Ophthalmology Flashcards
What is the first choice antibiotic in orbital cellultis?
Co-amoxiclav
What are the first choice IV antibiotics in orbital cellulitis?
Cefuroxime or ceftriaxone
Which HLA is associated with uveitis typically?
B27
What is the mainstay of treatment for uveitis?
Corticosteroids
Which medications used in uveitis cause mydriasis and reduce symptoms of photophobia?
Cyclopentolate
Atropine
What is mydriasis?
Pupillary dilatation
Which gene is responsible for retinoblastoma and where is it located?
RB1 gene on chromosome 13q14
What is leukocoria?
White pupillary reflex
What is strabismus?
Abnormal alignment of the eyes
When is ROP screening performed for infants <31 weeks gestation at birth?
Between 31+0-31+6 weeks or 4 weeks postnatal, whichever is later
What kind of visual defect will a retinal lesion cause?
Ipsilateral visual defect, opposite to site of lesion
What kind of visual defect will a optic nerve lesion cause?
Monocular visual field loss
What kind of visual defect will a optic chiasm lesion cause?
Bitemporal hemianopia
What kind of visual defect will a optic tract lesion cause?
Homonymous hemianopia
What kind of visual defect will a visual cortex lesion cause?
Contralateral homonymous hemianopia with macular sparing
What does the pharmacological treatment of optic neuritis usually entail?
High-dose corticosteroids e.g. methylprednisolone
What does the pharmacological treatment of ischaemic optic neuropathy usually entail?
Anti-platelets or anticoagulants
(aspirin or warfarin)
What does the pharmacological treatment of prolactinomas usually entail?
Dopamine agonists e.g. cabergoline or bromocriptine
What does the pharmacological treatment of GH-secreting tumours usually entail?
Somatostatin analogues e.g. octreotide
What does the pharmacological treatment of acromegaly usually entail?
GH-receptor antagonists e.g.peguisomant
What does the pharmacological treatment of IIH usually entail?
Diuretics (acetazolamide or furosemide)
Corticosteroids (dexamethasone)
What is the difference between esophoria and esotropia?
Esophoria is a latent squint whereas esotropia is visible at all times
What is amblyopia?
aka a lazy eye where the brain ignores visual input from one side for a variety of reasons.
Which gene is vital to initiation of eye development?
PAX6 gene
When does eye development occur during gestation?
3-10weeks
What is anophthalmia?
The absence of one or both eyes
What is microphthalmia?
One or both eyes are small and have anatomical abnormalities
What is a coloboma?
Hole in an ocular structureWhat
What causes a coloboma?
Failure of choroid fissure to fuse
What is aniridia?
Complete absence of 1 or both iris’
In cerebellar nystagmus is the fast component directed towards or away from the side of the lesion?
Towards
In vestibular nystagmus is the fast component directed towards or away from the side of the lesion?
Away
Vertical nystagmus is caused by a lesion to where?
Brainstem at the pontomedullary junction
What would typically be seen on fundoscopy in stage I sickle cell retinopathy?
Salmon patches and sunburst spots
What would typically be seen on fundoscopy in stage II sickle cell retinopathy?
Arteriovenous anastomoses
What would typically be seen on fundoscopy in stage III sickle cell retinopathy?
Sea-fan pattern
What would typically be seen on fundoscopy in stage IV sickle cell retinopathy?
Vitreous haemorrhage
What would typically be seen on fundoscopy in stage V sickle cell retinopathy?
Tractional retinal detachment
Which syndrome causes ptosis, miosis, reduced sweating on affected side and slow pupillary response to light?
Horner Syndrome
Which syndrome causes the eyelid to move upwards when the jaw is opened?
Marcus-Gunn syndrome
What is the classic triad of glaucoma presentation?
Tearing, photophobia and blepharospasm
What is Duane syndrome?
Eye unable to turn out and retracts into socket on adduction
What is Brown syndrome?
Defect in superior oblique tendon sheath meaning eye cannot look upwards especially in adduction
What is the most common pathogen that causes styes?
S.aureus
What is the first sign of diabetic retinopathy?
Dot haemorrhages
At what age does screening start for diabetic retinopathy?
12 years
Which nerve innervates the lateral rectus muscle?
6th - abducens
Which nerve innervates the medial rectus muscle?
3rd - oculomotor
Which nerve innervates the superior rectus muscle?
3rd - oculomotor
Which nerve innervates the inferior rectus muscle?
3rd - oculomotor
Which nerve innervates the superior oblique muscle?
4th - trochlear
Which nerve innervates the inferior oblique muscle?
3rd - oculomotor
What are the actions of the lateral rectus muscle?
Abduction
What are the actions of the medial rectus muscle?
Adduction
What are the actions of the superior rectus muscle?
elevation, adduction and intorsion
What are the actions of the inferior rectus muscle?
Depression, adduction and extorsion
What are the actions of the superior oblique muscle?
Depression, intorsion and adduction
What are the actions of the inferior oblique muscle?
Elevation, extorsion and abduction
What clinical sign within the eye is most expected to be seen in long chain hydroxy acyl-CoA dehydrogenase (LCHAD) deficiency?
Pigmentary retinopathy
At what gestation is the vascularisation of the retina complete?
40 weeks
What occurs in internuclear ophthalmoplegia?
One eye shows nystagmus on abduction whilst the other eye fails to adduct properly
At what age are Kay cards best used for measuring visual acuity?
2-4years
Which embryological structure goes on to form the vasculature and vitreous within the eye?
Mesenchyme
How does ornithine aminotransferase affect the eye?
Choroid and retinal atrophy
Presents with worsening myopia and poor night vision
Which cranial nerve is responsible for raising the upper eyelid?
CNIII
Findings of a swollen optic disc and RAPD should raise the concern of a lesion of which structure?
Optic nerve
What is the sign of stage 4 sickle cell retinopathy?
Retinal haemorrhage - sudden loss of vision
At what week of gestation does the optic fissure close?
Week 6
Which area of the brain is a lesion located in internuclear ophthalmoplegia?
Pons
Which nerve palsy presents with head tilt towards the unaffected side as well as vertical diplopia?
Trochlear nerve
What is the usual incubation period for chlamydia conjunctivitis in neonates?
5-28days
What is the usual incubation period for gonorrhoea conjunctivitis in neonates?
3-5days