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Finals > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Disadvantage if mast cell stabilisers in eyes?

A

Takes time to work need loading dose

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2
Q

What is shown?

A

Pappiloedema blurred disc

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3
Q

Non proliferative severe retinopathy no macula oedema?

If proliferative?

A

Consider Photocoagulation (laser)

urgently do if proliferative or very high risk

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4
Q

Risks for corneal ulcers?

A

Contact lense wear and overnight wear

Immune compromise

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5
Q

What is this?

What grade or hypertensive retinopathy has this?

A

Grade iv pappiloedema

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6
Q

What is shown? firstline treatment?

What makes this the diagnosis rather than another similar?

A

Stye- warm compress unless associated conjunctivitis

Likely to be painful wheras chalazion is nto and not inflamed also a stye not blepharitis because it features a small area that is white and bulging

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7
Q

What investigation will find a cataract?

A

Slit lamp examination, normal fundus and optic nerve seen on ophthalmoscopy

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8
Q

Features of acute glaucoma?

A

Severe pain- occular and or headache

Reduced visual acuity

Symptoms worse with mydriasis dilation(big word)

Semi dilated pupil (non reactive), halos around lights

Syetmic upset- unwell nausea

Hazy cornea- red eye

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9
Q

Eyelids burn, itch, and stick together.

Symptoms are worse in the mornings.

Both eyes are affected.

Symptoms come and go and flare?

A

Blepharitis

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10
Q

Proliferative vs non proliferative retinopathy?

A

comparison shown

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11
Q

Complications of cataract surgery?

A

Poterior capsule opacification, retinal detachment, inflammation of vitreous humour

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12
Q

AV nipping grade of hypertensive retinopathy?

A

Grade II silver/copper wiring

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13
Q

What is this what may cause it? Symptoms?

A

Dendritic ulcer often caused by herpes simplex- refer to ophthal and give topical aciclovir

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14
Q

See a defect in red reflex in elderly adult think?

A

Cataract as light can not reach retina

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15
Q

What has happened here?

A

Old laser burns from treatment of diabetic retinopathy (proliferative)

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16
Q

How to perform an RAPD test?

A

Swing lgiht from eye to eye, eye with problem will consistently start dilating whne light is shone on it and signifies a problem on that side with optic nerve

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17
Q

Initial treatment acute glaucoma?

A

Beta blockers (caution asthma) and steroids applied topically and pilocarpine (constrict pupil)

IV acetazolomide is used (caution sickle cell)

Surgery: peripheral iridotomy

Offer analgesia and antiemtic also

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18
Q

Non proliferative non-severe retinopathy and no macula oedema?

A

Observe

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19
Q

Most common blindness cause 35-65 years?

A

Diabetic retinopathy

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20
Q

Causes of cataract?

A

Smoking, alcohol, diebetes, trauma, steroids

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21
Q

What is this? best treatment?

A

Cataract- surgery

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22
Q

Symptoms of diabetic retinopathy?

A

Spots or dark strings floating in your vision (floaters)

Blurred vision.

Fluctuating vision.

Impaired color vision.

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23
Q

Conservative management of cataracts?

A

Stronger lenses.glasses, brighter lighting, does not slow progression, only improves vision for a while

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24
Q

What is shown? ?causes and treatment

A

Corneal ulcer focal staning with fluorescein

Give antibiotics, often gent and a quinolone

Commonly staph or pseudomonas

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25
Q

Cataract presentation?

A

Reduced vision, faded colour vision, glare and halos around lights

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26
Q

What is this? usual treatment?

A

Blepharitis, good lid hygiene and warm compresses

ABX not usually needed unless evidence of infection such as crusting which may indicate staph

27
Q

Signs of hypertensive retinopathy on pictures?

A

Flame haemorrhages, dots and blots, lots of cotton wool spots

28
Q

Retinal photo features of diabetic retinopathy (non proliferative) ?

A

microaneurysms

blot haemorrhages

hard exudates

cotton wool spots,

venous beading/looping and intraretinal microvascular abnormalities

29
Q

Grade iv hypertensive retinopathy?

A

Pappiloedema present

30
Q

Thickened macular oedema treatment?

