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Year 3 Semester 2 > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Which two structures separate during a retinal detachment?

A

Neural and pigmented retinal layers

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2
Q

List 3 structures in the eye which cause photophobia when affected

A
  1. Cornea (abrasion, foreign body, keratitis)
  2. Iris (iritis)
  3. Sclera (scleritis)

Not lid or conjunctival entities

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3
Q

What is the difference between an internal hordeolum and a chalazion?

A

A chalazion is an OBSTRUCTION of the Meibomian gland

An internal hordeolum is an ABSCESS of the Meibomian gland

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4
Q

What is a stye?

A

External hordeolum

Abscess of the sebaceous gland associated with an eyelash (Moll’s or Zeis)

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5
Q

What is the treatment for an internal hordeolum?

A

Warm compresses

Oral flu/dicloxacillin

Incision and drainage for persistent or recurrent abscesses

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6
Q

What is the treatment for an external hordeolum?

A

Warm compresses

Removal or the eyelash often aids resolution

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7
Q

What is the treatment for a chalazion?

A

Warm compresses

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8
Q

How is bacterial conjunctivitis treated?

A

Topical chloramphenicol

Hygiene

Regular cleaning with warm water

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9
Q

How is chlamydial conjunctivitis treated?

A

Oral azithromycin as a single dose

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10
Q

How is gonococcal conjunctivitis treated?

A

Ceftriaxone/cefotaxime IM or IV as a single dose

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11
Q

Pre-auricular lymphadenopathy is found in which ophthalmological condition?

A

Viral conjunctivitis

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12
Q

Which antibiotic is used for the treatment of bacterial keratitis?

A

Ciprofloxacin

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13
Q

What is the treatment for anterior uveitis?

A

Topical corticosteroids

Dilating drops e.g. cyclopentolate (reduces pain and prevent synechiae)

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14
Q

What is concomitant strabismus?

A

Ocular deviation is present in all directions of gaze

Non-paralytic

Primarily occurs in childhood

Constant angle of deviation in which the misaligned eye follows the unaffected eye

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15
Q

What is incomitant strabismus?

A

Ocular deviation present in specific directions of gaze

Paralytic

Functional weakness of individual extraocular muscles

Frequently acquired

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16
Q

What is heterophoria?

(Latent or manifest? And what does that mean?)

A

Latent strabismus

Only present once binocular vision is interrupted

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17
Q

What is heterotropia?

(Latent or manifest? And what does that mean?)

A

Manifest

Present during binocular vision

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18
Q

What is stereopsis?

A

Depth perception

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19
Q

Which tract is damaged in internuclear ophthalmoplegia?

A

Medial longitudinal fasciculus

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20
Q

What are the findings of internuclear ophthalmoplegia?

A

Ipsilateral loss of adduction (MR affected)

Contralateral nystagmus

Convergence is not affected (different pathways utilised)

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21
Q

Which type of strabismus does the cover test reveal?

A

Heterotropia (manifest)

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22
Q

Which type of strabismus does the uncover test reveal?

A

Heterophoria (latent)

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23
Q

List 4 treatment options for strabismus

A
  1. Correction of refractive errors
  2. Visual training
  3. Occlusion treatment
  4. Penalisation therapy (use cyclopentolate to blur vision in the good eye)
  5. Surgery
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24
Q

What is the definition of amblyopia?

A

Permanent loss of best corrected visual acuity in a structurally healthy eye

25
Q

List 3 causes of amblyopia

A
  1. Depravation e.g. ptosis, cataract
  2. Refractive
  3. Stabismus
26
Q

List 5 medications used in the treatment of glaucoma

A
  1. Pilocarpine
  2. Dorzolamide/brinzolamide
  3. Timolol
  4. Apraclonidine
  5. Latanoprost
  6. Mannitol
27
Q

What is the treatment for anterior uveitis?

A

Topical corticosteroids

Dilating drop (e.g. cyclopentolate) to reduce pain and prevent synechiae

28
Q

Which is worse, pre- or post-septal cellulitis?

A

Post-septal

29
Q

Where do pathogens causing post-septal cellulitis arise?

A

Paranasal sinus infection

Orbital trauma

30
Q

What is papillary conjunctivitis associated with?

A

Allergic conjunctivitis

31
Q

What are conjunctival follicles?

