ophthalmology Flashcards
What device measures intraocular pressure?
Goldmann tonometer
long-sightedness
Hypermetropia
short-sightedness
myopia
elderly female, history of haloes around lights presents to A&E in evening with N+V, blurred vision and pain over eye
acute glaucoma
fixed and mid-dilated pupil, cloudy iris and lens, reduced visual acuity
acute glaucoma
where does aqueous humour drain into in a healthy eye
trabecular meshwork into canal of schlemm
tunnel vision (gradual loss of peripheral vision)
open angle glaucoma
what is IOP in acute angle closure glaucoma?
> 60mmHg (normal 10-20ish)
management of acute angle closure glaucoma
topical BB (timolol) and carbonic anhydrase inhibitors (acetazolamide)- decreases aqueous production oral glycerin and IV mannitol pilocarpine (constricts pupil) laser iridotomy
what is presbyopia?
long-sightedness occuring in old age
when should you consider cataract surgery?
when the cataract is causing visual acuity of <6/12
how to record snellen chart results
Top number = distance at which the test chart was presented (usually 6m), Bottom number identifies the position on the chart of the smallest line read by the ‘patient’. Eg; 6/60 means the subject can only see the top letter when viewed at 6m
name 3 RFs for cataracts
age trauma UV exposure smoking DM systemic corticosteroids congenital
cataract surgery
phaecoemulsification
complications of phaecoemulsification
bleed (choroidal) endophthalmitis vitrous loss opacification of capsule glaucoma
causes of corneal ulceration
bacterial: chlamydia/ pseudomonas
viral: HSV (dendritic)/ HZV
fungal: candida
protozoan: acanthamoeba (contacts)
causes of conjunctivitis
bacterial- chlamydia (neonates)/ staph/ strep
viral- adenovirus/ HSV
allergic
name topical ABx eyes
chloramphenical/ fusidic acid
what dies the uveal tract consist of?
anterior: iris and ciliary body
posterior: choroid
photophobia, reduced visual acuity, pain, constricted pupil
anterior uveitis
name some causes of anterior uveitis
seronegative arthropathies: ank spond, IBD, psoriatic arthritis
infection: TB, syphilis, HIV, toxoplasmosis
AI: sarcoidosis
malignancy: NHL, leukaemia
what is a complication of anterior uveitis?
hypopyon
what is Talbot/s test?
pain increases as eyes converge (follow finger to nose) positive in anterior uveitis
redness and nodular swelling in 1 quadrant of eye, mild pain
episcleritis, self-limiting 1-2 weeks
deep boring pain, wakes patient at night, photophobia, red swelling, reduced visual acuity, systemically unwell
scleritis
conditions which may present with scleritis
collagen vascular disorders- RA, ank spond, SLE, wegener’s granulomatosus
sarcoidosis
IBD
gout
what is a stye?
infection of lash follicle aka hordeolum
how is a stye managed?
warm compress and chloramphenicol
inflamed lid, crusting, gritty sensation
blepharitis
management of blepharitis
chronic condition- baby shampoo and cotton wool
treat infections with ABx cream
tear replacement
what stain can be used to visualise corneal abrasions
fluorescin
management of corneal abrasion
analgesia
prevention of secondary infection with topical ABx and tetanus prophylaxis
pathophysiology of diaabetic retinopathy
microaneurysms
ischaemia of retina
AV shunt formation
non-proliferative diabetic retinopathy
Microaneurysms Dot and blot haemorrhages Cotton wool spots Hard exudates normal vision
proliferative diabetic retinopathy
Macular oedema- gradual reduction in vision
New vessel growth (neovascularisation)
Retinal haemorrhage
Vitreous haemorrhage- sudden loss of vision
black curtain descending in one eye
Amaurosis Fugax
how often are retinal photos taken for screening in DM?
5 yrs after diagnosis DM1, immediately DM2,
photos taken every year (every trimester in pregnancy)
in what circumstances might treatment be offered for diabetic retinopathy?
macular oedema- focal laser treatment to seal aneurysm
proliferative retinopathy- pan retinal photocoagulation to regress new vessels
name some changes that may be present in hypertensive retinopathy but not in diabetic retinopathy
AV nipping
sliver wiring
papilloedema
cherry red spot on fundoscopy
retinal detachment
drusen spots on fundoscopy
age related macular degeneration
