve require direct injection. A couple of weeks after this treatment we can start antiretroviral therapy if AIDS patient

39
Q

Mention the three main causes of keratitis (infectious), and a sentence on how to distinguish them

A

HSV – Immuno compromised, watery discharge, dendritic alteration on fluorescent

Staph/pseudomonas – In foreign body or contact lens wearers, will be purulent

Candida – in amino compromised, with soil exposure. Feathery margins and satellite lesions

40
Q

Hutchinson’s sign for Hsv opthalmicus

A

If the vesicles of shingles involve the nose tip, it will likely involve the eye

41
Q

Name three different techniques to treat central retinal artery occlusion

A

Anterior chamber paracentesis, ocular massage, revascularisation. Remember to do ultrasound of the carotid valuate for stenosis

42
Q

Contrast the appearance of vision loss in a central retinal artery occlusion and retinal detachment

A

In retinal artery occlusion we tend to get vertical dropping of the visual field. In retinal detachment we have curtains across (both sides peripherally to central)

43
Q

Anterior vs posterior uveitis symptoms

A

Anterior causes eye redness and pain

Posterior is painless and causes floaters

44
Q

Other than CVT, what are other causes of cavernous sinus syndrome

A

Pituitary mass, fistula

45
Q

Orbital blowout fracture. Risk of what

A

Inferior rectus and orbital fat entrapment. Infraorbital nerve can be caught too

46
Q

First order horners syndrome causes

A

Pontine hemorrhage. Lateral medullary syndrome. Spinal cord lesion above T1. Late syringomuelia

47
Q

What else can cause Marcus Gunn apart from MS

A

GCA

48
Q

In Papilledema. What else can be seen on Fundoscopy

A

Dilated tortuous veins

49
Q

Retinitis pigmentosa is associated with what genetic disease

A

Abetaliproteinemia

50
Q

Papilledema in a HTN patient? Do what

A

This is malignant HTN. So must immediately lower BP

51
Q

Black spots and cobweb shapes in visual field

A

Vitreous haemorrhage

52
Q

Curtain down over eye vision. Sudden, and flashing lights. Had preceding floaters

A

Retinal haemorrhage

53
Q

Causes of central retinal artery occlusion

A

AF, Behcets, GCA, SCD,

54
Q

Biggest risk factor for central vein occlusion in retina

A

HTN

55
Q

Drugs causing optics neuritis

A

Methanol, ethambutol, linezolid, infliximab

56
Q

Fundoscopy finding in optic neuritis

A

Usually normal, but can have Disc swelling similar to papilledema

57
Q

Metamorphopsia

A

Straight lines appear wavy. Seen early on in age related macular degen

58
Q

Headache worsened by darkness vs brightness

A

Brightness is obviously migraine. But darkness could be closed angle glaucoma

59
Q

Myopia needs what lens?

A

Concave

60
Q

Hyperopia needs which lens

A

Convex

61
Q

Keratitis Dx test and what we see

A

Slitlamp. And will see white clumps (WBCs in the anterior chamber or vitreous chamber)

62
Q

Redness and pain of eye. Especially seen at limbus .

A

Anterior uveitis

63
Q

Main complication of acute dacrocysttitis

A

Orbital cellulitis

64
Q

Bac causing acute dacryocystitis

A

Strep and staph

65
Q

Bac causing contact lens keraitis

A

Pseudomonas

66
Q

Orbital cellulitis vs periorbital cellulitis

A

Orbital has: painful eye movement, lower acuity, Diplopia, proptosis, RAPD

67
Q

Patient with orbital cellulitis and signs of nasal or mucosal ulceration or ethmoidao/maxillary sinusitis….

A

Mucormycosis or Rhizopus

68
Q

Dacro cystitis, Maine bacterial cause

A

Strep and staff

69
Q

First line for open-angle glaucoma

A

Latanoprost. Timolol also ok

70
Q

What is blepharitis.

A

Inflammation of the eyelid Marjan. Just to warm compress and lid massage

71
Q

Treatment for neo Nate chlamydial conjunctivitis

A

Oral erythromycins.

72
Q

Overview of symptoms for acute globe perforation

A

Decrease security, teardrop pupil, fluid moving out from the eye. RAPD. Drop in intraocular pressure.

73
Q

If a patient has strabismus, what sort of investigation should I do

A

Should do a funduscopic exam, to rule out things like retinoblastoma

74
Q

Name some infectious causes of keratitis

A

Pseudomonas, staphylococcus, Canada, HSV

75
Q

Keratitis with linear Dritic alteration

A

Dendritic alteration. HSV

76
Q

Somebody with keratitis with soil exposure, feathery margins and satellite lesions

A

Candida

77
Q

Someone has bleeding in the joint, but the coagulation studies and LFTs a normal. They also had a gastric bypass surgery six months ago

A

Could be scurvy.