Ophthalmology Flashcards
Fundoscopy appearance of diabetic retinopathy
Non-proliferative:
Micro aneurysms, haemorrhages, venous bleeding, hard exudates and cotton wool spots.
Proliferative: Neovascularisation
Treatment of diabetic retinopathy
Laser photocoagulation and anti-VEGF?
Fundoscopy of hypertensive retinopathy
Arteriolar narrowing, silver wiring, AV nicking, retinopathy and papilloedema
Symptom of both retinal artery and vein occlusion
Sudden painless vision loss of all (central occlusion) or part (branch occlusion) of vision
Retinal artery occlusion fundoscopy
Swollen, pale retina and cherry red spot
Treatment for central retinal artery occlusion
Under 24 hours is a ocular massage and then vascular management (carotid doppler)
What is amaurosis fugax
Transient CRAO
Symptoms of amaurosis fugax
Transcient painless vision loss, curtain coming down and 5 mins with full recovery
Treatment of amaurosis fugax
Stroke referral and aspirin
Fundoscopy of retinal vein occlusion
Tortous dilated vessels and wide-spread retinal haemorrhages
Treatment for CRVO
Anti-VEGF
Symptoms for retinal detachment
Four Fs (floaters, flashes, fall in acuity and field loss)
Treatment for retinal detachment
Prompt surgical treatment
Symptoms of wet macular degeneration
Central scotoma and distortion
Symptoms of dry macular degeneration
Gradual decline in vision
What are drusens and what disease
Build up of waste below RPE and dry age related macular degeneration
What disease is associated with optic neuritis
MS
Symptoms of optic neuritis
Progressive visual loss, pain behind eye especially on movement and colour desaturation
Treatment of optic neuritis
Goes away itself
What is glaucoma
Injury to the optic nerve associated with elevated intraocular pressure
Describe acute angle closure glaucoma
Aqueous humour cannot leave the eye and causes increase pressure
Symptoms of acute angle closure glaucoma
Very painful, red eye, stony hard eye, nausea and vomting.
Who is acute angle more common in
Hypermetropics
Most common glaucoma
Open angle
Treatment of glaucoma
Beta blockers eye drops, prostaglandin eye drops, alpha-agonists and carbonic anhydrase inhibitors
Painful!, red eye, keratic precipitates, hypopyon, photophobia, synachiae
Anterior uveitis
Diseases related to anterior uveitis
Reiters, UC, ank spon, sarcoid
Treatment of anterior uveitis
Topical steroids (pred forte) and mydriatics (cyclopentolate)
What is tepee sign
Lashes matted together in blepharitis
Most common blepharitis
Mixed (anterior and posterior)
What is the difference between anterior and posterior blepharitis
Anterior: around eye lashes, a reaction to staph aureus and associated with seborrhoeic dermatitis.
Posterior: Glands blocked by debris/skin flakes and associated with rosacea and seborrhoeic dermatitis
Treatment for blepharitis
Bathing/warm compresses, suplementary tears and oral doxycycline in worst cases
What is a chalazion, ho does it present and treatment.
Blocked meibomian gland that may become infected and is a firm round lump of eyelid. Treatment is hot compression, antibiotic massage and in clinic an incision and curettage under local anaesthetic
What is chorioretinitis
Inflammatory and exudative condition of the choroid and retina
Symptoms and signs of conjunctivitis
Red eye, foreign body, discharge, papillae or follicles, chemosis and pre-auricular glands
What is chemosis
Conjunctival oedema
How is neonatal conjunctivitis usually caused
STD from birth canal
What is the common organisms for bacterial conjunctivitis
Staph aureus
Tx of bacterial conjunctivitis
Chloramphenicol
Most common organism in viral conjunctivitis
Adenovirus
What is hutchinsons sign
Herpes zoster along the nasociliary nerve
Chlamydial conjunctivitis signs and symptoms
Red irrated eyes, subtarsal scarring, follicles
Treatment of chlamydial conjunctivitis
Oxytetracycline
What dye shows abrasions
Fluroscein
Treatment of corneal abrasion
Heal in a few days and deep may require antibiotics
Corneal ulcer symptoms
Very painful (needle like), photophobia, lacrimation, circumcorneal red eye
Where do autoimmune ulcers occur
Peripherally (limbus)
What diseases are associated with corneal ulcer
Thyroid, sjorgens, keratitis and vitamin A deficiency
What is dacryocystits
Inflammation of the lacrimal sac
Treatment of dacryocystitis
Antibiotic eye drops
What is endophthalmitis
Devastating infection inside the eye
Symptoms of endophthalmitis
Very painful, decreasing vision, very very red eye
Organism for endophthalmitis and how to diagnose
Staph epidermis with a aqueous/vitreous culture
Treatment of endophthalmitis
Intravitreal amikacin and vancomycin with a topical antibiotic (chlorophenicol)
Which diseases show blanching/non-blanching on phenylephrine
Episcleritis will blanch and scleritis vessels will not
What disease is epislceritis related to
Gout
Treatment of episcleritis
Oral NSAIDs
What is keratitis
A corneal infection
Treatment of bacterial keratitis
Admission for hourly drops and ofloxacin or gentamicin and cefuroxime
What is bacterial keratitis related to
Corneal pathology or contact lense wear
What is a dendritic ulcer
Herpes simplex keratitis
What should be avoided in dendritic ulcer and why
Steroids as it causes a corneal melt and perforation of the conrea
Treatment of dendrtitic ulcers
Antivirals (aciclovir)
What does adenoviral keratitis follow
URtI
What is keratoconjuncitivtis sicca
Dry eye (sjorgens)
What scan should be done in orbital cellulitis and why
CT to identify abscesses
What is pinguecula and how are they caused
Yellowish, raised thickening of the conjunctiva over the sclera and caused by Iv exposure
What is a pterygium
Benign growth of the conjuctiva
Treatment of stye
Hot compression and antibiotics
What is sympathetic opthalmia
Autoimmune granulomatous reaction to surgery or trauma in one eye and spreads to both eyes. Systemic steroids!
