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year 3 conditions > ophthalmology > Flashcards

ophthalmology Flashcards

1
Q

first line management for pt with AAU (new presentations of and recurrent acute anterior uveitis)

A

urgent referral to ophthalmologists within 24hrs
then afterwards may be given prednisolone eyedrops and cylcoplegic eyedrops to dilate the pupil eg atropine

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2
Q

epislceritis vs scleritis

A

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

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3
Q

what is the name for the condition which causes inflammation at the eyelid margins / base of eyelashes

A

blepharitis

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4
Q

tx for blepharitis

A

there is no cure, just do conservative management eg cleaning the area

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5
Q

painful red eye
pain is worse when moves eye
photophobia
PMH of RA
diagnosis?

A

scleritis

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6
Q

what is chemosis

A

swelling of conjunctiva

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7
Q

which 3 features point to a diagnosis of orbital cellulitis over periorbital cellulitis

A

opthalmoplegia
pain with eye movements
proptosis

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8
Q

effect of hydroxychloroquine on the eye

A

bulls eye maculopathy - irreversible damage to macula

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9
Q

which medication can cause raised IOP (intraocular pressure)

A

steroids

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10
Q

what is corneal arcus

A

a white, blue or grey opaque ring around edge of iris

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11
Q

gradual visual loss tat affects the peripheral visual fields at first
diagnosis

A

retinitis pigmentosa
hereditary
black pigmentaion on the retina

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12
Q

in which condition are bright yellow deposits (called “drusen” - deposits of protein) seen on the macula / retina

A

Dry age related macular degeneration (Dry AMD)

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13
Q

nausea
headaches
servere ocular pain
blurred vision
haloes around lights
pupil in fixed dilated position
diagnosis

A

acute angle closure glaucoma

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14
Q

He reports seeing bright flashing lights and a curtain in his right visual field
diagnosis

A

retinal detachment

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15
Q

what are new onset flashers and floaters followed by loss of vision indicative of

A

retinal detachment

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16
Q

Her headaches are worse in the morning and worse when she lays down to go to sleep at night.
what is this indicative of

A

raised inter cranial pressure

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16
Q

what is used to treat raised intracranial hypertension secondary to intracerebral malignancy

A

dexamethasone

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17
Q

which 2 medications are used in emergency only for acutely raised intercranial pressure, due to their risk of causing electrolyte disturbances

A

mannitol
hypertonic saline

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18
Q

which medication can be used to relieve idiopathic intracranial hypertension

A

acetazolamide (+weight loss, lifestyle adjustments, optic nerve fenestration if vision is threatened and ventriculo-peritoneal shunting if headaches are refractory to medical management)

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19
Q

which med causes red coloration of secretions

A

rifampicin

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20
Q

what is the main side effect of ethambutol

A

optic neuropathy

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21
Q

initial Tx for GCA to minimise permanent visual loss

A

no vision loss: high-dose steroids such as oral prednisolone
vision loss: IV methylprednisolone

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22
Q

elderly female presenting with sudden, painless, monocular loss of vision usually on a background of scalp tenderness, headaches, or jaw claudication
diagnosis?

A

GCA

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23
Q

what are cyclopentolate or cycloplegc eyes drops used for

A

uveitis

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24
Q

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?

A

cataracts

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25
Q

definitive mx of cataracts

A

surgical removal of the cloudy lens and replacement with an artificial one

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26
Q

main modifiable risk factor for age related macular degeneration

A

smoking

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27
Q

what does central visual loss (straight lines appear wavy) , esp in dim light (night blindness) indicate

A

age related macular degeneration

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28
Q

what is a gonioscopy

A

an eye test that checks for signs of glaucoma

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29
Q

vision loss
reduced visual acuity
peri orbital pain, exacerbated by eye movements
colour desaturation
RAPD
diagnosis?

A

optic neuritis

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30
Q

what is the main cause of corneal arcus

A

hyperlipidaemia

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31
Q

which examination can confirm a diagnosis of refractive error?

