Ophthalmology Flashcards

1
Q

What are the features of acute closed-angle glaucoma?

A

Acute, severe unilateral eye pain, systemic features. A fixed dilated pupil, enlarged conjunctival blood vessels and a hazy cornea. Pain worse in the dark, due to angle closure increasing intra-ocular pressure

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1
Q

What does hypermetropia mean?

A

Long-sightedness

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2
Q

What are cotton wool spots in the eye?

A

pre-capillary arteriolar occlusion - part of diabetic retinopathy

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3
Q

What is the management of visual loss secondary to temporal arteritis?

A

IV methylprednisolone

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4
Q

What is the management of acute angle closure glaucoma?

A

timolol/pilocarpine eye drops and IV acetazolomide

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5
Q

What is the management of primary open angle glaucoma?

A

laser trabeculopathy
consider lanatoprost eyedrops

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6
Q

What is the management of anterior uveitis?

A

steroid and cycloplegic eye drops

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7
Q

What are the features on fundoscopy of anterior ischaemic optic neuropathy?

A

swollen pales disc with blurred margins

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8
Q

What are the features of diabetic retinopathy on fundoscopy?

A

cotton wool spots, hard exudates and blot haemorrhages

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9
Q

What are the features of papilloedema on fundoscopy?

A

elevated optic disc with blurred margins

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10
Q

What is keratitis?

A

Inflammation of the cornea - can be sight threatening

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11
Q

What are the risk factors for retinal detatchment?

A

diabetes mellitus, myopia (near-sightedness), age, previous surgery, eye trauma

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12
Q

What are the symptoms of retinal detatchment?

A

new onset floaters/flashes, sudden onset painless, progressive vision loss

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13
Q

What are the features of keratitis?

A

red eye, pain, photophobia, foreign body/gritty sensation, hypopyon may be seen. usually in contact lens wearers

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14
Q

What are the common causes of keratitis?

A

staph aureus
pseudomonas aeruginosa in contact-lens wearers
acanthoamoebic keratitis - much more painful, seen after exposure to soil or water

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15
Q

What is the management of keratitis?

A

topical quinolones, cycloplegic for pain relief (cyclopentolate)

16
Q

What are the three main risk factors for macular degeneration?

A

advancing age, smoking, family history

17
Q

What is the difference between wet and dry macular degeneration?

A

Dry: most common. Gradual vision loss over years. accumulation of drusen (lipid and protein deposits)
Wet: abnormal growth of blood vessels under the retina, leaks fluid, sudden severe visual loss

18
Q

What are the features of macular degeneration?

A

reduction in visual acuity for near objects, difficulty with night vision, and glare. May have charles bonnet syndrome

19
Q

What is the first line investigation for macular degeneration?

A

Slit-lamp microscopy. After can do fluorescein angiography or optical coherence tomography

20
Q

What is the treatment of age related macular degeneration?

A

wet: anti-vascular endothelial growth factor, laser (2nd line)
dry: zinc, vit A, C, E

21
Q

What is a central scotoma?

A

an area of depressed central vision - often seen in MS optic neuritis

22
Q

What are the features of optic neuritis?

A

unilateral decrease in visual acuity over hours/days, poor colour discrimination, pain worse on eye movement, relative afferent pupillary defect, central scotoma

23
Q

How do you diagnose MS?

A

MRI of brain and orbits with gadolinium contrast

24
Q

What are the features of acute angle-closure glaucoma?

A

severe pain around/in eye, decreased visual acuity, worse in the dark, hard, red eye, semi-dilated non-reacting pupil, hazy cornea. systemic upset

25
Q

how do you investigate acute angle-close glaucoma?

A

tonometry - assess for IOP
gonioscopy - look at angle with special slit-lamp

26
Q

What is the immediate management of acute angle-closure glaucoma?

A

Refer to emergency eye
parasympathomimetic (pilocarpine, causes contraction of ciliary muscles allowing drainage of aqueous humor), beta-blocker (timolol, decreases aqueous humour production)
alpha-2-agonist (apraclonidine, decreases production)
IV acetazolomide (carbonic anhydrase inhibitor, reduces secretions)

27
Q

What is the definitive management of acute angle-closure glaucoma?

A

Laser peripheral iridotomy - allows humour flow

28
Q

what are the characteristic features of a vitreous haemorrhage?

A

Usually history of diabetes, painless visual loss or haze, red hue in the vision, dark floaters

29
Q

What investigations can be done in a vitreous haemorrhage?

A

Dilated fundoscopy, slit-lamp, US - can be used to rule out retinal detachment, fluorescein angiography (neovascularisation), orbital CT if open globe injury

30
Q

What is the management of a vitreous haemorrhage?

A

Urgent referral to ophthalmology, consider vitreoretinal surgery

31
Q

What is the word for dilated pupils?