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Ophthalmology Flashcards

1
Q

Vesicular rash involving the tip of the nose or eyelid margins

A

Hutchinson’s sign. Herpes zoster opthalmicus

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2
Q

TX for herpes zoster

A

high dose acyclovir w within 72 hours afte eruption fo the rash

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3
Q

inward turn of the eyelid

A

entropion

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4
Q

Tx for entropion

A

surgery if the lashes rub on the cornea

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5
Q

outward turning of the lower lid

A

Ectropion

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6
Q

Tx for ectropion

A

Surgery if ectropion causes excessive tearing, exposure keratitis or a cosmetic problem

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7
Q

chronic bilateral inflammation of the lid margins. Presents with irritation, burning, itching, scales on the lashes

A

anterior blepharitits

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8
Q

Tx for anterior blepharitits

A

remove scales w/ damp cotton applicator and baby shampoo, antistaph abx eye ointment

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9
Q

Inflammation of the eyelids secondary to dysfunction of the meibomian glands

A

posterior blepharitis

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10
Q

Tx for posterior blepharitits

A

low dose systemic abx, short term topical steroids

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11
Q

what does posterior blepharitits have a strong association w/?

A

acne rosacea

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12
Q

infection of the lacrimal sac due to obstruction fo the nasolacrimal system, usually unilaterla. Often in infants or people over 40

A

dacryocystitits

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13
Q

What causes acute dacryocystitis?

A

staph auerua and beta hemolytic strep

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14
Q

tx for dacryocystitits

A

adult- dacryocystorhinosotmy
baloon dilation or probe in peds
can add systemic abx

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15
Q

painful, localized red, swollen, acutely tender area on the upper or lower lid

A

hordeolum (internal- meiboian gland external- stye)

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16
Q

Tx for hordeolum

A

warm compresses, abx ointment,

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17
Q

chronic ganulomatous inflammation of a meibomian gland

A

chalazion

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18
Q

nontender, hard swelling on the upper or lower lid of the eye

A

chalazion

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19
Q

tx of chalazion

A

warm compresses, oral tetracycline, incision and curettage, +/- intranasal steroids

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20
Q

Tx for bacterial conjunctivitis

A

polymyxin B/ trimethoprim TID abx

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21
Q

why is gonococcal conjunctivitis considered an opthalmologic emergency

A

possible for corneal perforation

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22
Q

Tx for gonococcal conjunctivitis

A

topical abx (erythromycin or sulfa)

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23
Q

tx for gonococcal conjunctivitis if cornea is perforated

A

5 day course of parenteral ceftriaxone

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24
Q

recurrent b/l follicular jonjunctivitis, epithelial keratitis and corneal vascularization

A

chlamydial deratoconjunctivitis

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25
Q

tx for chlamydial keratoconjunctivitis

A

oral tetracycline or erythromycin for 3-5 weeks

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26
Q

what typically causes viral conjunctivitis

A

adenovirus

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27
Q

red palpebral conjunctiva with copious watery discharge and scanty exudate

A

viral conjunctivitis

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28
Q

what is an associated symptoms w/ viral conjunctivitis

A

pharyngitits, fever, malaise, preauricular adenopathy

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29
Q

tx for viral conjunctivitis

A

warm compress TID

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30
Q

dry, red and scratchy eyes associated w/ aging, systemic drugs, hereditary disorder, systemic diseases

A

keratoconjunctivitis sicca

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31
Q

diagnosis of keratoconjunctivitis sicca

A

+ schirmer’s test (filter paper)

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32
Q

patient will have edema of the conjuntiva, cobblestone papillae, and have itching, tearing, redness

A

allergic conjunctivitis

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33
Q

Tx for allergic conjunctivitis

A

antihistamine or mast cell stabilizer drops

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34
Q

painful red eye with photophobia,

tearing, circumcorneal injection, +/‐ discharge

A

kreatitis/ corneal ulcer

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35
Q

• S/Sx : cornea is hazy usually with a central ulcer,
+/‐ hypopyon
• Usually aggressive and often due to prolonged
contact wearing or corneal trauma

