Ophthalmology Flashcards
What causes a *painful 3rd nerve palsy?
*eye down and out
pupil dilated
eyelid drooping
Posterior communicating artery aneurysm
What is the most common cause of a IV nerve palsy? (superior oblique)
What is the most common cause of a VI nerve palsy? (lateral rectus)
Congenital trauma - IV
Microvascular - VI
What causes blurring of vision years after cataract surgery?
posterior capsule opacification
What’s the difference between a chalazion and hordeolum externa?
Chalazion - meibomian cyst - intenral eyelid, usually not painful
Hordeolum externa - stye - infection of the gland on the eyelid - painful
What is the holme’s adie pupil?
Benign cause of a dilated pupil
Usually in women
Usually unilateral
Once the pupil has constricted it remains small for an abnormally long time
slowly reactive to accommodation but very poorly (if at all) to light
May be associated with absent ankle/knee reflexes
What is Hutchinson’s sign?
Hutchinson’s sign: rash on the tip or side of the nose. Indicates nasociliary involvement and is a strong risk factor for ocular involvement
Age-related macular degeneration is the most common cause of blindness in the UK.
What is wet versus dry macular degeneration?
Age-related macular degeneration is the most common cause of blindness in the UK. Degeneration of the central retina (macula) is the key feature with changes usually bilateral. ARMD is characterised by degeneration of retinal photoreceptors that results in the formation of drusen which can be seen on fundoscopy and retinal photography. It is more common with advancing age and is more common in females.
Dry AMD
- Most common
- Accumulatuion of drusen
- Gradual decline in central vision
Wet ADM
- Central scotoma and wet patches on funcdoscopy
- Gradual decline and sudden deterioration
What is the treatment for conjunctivitis in pregnancy?
Fusidic acid
*Not chloramphenicol
How quickly should suspected macular degeneration be referred to ophthalmology?
Urgent 1 week wait - even if suspected to be dry. This is because any chance of wet degenration can lead to quick visual loss and so they need to be assessed and considered for treatment. There is however no real treatment if it is dry.
What is the Argyll Robertson pupil?
Argyll Robertson
Accomodate but don’t react
Bilateral - if this change were unilateral> think of holmes adie pupil
Causes include neurosyphilis and diabetes
What is the Marcus Gunn pupil aka rapid afferent pupillary defect?
Found by the ‘swinging light test’
Caused by a lesion anterior to the optic chiasm - optic nerve or the retina
Affected and normal eye both dilate when light is shone in the affected eye
Causes: retinal detachment, optic neuritis
What is pinguecula versus pterygium?
Pinguecula - Yellow fat deposits on the sclera. Asymptomatic. Can get inflamed > pingueculitis. .
Pterygium - Fatty deposits on the cornea, More serious.
What is dacrocystitis?
Infection of the lacrimal sack, hot painful lump medial to the eye. Managed with oral antibiotics (co-amoxiclav).
When are steroids used in ophthalmology?
Post- op cataract surgery, uveitis, prevention of graft rejection
What is myopia versus hypermetropia?
Myopia = short sighted - distant objects are blurry
Need a concave lens. Eyeball is too long. Images are focused too soon.
Hypermetropia = long sited - near objects are blurry
Need a convex lens. Eyeball is too short. Image is focused too far back
