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YEAR 3 & 5 CORE CONDITIONS > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What are the different types of conjunctivitis? What is the discharge like for each?

A

Bacterial - mucopurulent
Viral - watery
Chlamydial - watery
Allergic - stringy

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2
Q

What is the main treatment for bacterial conjunctivitis?

A
  1. Chloramphenicol - risk of aplastic anaemia

2. Fusidic acid

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3
Q

How does blepharitis present?

A 
Burning feeling
Crusting = staph infection
Gunking = secretions from Meibomian glands
Loss of eyelashes
Frothy tears
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4
Q

Differentiate between entropion and ectropion?

A

Entropion = inversion of eyelids caused by lower lid laxity so orbicularis muscle overrides tarsal plate

  • Red, itchy, sore, gritty, uncomfortable eyes
  • Irritation from eyelashes can cause corneal ulcer

Ectropion = eversion of eyelids due to laxity causing exposure of tarsal conjunctiva

  • Dryness, redness
  • Frequently discharging
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5
Q

What is a chalazion?

A

Meibomian cyst

Blockage of gland within tarsal plate traps sebaceous secretions, leading to chronic granulomatous inflammation

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6
Q

How can you treat a chalazion?

A

Hot compresses
Massage
Incision + curettage to drain

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7
Q

What can cause ptosis?

A

Age-related degeneration of levator muscle aponeurosis
CNIII palsy/Horner’s syndrome
Myasthenia gravis/muscular dystrophy

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8
Q

What most commonly causes a corneal ulcer?

A

Contact lenses

Bacteria
Viruses
Acanthamoeba (live in water)
Fungi (immunocompromised)

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9
Q

How does anterior uveitis present?

A

Pain worse in bright lights (spasm of iris muscles)
Headache
Blurred vision

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10
Q

What would you see on examination of uveitis?

A

Hypopyon = leukocyte exudate in the anterior chamber

Red eye

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11
Q

What conditions is uveitis associated with?

A

HLA-B27

  • Ankylosing spondylitis
  • Psoriasis
  • IBD
  • Sarcoidosis
  • Behcet’s
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12
Q

How do you treat uveitis?

A

Prednisolone 1% eye drops

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13
Q

How would scleritis present?

A 
Deep boring pain
Wakes patient up from sleep
Radiates to forehead
Red eye 
Vision may decrease
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14
Q

What conditions is scleritis associated with?

A

Rheumatoid arthritis

SLE

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15
Q

How is episcleritis different from scleritis?

A

There is no pain
Vision is normal
It is associated with IBD

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16
Q

Define glaucoma

A

Optic neuropathy usually with high intraocular pressure (>21mmHg), optic disc cupping and progressive visual loss

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17
Q

What type of glaucoma is most common? How does it present?

A

Open angle glaucoma

Bilateral peripheral visual loss (can be asymptomatic)

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18
Q

What are the risk factors for open angle glaucoma?

A

Family history
Hypertension
Diabetes
Myopia = short sighted

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19
Q

How does closed angle glaucoma present?

A 
Acute eye pain
Associated nausea + vomiting
Decreased visual acuity
Haloes when look at lights
Abdominal pain
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20
Q

What causes angle closure glaucoma?

A

Long sightedness (small eyes) - when the pupil is mid-dilated the iris blocks the drainage of fluid so pressure increases

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21
Q

What is the treatment for open angle glaucoma?

A

Latanoprost (prostaglandin analogue) - increases outflow

Timolol (beta-blocker) - reduces aqueous

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22
Q

What are the side effects of latanoprost?

A

Thicker, darker, longer lashes

Darker iris + skin around eyes

23
Q

What is the treatment of acute angle closure glaucoma?

A

IV acetazolamide (carbonic anhydrase inhibitor) - reduces aqueous production

24
Q

What are the red flags in a red eye?

A 
Severe pain
Reduced vision
Photophobia
Proptosis (protrusion of eye)
Miosis in affected eye
25
Q

What are the 5 stages of cellulitis?

A 
I = preseptal
II = orbital
III = subperiosteal abscess
IV = orbital abscess
V = cavernous sinus thrombosis
26
Q

What organisms most commonly cause preseptal and orbital cellulitis? How do you treat each?

A

Preseptal

  • Staph aureus
  • Abx: co-amoxiclav 10 days

Orbital

  • Strep pneumoniae
  • Abx: flucloxacillin/ceftriaxone IV
27
Q

How can you differentiate between preseptal and orbital cellulitis?

