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The Holy Grail (Treatments) > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Papilloedema

Optic disc swelling due to raised ICP

A

Treat underlying cause

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2
Q

Myopia (short sighted)

A

Concave lenses

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3
Q

Hyperopia (long sighted)

A

Convex lenses

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4
Q

Optic neuritis

A

High-dose steroids

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5
Q

Bacterial conjunctivitis

Purulent discharge
Eyes may be ‘stuck together’ in the morning)

A

Self-limiting
Chloramphenicol drops 2-3 hours, ointment qds
Topical fusidic acid for pregnant women

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6
Q

Chlamydial conjunctivitis

A

Topical oxytetracycline

Azithromycin- for genitals

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7
Q

Viral conjunctivitis

Serous discharge
Recent URTI
Preauricular lymph nodes

A

Aciclovir

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8
Q

Allergic conjunctivitis

A

1st line: topical or systemic antihistamines

2nd line: topical mast-cell stabilisers, e.g. Sodium cromoglicate and nedocromil

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9
Q

Bacterial keratitis

A

1st: Ofloxacin
2nd: Gentamycin and cefuroxime

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10
Q

Herpetic keratitis

Herpes simplex keratitis most commonly presents with a dendritic corneal ulcer

A

Immediate referral to an ophthalmologist

Topical aciclovir

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11
Q

Orbital Cellulitis

Inflammation of the tissues behind the eye

A

Antibiotics and drainage

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12
Q

Endophthalmitis

Inflammation of the inner eye
Associated with cataract surgery

A

Amikacin
Ceftazidine
Vancomycin

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13
Q

Cytomegalovirus retinitis

Common in AIDs patients

A

Ganciclovir

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14
Q

Chorioretinitis

Often caused by Toxoplasmosis/ Toxocara

A

Corticosteroids

Antibiotics

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15
Q

Uveitis

A
  • Cycloplegics/Mydriatic eye drops (dilates the pupil which helps to relieve pain and photophobia) e.g. Atropine, cyclopentolate
  • Steroid eye drops
  • Steroid injection
  • Steroid oral tablets
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16
Q

Wet ARMD

Wet (exudative, neovascular) macular degeneration: characterised by choroidal neovascularisation. Leakage of serous fluid and blood can subsequently result in a rapid loss of vision. Carries worst prognosis

A

Photocoagulation
Photodynamic therapy
Anti-vascular endothelial growth factor (anti-VEGF): intravitreal ranibizumab

17
Q

Dry ARMD

Dry (geographic atrophy) macular degeneration: characterised by drusen - yellow round spots in Bruch’s membrane

A

Not much tbh
Vision aids- magnifiers etc

Stop smoking
High dose of beta-carotene, vitamins C and E, and zinc may help to slow down visual loss for patients with established macular degeneration. Supplements should be avoided in smokers due to an increased risk of lung cancer

18
Q

Primary Open Angle Glaucoma

Peripheral visual field loss - nasal scotomas progressing to ‘tunnel vision’
Decreased visual acuity
Optic disc cupping

A

1st line:

  • Prostaglandin analogues (e.g. Latanoprost)
  • Beta-blockers (e.g. Timolol)

2nd line:
- Combining a topical prostaglandin analogue or prostamide with a topical beta-blocker

3rd line:

  • Sympathomimetics (e.g. brimonidine, an alpha2-adrenoceptor agonist)
  • Carbonic anhydrase inhibitors (e.g. Dorzolamide, a topical. Acetazolamide, systemic)
  • Miotics (e.g. pilocarpine, a muscarinic receptor agonist)
19
Q

Acute angle Glaucoma

In acute angle closure glaucoma (AACG) there is a rise in IOP secondary to an impairment of aqueous outflow.

A

Reducing aqueous secretions with acetazolamide

Inducing pupillary constriction with topical pilocarpine

20
Q

CRAO

due to thromboembolism (from atherosclerosis) or arteritis (e.g. temporal arteritis)
features include afferent pupillary defect, ‘cherry red’ spot on a pale retina.

A

No treatment

Can often try with:

Eye massages
Nitrates
Acetazolamide
Inhaled carbogen

21
Q

CRVO

Incidence increases with age, more common than arterial occlusion
causes: glaucoma, polycythaemia, hypertension
severe retinal haemorrhages are usually seen on fundoscopy

A

Laser treatment

Anti-VEGF

22
Q

Vitreous haemorrhage

causes: diabetes, bleeding disorders
features may include sudden visual loss, dark spots

A

Self-resolving

Vitrectomy (removal of vitreous fluid)

23
Q

Retinal Detachment

A

Urgent surgery

24
Q

Cataract

Cloudiness of lens

A

Surgery

25
Q

Blepharitis

Blepharitis is inflammation of the eyelid margins. It may due to either meibomian gland dysfunction (common, posterior blepharitis) or seborrhoeic dermatitis/staphylococcal infection (less common, anterior blepharitis). Blepharitis is also more common in patients with rosacea

A

Softening of the lid margin using hot compresses twice a day
Mechanical removal of the debris from lid margins - cotton wool buds dipped in a mixture of cooled boiled water and baby shampoo is often used/ sodium bicarbonate
Artificial tears may be given for symptom relief in people with dry eyes or an abnormal tear film
If bacterial: oral doxycycline for 2-3 months

26
Q

Corneal ulcers

Corneal ulcers are more common in contact lens users

A

Bacterial: Ofloxacin
Viral: Aciclovir
Autoimmune: oral steroids

27
Q

Scleritis

a serious inflammatory disease that affects the white outer coating of the eye

A

Oral NSAID

Oral Steroid

28
Q

Episcleritis

a benign, self-limiting inflammatory disease affecting part of the eye called the episclera. The episclera is a thin layer of tissue that lies between the conjunctiva and the connective tissue layer that forms the white of the eye (sclera).

Association with gout

A

Self limiting
Lubricant
NSAID/ steroids

29
Q

Diabetic Retinopathy

A

Treat systemic diabetes
Laser therapy
Anti-VEGF

30
Q

Thyroid Eye Disease

A 
Control thyroid dysfunction
Lubricants to help prevent corneal inflammation caused by exposure
Surgical decompression 
steroids
radiotherapy
31
Q

Retinoblastoma

A 
Enucleation- removal of the eye
External beam radiotherapy
Brachytherapy- radioactive implant 
Thermotherapy
Laser photocoagulation
Cryotherapy
Chemotherapy

The Holy Grail (Treatments) (13 decks)

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