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YEAR 4 > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What conditions are associated with Episcleritis?

A

Inflammatory Bowel Disease
Rheumatoid Arthritis

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2
Q

What are the features of episcleritis?

A

Red eye that is classically not painful (may be mild irritation/pain) with watering and mild photophobia. The injected vessels move when gentle pressure is applied.

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3
Q

What is the treatment for episcelritis?

A

Conservative
Artificial tears are sometimes used.

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4
Q

What can be used to differentiate between scleritis and episcleritis?

A

Phenylephrine, blanches the conjunctival and episcleral vessels but not the scleral vessels.

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5
Q

What is scleritis?

A

Full thickness inflammation of the sclera which generally has a non-infective cause and causes a painful red eye.

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6
Q

Rheumatoid arthritis and SLE are two risk factors for the development of scleritis, name two more.

A

Sarcoidosis
Granulomatosis with polyangitis

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7
Q

Red and painful eye are two of the main features of scleritis, name 3 more.

A

Photophobia
Watering
Gradual decrease in vision.

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8
Q

What is the management of scleritis?

A

Same-day ophthalmology review.
Oral NSAIDs
Oral glucocorticosteroids may be used for more severe presentations.
Immunosuppressive drugs for resistant cases - which can also be used to treat the underlying condition.

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9
Q

What are the features of central retinal artery occlusion?

A

Sudden painless, unilateral vison loss.
Relative afferent pupillary defect

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10
Q

What are the risk factors for CRAO?

A

Cardiovascular risk factors (smoking, hypertension, hypercholesterolaemia, diabetes).
Risk factors for GCA: white, older age, female and polymalgia rheumatica.

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11
Q

What is seen on fundoscopy in CRAO?

A

Cherry red spot on a pale retina.
Cherry red spot = fovea

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12
Q

What is the management of CRAO?

A

Treat any underlying conditions (e.g. GCA)
Attempt to dilate artery: inhaled carbogen, sublingual isosorbide dinitrate, oral pentoxifylline.
Decreased IOP: Acetazolamide IV, IV mannitol, topical timolol.
Acute presentation = intraarterial thrombolysis may be attempted.

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13
Q

Family history is a risk factor for Acute angle-closure glaucoma, name 5 more.

A

Hypermetropia
Lens growth (age realated)
Female
Shallow anterior chamber
Pupil dilatation

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14
Q

Severe pain (ocular or headache), decreased visual acuity and red eye are 3 features of acute angle-closure glaucoma, name 5 more.

A

Pain worse with mydriasis
Fixed semi-dilated pupil
Haloes around lights
Corneal oedema = hazy cornea
Systemic upset = nausea, vomiting, abdominal pain.

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15
Q

What investigations are carried out for AACG?

A

Tonometry = raised IOP
Gonioscopy = angle between the cornea and the iris.

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16
Q

Which medications can precipitate AACG?

A

Adrenergic medications - noradrenaline
Anticholingergic medications - oxybutynin and solifenacin
TCAs - amitriptyline

17
Q

What medications are involved in treatment of AACG?

A

Pilocarpine
Acetazolamide (IV/oral)
Timolol
Dorzolamide
Brimonidine

18
Q

What is the definitive treatment for AACG?

A

Laser iridotomy - hole in the iris which allows the aqueous fluid to drain.

19
Q

What is the most common complication following panretinal laser photocoagulation?

A

Decrease in night vision.

20
Q

Recent eyelid infection is a risk factor for the development of orbital cellulitis, name 4 more.

A

Ear or facial infection
Previous sinus infection
Childhood
Lack of Hib vaccine

21
Q

Redness and swelling around the eye, severe ocular pain and visual disturbance are 3 features of orbitial cellulitis, name 4 more.

A

Proptosis
Ophthalmoplegia
Eyelid oedema and ptosis
Dowsiness, nausa and vomiting in meningeal involvement (rare)

22
Q

What features of orbital cellulitis are not seen in periorbital cellulitis?

A

Reduced visual acuity
Proptosis
Ophthalmoplegia

23
Q

Haemophilus influenzae B is a common bacterial cause of orbital cellulitis, name 2 more.

A

Streptococcus
Staphylococcus aureus

24
Q

What is the management of orbital cellulitis?

A

Admission
IV antibiotics

25
Q

Diabetic retinopathy and age are two risk factors for retinal detachment, name 3 more.

A

Myopia
Previous cataract surgery
Eye trauma

26
Q

Describe the vision loss that is experienced by patients with retinal detachment?

A

Sudden onset
Painless
Progressive visual field loss described as a curtain or shadow progressing to the centre of the visual field from the periphery.

27
Q

When would a patient with retinal detachment experience loss of central vision?

A

Macula detachment

28
Q

What is ‘deacreased vision at the point of fixation’ describing?

A

Central scotoma

29
Q

How do you differentiate between causes of horners syndrome?

A

Horner’s syndrome - anhydrosis determines site of lesion:
head, arm, trunk = central lesion: stroke, syringomyelia
just face = pre-ganglionic lesion: Pancoast’s, cervical rib
absent = post-ganglionic lesion: carotid artery

30
Q

What is the most common organism for keratitis with a history of swimming or contact with water?

A

Ancathomoeba

31
Q

What would be seen on fundoscopy for a patient presenting with an acute vision loss, secondary to WET AMD?

A

Well-demarcated red patches - haemorrhages as a result of neovascularisation.

32
Q

At what age should patients with a family history of glaucoma begin screening?

A

40

33
Q

What is the treatment of proliferative diabetic retinopathy?

A

Anti VEGF
Panretinal Photocoagulation Laser Therapy

34
Q

How would vision loss present with diabetic maculopathy?

A

Blurring of vision

35
Q

What vision loss do you get with glaucoma?

A

Peripheral vision loss - tunnel vision

36
Q

What is the firstline treatment for open-angle glaucoma?

A

Latanoprost

37
Q

Old age is a potential contributor to cataract formation, name 4 more.

A

Hypocalcaemia
Diabetes
Downs Syndrome
Long Term Steroid use

38
Q

What is the treatment for anterior uveitis?

A

Steroid drops (reduce inflam) + cycloplegic eye drops (prevent adhesions between the lens and the iris)

39
Q

What is the firstline treatment for allergic conjunctivitis?

A

Topical Antihistamine

YEAR 4 (11 decks)

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