Ophthalmology Flashcards
Cataracts: risk factors
- Ageing / Senility
- Corticosteroid therapy
- Diabetes
- Hypoparathyroidism
- Dystrophia myotonia
- Trauma (may be delayed)
- Ocular disease (e.g. glaucoma)
- Smoking
Cataracts features
– Reading Difficulty
– Difficulty in recognising faces
– Problem with driving especially at night
– Difficulty with television viewing
– Reduce ability to see in bright light (glaring)
– May see haloes around light
Traumatic cataract features
- under 45 years of age
- injury to the lens by foreign body or direct impact
Cataracts management
- Intraocular lens
-phaecoemulsification to replace intraocular lens
Hyphaema causes
Trauma (squash ball, rugby)
- Blood clotting disturbances
- Medications (anticoagulants)
- Neovascularisation (diabetic retinopathy, previous eye surgery0
- melanoma or retinoblastoma
- abnormal vasculature
Hyphaemia features
- presence of blood in the anterior chamber
- ## impaired visual acuity
Hyphaemia management
- Urgent referral to the ophthalmologist
- bed rest with the head elevated 30 to 45° with eye shield
Unilateral cataract features
– A progressive blurring of vision.
– Glare, especially in bright light or when driving at night
– Monocular double vision
Nasolacrimal duct obstruction features
- Clear eye discharge & crusting of the eyelashes
- No redness or irritation
- 6 to 20% of newborns
Nasolacrimal duct obstruction management
- resolves spontaneously
- requires antibiotics only when
complicated conjunctivitis or dacryocystitis - Ophthalmologic consultation if persists past 12 months of age or earlier if complicated by recurrent infection
Diabetic retinopathy screening
2 yearly by either optometrist or ophthalmologist unless:
- Aboriginal and Torrens Islanders
- Non-English-speaking backgrounds
- Visual loss
- Poor diabetic control
- hypertension
-hyperlipidaemia - anaemia
- renal disease
-long duration of diabetes
Diabetic retinopathy predictors
- Non-English-speaking backgrounds
- Duration of diabetes
- Control of diabetes
Diabetic retinopathy screening in diabetic pregnant women
1st trimester
Diabetic retinopathy screening in children
Puberty
Diabetic retinopathy screening in gestational diabetes
diabetes persists after pregnancy
Diabetic retinopathy screening in Non proliferative diabetic retinopathy
Screen every 3–6 months
Diabetic retinopathy risk factors
-Poor glycemic control.
-Longer duration diabetes.
-Poor lipid or blood pressure control.
-Aboriginal and Torrens Islanders
Diabetic retinopathy management
Prophylactic photocoagulation
Base orbital fracture features
- Damage to infraorbital nerve failing to “push” the eyeball up
1. Diplopia when gazing upwards
2. enophthalmos (eye receding into the orbit)
3. Numbness (cheek, upper lip, or upper gingiva) - Blurry vision
Superior orbital fracture features
- vertical diplopia when gazing downwards
- no numbness
Zygomatic fracture features
- horizontal diplopia
- Mallar flattening
-difficulty in opening mouth
Hyphaemia complications
- recurrent bleeding
- glaucoma
- blood staining of the cornea
- all leading to permanent vision loss
Nasal bone fracture features
- horizontal diplopia
- cerebrospinal fluid leakage
- epistaxis
Glaucoma risk factors
-The family history of glaucoma.
-Myopia.
-Diabetes Mellitus.
– Migraine.
– History of trauma to the eyes
– Abnormal blood pressure