Ophthalmology Flashcards

1
Q

Ocular pain

A

Blepharospasm
Lacrimation
Photophobia
High blink rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Assess vision

A

Menace
Dazzle
Palpebral
Vestibulo-ocular reflex
PLR
Visual tracking
Maze test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dazzle reflex

A

Bright light
Subcortical reflex - GA poss
CN2 and7
Present in centrally blind
Absent in subcortical disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Menace

A

Learned by 3m
Avoid air current (false positive)
Coritcal processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PLR

A

Sym (dilation)
Asym (constriction
Not reflective of subcortical reflex
Symmetry
Affected by fear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lens selection (+/-D)

A

<-0 if problems right at back (pos)
-2D to +2D examine fundus
+2D to +10D examine vitreous
+10D to +20D examine lens/AC
+20D to +30D examine cornea/adnexa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Further tests

A

Dilation - tropicamide (shorter acting and duration, atropine (not for dry eye)
IOP (tonometry) - 10-25mm/Hg
Schimmer tear test - >15 mm/min
FLuoroscein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Filters scope

A

Green - blood black, pigment grey
Blue - fluoroscein
White - examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Sclera

A

Posterior fibrous layer
Layer - episclera, scleral stroma, lamina fusca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Corneal anatomy

A

Avascular
Layers - epithelium, stroma, Descemet’s membrane, endo
Precise collagen arrangement and low cell density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Epithelium

A

Stratified squamous
Not keratinised
Microvili-mucin PTF
Stem cells in limbus
Good regeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Stroma

A

Collagen
Keratocytes
ECM, H2O
Rigidity
Avasc healing-
neutrophils, fibroblasts
Vascular -
Vascular invasion, fibrovascular invasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Descemets membrane

A

Basement membrane of endothelium
Secreted by Endo (thicker if old)
Break - Haab’s striae
Deep ulcer - descemetocoele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Endothelium

A

1 cell thick
Ion pump and dehydrator (stroma)
Limited healing
Hyperplasia/ sliding
Decompensation -> oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Opacification

A

Ulcer
Vascularisation
Pigmentation
Oedema
Keratinisation
Fibrosis
Mineral/ lipid deposit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pathology

A

Corneal oedema
Vascularisation
Keratinomalacia
Stromal infiltrate
Fibrosis
Melanosis

16
Q

Reflex uveitis

A

Caused by ulcers
Mediated by axonal CN V reflex
Cycloegia and sys NSAID

17
Q

Ulcer

A

Hole in epi
CS not Dx
Facet -
Dent, Fl -ve, not painful
Perforation -
Siedal test, reduced IOP

18
Q

Siedal test

A

Test for corneal perforation and aqueous leakage
Apply stain
Cobalt blue
Aqueous running through dye

19
Q

SCCED

A

Spontaneous Chronic Corneal Epithelial Defect
Boxers, mid aged
Painful persistent
Slow healing
Topical Ana, debride, Ab, lateral partial tarsorrhaphy
GRID keratotomoy
- only for SCCED
Corneal-conjunctival transposition/ pedicle graft (tectonic support)
Cross linking

20
Q

Dermoids

A

Congenital choristoma of the orbit
Long hairs cause irritation, wick tears
Sx resection, ectomy

21
Q

Corneal lacerations

A

Risk of perforation
AC collapse
Iris prolapse
Endophthalmitis
2nd glaucoma
Phacoclastic uveitis (refer)

22
Q

Acquired cornea dz

A

Corneal sequestrum
Corneal lipidosis
- arcus, keratopathy, stromal dystrophy
Ca degeneration
Endothelial dystrophy
pigment keratopathy
Trauma

23
Q

Ca degeneration

A

Older patients, often 2ndary
High sera Ca
Ca infiltrate and vascularisation
Chalky
Epithelial defects
Keratectomy

24
Q

Corneal lipidosis

A

Crystaline stromal dystrophy
Young adults
Slow progression
Superficial lipid deposition (ctrl)
No Tx
Lipid keratopathy -
2°, inflammation, vascularised
Corneal arcus-
Sys Hyperlipoproteinaemia
Lipid infiltration perilimbal (arc shape)
Treat sys dz

25
Q

Endothelial degeneration

A

Boston terriers
Slow progressive decompensation of temporal endothelium -> oedema
Keratectomy

26
Q

Pigmentary keratopathy

A

Response to chronic corneal surface irritation
→Progressive corneal surface pigmentation
Brachycephalics
Genetic component
Treatment: Remove irritation
Topical ciclosporine