A

Small foci of hyperplastic lymphoid tissue

Associated with viral conjunctivitis

32
Q

Which condition are conjunctival follicles associated with?

A

Viral conjunctivitis

33
Q

When can people with conjunctivitis return to work/school?

A

Once the discharge has stopped

34
Q

What are keratic precipitates and when are they found?

A

Inflammatory deposits on the corneal endothelium

Indicative of inflammatory disease

Seen in anterior uveitis

35
Q

What are the two components of the uvea?

A

Anterior - iris and ciliary body

Posterior - choroid

Anterior uveitis = iritis

36
Q

What is epidemic keratoconjunctivitis?

A

Complication of some adenovirus conjunctivitis infections

An intense inflammatory response involving the cornea

Pseudomembrane formation (coagulated fibrinous exudate)

37
Q

Which features distinguish simple adenovirus infection with epidemic keratoconjunctivitis?

A

Intense redness, irritation, tearing

Blurred vision and photophobia

Follicular conjunctivitis

Preauricular lymphadenopathy

Subconjunctival haemorrhage

Conjunctival oedema

Pseudomembrane formation

38
Q

What is a pseudomembrane (epidemic keratoconjunctivitis)

A

Coagulated fibrinous exudate

39
Q

How is epidemic keratoconjunctivitis treated?

A

Removal of pseudomembrane

Topical corticosteroids

Urgent ophthalmological referral

40
Q

How is chlamydia trachomatis treated?

A

Azithromycin as a single dose

Contact tracing

Facial and hand hygiene

Trichiasis management

41
Q

What is the likely causative agent of bacterial keratitis/corneal ulcers in a patient who has been swimming with contact lenses?

A

Acanthamoeba

42
Q

What is pseudostrabismus?

A

Part of the nasal sclera is covered, forming an optical illusion of esotropia

Occurs in the first few years of life due to a wide nasal bridge or large epicanthal folds

43
Q

A foreign body sensation is associated with involvement of which ocular structure?

A

Cornea

Conjunctivitis is associated with a gritty feeling

44
Q
A

Bacterial keratitis

Characteristic white spot on cornea

45
Q
A

Anterior uveitis

Irregular pupil shape due to inflammatory adhesions of the iris margin to the anterior lens

46
Q
A

Episcleritis

47
Q
A

Scleritis

48
Q

List 2 causes of a red-eye associated with reduced visual acuity

A
  1. Infectious keratitis
  2. Iritis
  3. Acute angle-closure glaucoma
49
Q

What are two features which can help distinguish corneal abrasion from iritis?

A
  1. Abrasions have a staining defect on fluorescein examination
  2. Abrasions have a foreign body sensation
50
Q

How is ciliary flush distinguished from conjunctivitis?

A

Redness does not extend into the palpebral conjunctiva

51
Q

Which condition is most strongly associated with scleritis?

A

Rheumatoid arthritis

  • Scleritis is associated with systemic disease in 50% of cases, the most common of which being RA*
  • When scleritis complicates RA, it is a manifestation of rheumatoid vasculitis, indicating the need for an intensification of therapy*
52
Q

Ocular pain worst at night or early morning is characteristic of which condition?

A

Scleritis

53
Q

What complication of adenovirus is associated with fibrous exudates?

A

Epidemic keratoconjunctivitis

54
Q

How does trachoma occur?

A

Chronic/recurring chlamydia in both eyes → conjunctival scarring → progressive conjunctival shrinkage → corneal ulcers and opacities, neurovascularization, entropion, trichiasis (ingrown eyelashes)

55
Q

What is the major complication of epidemic keratoconjunctitis?

A

Keratitis

56
Q

What is sodium cromoglycate?

A

Mast cell stabiliser

Used for allergic conjunctivitis

57
Q

What are the adverse effects of topical corticosteroids on the eye?

A

Ocular hypertension

Ocular infection

Delayed corneal healing

Rebound inflammation upon treatment cessation

Posterior subcapsular cataracts

58
Q

List 4 causes of bacterial conjunctivitis

A

Staphylococcus aureus

Streptococccus pneumoniae

Haemophilus influenzae

Moraxella catarrhalis

Chlamydia trachomatis

Neisseria gonorrhoeae

59
Q

Follicular or papillary?

A

Follicle

Pale on surface with red base

Year 3 Semester 2 (7 decks)

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