Ophthalmology Flashcards
Causes of tunnel vision
papilloedema
glaucoma
retinitis pigmentosa
choroidoretinitis
optic atrophy secondary to tabes dorsalis
hysteria
Primary open angle glaucoma Mx
Latanoprost - increases uveoscleral outflow. (also make iris brown, increase eye lash length)
Timolol - reduce aqueous production
Brimonidine - both (contraindicated in those using MAOI)
Posterior vitreous detachment Fx
flashes of light
floaters in periphery
Retinal detachment Fx
Dense shadow from periphery into centre
straight lines appear curved
Vitreous haemorrhage Fx
Large bleed - sudden loss
moderate bleed - numerous dark spots
small bleeds - floaters
Horners syndrome Fx
ptosis - drooping of eyelid
miosis - constricted pupil
anhidrosis - lack of sweating
Third nerve palsy Fx
pstosis - drooping of eyelid
mydriasis - dilated pupil
“down and out” = appearance of eye
Argyll Robertson pupil Fx
accommodating pupils - bilateral constricted pupils
Do not react to light
associated with neurosyphilis
Holmes-Aidie pupil Fx
Unilateral dilated pupil
Poorly reacts to light
Slow constriction on accommodation
Absent reflexes in other parts of the body
Central vein occlusion Fx
Sudden, painless, unilateral vision loss
Associated with
CVD, HTN, increase age
Age related macular degeneration Ix and Mx
Amsler grid - distortion of line perception
Urgent Ophthalmology referral
Optic neuritis Fx
unilateral gradual decrease in vision
pain on eye movement
poor discrimination of colours
RAPD
central scotoma
Nasolacrimal duct obstruction Fx
Persistent watery eye <1yo
Mx
lacrimal duct massage
self resolve by 1yo
if >1yo - refer ophthalmology
Red painful eye differential
Acute angle closure glaucoma: severe pain, haloes, ‘semi-dilated’ pupil
Uveitis: small fixed pupil, photophobia
Keratitis: photophobia, fluorescein stain shows ulcer
Meibomian cyst Mx
1st- warm compress BD
If atypical - 2WW refer Ophthal
- bleeding, ulceration, loss of eye lashes, distortion of eyelid margin
Contact lens associated keratitis cause
pseudomonas aeruginosa
Retinitis pigmentosa Fx
night blindness + tunnel vision
inherited/ strong family history
Acute angle closure glaucoma
can be precipitated by Mydriatic drops
Eyelid issues examples (5)
blepharitis: inflammation of the eyelid margins typically leading to a red eye
stye (hordeolum externum): infection of the glands of the eyelids
chalazion (Meibomian cyst)
entropion: in-turning of the eyelids
ectropion: out-turning of the eyelids
https://geekymedics.com/fundoscopic-appearances-of-retinal-pathologies/
Fundoscopy images revision
https://geekymedics.com/fundoscopic-appearances-of-retinal-pathologies/
Fundoscopy images revision
blepharitis Mx
hot compress + lid hygiene
herpes zoster ophthalmicus Mx
PO Aciclovir
(Top steroid can help with inflammation)
herpes zoster ophthalmicus Fx
red, painful eye with discharge
decreased acuity
dendritic ulcer on staining
Primary open-angle glaucoma Mx
Refer to Ophthalmology
1st - 360° selective laser trabeculoplasty (SLT)
2nd - prostaglandin analogue - eg latanoprost
3rd - Timolol, Brimonidine
Older person, painless visual loss DDx
Macular degeneration = central field loss
Primary open-angle glaucoma = peripheral field loss
Corneal abrasion Mx
Top Chloramphenicol
Most common post surgical complication of cataract surgery
posterior capsule thickening
Marcus Gunn/ Relative Afferent Pupil defect Fx
When light is shone into the affected eye - the affective eye dilates. (should constrict if normal)
Allergic conjunctivitis Mx
Sodium Cromoglicate (Top mast cell stabiliser)
Amiodarone eye side effect
corneal microdeposit - night glare
