Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals Bible: Surgery > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What nerve causes a RAPD?

A

CN2, the optic nerve

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

What will you see in RAPD?

A

Affected eye = no direct response to light, consensual response intact.

Swinging light test gives apparent dilation when moving to the pathological eye

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

What nerve causes an efferent defect?

A

CN3, occulomotor

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

What are the types of 3rd nerve palsy?

A

Surgical = Compresses the outer fibres where the parasympathetic fibres run = dilated pupil

Medical = damages vast forum = pupil sparing

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

Examples of medical and surgical 3rd nerve palsy?

A

Medical = MS and diabetes

Surgical = Posterior communicating artery aneurysm

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

Signs of a 3rd nerve palsy?

A

Down and out pupil

Affected eye will elicit a consensual response, but will not constrict itself to direct or consensual reflex

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

What causes Holmes-Adie pupil?

A

Damage to the post-ganglionic parasympathetic fibres

These fibres allow pupillary constriction and near vision

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

Clinical features of Holmes-Adie pupil?

A

Young woman with sudden blurring vision
Dilated pupil with no response to light
Sluggish response to accommodation

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

What is Holmes-Adie Syndrome?

A

The pupil + absent knee/ankle reflexes + hypotensive

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

What causes Argyll-Robertson pupil?

A

Focal lesion in pretectal nucleus.

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

Clinical features of AR pupil?

A

Small irregular pupil

Accommodates but doesn’t react to light.

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

What are the different causes of Horners Syndrome?

A

1st order = Central lesion = MS / stroke

2nd order = pre-ganglionic = Pancoasts, apical TB, cervical rib

3rd order = post-ganglionic = Herpes zoster, carotid dissection / aneurysm

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

What is the cause of INO?

A

Lesion to the medial longitudinal fasciculus, which runs between the pons and the midbrain

Connects CN3/4/6

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

Clinical features of INO?

A

Dissociated eye movements
Impaired adduction ipsilaterally
Nystagmus contra laterally on abduction

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

Clinical features of CN4 lesion?

A

Paralysis of superior oblique = when lateral eye is up and out. When medial eye is slightly elevated

Diplopia when looking down and in e.g. going down stairs

May see abnormal head tilt

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

Causes of CN4 lesion?

A

Diabetes

Cavernous sinus thrombosis

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

Clinical features of CN6 lesion?

A

Usually abducts the eye via lateral rectus

So get esotropia and diplopia

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

Causes of CN6 lesion?

A

Long course
Tumours, trauma, CVA e.g. Millard Gubler
Wernickes
mononeuritis multiplex

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

What is glaucoma?

A

Group of disorders characterised by optic neuropathy, usually due to raised IOP

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

RF’s for acute glaucoma?

A

Hypermetropia (long sighted)
Pupillary dilation
Lens growth associated with increasing age

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

Clinical features of acute glaucoma?

A

Severe pain ± headache, N&V
Decreased acuity peripherally
Haloes around lights

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

Fundoscopy findings in glaucoma?

A

Dull hazy cornea
Optic disc cupping (cup:disc ratio >0.7)
Optic disc pallor
Bayonetting of vessels

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

Management of acute glaucoma?

A

Urgent ophthalmology referral
Pilocarpine drops = miosis to open blockage
Timolol = reduce aqueous formation
Acetazolamide 500mg IV stat = reduce aqueous formation

Follow up = laser peripheral iridotomy = hole in outer edge = fluid bypasses pupil

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

What is anterior uveitis?

A

Inflammation of the iris and ciliary body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Clinical features of anterior uveitis?

A

Pain and photophobia

Reduced acuity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Exam findings of anterior uveitis?

A

Small fixed pupil, ciliary flush
Hypopynon
White precipitates on back of cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Anterior uveitis associated conditions?

A

Crohns, UC
Ankylosing Spondylitis
Bechets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Management of anterior uveitis?

A

Referral
Steroid eye drops
Atropine = dilate pupil = relieve pain and photophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is keratitis?

A

Inflammation of the cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Causes of keratitis?

A 
Infective = HSV, S. aureus and pseudomonas in contact lens wearers
Environmental = Photokeratitis in welders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Clinical features of keratitis?

A

Red eye + photophobia
Foreign body / gritty sensation
Hypopynon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Management of keratitis?

A

Antibiotic eye drops = Gentamicin and cefazolin

Atropine for symptom relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is corneal abrasion

A

Epithelial breech without keratitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Investigation of abrasion?

A

Slit lamp with fluroscein stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Management of abrasion?

A

Chloramphenicol for prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Management of scleritis?