A

bacterial keratitis

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36
Q

etiology of bacterial keratitis

A

pseudomonas, strep, staph, moraxella

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37
Q

Tx for Gram + bacterial keratitis

A

ceaphlosporin drops

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38
Q

tx for gram - bacterial keratitis

A

fluoroquinolone or aminoglycoside drops

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39
Q

branching ulcer of the eye seen with fluorescent examination

A

herpes simplex keratitis

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40
Q

Tx for herpes simplex keratitis

A

ganciclovir opthalamic gell 0.15% 5 times daily

oral acyclovir 400 mg 5 times daily x 10 days

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41
Q

Abrupt onset of fever, proptosis, restriction of
extraocular movements, swelling and redness
of the lids

A

orbital cellulitis

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42
Q

Tx for orbital cllulitis

A

IV abx

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43
Q

what causes orbital cellulitits

A

infection of the paranasal sinuses

44
Q

Bilateral lens opacities causing blurred vision &

gradual visual loss without pain or redness

45
Q

Risk factors for cataracts

A

smoking, corticosteroid use

46
Q

Severe pain and blurred vision, halos around lights, moderately dilated fixed pupil

A

acute (angle-closure) glaucoma

47
Q

RF for acute angle closure glaucoma

A

elderly, farsightedness, asians , pupillary dilation

48
Q

what medications cause pupillary dilation

A

atropine, imipramine, atrovent

49
Q

what is normal eye pressure (measure with tonometry)

A

12-22 mmHg

50
Q

Tx for acute angle closure glaucoma

A

IV acetazolamide, IV mannitol, beta blocker drops, pilocarpine (miotic aent), laser peripheral iridotomy

51
Q

slow bilateral increase of intraocular pressure leading to peripheral vision loss

A

chronic open angle glaucoma

52
Q

what will be seen on exam with open angle galucoma

A

pathologic cupping of the optic discs

53
Q

Tx for open angle glaucoma

A

prostaglandin analogues (lantanoprost), Beta blocker drops (timolol), pilocarpine, laser trabeculoplasty

54
Q

inflammation of the iris, ciliary body or choroid

55
Q

What conditiosn is uveitits associated with?

A

HLA-B27, ankylosing spondylitis, ulcerative colitis, Crohn’s disease, psoriasis, Reiter’s yndrome, herpes simplex/ zoster, syphilis

56
Q

S/S of uveitits

A

acute onset unilateral pain, redness, photophobia, visual loss

57
Q

findings with anterior uveitits (iritis) 4 findings

A

– Inflammatory cells and flare within the aqueous
– Hypopyon (layered collection of white cells)
– Small pupil & posterior synechiae (adhesions)
– Normal intraocular pressure

58
Q

Tx for uveitits

A

topical steroids, analgesics, mydriatics

59
Q

how does dilation of the pupil help with uveitits

A

relieves discomfort and helps prevent posterior synechiae

60
Q

Fleshy, triangular encroachment of the
conjunctiva onto the nasal side of the cornea
• Usually associated with constant exposure to
wind, sun, sand, and dust

61
Q

Tx for pterygium

A

excision if the growth treatens to interfere w/ vision loss

62
Q

Yellow elevated nodule on either side of the

cornea (more commonly on the nasal side)

A

pingueculae

63
Q

Tx for pingueculae

A

artificial tears or short courses of topicals NSAIDs

64
Q

Sudden painless visual loss often upon waking

in the morning

A

central vein occlusion

65
Q

Risk factors for central vein occlusion

A

glaucoma, HTN< DM< uveitits, increased lipids, thrombotic disease

66
Q

PE findigns with central vein occlusion

A

disc swelling, venous dilation, retinal hemorrhages, cotton wool spots

67
Q

Tx for central vein occlusion

A

treat macular edema with laser tx

68
Q

sudden profound visual loss that has cherry red spots at the fovea, swelling of the retina, cotton wool spots

A

centray artery occlusion

69
Q

Tx for central artery occlusion

A

lay patient falt, occular massage, high concentrations of O2, IV acetazolamide and anerior chamber paracentesis, thromboyysis

70
Q

spontaneous or traumatic blurred vision without pain or redness often with flashing lights or new floaters