A

Anti VEGF

31
Q

What type of glaucoma can present suddenly?

A

Acute angle closure

32
Q

Usual first test for evaluationg ocular trauma?

A

CT

Possible xrays if clear history of radio-opaque injury eg hammering nail or iron filings

33
Q

Causes of RAPD?

A

Optic neuritis

Glaucoma

Optic nerve lesion

Retinal detachment

Ischaemic optic disease

34
Q

What is shown? Diagnosis and why?

A

Proliferative retinopathy due to new vessel formation in disc and overlying vessels everywhere

35
Q

Recent URTI presents with gritty painful red eye?

A

Likely viral conjuncitivitis self limiting condition

36
Q

Purulent red eye, eyes stuck together?

Treatment?

A

Acute bacterial conuncitivitis

Self limiting often given ABX chloramphenicol or fusidic acid in pregnancy

37
Q

Symptoms of corneal ulcer?

A

watery eyes, discharge, visual acuity loss, painful, red eye, photophobia

38
Q

Cataract type with diabetes?

A

Dot opacities

39
Q

What is this what can be seen?

A

HTN retinopathy lots of cotton wool spots and haemorrhages

40
Q

Subscapular cataract?

A

Steroid use

41
Q

What should BP be in diabetics with end organ damage eg eye involvement?

A

130/80

42
Q

Red eyes

Itch is prominent

the eyelids may also be swollen

May be history of atopy

What and first line treatment?

A

Allergic conjunctivitis often associated with hayfever

topical antihistamines first line

sodium cormiglicate second line

43
Q

Factors that predispose to angle closure glaucoma?

A

Long sightedness, pupil dilation and lense growth with age

44
Q

Most common type of cataract and cause?

A

Nuclear changes refractive index of lenses common old age

45
Q

Most common cause of cataract?

A

Ageing

46
Q

Patient presents with this eye, feels sick has had ocular pain too … diagnosis?

A

Acute glaucoma- note reddening and mid dilated pupil with history of vision loss and pain

47
Q

What features are shown? Likely cause?

A

macular oedema: exudate (yellow arrow), microaneurysms (red arrow), thickened retina (white circle), cystic change at macula (blue arrow)

Non-proliferative diabetic retinopathy

48
Q

Inherited cataract type?

A

Polar

49
Q

Presentation of scleritis and episcleritis? Differentiate?

A

Both conditions present with a red eye which may be painful

Episcleral vessels can be moved with a cotton bud. When phenylephrine 10% is applied, they blanch

Scleral vessels appear darker, follow a radial pattern, are immobile and do not blanch.

50
Q

Specific pain of scleritis?

A

Boring eye pain

51
Q

Onset of episcleritis vs Scleritis?

A

Epi acute scler insidious

52
Q

Associated symptoms of sclertiis and episcler?

A

scleritis Yes, nausea vomiting

Episcleritis no

53
Q

Visual problems scleritis or episcleritis?

A

Scleritis

54
Q

Associated diseases with episcleritis?

A

Often idiopathic but may be common in IBD

rarely RA or connective

55
Q

Episcleritis management?

A

Artificial tears may provide some relief, particularly in nodular disease.

The use of topical non-steroidal anti-inflammatory drugs (NSAIDs) can be helpful in more symptomatic patients.

56
Q

Scleritis associated disease? How common?

A

Very common up to 50% usually RA

57
Q

Suspect scleritis do what? What investigations?

A

Refer immediately to ophthal think about underlying pathology as very often there is some

58
Q

Scleritis treatment?

A

Nsaids initially Ibuprofen and then if not effective steroids 80mg

If necrotising steroids and immunosupression immediately

59
Q

Anterior uveitis/iritis associated with?

A

HLA b27 Ank spon

60
Q

What condition is shown?

A

Uveitis

61
Q

Presentation of anterior uveitis?

A

Usually unilateral.

Pain, redness and photophobia are typical.

Eye pain is often worse when trying to read.

excessive tearing

headache, unreactive and irregular shaped pupil

62
Q

What is entropion?

A

Invertion of the eyelashes irritating the eyes

63
Q

Types of ARMacDegen and which more common?

A

Wet and dry- wet 10% dry 90%

Finals (16 decks)

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