A

Pinhole-aided visual acuity

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32
Q

retinal oedema, retinal pigment epithelium detachment and macular exudates
is this dry or wet age-related macular degeneration

A

wet

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33
Q

drusen, chorioretinal atrophy
is this dry or wet age-related macular degeneration

A

dry

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34
Q

what symptoms does diabetic macular oedema cause

A

reduced visual acuity
straight lines appear wavy

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35
Q

what is a myopic shift

A

patient becomes more short sighted due to the increased refractive index of the cataract

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36
Q

classic triad of Horners syndrome

A

mitosis
partial ptosis
anhidrosis

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37
Q

what is posterior synechiae and which condition can it be seen in

A

adhesions between the lens and iris causing an irregularly shaped pupil
this occurs in anterior uveitis

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38
Q

which type of uveitis can cause exudative retinal detachment

A

posterior uveitis

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39
Q

in which type of uveitis can vitreous cells be visualised

A

intermediate uveitis

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40
Q

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

A

ischaemic optic neuropathy (ION)

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41
Q

what eye manifestation is associated with infective endocarditis

A

Roth spots

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42
Q

which vision field is affected first in glaucoma

A

peripheral

43
Q

what is cupping of the optic disc a feature of

A

glaucoma

44
Q

what is AV nipping a feature of

A

hypertensive retinopathy

45
Q

what is cherry red spot a feature of

A

central retinal artery occlusion

46
Q

Retinal hyperaemia and haemorrhages, sometimes called the ‘stormy sunset’ appearance
what is this a typical fundoscopy appearance of

A

central retinal vein occlusion

46
Q

what is photopsia

A

flashers

47
Q

pain on eye movement and visual loss
diagnosis

A

optic neuritis
(scleritis and orbital cellulitis don’t present with visual loss)

48
Q

what is the cause of Horners syndrome

A

loss of innervation of the sympathetic chain

49
Q

what eye position does fourth cranial nerve palsy cause

A

up and in

50
Q

what eye position does third cranial nerve palsy cause

A

down and out

51
Q

what eye position does sixth cranial nerve palsy cause

A

abduction - double vision

52
Q

what is a central scotoma

A

blind spot in the middle of your vision

53
Q

what are the 4 signs of acute optic neuropathy

A

monocular visual field defect - usually central scotoma
reduced colour vision
RAPD
optic disc swelling, or if chronic, atrophy of optic nerve fibres –> pale optic disc

54
Q

what are latanoprost eye drops used for

A

treat high pressure in the eye , and treat glaucoma

55
Q

which eye condition is associated with RA

A

scleritis

56
Q

which eye condition is associated with MS

A

optic neuritis

57
Q

blurry vision
difficulty driving at night due to glare from street lights
diagnosis?

A

cataracts

58
Q

if child has an eye that drifts to the side they look forwards, what complication could this lead to if not treated

A

amblyopia

59
Q

what is entropion

A

the eyelid turns inwards with the lashes against the eyeball, subsequently causing corneal damage and ulceration

60
Q

what is keratitis sicca

A

“dry eyes” - chronic, bilateral desiccation of the conjunctiva and cornea due to an inadequate tear film.

61
Q

what is entropion and ectropion

A

entropion- inward curling of the eyelid
ectropion - outward turning of the eyelid

62
Q

which peripheral facial neuropathy is caused by varicella zoster virus

A

Ramsay hunt syndrome

63
Q

how does a sub conjunctival haemorrhage present

A

bright red eye
common causes include sneezing, coughing, eye trauma
no pain

64
Q

what are Lid retraction (Dalrymple’s sign) and lid lag on down gaze (Von Graefe’s sign) classic signs of

A

thyroid eye disease

65
Q

what condition are Anti-acetylcholine receptor antibodies tested to check for

A

myasthenia gravis

66
Q

what is posterior lens capsule opacification

A

relatively common complication of cataract surgery that usually occurs a few weeks following the operation
patient complains of blurry vision as if their cataract has returned, and a white opacity may be visible on observation