A

retinal detachment

71
Q

What will you see on exam with retinal detachment

A

hanging retina in the vitreous, superior temporal area is most common

72
Q

Tx for retinal detachment

A

surgery w/ cryotherapy or photocoagulation to the retina

73
Q

“curtain passing vertically across the
visual field with complete monocular visual loss
lasting a few minutes

A

amaurosis fugax

74
Q

Etiology of amaurosis fugax

A

retinal amboli from ipsilateral carotid disease

75
Q

Dx for amaurosis fugax

A

carotid ultrasound or angiography

76
Q

Tx for >70% stenosis of cartodi artery

A

carotid endarterectomy or stent

77
Q

Tx for carotid stenosis <70%

A

aspiring (81 mg) or clopidogrel

78
Q

leading cause of new blindness in ages 20-65

A

diabetic retinopathy

79
Q

Diabetic retinopathy with dilated veins, microaneurysms, retinal hemorrhages, retinal edema dn hard exudates

A

nonproliferative

80
Q

diabetic retinopathy with neovascularization

A

proliferative retinopathy

81
Q 
are these eye changes seen with chronic HTN or acute HTN?
arterioral narrowing
cotton wool spots
retinal hemorrhages
retinal edema
disc edema
82
Q

what eye chagnes are seen with chronic HTN

A

silver wiring and copper wiring, AV nicking, flame hsaped hemorrhages, retinal exudates

83
Q

sudden U/L loss of vision and pain with eye movements (vision returns in 2-3 weeks)

A

optic neuritis

84
Q

what conditions are associated w/ optic neuritis

A

MS, viral infections (measles, mumps, varicella)

85
Q

S/Symptoms of optic neuritics

A

Loss of color vision

86
Q

What will be seen on exam with optic neuritits

A

flam shaped hemorrhages, optic nerve swellign (rare)

87
Q

Tx for optic neuritits

A

IV steroids

88
Q

optic disc swelling due to raised intracranial pressure, usually B/L

A

papilledema

89
Q

Etiology of papilledema

A

idiopathic intracranial HTN (pseudotumor cerebri), tumors, inflammation, edema, encephalitits

90
Q

S/symptoms of papilledema

A

enlargement of blind spot +/- loss of acuity

91
Q

Tx for papilledema

A

acetazolamide, optic nerve sheath, fenestration or lumbopoperitoneal shunt

92
Q

Leading cause of permanent visual loss in the
elderly due to atrophy of outer retina
• RF : whites, F>M, family Hx, smoking

A

macular degeneration

93
Q

S/symptoms of macular degeneration

A

gradual progressive B/: visual loss.

94
Q

What will be seen on exam with macular degeneration

A

retinal drusen (yellow deposits around macular region)

95
Q

Tx for macular degeneration

A

Non, laser photocoagulation may delay the onset of permanent visual loss

96
Q 
• Scratch on cornea
• Foreign body sensation
• Exam : evert lid and
observe with
fluorescein dye
A

coreal abrasion

97
Q

Tx for corneal abrasion

A

antibiotic drops or ointment

98
Q

after eye foreign body removal what should be done?

A

polymyxin-bacitracin ophthalmic ointment, examine 24 hours later, rust ring may need removal by ophthalmologist

99
Q

Does a subconjunctival hemorrhage affect vision? where does it stop?

A

doesn’t affect vision, stops at limbus

100
Q

Blood in anterior chamber, causes pain, photophobia, blurred vision

101
Q

• Orbital wall fracture due to trauma
• Forces rupture the medial wall and floor of
the globe
• Muscle and fat becomes trapped

A

blowout fracture

102
Q

what will be seen on PE with blowout fracture

A

diploplia on upward gaze, enphthalmos

103
Q

Tx for blowout fracture

104
Q

will have complete ptosis, slightly depressed eye, dilated pupil

A

3rd nerve paralysis

105
Q

what cuases 3rd nerve paralysis

A

trauma, DM, HTN

106
Q

upward deviation of the eye causeing vertical diplopia

A

4th nerve paralysis (cause is trauma) (trochlear)

107
Q

failure of abduction of affected eye cuasing horizontal diploplia

A

6th nerve paralysis (abducens)

PANCE (14 decks)

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