Ophthalmology Flashcards
What are the risk factors for ARMD?
Female, smoking, hypertension, cataract surgery
What are the clinical features of ARMD?
Blurred/loss of central vision
Absent foveal reflex
Yellow drusen
Areas of hypo and hyper pigmentation
What are the clinical features of wet AMD?
Fluid/bloods develops in retina
Sudden loss of central vision
Needs urgent referral and anti-VEGF
What is glaucoma?
Damage to optic nerve due to increased ocular pressure
Visual field defect
Cupping of optic disc
What is the normal flow of aqueous humour?
Ciliary process
Posterior chamber
Anterior chamber
Trabecular meshwork, Schlemm’s canal, episcleral veins
What are some risk factors for primary open angle glaucoma?
Age, male, race, FH, short-sighted (myopia), DM, tight collar and tie
What is the treatment of primary open angle glaucoma?
Medical - prostaglandin analogues e.g. latanoprost
Laser trabeculoplasty
Trabeculectomy
What are the clinical features of closed angle glaucoma?
May be preceded by subacute episodes - headaches, coloured haloes around lights Photophobic and painful eye Watering and loss of vision May be systemically unwell Dilated pupil, cloudy cornea, red eye
Which eye drops should be cautioned in glaucoma?
Tropicamide and phenylephrine
Increase pupil size - narrows drainage angle
What are the clinical features of central retinal artery occlusion?
Sudden painless loss of vision
Cherry red spot, pale retina
Exclude GCA
What are the clinical features of central retinal venous occlusion?
Acute monocular loss of portion of visual field
Intraretinal haemorrhage and lipids, dilated retinal veins
What investigations should be done in orbital cellulitis?
Orbit MRI/CT Conjunctival swab FBC Blood cultures Pulse, BP, temperature, visual acuity - hourly
What are the clinical features of infective endophthalmitis?
Usually follows eye surgery
Increasingly painful eye and reduced visual acuity
Red eye, hypopyon, corneal oedema and infection
Give intra-vitreal antibiotics
What are the clinical features of herpes eye infections?
Mild fever, malaise, URTI
Dendritic ulcer on fluorescein and cobalt blue
HSV1
What are the clinical features of an abducens palsy?
Lateral rectus palsy - can abduct one eye
Usually due to microvascular infarct
What are the red flags for an abducens palsy?
Under 35, other palsies, papilloedema
What are the clinical features of an oculomotor palsy?
Ptosis, eye turned down and out
Microvascular infarct or berry aneurysm
Pupil dilated - think aneurysm, urgent neuroimaging
Which drops should be used to dilated pupils in children?
Cyclopentolate
When should babies be screened for ROP?
Babies born under 31 weeks should be screened at 4-7 weeks postnatally
What conditions are associated with congenital cataracts?
Cytomegalovirus, varicella, rubella
Down’s, Edward’s
What is the treatment of congenital cataracts?
Bilateral dense - surgery at 4-6 weeks
Bilateral partial - may not need surgery
Unilateral dense - urgent surgery and aggressive anti-amblyopia therapy