67
Q

what condition does cupping of the optic disc indicate

A

chronic open angle glaucoma

68
Q

what condition does bone spicule pigmentation indicate

A

retinal defect found in patients with retinitis pigmentosa

69
Q

what condition is eczema on the eyelids seen in

A

allergic conjunctivitis

70
Q

what condition is pre-auricular lymph nodes, watery, gritty eyes, symptoms of an upper respiratory tract infection associated with

A

viral conjunctivitis

71
Q

what visual field loss is caused by left optic neuritis affecting left optic nerve

A

left monocular blindness

72
Q

what visual field loss is caused by a right-sided optic tract lesion

A

Left homonymous hemianopia

73
Q

what visual field loss is caused by a left-sided optic tract lesion

A

Right homonymous hemianopia

74
Q

progressive loss of vision over past few days
central vision worse
trouble reading
retinal oedema / grey-green macula
diagnosis

A

wet age-related macular degeneration

75
Q

tx for wet age-related macular degeneration

A

anti VEGF injections

76
Q

what is sumatriptan used to treat

A

migraines

77
Q

what condition is associated with poor contact lens hygiene

A

microbial keratitis

78
Q

what is microbial keratitis

A

infection of the cornea
painful
photophobia
sticky discharge
hypoyon (pus in anterior chamber)

79
Q

main risk factors for developing cataracts

A

age
smoking
diabetes
systemic corticosteroid use

80
Q

mx of cataracts

A

surgical intervention called “pseudophakia”
removal of affected lens by using “phacoemulsification” then replacing it w an artificial lens

81
Q

2 main complications of cataract surgery

A

endophthalmitis
- pain, vision loss, red, within DAYS, emergency

posterior lens capsule opacification
- blurry vision, white opacity, within WEEKS

82
Q

Ix for cataract

A

slit-lamp biomicroscopy
reveals a brown/white appearance of the lens

83
Q

cataract signs and symptoms

A

difficulty seeing at light
halos around lights esp at night
blurred vision
difficulty reading and recognising faces
gradual PAINLESS Visual loss

loss of red reflex
brown/white lens on slit-lamp bio microscopy

84
Q

what is ptosis

A

eyelid drooping

85
Q

proptosis
severe pain
restricted eye mouvements
rapid deterioration in vision
all following trauma
diagnosis?

A

retrobulbar haemorrhage - requires urgent lateral canthotomy

86
Q

night blinds and tunnel vision are indicative of what

A

retinitis pigmentosa

87
Q

what do flashers and floater suggest

A

retinal detachment

88
Q

what does visual fluctuations suggest

A

Age related macular degeneration

89
Q

what does glare from bright light

A

cataracts

90
Q

what is hypermetropia

A

long-sightedness

91
Q

what is myopia

A

short-sightedness

92
Q

what is enopthalmos

A

eyes sinking deeper into socket

93
Q

what treat meant is C/I in thyroid eye disease

A

radioactive iodine ablation therapy

94
Q

immediate next step after suspicion of temporal arteritis

A

high dose steroids, confirm w temporal artery biopsy later

95
Q

what could cause bilateral central field of visual loss

A

retinal disease eg AMD or diabetic maculopathy

96
Q

fundoscopy appearance of central retinal artery vs being occlusion

A

central retinal artery occlusion
- pale retina with cherry red spot on macula

central retinal vein occlusion
- stormy sunset appearance

97
Q

what does crusting at eyelid margins suggest

A

blepharitis

98
Q

what does purulent discharge suggest

A

bacterial conjunctivitis

99
Q

what do pupils which constrict on convergence but do not constrict in response to light suggest

A

argyll-roberston pupil
- suggests neurosyphilis

100
Q

tx for scleritis

A

URGENT REFERRAL
1) NSAIDs
2) systemic glucocorticosteroids
3) azathioprine / methotrexate

101
Q

tx for uveitis

A

URGENT REFERRAL
corticosteroid eye drops eg prednisolone
cycloplegic eye drops eg atropine

102
Q

tx for optic neuritis

A

high dose prednisolone

103
Q

peri orbital cellulitis mx

A

oral co-amoxiclav
secondary career referral

104
Q

orbital cellulitis

A

IV vancomycin + cefotaxime
hospital admission

year 3 conditions (17 decks)

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