Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MD2 > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What is the circulatory pathway of aqueous humour?

A

Produced by the ciliary body, circulates within the anterior chamber, and is filtered back into venous system through trabecular meshwork

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

Where is central vision best?

A

Fovea, the central most part of the macula, which is the central retina

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

Where does the optic nerve enter the retina?

A

Optic disc

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

Components of an eye exam

A 
History
Exam:
- general inspection
- visual acuity (best corrected)
- Slit lamp (anterior segment of eye)
- Pupils 
- Fundoscopy 
- Other tests (H test, CT scan, orbital x-ray, bloods)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Characteristic signs of iritis

A

Pain and photophobia
Red eye with CILIARY FLUSH
Slight blurred vision

Pain in contralateral eye on direct light exposure
Irregular pupil with synaechiae

Pupil may not be reactive to light

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

Characteristic signs of acute angle closure glaucoma

A

Mid-dilated, very poorly responsive to light

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

What does fluorescein stain check?

A

Corneal pathology

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

Most common causes of chronic vision loss

A 
Refractive error
Lens: Cataract
Macula: AMD
Retinal: Diabetic retinopathy
Optic nerve: Glaucoma (open-angle)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common causes of acute vision loss

A

Transient - Amaurosis Fugax

Persistent:
- Vaso-occlusive: central retinal artery/vein occlusion

  • Optic nerve: Optic neuritis OR giant cell arteritis
  • Retinal detachment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of BILATERAL vision loss

A

Central:

  • Pituitary apoplexy
  • Stroke

Ocular:
- Quinine or methanol poisoning

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

Causes of unilateral vision loss if eye is:

  • Sore or red
  • Not sore or red: flashes or floaters vs. none
A

Sore or red (pathology in anterior chamber)

  • ACUTE IRITIS
  • CLOSED ANGLE GLAUCOMA

Not sore/red
Flashes or floaters:
- RETINAL DETACHMENT
- VITREOUS HAEMORRHAGE

No floaters

  • CRA occlusion
  • CRV occlusion
  • Vasospasm

Visual field distortion
- AMD

Swollen optic disk

  • Optic neuritis
  • Giant cell arteritis
  • Anterior ischaemic optic neuropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of vasospasm that can cause visual loss

A

Migraine
SA haemorrhage
Hypertensive crisis

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

Where is the lesion:

  • homonymous hemianopia
  • bitemporal hemianopia
A

Homonymous: behind optic chasm

Bitemporal: at optic chasm (pituitary tumour)

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

Myopia vs hyperopia: what are they and where are light rays focussed in each case?

A

Myopia - short sighted; light rays focused anterior to fovea

Hyperopia - far sighted; light rays focussed posterior to fovea

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

What is presbyopia and what causes it?

A

Age-related loss of near vision (onset around 40s)

Due to diminished accomodation power

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diseases of refractive error and treatment

A

Hyperopia
Myopia
Astigmatism
Presbyopia

Correct w glasses/ contact lenses
LASIK - laser surgery alters corneal surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cataract - what is it?

  • Causes?
  • Clinical picture?
  • Treatment?
A

Opacification of lense

Causes: age-related; steroids; diabetes; previous inflammation or scarring (surgery, trauma)

Clinical picture:
Bilateral, asymmetric, slowly progressive
SX: Blurred vision with glare especially at night, difficulty driving
Signs: Impaired VA, clouding of sense on slit lamp exam (decr red light reflex, hard to see optic disk and retina)

TX:
Glasses + surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a chalazion?

what is it often associated with?

A

ABSCESS beneath lid resulting from focal noninfectious blockage of meibomian gland -> non-tender lump in eyelid

Assoc w Rosacea

Non-tender swelling of lid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a hordeolum ?

Aetiology?

A

Abscess at corner of eye, can be internal (on conjunctival side of eyelid) or external (=sty)

Painful focal lid erythema often accompanied by blepharitis

Staph aureus infection commonly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What common viral infection can spread to the eye?

how do you investigate for it?

Treatment?

A

HSV infection of trigeminal nerve can spread to eye, causing keratitis, uveitis, scleritis, retinitis

Fluroscene stain -> classic dendritic ulcer with BULB end

Antivirals - DO NOT give steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is blepharitis and what causes it?

A

Clogging of meibomian glands within tarsal plate, leading to chronic irritation and inflammation of eyelid

-> dry, watery, itchy eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you treat corneal abrasions and ulcers?