A

Referral
NSAIDs
Corticosteroids

37
Q

What is conjunctivitis?

A

Inflammation of the lining of eyeball and eyelids

38
Q

Clinical features of bacterial vs Viral vs allergic conjunctivitis ?

A

Bacterial = purulent discharge, eyes stuck in morning

Viral = Serous discharge, recurrent URTI, LN’s

Allergic = Bilateral, itch, atopy Hx

39
Q

Management of conjunctivitis

A

Conservative = No towel sharing, no lenses, can go to school

Medical = Topical chloramphenicol
Topical fusidic acid if pregnant

Allergic = Topical / systemic anti-histamines

40
Q

Clinical features of optic neuritis?

A

Only painful cause of sudden visual loss

Red desaturation
Pain worse on eye movement
Central visual loss

41
Q

Causes of optic neuritis?

A

MS
Diabetes
Syphilis

42
Q

Management of optic neuritis?

A

High dose methylpred. IV then oral.

43
Q

Clinical features of vitreous haemorrhage?

Management?

A

Painless sudden visual loss
Floaters and dark spots
Big bleed = No red reflex and cannot visualise retina

Often spontaneous reabsorption
Vitrectomy if dense

44
Q

Central retinal artery occlusion causes?

A

Due to thromboembolism from atherosclerosis or temporal arteritis

45
Q

Clinical features of CRAO?

Management?

A

Painless sudden visual loss
Afferent pupillary defect
PALE RETINA = cherry red spot

If within 6 hours = reduce IOP:
Surgical removal of aqueous
Local/systemic anti-HTN

46
Q

Retinal vein occlusion causes?

A

Atherosclerosis
HTN
DM
Polycythaemia

47
Q

Clinical features of RVO?

A 
Painless vision loss
RAPD
Stormy sunset appearance
Tortuous dilated vessels
Haemorrhage
48
Q

Retinal detachment types?

A

Rhematogenous = tear/break in retina lets vitreous fluid leak in = separates

Tractional = tissue grows on retina pulling it away e.g. diabetic proliferative retinopathy

Exudative = fluid under retina but no tear. rare

49
Q

Clinical features?

Management?

A 
Four F's:
Floaters
Flashes
Field loss = curtains falling
Fall in acuity = straight lines appear curved

Urgent surgery = Vitrectomy and laser coagulation to secure the retina

50
Q

RF’s for age related macular degeneration?

A

Smoking
Female
FHx

51
Q

Types of ARMD?

A

Dry = Drusen around Bruch’s membrane. Slow visual decline over 2 years

Wet = Aberrant vessel growth from choroid into retina = haemorrhage
Visual decline over weeks

52
Q

Investigations and management for AMRD?

A

Optical coherence topography (OCT)
If neovascularisation = fluorescein hagiography

Conservative = stop smoking and high dose beta carotene/Vitc/Zinc (unless smoker as cancer risk)

Dry = no management

Wet = Anti VEGF intravitreal

53
Q

RF’s for COAG?

A

FHx
Black
HTN, DM
Myopia

54
Q

If FHx of glaucoma when do you screen from?

A

Annually at 35

55
Q

COAG investigations

A

Tonometry = IOP > 21

Fundoscopy

56
Q

Management of COAG?

A

Lifelong follow up
1st line = Latanoprost
2nd line or if IOP still >24 = Timolol
3rd line = Brimonidine / Acetazolamide / Pilocarpine

Still refractory = laser trabeculoplasty

57
Q

Which COAG drugs reduce aqueous formation and their class?

A 
Timolol = BB
Brimodine = alpha agonist
Acetazolamide = Carbonic anhydrase inhibitor
58
Q

Which COAG drugs increase uveoscleral outflow and class?

A 
Latanprost = Prostaglandin analogue
Miotics = Pilocarpine
59
Q

What is the leading cause of blindness <60?

A

Diabetes

60
Q

Pathology of diabetic eye?

A

Blood is hyperviscous = Inner endothelial cels thicken, but outer pericytes atrophy
This atrophy = thin walls and leaky walls = micro-aneurysms and dot haemorrhages
These then cause oedema
Once the oedema clears it leaves fatty deposits = hard exudate.

61
Q

Classification of pre-proliferative diabetic retinopathy?

A

mild = >1 microaneurysm

Moderate = Microaneurysm, dot haemorrhages and hard exudate

Severe = Dot haemorrhages and microaneurysm in 4 quadrants
Venous bleeding
Intra-retinal microvascular abnormalities = IRMA

62
Q

Signs of proliferative diabetic retinopathy?

