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AKT > Ophthalmology 2 > Flashcards

Ophthalmology 2 Flashcards

1
Q

What is blepharitis?

A

Inflammation of eyelid margins
Meibomian gland dysfunction

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2
Q

What is a stye?

A

Infection of the glands of the eyelid

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3
Q

What is a chalazion?

A

Meibomian cyst

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4
Q

What is entropion?

A

In-turning of eyelids

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5
Q

What is ectropion?

A

Out turning of eyelids

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6
Q

Mx stye (2)

A

Hot compress and analgesia

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7
Q

A dendritic corneal ulcer is a common presentation of what condition?

A

Herpes simplex keratitis

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8
Q

Herpes simplex keratitis features (5)

A

Red, painful eye,
Epiphora - excessive tear production
Photophobia
Reduced vision

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9
Q

Fluorescein staining for herpes simplex keratitis may show?

A

Epithelial ulcer

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10
Q

Rx herpes simplex keratitis (2)

A

Urgent ophthalmology referral
Aciclovir

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11
Q

Vesicular rash around eye = which condition?

A

Herpes zoster ophthalmicus

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12
Q

What is Hutchinson’s sign?
Which condition?

A

Rash on the tip or side of the nose
Herpes zoster ophthalmicus

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13
Q

Mx herpes zoster ophthalmicus (3)
When should treatment start?

A

Urgent ophthalmology review if eye involvement
Oral aciclovir for 7-10 days
Topical steroids if any inflammation of the eye

Start within 72 hours

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14
Q

Hypertensive retinopathy classification (4)

A

I - arterial narrowing + tortuosity, silver wiring
II arteriovenous nipping
III - cotton wool exudates, flame and blot haemorrhages
IV - papilloedema

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15
Q

Bacterial (2) versus viral conjunctivitis (3)

A

Bacterial - purulent discharge, eyes tuck together
Viral - serous discharge, recent URTI, pre-auricular lymph nodes

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16
Q

Mx infective conjunctivitis
How long will it last?
Rx for non pregnant and pregnant people

A

Normally self limiting 1-2 weeks
Chloramphenical drops 2-3 hourly or ointment QDS
Pregnant - Fusidic acid rx BD

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17
Q

What is keratitis?

A

Inflammation of the cornea

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18
Q

Pseudomonas aeruginosa causing keratitis is seen in what kind of patients?

A

Contact lens wearers

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19
Q

Most common bacteria causing keratitis

A

Staph Aureus

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20
Q

Amoebic keratitis more common with exposure to?

A

Soil or contaminated water

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20
Q

Keratitis features (4)

A

Red painful eye
Grittiness
Hypopyon - pool of white cells
Photophobia

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21
Q

Mx keratitis (2)

A

Topical quinolones
Cycloplegic for pain relief

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22
Q

What is epiphora?

A

Watering eye

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23
Q

What is dacryocystitis?

A

Infection of the lacrimation sac

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24
Q

Dacryocystitis features (2)

A

Epiphora
Swelling and erythema at the inner canthus of the eye

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25
Q

Congenital lacrimal duct obstruction usually resolves at what age?

A

12 months

26
Q

Causes of mydriases (dilated pupil) (3)

A

Third nerve palsy
Phaeo
Holmes adie

27
Q

What is the most common cause of a persistent watery eye in an infant?

A

Nasolacrimal duct obstruction

28
Q

Nasolacrimal duct obstruction mx (1)
Majority resolve in how long?
When do you refer?

A

Massage of lacrimal duct
Majority resolve by 1 year
Otherwise ophthalmology referral

29
Q

What is hyphema?
Mx (3)

A

Blood in the anterior chamber of the eye
Strict bed rest + daily ophthal review + daily IOP checks

30
Q

Rock hard eyelids
RAPD
Proptosis
Eye pain
=

A

Orbital compartment syndrome

31
Q

Orbital compartment syndrome mx

A

Urgent lateral canthotomy

32
Q

Causes of optic neuritis (3)

A

MS
Diabetes
Syphyillis

33
Q

Pain worse on eye movement
RAPD
Central scotoma
Red desaturation (poor differentiation of colours)
Unilateral decrease in visual acuity over hours or days
= which condition?

