ophthalmology Flashcards
first line management for pt with AAU (new presentations of and recurrent acute anterior uveitis)
urgent referral to ophthalmologists within 24hrs
then afterwards may be given prednisolone eyedrops and cylcoplegic eyedrops to dilate the pupil eg atropine
epislceritis vs scleritis
episcleritis
- inflammation of episclera which is the outer layer of the sclera
- painless, doesnt affect vision
- episcleral vessels are mobile in response to phenylephrine drops
scleritis
- pain, photophobia and reduced vision
- the vessels in the eye are not moveable and will show no response to phenylephrine drops
what is the name for the condition which causes inflammation at the eyelid margins / base of eyelashes
blepharitis
tx for blepharitis
there is no cure, just do conservative management eg cleaning the area
painful red eye
pain is worse when moves eye
photophobia
PMH of RA
diagnosis?
scleritis
what is chemosis
swelling of conjunctiva
which 3 features point to a diagnosis of orbital cellulitis over periorbital cellulitis
opthalmoplegia
pain with eye movements
proptosis
effect of hydroxychloroquine on the eye
bulls eye maculopathy - irreversible damage to macula
which medication can cause raised IOP (intraocular pressure)
steroids
what is corneal arcus
a white, blue or grey opaque ring around edge of iris
gradual visual loss tat affects the peripheral visual fields at first
diagnosis
retinitis pigmentosa
hereditary
black pigmentaion on the retina
in which condition are bright yellow deposits (called “drusen” - deposits of protein) seen on the macula / retina
Dry age related macular degeneration (Dry AMD)
nausea
headaches
servere ocular pain
blurred vision
haloes around lights
pupil in fixed dilated position
diagnosis
acute angle closure glaucoma
He reports seeing bright flashing lights and a curtain in his right visual field
diagnosis
retinal detachment
what are new onset flashers and floaters followed by loss of vision indicative of
retinal detachment
Her headaches are worse in the morning and worse when she lays down to go to sleep at night.
what is this indicative of
raised inter cranial pressure
what is used to treat raised intracranial hypertension secondary to intracerebral malignancy
dexamethasone
which 2 medications are used in emergency only for acutely raised intercranial pressure, due to their risk of causing electrolyte disturbances
mannitol
hypertonic saline
which medication can be used to relieve idiopathic intracranial hypertension
acetazolamide (+weight loss, lifestyle adjustments, optic nerve fenestration if vision is threatened and ventriculo-peritoneal shunting if headaches are refractory to medical management)
which med causes red coloration of secretions
rifampicin
what is the main side effect of ethambutol
optic neuropathy
initial Tx for GCA to minimise permanent visual loss
no vision loss: high-dose steroids such as oral prednisolone
vision loss: IV methylprednisolone
elderly female presenting with sudden, painless, monocular loss of vision usually on a background of scalp tenderness, headaches, or jaw claudication
diagnosis?
GCA
what are cyclopentolate or cycloplegc eyes drops used for
uveitis
gradual history of unilateral blurred vision, haloes around light sources
loss of the red light reflex
worse vision at night
myopic shift (patient becomes more short sighted due to the increased refractive index of the cataract)
suggests a diagnosis of what?
cataracts
definitive mx of cataracts
surgical removal of the cloudy lens and replacement with an artificial one
main modifiable risk factor for age related macular degeneration
smoking
what does central visual loss (straight lines appear wavy) , esp in dim light (night blindness) indicate
age related macular degeneration
what is a gonioscopy
an eye test that checks for signs of glaucoma
vision loss
reduced visual acuity
peri orbital pain, exacerbated by eye movements
colour desaturation
RAPD
diagnosis?
optic neuritis
what is the main cause of corneal arcus
hyperlipidaemia
which examination can confirm a diagnosis of refractive error?
Pinhole-aided visual acuity
retinal oedema, retinal pigment epithelium detachment and macular exudates
is this dry or wet age-related macular degeneration
wet
drusen, chorioretinal atrophy
is this dry or wet age-related macular degeneration
dry
what symptoms does diabetic macular oedema cause
reduced visual acuity
straight lines appear wavy
what is a myopic shift
patient becomes more short sighted due to the increased refractive index of the cataract
classic triad of Horners syndrome
mitosis
partial ptosis
anhidrosis
what is posterior synechiae and which condition can it be seen in
adhesions between the lens and iris causing an irregularly shaped pupil
this occurs in anterior uveitis
which type of uveitis can cause exudative retinal detachment
posterior uveitis
in which type of uveitis can vitreous cells be visualised
intermediate uveitis
sudden painless vision loss in ONE eye
optic disc swelling
RAPD
TIAs of visual loss prior to the sudden visual loss
RFs = age, htn, dm, sleep apnoea
diagnosis
ischaemic optic neuropathy (ION)
what eye manifestation is associated with infective endocarditis
Roth spots