A

Abrasion: lubrication and prophylactic erythromycin

Small ulcers: erythromycin

Large ulcers >3mm: MCS (sensitivities) and vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Different types of conjunctivitis

A

Viral: watery discharge, swollen pre-auricular nodes
- most common form in adults
- adenovirus and rhinovirus are common causes (HSV is more severe)
- recent flu-like illness
TX: self-limiting; good heigine to limit spread

Bacterial: mucus discharge

  • most common form in kids
  • follicles and papilla on inner surface of lid
  • treat with erythromycin gel

Allergic: itchy, watery, chemosis (swelling of sclera)
+/- dark area underneath eyes
- antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is endopthalmitis?

A

Severe infection WITHIN the eye, often post-surgical procedures

With hypopion (pus forms fluid level at bottom of iris)

Needs aggressive treatment -> vitrectomy to eject pus from eye -> send for MCS -> antibiotics

25
What infective agents cause conjunctivitis?
Staph aureus, strep in kids H influenza in adults Neisseria gonorrhoea in sexually active adults (needs urgent referral because sigh threatening)
26
What is a hyphaemia?
Blood in anterior chamber of eye, forms fluid level at bottom of iris Requires urgent ophthalmologist referral
27
what are the 2 broad categories of causes/risk factors for scleritis?
Autoimmune - RA, UC, SLE, ankylosing spondylitis, psoriatic arthritis, Wegener's granulomatosis Granulomatous disease - Tb, syphilis, sarcoid, leprosy
28
Clinical presentation of scleritis TX?
Red/purple discolouration of sclera and conjunctivae Ocular pain that is tender to palpation Photophobia TX: NSAIDs and systemic corticosteroids
29
CN3 palsy - causes - presentation
Causes - Vasculitic (HTN, DM) - pupil sparing - Aneurysm/tumours - pupil dilated Presentation: - Eye is down and out - Ptosis - If pupil is dilated, suspect aneurysmal cause
30
CN6 palsy - causes - presentation
Causes - Vasculitic - Incr ICP/Idiopathic intracranial HTN Presentation: - Cross eyed - Double vision when looking towards affected side - bilateral papilloedema if Incr ICP
31
CN4 palsy - causes - presentation
Causes: - Vasculitis - Trauma - Congenital - Tumour Presentation - Hypertropia - Head tilts away from affected side (to offset extortion) - Double vision when READING or walking down stairs - eye shoots up when looking towards affected side
32
Neovascular vs non-neovascular AMD
Wet/ Neovascular/exudative: - Break in the Brux membrane (layer between PRs and choroid) allows choroidal neovascularisation under retina, leading to QUICK and permanent vision loss. Wet because vessels can bleed. Dry/non-neovacular/non-exudative - ~90 of AMD - 'Drusen' on ophthalmoscopy are small deposits in the macula - HTN is RF for progression of dry to wet AMD
33
Risk factors for AMD
Old age Family HX Smoking HTN predicts progression from wet to dry
34
Clinical picture of AMD - SX and signs - Fundoscopy
Blurred central vision Metamorphopsia: distortion of straight lines centrally (occurs early) Scotoma (blind spots) with progression No pain/redness Peripheral vision intact Fundoscopy: - Dry: druse deposits - Wet: choroidal haemmhorage
35
Treatment for wet and dry AMD
Dry: antioxidants, zinc, vitamin C and E and carotenoid supplements HTN control, stop smoking Wet: - anti VEGF +/- IV steroids or laser therapy - laser photocoagulation
36
Features of Diabetic retinopathy: pre-proliferative and prolferative/end-stage
Pre-proliferative - cotton wool spots - hard exudates - blot haemorrhages - micro aneurysms - venous beading - retinal oedema Proliferative - Neovascularisation - Vitreous haemorrhage - Angle closure neovascularisation glaucoma End-stage - vessel fibrosis and retinal detachment
37
treatment for Diabetic retinopathy
Diabetic, HTN, hyperlipidaemia control Grid or pan-retinal laser photocoagulation Intra-vitreal VEGF antagonist injections Surgical repair if vitreous haemorrhage or retinal detachment
38
Primary chronic open angle glaucoma: what is a characteristic feature? What is the underlying pathophys?
Slowly progressive optic neuropathy Optic disc cupping Due to excess glycosaminoglycan deposition in trabecular meshwork, blocking aqueous outflow -> incr IOP damages optic nerve fibres
