Ophthalmology Flashcards by Lucy M

contact lense wearer + red eye, photophobia and gritty sensation (1)
bacteiral causes (2)

Keratitis (inflammation of cornea)

typically Staphylococcus aureus
Pseudomonas aeruginosa is seen in contact lens wearers
Other: Herpes

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Bacterial conjunctivitis in pregnancy

fusidic eye drops (can’t have chloramphenicol)

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recurrent watery or sticky eye in neonates - doesn’t respond to Abx

Congenital tear (lacrimal) duct obstruction, resolves by 1 year

REASSURANCE until 1 year

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cotton wool spots represent areas of…

RETINAL INFARCTION

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Corneal abrasion: treatment

cholcamphenicol to prevent infection

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Orbital compartment: what to do ((blood in the anterior chamber, proptosis, stiff eyelid, and a relative afferent pupillary defect)

URGENT decompression PRE imaging
immediate canthotomy

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mydriatic

large pupil

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Argyll-Robertson pupil

Argyll-Robertson pupil is one of the classic pupillary syndromes. It is sometimes seen in neurosyphilis. Typically the pupil accommodates but doesn’t react. A mnemonic used for the Argyll-Robertson Pupil (ARP) is Accommodation Reflex Present (ARP) but Pupillary Reflex Absent (PRA)

Features
small, irregular pupils
no response to light but there is a response to accommodate

Causes
diabetes mellitus
syphilis

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Punctate fluorescein staining of the cornea

dry eyes

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Ptosis + dilated pupil =;
ptos§is + constricted pupil =

Ptosis + dilated pupil = third nerve palsy; ptosis + constricted pupil = Horner’s

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Phenylephrine drops can be used to distinguish between

episcleritis and scleritis

. It blanches the redness in episcleritis but doesn’t in scleritis.

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positive Chvostek and Trousseau signs.

hypocalcaemia

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what metabolic disorder causes cataract

hypocalceamia

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Lens dislocation

Causes
Marfan’s syndrome: upwards
homocystinuria: downwards
Ehlers-Danlos syndrome
trauma
uveal tumours
autosomal recessive ectopia lentis

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A 32-year-old man with known Marfan’s syndrome presents to the emergency department with sudden, painless loss of vision in the left eye. There were no preceding symptoms and no trauma.

lens dislocation

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cheese and tomato pizza fundoscopy

central retinal vein occlusion

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chronic unilateral conjunctivitis resistant to treatment

Orbital lymphoma

Argyll-Robertson causes

diabetes
syphilis

what type of vision loss do you get in optic neuritis

Central scotoma is a classic finding in optic neuritis where patients experience a central visual field defect. This occurs because the papillomacular bundle, which serves central vision, is preferentially affected by the inflammatory process. The central scotoma may be absolute or relative and is typically demonstrated on visual field testing.

SUBACUTE visual loss

black bone-spicule pigmentation on fundoscopy

Retinitis pigmentosa

opaque retina with a cherry-red spot seen in CRAO.

Central retinal artery occlusion

most common eye manifestation of RA

Keratoconjunctivitis sicca

What is blepharitis?

Blepharitis is a common eye condition that makes your eyelids red, swollen, irritated, and itchy. It can cause crusty dandruff-like flakes on your eyelashes. Blepharitis can be uncomfortable. But it isn’t contagious, and it usually doesn’t cause any lasting damage to your eyes.

stye (hordeolum external) VS chalazion

Chorioretinitis

Chorioretinitis is an inflammatory condition affecting the choroid and retina of the eye. This dual inflammation can be precipitated by infectious or autoimmune aetiologies, leading to the potential for significant visual impairment if not promptly and effectively managed. Causes infectious toxoplasmosis: most prevalent cause worldwide cytomegalovirus: particularly in immunocompromised individuals such as HIV patients syphilis tuberculosis autoimmune sarcoidosis Behçet's disease systemic lupus erythematosus

hypertensive retinopathy stages: Keith-Waganer classifcaiton

1= arteriolar narrowing and tortuosity increased light II= AV nipping III= cotton wool flame and blot IV= papilloedema First they start to twist and turn [silver wiring], then they nip about the place [AV nipping], afterwards they play with cotton wool and fire [cotton wool spots, flame and blot haemorrhages], finally they swell up [papilloedema].

a firm painless lump in the eyelid

meibomian cyst (chalazion)

temporal arteritis managemtnet

high dose prednisolone IF visual symptoms/ fungus changes= IV Methylpred

On fundus examination, you can see a mixture of white and red retinal lesions.

PIZZA PIE = chorioretinitis inflammation of the choroid and the retina. Causes infectious toxoplasmosis: most prevalent cause worldwide cytomegalovirus: particularly in immunocompromised individuals such as HIV patients syphilis tuberculosis autoimmune sarcoidosis Behçet's disease systemic lupus erythematosus Management infectious pyrimethamine and sulfadiazine for toxoplasmosis ganciclovir or valganciclovir for CMV autoimmune systemic corticosteroids are the mainstay of treatment, often in combination with other immunosuppressive agents like methotrexate or azathioprine for more severe or refractory cases

dendritic ulcer on eye exam management

topic acyclovir (HERPES SIMPLEX)

shingles eye involvement

ocular: conjunctivitis, keratitis, episcleritis, anterior uveitis ptosis post-herpetic neuralgia

Retinitis pigmentosa is a classically inherited retinal disorder, characterised by tunnel vision and night blindness due to its effect on the peripheral retina. Fundoscopy reveals 'bone-spicule' pigmentation in the peripheral retina.

retinitis pigments

AMD management

REFER to opthal within 1 week

Blurring of vision again years after cataract surgery can occur due to

posterior capsule opacification

fluctuating vision particularly at night accusations iof extracellular material between rential pigment epithelium and Bruch's membrane

dry age related macular degeneration

when to give antibiotics for stye (hordeolum)

if conjunctivitis too

recurrent sticky eyes <1 year

Congenital tear (lacrimal) duct obstruction is a cause of recurrent watery or sticky eye in neonates and usually, self-resolves by 1 year of age

Chorioretinitis suspected = must do..

HIV test (common in cytomegalovirus which affects 40% of pts with AIDS)

holmes adie pupil

Holmes-Adie pupil is a benign condition most commonly seen in women. It is one of the differentials of a dilated pupil. Overview unilateral in 80% of cases dilated pupil 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 Holmes-Adie syndrome association of Holmes-Adie pupil with absent ankle/knee reflexes

Key features based on location rather than severity, anything is potentially serious hard exudates and other 'background' changes on macula check visual acuity more common in Type II DM

maculopathy (Since there is no evidence of any abnormality outside the macula in the rest of the retina, options 1-3 (background, pre-proliferative and proliferative diabetic retinopathies) are incorrect.)

A 70 year old woman complains that her left eye is acutely watering, painful and red with some blurring of her vision. Her visual acuity is reduced, but the pupillary reaction is normal.

dendritic ulcer

A 64 year old man having a routine blood pressure check whose pulse rate is 68. The rate is noted to increase during inhalation and decrease during exhalation.

Sinus arrhythmia