A

Neoangiogenesis = Can be disk or outside disc
Vitreous haemorrhage
Retinal detachment

63
Q

Eye screening for diabetics?

A

Annually
Photographs
Refer if Maculopathy, PDR, NPDR

64
Q

Management of diabetic retinopathy?

A

Good control
Laser photocoagulation:
Maculopathy = focal / grid
Proliferative disease = pan-retinal

65
Q

Hypertensive retinopathy classification?

A

Keith-Wagner classification:
1 = Arteriolar narrowing and silver wiring
2= AV nipping
3 = Cotton wool exudates and flame haemorrhages
4 = Papilloedema

66
Q

What is cataracts?

A

Opacification of the crystalline lens

67
Q

Causes of cataracts?

A

Age
DM
Steroids
Congential e.g. Rubella

68
Q

4 types of cataracts?

A

Nuclear = change lens refractive index

Polar = localised, in the visual axis

Subcapsular = due to steroid use, deep in the lens capsule, in visual axis

Dot opacities = common in normal lens, also seen in DM

69
Q

Clinical features of cataracts?

A

Increasing short sightedness
Gradual vision loss, not corrected by glasses
Dazzling in light

70
Q

management of cataracts?

A

Conservative = sunglasses and regular follow up

Surgical:
Phaecoemulsification ± intra-ocular lens implant

71
Q

What is phaecoemulsification?

Complications?

A

Under local
Incision in eye and circular incision in membrane around cataracts
US wave used to break up and suctioned out
New folded intra-ocular lens use to replace

1% of serious e.g. retinal detachment
infection
Lens displacement

72
Q

Clinical features of retinitis pigmentosa?

A

Night blindness
Tunnel vision
Blind by mid-30’s

73
Q

What is retinitis pigmentosa?

A

Genetic disorder with breakdown of retinal cells

74
Q

Conditions associated with RP?

A

Ushers
Friedrichs ataxia = Absent ankle jerk, cerebella ataxia and optic atrophy
Refsums disease = Cerebellar damage due to phytanic acid storage
Keams-Sayre

75
Q

Clinical features of retinoblastoma and management?

A

Absent red reflex, strabismus

No vitreous seeding = chemo + laser ablation

Vitreous seeding post chemo = External beam radiation

Vitreous seeding = enucleation and prosthesis

76
Q

What is blepharitis?

Cause?

A

Inflammation of eyelid margins

Meibomian gland dysfunction = posterior

Anterior = seborrheic dermatitis

77
Q

Clinical features of blephairits and management?

A

Bilateral red eyes
Gritty and itchy
Scales on lashes

Clean crust with warm soaks

78
Q

types of stye?

A

Hordeolum external = infection of the glands of Zeis

Hordeolum internal = Infection of Meibomian gland

79
Q

What is a chalazion?

A

Retention cyst of Meibomian gland = firm painless lump

80
Q

Entropion vs Ectropion

A 
Entropion = inversion
Ectropion = eversion
81
Q

Orbital vs peri-orbital cellulitis?

A

Orbital = infectious process in muscles / fat of orbit = due to bacterial sinusitis

Peri-orbital = Infectious process in eyelid tissue superficial to orbital septum = Superficial injury e.g. bug bite

82
Q

Clinical features and management of cellulitis?

A

Child, swelling and exophthalmos

Empirical antibitoics e.g. Cefazolin

83
Q

What is myopia?

A

Short sighted = Eye is too long, distant object are focused to far forwards

Concave lens

84
Q

Hypermetropia?

A

Long-sighted = eye is too short, cannot accommodate objects close up
Can cause convergent squint in children as contraction of ciliary muscles to focus images

Convex lens

85
Q

Astigmatism

A

Cornea or lens doesn’t have same degree of curvature in horizontal and vertical planes

Images distorted vertically / horizontally

Convex lens

86
Q

What is strabismus?

A

Misalignment of eyes

Esotropia = Convergent squint

Exotropia = Divergent squint

87
Q

Non paralytic vs paralytic quint?

A

Diagnosis?

Corneal reflection test = if not symmetrical = squint

Cover test = Movement of uncovered eye to take up fixation demonstrates quint
If eye goes out = esotropia
If eye moves medially = exotropia

If paralytic = Eye won’t fixate on covering. Cover each eye in turn, which ever eye see the outer image is dysfunctioning

88
Q

Management of strabismus?

A

3 O’s

Optical = correct refractive errors
Orthoptic = patch over good eye
Operations = Resection of rectus muscles

Finals Bible: Surgery (3 decks)

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