A

Optic neuritis

34
Q

Mx optic neuritis
Recovery length

A

High dose steroids
4-6 weeks

35
Q

Features of papilloedema (6)

A

Venous engorgement
Loss of venous pulsation
Optic disc blurring
Elevation of optic disc
Loss of optic cup
Paton’s lines

VELLOP

36
Q

Papilloedema causes (8)

A

Hydrocephalus
Idiopathic intracranial hypertension
Malignant hypertension
Vitamin A toxicity
Hypoparathyroidism
Space occupying lesions
Hypercapnia
Hypocalcaemia

37
Q

What is glaucoma?

A

Optic neuropathies associated with raised IOP which in turn damages the optic nerve

38
Q

Raised IOP =

A

IOP >24mmHg

39
Q

Open angle glaucoma Mx
1st line (1)
2nd line (3)

A

1st line
PG analogue
2nd line
BB
Carbonic anhydrase inhib
Sympathomimetic eyedrop

40
Q

Example of PG analogue

A

Latanoprost

41
Q

Example (2) of BB in context of eye drops

A

Timolol
Betaxolol

42
Q

Sympathomimetics example

A

Brimonidine

43
Q

Carbonic anhydrase example (1)

A

Dorzolamide

44
Q

Miotics examples (1)

A

Pilocaripine

45
Q

All except which two medications reduce aqueous production?
(Medications for the management of primary open angle glaucoma)

A

Miotics
PG analogues

46
Q

RF glaucoma (7)

A

Age
FH
Afro Caribbean
Myopia (near sightedness)
HTN
DM
Steroids

47
Q

Open angle glaucoma features
Onset
(2 further features)

A

Insidious
Peripheral visual field loss (tunnel vision)
Optic disc cupping

48
Q

Name five fundoscopy signs of POAG

A

Optic disc cupping
Optic disc pallor
Bayonetting of vessels
Cup notching
Disc haemorrhages

49
Q

Severe pain, red eye
Vision loss
Haloes
Semi-dilated pupil
Hazy cornea
= which condition?

A

Acute angle closure glaucoma

50
Q

Red eye, pain, visual loss following intraocular surgery =

A

Endophthalmitis

51
Q

Purulent discharge, clear discharge =

A

Bacterial/ viral conjunctivitis

52
Q

Trauma + coughing bouts + red eye + normal vision =

How long till it resolves?

A

Subconjunctival haemorrhage

2-3 weeks

53
Q

Severe pain, worse on movement, underlying autoimmune condition =

A

Scleritis

54
Q

Small, fixed, oval pupil, ciliary flush
Pain, red eye, blurred vision and photophobia =

A

Anterior uveitis

55
Q

What is RAPD?
AKA

A

Swinging light test
Pupil dilates when light is shone
Marcus Gunn pupil

56
Q

RAPD causes (2)

A

Retinal detachment
Optic neuritis

57
Q

Pupillary light reflex
Nerves

A

In on two out on three
Retina –> optic nerve –> lateral geniculate body –> midbrain

Edinger Westphal nucleus (midbrain) –> occulomotor nerve

58
Q

New onset floaters or flashers
Sudden onset, painless progressive visual field loss
Curtain or shadow
Loss of red reflex =

A

Retinal detachment

59
Q

Retinal detachment RF (5)

A

Diabetes
Myopia (near sightedness)
Age
Prev surgery for cataracts
Eye trauma

60
Q

Tunnel vision
Night blindness is the initial sign
Black bone spicule shaped pigmentation =

A

Retinitis pigmentosa

61
Q

RA ocular manifestations (x5 total)
Most common =

A

Keratoconjunctivitis sicca
Episcleritis
Scleritis
Corneal ulceration
Keratitis

62
Q

What is the cover test in identifying the nature of a squint?

Mx

A

Ask the child to focus on an object
Cover one eye
Observe movement of the other eye
Cover other eye and repeat test

Mx refer to secondary care

AKT (52 decks)

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