Ophthalmology Flashcards
What are chloramphenicol eye drops used for?
Hordeolum (stye) with conjunctivitis, Dacryocystitis, Bacterial conjunctivitis, Corneal abrasion.
hat conditions benefit from lid hygiene with warm compresses?
Blepharitis, Hordeolum, Viral non-herpes conjunctivitis.
When are artificial tears (hypromellose) used?
Keratoconjunctivitis sicca (dry eye) - bilateral dryness and grittiness often in the elderly, worse at the end of the day.
What are the symptoms of cataracts?
Gradual painless vision loss globally, faded color vision, glare with halos around lights, defect in red reflex, cloudy lens.
How is macular degeneration managed?
Amsler grid, fundoscopy, antioxidants for dry type, anti-VEGF injections for wet type.
What are the symptoms of primary open-angle glaucoma?
Bilateral gradual painless vision loss peripherally to centrally, impaired adaptation to darkness, halos around lights, headaches.
What are the symptoms of macular degeneration?
Unilateral or bilateral gradual painless vision loss centrally, metamorphopsia, scotoma, impaired adaptation to darkness.
What is the management for primary open-angle glaucoma?
Prostaglandin analogue eye drops (e.g., latanoprost).
How is cataract managed?
Phacoemulsification.
How is diabetic retinopathy classified?
Non-proliferative (NPDR), proliferative (PDR), or maculopathy.
What are the treatment options for NPDR?
NPDR mild - observation, NPDR moderate/severe - focal laser photocoagulation.
What is the treatment for PDR?
Pan-retinal photocoagulation + anti-VEGF injections.
What are the symptoms of acute closed-angle glaucoma?
Unilateral acute painful vision loss, hard red eye, halos around lights, headaches, N&V, cloudy cornea.
How is acute closed-angle glaucoma treated?
Pilocarpine eye drops + acetazolamide
What are the symptoms of uveitis?
Unilateral acute painful red eye, blurry vision, photophobia, epiphora, hypopyon.
What are the symptoms of retinal detachment?
Unilateral sudden acute painless vision loss like a curtain or black shadow moving across vision with preceding floaters and flashes.
What is periorbital and orbital cellulitis associated with?
Inflammation of tissues anterior and posterior to the orbital septum, often secondary to local infection (e.g., sinusitis, dacryocystitis).
What is the association of hypermetropia with acute closed-angle glaucoma?
Hypermetropia (long-sighted, Asian).
What is amaurosis fugax?
Essentially a transient central retinal artery occlusion
What are the symptoms of vitreous detachment?
Floaters (cobwebs) and flashes (photopsia), blurry vision, red hue to vision.
What is the characteristic appearance of central retinal vein occlusion (CRVO)?
Cheese and tomato pizza’.
Describe the appearance of central retinal artery occlusion (CRAO).
‘Pale retina with cherry-red spot in fovea’.
What is optic neuritis associated with?
Unilateral acute or gradual visual loss often causing scotomas, red desaturation, pain on eye movements.
What is the imaging modality used for optic neuritis?
MRI.
What is the treatment for optic neuritis?
Prednisolone.
How is temporal arteritis diagnosed?
Temporal artery biopsy.
What is the treatment for temporal arteritis?
Prednisolone.
What is the first-line management for bacterial conjunctivitis?
Chloramphenicol eye drops.
What is the hallmark symptom of blepharitis?
Bilateral grittiness.
What is the characteristic symptom of keratoconjunctivitis sicca?
Bilateral dryness and grittiness often in the elderly, worse at the end of the day.
What is the primary complaint in keratoconjunctivitis sicca?
Dryness.
What is the visual symptom often associated with macular degeneration?
Metamorphopsia (straight lines appear wavy).
Features of keratitis
Red eye, photophobia and gritty sensation
Which condition is both tonometry and gonioscopy needed for diagnosis?
acute angle-closure glaucoma
Of scleritis and episcleritis, which one is painful?
Scleritis is painful
How do we treat cellulitis near the eyes?
Co-amoxiclav (rather than flucloxacillin)
Opthalmoscope changes in hypertension
AV nipping, flame / blot haemorrhage, cotton wool spots, hard exudates, papilledema
Patient has no symptoms, but is extremely bradycardic - what is the most likely diagnosis and underlying cause
3rd degree / complete heart block; sino-atrial disease
What are the risk factors for macular degeneration?
Smoking / Family History / Cardiovascular Disease or Hypertension / Obesity / Poor Diet / increased age
Anti VEGF role in wet macular degeneration
Prevents neovascularisation
Which type of visual loss is associated with temporal arteritis?
anterior ischaemic optic neuropathy
What is the presentation of anterior ischaemic optic neuropathy (temporal arteritis) on examination
shows a swollen pale disc and blurred margins (secondary to optic nerve ischaemia)
Treatment of anterior ischaemic optic neuropathy
Urgent IV steroids
Which ophthalmological condition presents with choroidal neovascularisation
Wet macular degeneration
What happens to pupil size in anterior uveitis?
Constricted
Treatment for anterior uveitis / iritis
steroid + cycloplegic (mydriatic) drops
Which visual problem is a RF for retinal detachment?
Myopia (nearsightedness)
Differentiate between wet and dry ARMD and why is one worse than the other?
In wet ARMD there is retinal neovascularisation from the choroid Which leak and cause oedema and faster vision loss than dry
Ophthalmological signs of shaken baby
Retinal haemorrhages
Pathophysiology of acute angle closure glaucoma
The iris bulges forward and seals off the trabecular meshwork from the anterior chamber
This prevents aqueous humour from draining
Increasing the ocular pressure
Which further exacerbates the angle closure, and places pressure on the optic nerve
Why is timolol used in acute angle closure glaucoma?
Reduce production of aqueous humour
Definitive management of acute angle closure glaucoma?
Laser iridotomy
What investigation is recommended for corneal injury?
Fluorescein staining
