Ophthalmology Flashcards
Homonymous quadranopia defect location
PITS
pituitary inferior, temporal superior
Congruent Vs incongruent visual field defects
Incongruent likely optic tract, congruous optic cortex or optic radiation lesion
Distinguish between scleritis and episcleritis
Scleritis is painful
Both associated with RA and both have rythema
Distinguish between scleritis and episcleritis
Scleritis is painful
Both associated with RA and both have rythema
Distinguish between MS and neuromyelitis optica
Brain MRI
Spinal cord MRI involving 3 it more levels
NMO IgG seropositive (antibody against aquaporin 4 antigen)
Most common bacterial causes of peri orbital cellulitis
Steptococcus, staph A, haemophylis influenza B (so check for vaccine)
Distinguish between glaucoma and uveitis
Glaucoma is severe pain, haloes, semidilated pupils.. hazy cornea
Uveitis is small fixed oval pupil
What conditions are associated with angoid streaks
Pseudoxanthoma elasticum
Ehlers danlos
Paget’s disease
Sickle cell
Dendritic corneal ulcer on fluorescent staining diagnosis
Herpes simplex keratitis
Management of primary open angle glaucoma
Prostaglandins analogue like lantaprost
Most common visual problem associated with Charles bonnet syndrome
Age related macular degeneration
Patient presents with blurred vision
Fundoscopy shows retinal haemorrhages and necrosis - ‘pizza’ retina
CMV retinits, common in patients with HIV CD4<50
Treat with IV ganciclovir
Rheumatoid arthritis, painless eye redness no itch
Episcleritis
If itchy: Keratoconjunctivitis sicca
h/o RA +dryness ,itchy
Keratoconjunctivitis sicca (most common ocular manifestation of RA)
h/o RA +painfull , redness
Scleritis (episcleritis is painless)
Patient who is tall with low IQ has downward lens dislocation… Likely diagnosis?
Homocystinuria (IQ down, lens down)
Marfan’s have normal IQ but upward dislocation
Mnemonic for eye movements and cranial nerves
LR6 SO4
ee3
Lateral rectus CN 6,
Superior oblique CN 4
Everything else 3
What congenital infection causes chorioretinitis?
75% of patients with congenital toxoplasmosis have it
Patients with rubella can get it but not as common… They mostly get congenital cataracts
Sudden painless loss of vision, Flame shaped haemorrhages on fundoscopy
Central retinal vein occlusion
patient with Paget’s has irregular dark red streaks radiating from the optic nerve head… Diagnosis?
Angioid retinal streaks
Also associated with Ehlers Danlos, sickle cell, acromegaly, pseudoxanthoma elasticum
Which is more common, Central retinal vein or arterial occlusion?
Vein
May see retinal haemorrhage with it too
Sudden loss of vision in diabetic, w 2-hour history of progressively enlarging dark spots
Vitreous haemorrhage
Pt presents w Flashes and floaters. Normal fundoscopy
Posterior Vitreous detachment is most likely ( 50-75% of >65yr) . But rule out retinal detachment
Can be in vitreous haemorrhage too but is likely to obscure fundoscopy
night blindness + tunnel vision
Retinitis pigmentosa
MOA of treatments for primary angle glaucoma
PBL ( PBL medschool it makes you want to leave) so pilocarpine, brimonidine and latanoprost improve uveoscleral outflow.
CBT reduced tears, so reduces aqueous production, so Carbonic anhydrase inhibitors, Brimonidine and Timolol reduce aqueous production
Patient with heterochromia… Ptosis
Congenital Horner’s
What nerve does Herpes zoster ophthalmicus affect
Ophthalmic division of trigeminal nerve
Keith-Wagener classification of retinopathy
1-4…
First they start to twist and turn [1: silver wiring], then they nip about the place [2: AV nipping], afterwards they play with cotton wool and fire [3:cotton wool spots, flame and blot haemorrhages], finally they swell up [4: papilloedema]
Sudden painless loss of vision w red spot over a pale and opaque retina
Central retinal artery occlusion
Mx of patient with severe eye pain, decreased acuity,semi-dilated non-reacting pupil
Acute angle glaucoma…. Treat with IV acetazolamide and pilocarpine
Bilateral vitreous haemorrhage
Von Hippel lindau has Retinal and cerebellar haemangiomas
Dacryocystitis
Watery eye, swelling and erythema of inner canthus of eye
Treat with abx or IV if periorbital cellulitis
Female patient presents with One pupil dilated, when constricts it is slow to dilate. Absent knee/ankle reflex
Holmes Adie syndrome
Sluggish pupil, haloes around lights
Acute angle closure glaucoma
Dense shadow that starts peripherally progresses towards the central vision
A veil or curtain over the field of vision
Retinal detachment
Diabetic patient, poor control, new vessel formation at optic disc
Urgent referral for panretinal photocoagulation by laser