A

Preseptal

  • Normal eye
  • Normal vision
  • No proptosis

Orbital

  • Red eye
  • Blurred vision
  • Proptosis
28
Q

What are the main complications of orbital cellulitis?

A

Blindness
Meningitis
Cavernous sinus thrombosis

29
Q

What can cause a painful loss of vision?

A 
Acute angle closure glaucoma
Giant cell arteritis
Optic neuritis
Uveitis, slceritis, keratitis
Shingles
Orbital cellulitis
30
Q

What can cause a painless loss of vision?

A 
Cataracts
Retinal detachment
Retinal vessel occlusion
Diabetic retinopathy
Age-related macular degeneration
Optic nerve compression (Berry aneurysm)
31
Q

What are the symptoms of retinal detachment?

A

4 Fs

Flashes = photopsia
Floaters
Fall in visual acuity
Field loss - ‘curtain coming down’

NO pain

32
Q

What is amaurosis fugax?

A

TIA of a retinal artery

Causes transient monocular blindess due to transient retinal ischaemia

33
Q

What does fundoscopy of a retinal artery occlusion look like?

A

Pale retina with oedema
Cherry-red macula
Arteriolar narrowing

34
Q

What causes retinal vein occlusion?

A

Arteries go over veins so if the artery is hardened due to longstanding hypertension, the vein is nipped

35
Q

What would fundoscopy of retinal vein occlusion show?

A 
Cotton-wool spots = nerves dying due to ischaemia 
Tortuous dilated vessels
Flame haemorrhages (sudden hypertension)
Disc oedema
Macular oedema
36
Q

How do you manage retinal vein occlusion?

A

anti-VEGF

Vascular endothelial growth factor is released to recruit new blood vessels

37
Q

What is the triad for presentation of optic neuritis?

A

Unilateral reduced vision
Reduced colour vision (especially red)
Eye pain

38
Q

What can cause optic neuritis?

A

Acute demyelination - MS
Ischaemic optic neuropathy - GCA, diabetes
Other - steroids, TB, syphilis, orbital cellulitis, B12 deficiency, amiodarone

39
Q

What are the macula and fovea?

A 
Macula = 3mm temporal from optic disc
Fovea = centre of macula
40
Q

Differentiate between dry and wet age-related macular degeneration

A

Dry

  • Atrophic
  • Drusen in macula (yellow spots)

Wet

  • Exudative
  • Neovascularisation
  • Subretinal haemorrhages in/around macula
41
Q

What are the risk factors for age-related macular degeneration?

A 
Smoking
Cardiovascular disease
Malnutrition
Obesity 
UV light
42
Q

How does ARMD present?

A

Progressive central visual deterioration

43
Q

How do you treat wet ARMD?

A

Anti-VEGF - prevents neovascularisation

Laser phocoagulation

44
Q

What are cataracts?

A

Lens opacities

45
Q

What are congenital cataracts associated with?

A

TORCH

  • Toxoplasmosis
  • Rubella
  • CMV
  • Herpes

EBV
Chickenpox

46
Q

How does herpes simplex present in the eye?

A

Dendritic ulcer
Red eye
Extremely painful
No discharge

47
Q

What are the stages of diabetic retinopathy?

A 
Background
- Microaneurysms (dots)
- Haemorrhages (blots)
- Hard exudates (yellow clouds) 
Pre-proliferative
- Cotton-wool spots (nerve infarcts)
- Haemorrhages
Proliferative
- Neovascularisation
Maculopathy
- Oedema around fovea
48
Q

How do you treat diabetic retinopathy?

A

Laser phocoagulation

49
Q

What does retinal detachment look like on fundoscopy?

A

Grey retina ballooning fowards

50
Q

How does giant cell arteritis present?

A

Vision goes dark

51
Q

What signs would vitreous haemorrhage give with fundoscopy?

A

No red reflex
Can’t see retina

(if you can’t see in and patient can’t see out, it is likely vitreous haemorrhage and retinal detachment is the differential)

52
Q

What causes optic atrophy (big cup)?

A

Optic neuritis
End stage glaucoma
Tumour compressing optic nerve

53
Q

How does papilloedema look in fundoscopy?

A

Bilateral swollen discs

54
Q

How do you treat giant cell arteritis?

A

High dose IV steroids

YEAR 3 & 5 CORE CONDITIONS (30 decks)

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