39
Acute angle closure glaucoma What is the underlying pathophys
aqueous cannot get through the space between the pupil and iris from the posterior chamber into anterior chamber, so pressure gradient forms within the posterior chamber, pushing the iris forwards and closing it to block off the entrance to the trabecular meshwork so aqueous cannot drain.
40
RF for open angle glaucoma
``` Genetic Incr age Family history Thin cornea African, latino ethnicity ```
41
RF for closed angle glaucoma
Asian Small eyes, hyperopia big cataracts Shallow chamber
42
Clinical features of open angle glaucoma - Sx and signs - ophthalmoscopy findings
SX and signs: Asymptomatic until late stage Visual field is end-stage - Initially upper arcuate scotoma - progresses to full visual field loss with sparing of small central field +/- small temporal field No eye pain or tenderness Headache rare except when IOP is v high Ophthalmoscopy: - Enlarged cup: disc ratio (>=0.5) - Elevated IOP
43
Treatment for chronic open angle glaucoma
Surgical - Drainage trabeculectomy - Laser trabeculoplasty Medical - PGE analogues - Topical beta blockers - Topical carbonic anhydrase inhibitors - Adrenergic agonists - Cholinergic agonists (pilocarpine)
44
Clinical features of acute closed angle glaucoma Signs and SX exam findings
Rapid elevation in IOP and ischaemic tissue damage resulting in: - painful red eye - photophobia - haloes - pain on eye movement - watering of eye - rapidly decreasing visual acuity +/- headache, nausea and vomiting Exam: - red eye - cloudy cornea - oval, fixed, dilated pupil
45
Treatment for acute closed angle glaucoma
Medical: IV Acetazolamide (carbonic anhydrase inhibitor) + PO topical pilocarpine (cholinergic agonist) + PO beta blockers Surgical: Laser iridotomy in BOHT eyes (prophylactic in opposite eye)
46
Non-painful diffuse red eye conditions With eyelid involvement without
With eyelid involvement: - Blepharitis (Can also be painful) - Ectropion - Trichiasis - Eyelid lesion Without - conjunctivitis (also painful)
47
PainLESS LOCALISED red eye conditions
Localised: - pterygium - corneal foreign body (can also be painful) - ocular trauma (can also be painful) - subconjunctival haemmhorage
48
What is blepharitis?
Noninfectious lid margin inflammation with chronic redness +/- crusting (like chalazion but no cyst formation) +/- bacterial superinfection
49
What is ectropion?
Lid turns outwards with exposure of conjunctival sacs
50
What do you call the condition when the eyelashes are turned inwards? What commonly causes this?
Trichiasis Caused by trachoma (infectious disease caused by bacterium Chlamydia trachoma's, common in children with poor sanitation)
51
What is pterygium?
Flesh grows over the sclera. Benign. May become inflamed and painful. Needs lubrication and sunglasses w non-urgent referral.
52
What is the cause of a painless, unilateral, well circumscribed bloody red patch on eyeball With no other visual abnormalities
Subconjunctival haemorrhage
53
what is the difference between episcleritis and scleritis?
Episcleritis blanches when injected w 10% phenylephrine ophthalmic drops, but NOT in scleritis Scleritis generally more red and painful with tenderness to palpation. Episcleritis generally NOT painful and is self-resolving. Both red but have no photophobia and normal vision and pupil.
54
What is episcleritis usually caused by?
Autoimmune conditions - RA - SLE - graves - ankylosing spondylitis - IBD - psoriatic arthritis
55
Treatment of episcleritis
Self limiting Hydration Topical prednisilone if prolonged steroids +/- systemic NSAID/CS Workup for autoimmune diseases
56
What usually causes bacterial/acanthamoebal ulcer? (epithelial keratitis)
from unclean contacts
57
What is the common cause of keratitis that needs urgent opthal referral? TX?
HSV-1 TX: trifluoridine eye drops with antiviral therapy AVOID topical steroids! makes it worse!
58
Signs of hypertensive retinopathy
Grade 1: copper wiring Grade 2 As grade 1 + Irregularly located, tight constrictions - Known as `AV nicking` or `AV nipping` - Salu's Sign Grade 3 As grade 2 + cotton wool spots and flame-hemorrhages Grade 4 As grade 3 + optic disc swelling + macular star

MD2 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions