Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Specialties > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

4 types of change in appearance of the eyelid

A

Ptosis
Swelling
Entropion (turning in)
Ectropion (turning out)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which muscles are innervated by CN3?

A

Medial rectus
Superior rectus
Inferior rectus
Inferior oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the appearance of the eye due to 3rd nerve palsy?

A

Down and out
Ptosis
Fixed dilated pupil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is strabismus

A

Misalignment of the eyes (squint)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What vascular disease is important to exclude in transient loss of vision?

A

Giant cell arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the management of giant cell arteritis?

A

Steroids - 60mg oral prednisolone
Urgent referral to specialist
Temporal artery biopsy
Very high inflammatory markers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What common eye condition causes loss of peripheral vision?

A

Glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

5 causes of gradual vision loss?

A 
Glaucoma
Cataracts
Macular degeneration 
Diabetic retinopathy
Increased intracranial pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 types of cataracts?

A

Nuclear sclerosis
Cortical
Posterior subcapsular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which type of cataracts causes temporary improvement in short sightedness?

A

Nuclear sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which type of cataracts causes wedge shaped opacities/fragments/streaks?

A

Cortical (aka spokes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which groups of people are most likely to get posterior subcapsular cataracts?

A

Diabetics

Patients taking high dose steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which type of cataracts causes poor vision in bright light eg glares and haloes?

A

Posterior subcapsular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is phacoemulsification?

A

Fragmentation of lens fibres using ultrasound.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common type of glaucoma?

A

Chronic open angle glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the ‘angle’ refer to in glaucoma?

A

The angle between the posterior surface of the cornea and the anterior surface of the iris (iridocorneal angle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What produces the aqueous in the eye?

A

Ciliary body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where does aqueous leave the eye?

A
  • Trabecular meshwork in the iridocorneal angle

- Enters the episcleral veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is normal intraocular pressure?

A

<21mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is chronic open angle glaucoma?

A

Optic neuropathy where by there is:

  • Increased IOP >21 mmHg
  • Enlargement of the optic disc cup (results in loss of neurones). Normal cup to disc ratio is <0.5)
  • Progressive loss of visual field (results in tunnel vision)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What sort of vision is characteristic of open-angle glaucoma?

A

Tunnel vision (peripheral visual loss)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Types of glaucoma syndromes

A

Manifest glaucoma = High IOP, large cup, field loss
Glaucoma suspect = Abnormal disc or field loss (not both)
Ocular hypertension = High IOP, normal disc and fields
Normal tension glaucoma = normal IOP, large cup, field loss
Secondary glaucoma = after trauma, use of steroids or inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What size should the optic disc cup be?

A

Less than half the diameter of the disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which visual fields do arcuate scotomas begin in?

A

Superior or inferior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the 1st line treatment of glaucoma?

A

Topical ophthalmic prostaglandins eg lantanoprost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What classes of medications are used to treat glaucoma other than prostaglandins?

A

Beta adrenergic antagonists (B blockers) eg timolol
Carbonic anhydrase inhibitors eg dorzolamide
Alpha-2 adrenergic agonists eg brimonidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What surgical treatment is there for glaucoma?

A

Laser trabeculoplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

At what part of the retina is visual acuity highest?

A

Macula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where is the macula located?

A

3mm temporal to the optic disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the 2 types of photoreceptors? Where are they located? What are they responsible for?

A

Rods - Peripheral vision, vision at low light levels (scotopic), not present in fovea centralis of macula
Cones - Central vision, high spatial acuity, vision at higher light levels (photopic vision). Found in the fovea centralis of macula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What 3 things does good visual acuity depend upon?

A
  • Functioning photoreceptors
  • Healthy retinal pigment epithelium
  • Perfusion of the capillary layer of the choroid (the choriocapillaris)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are drusen?

A

Yellow fatty lipid deposits (waste material from photoreceptors) which accumulates below the retinal pigment epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the most common type of age related macular degeneration?

A

Dry AMD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the visual loss seen in dry AMD?

A

Central scotoma with good peripheral vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the pathology of dry AMD?

A

Atrophy of the retinal pigment epithelium, choroid and photoreceptors in retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What can be seen with opthalmoscope in patient with dry AMD?

A

Drusen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What can be seen with opthalmoscope in a patient with wet AMD?

A

Exudates and haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What percentage of AMD cases are wet AMD?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the pathology of wet AMD?

A

New vessels in choroid are formed (choroidal neovascularisation)
New vessels leak fluids, lipids and blood into layers behind retina
Localised retinal detachment
Retinal scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Visual loss in wet AMD?

A

Distorted central vision eg microscopia, which develops into central scotoma.
More rapid change than dry AMD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What does myopia mean? What type of lens is required to correct it?

A

Short sighted

Concave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What does hyperopia mean? What type of lens is required to correct it?

A

Long sighted

Convex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

3 features of glaucoma

A

loss of visual fields
cupping of optic disc
intra ocular hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Side effect of carbonic anhydrase?

A

Pins and needles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What can make the intraocular pressure appear higher than it is?

A

Thick central cornea - some people are born with this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Treatment options for wet AMD?

A

Laser photocoagulation

Intravitreal anti-VEGF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the treatment of early dry AMD?

A

Nutritional therapy - high in antioxidants, carotenoids and omega 3 fatty acids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

In what groups of people can wet AMD occur other than the elderly?

A 
Myopic patients (extreme short sightedness)
Choroidal rupture after blunt trauma
Angioid streaks associated with psuedoxanthoma elasticum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What can be seen with opthalmoscope in a patient with diabetic retinopathy?

A 
Haemorrhages
Microaneurysm
Cotton wool spots
Neovascularisation
Exudate
Macular oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Differential diagnoses for causes of microaneurysms?

A

Diabetes
Retinal vein occlusion
Ocular ischaemia
Any cause of retinal/general slow flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are the classifications of diabetic retinopathy in the UK?

A

Background
Background/preproliferative
Preproliferative
Proliferative

52
Q

What is the management of background diabetic retinopathy?

A

No treatment as not currently sight threatening
Annual review
Investigation of other organs that are affected by diabetes.

53
Q

What area does the macular cover?

A

A circle whose radius is the distance from the foveola to the temporal edge of the optic disc.

54
Q

What are the causes of visual loss of diabetic maculopathy?

A

Macular oedema
Foveal ischaemia
Foveal haemorrhage

55
Q

What are the treatment options for diabetic maculopathy?

A

Macular grid laser

Intravitrial steroid eg triamcinolone

56
Q

How do you determine the sites of leakage in diabetic maculopathy?

A

Flourescein angiography

57
Q

What are the symptoms of diabetic retinopathy?

A

Sudden changes in vision/blurred vision
Eye floaters and spots
Double vision
Eye pain

58
Q

Symptoms of diabetic maculopathy

A

Blurring in the central vision causes trouble reading and recognising faces in the centre of the vision

59
Q

Treatment options for proliferative retinopathy?

A

Laser photocoagulation
Anti-VEGF injections
Virectomy surgery

60
Q

What muscle and nerve is responsible for pupillary constriction?

A

Pupillary constrictor muscle

Parasympathetic fibres on CN III

61
Q

What neurotransmitter is involved in pupillary constriction? And which receptors does it bind to?

A

Acetylcholine

M3 muscarinic receptors

62
Q

What muscle is responsible for pupillary dilation and what is it innervated by?

A

Dilator pupillae muscle

Sympathetic fibres carries to the eye via blood vessels

63
Q

What neurotransmitter is involved in pupillary dilation and what receptors does it bind to?

A

Noradrenaline

Alpha 1 adrenergic receptors

64
Q

What nucleus supplies the preganglionic parasympathetic fibres to the eye?

A

Edinger Westphal nucleus (CN III nucleus)

65
Q

What are the 3 pupillary reflexes?

A

Reaction to light - constriction
Reaction to dark - dilation
Reaction to near target - convergence

66
Q

What is anisocoria?

A

Pupils of different sizes

67
Q

What does an afferent pupillary defect indicate there is a problem with?

A

Pupil or optic nerve

68
Q

What does an efferent pupillary defect indicate there is a problem with?

A

CN III or sphincter muscle

69
Q

What are the causes of rapid afferent pupillary defect (RAPD)?

A 
Sudden:
Retinal vein/artery occlusion
Retinal detachment
GCA
Gradual:
Glaucoma
Macular degeneration
Other:
Optic nerve damage eg trauma, radiation, tumour (anterior ischaemic optic neuropathy)
Retinal disease
Optic neuritis
Retinal infection
70
Q

If there was a problem with the retina in the right eye and RAPD was present, what would you expect to see?

A

Pupils equal before illumination
Neither pupil constricts in response to illumination of right eye
Both pupils constrict in response to illumination of left eye
Appearance of right pupil dilating in response to light when illumination changes from left to right, when in actual fact the eyes are returning to normal state after left eye being illuminated.

71
Q

If there was an efferent defect associated with a problem with the right eye, what would you expect to see?

A

Right pupil > left pupil
Right eye will not response to illumination
Left eye constricts in response to illumination from either eye.

72
Q

Causes of anisocoria?

A 
Horner's syndrome
Adie's pupil (efferent defect)
3rd nerve palsy
Drugs eg atropine/pilocarpine
Iris damage eg glaucoma, iritis, surgery
73
Q

Features of horner’s syndrome?

A

Miosis
Ptosis
Anhidrosis
Enophthalmos

74
Q

Features of 3rd nerve palsy

A

Fixed dilated pupil
Ptosis
Eye deviated downwards and out (divergent eye)

75
Q

What is miosis?

A

Constriction of pupil

76
Q

Causes of horner’s syndrome

A

Apical lung tumour eg pancoast tumour
Thyroid surgery
Internal carotid artery dissecting aneurysm
Cavernous sinus and orbital disease

77
Q

Test to confirm horner’s syndrome

A

Cocaine test
Cocaine prevents the reuptake of noradrenaline. It dilates the pupil in the normal eye, but eye affected by horner’s syndrome fails to dilate, due to lack of noradrenaline.

78
Q

Features of Adie’s pupil?

A

Caused by parasympathetic denervation.
Mydriasis (dilated pupil)
Reduced accommodation (blurred vision when reading)
Light near dissociation

79
Q

What is important to exclude with 3rd nerve palsy?

A

Posterior communicating artery aneurysm

80
Q

How is RAPD detected?

A

Swinging torch test

81
Q

What are the 3 layers of the eyeball?

A

Sclera, Choroid, Retina

82
Q

Which muscles are responsible for the focussing of the lens?

A

Ciliary muscles

83
Q

Which muscles are responsible for the dilation and constriction of the iris?

A

Pupillary dilator and pupillary constrictor muscles

84
Q

Which eye conditions are associated with rheumatoid arthritis?

A

Sjogren’s
Episcleritis/sceritis
Anterior uveitis

85
Q

What are the 4 symptoms of Horner’s syndrome?

A

Ptosis
Meiosis
Anhydrosis
Enophthalmos

86
Q

What tumour causes a bitemporal hemianopia?

A

Pituitary adenoma - pressing on the optic chiasm

87
Q

What are the causes of Horner’s syndrome?

A

Central: Stroke, MS
Pre-ganglionic: Pancoast tumour
Post-ganglionic: Carotid artery dissection

88
Q

What are the most common cause of bacterial conjunctivitis?

A

Staph aureus
Haemophilus influenza
Strep pneumoniae

89
Q

What antibiotics are used to treat conjunctivitis?

A

1st line: Chloramphenicol

2nd line: Fusidic acid

90
Q

Most common cause of keratitis (corneal ulceration)?

A

Non infectious eg dryness, contact lens injury

91
Q

Most common infectious cause of keratitis?

A

HSV1

92
Q

What are my 7 differentials for red eye?

A 
Conjuntivitis
Keratitis
Episcleritis
Scleritis
Subconjunctival haemorrhage
Anterior uveitis
Acute closed-angle glaucoma
93
Q

What is reiter’s syndrome?

A

Conjunctivitis
Urethritis
Arthritis (reactive)

94
Q

How does keratitis present?

A

Painful red eye
Photophobia
Watery eye
Blurred vision

95
Q

What investigation is specific for keratitis caused by HSV1?

A

Branching dendrite is seen on cornea when using Fluorescein and cobalt blue light

96
Q

Presentation of episcleritis?

A

Can be asymptomatic

Mild pain, redness and irritation

97
Q

How can you tell between episcleritis and scleritis?

A

Episcleritis - mild pain, vessels are mobile and blanch with phenylephrine drops
Scleritis - Severe pain (patient will not let you touch eye) , vessel are not mobile, aderhent to globe and do NOT blanch with phenylephrine drops

98
Q

How do you treat scleritis?

A

Oral NSAIDs
Topical steroid drops
Systemic immunosuppression (corticosteroids/cyclophosphamide)

99
Q

How does subconjunctival haemorrhage present?

A

Harmless collection of blood under conjunctiva, looks a lot worse than it is

100
Q

How does scleritis present?

A

Severe pain
Blurred vision
Photophobia
Headache

101
Q

What conditions is scleritis associated with?

A

Rheumatological disease eg RA, SLE, ank spond, GPA

102
Q

What is a complication of scleritis?

A

Globe perforation

103
Q

Which causes of red eye cause photophobia?

A

Keratitis
Scleritis
Anterior uveitis

104
Q

How do you differentiate between keratitis and anterior uveitis?

A

The redness in anterior uveitis starts at the circumcorneal injection. The pupil may also appear irregular due to the iris sticking to the lens (posterior synechiae).
Branching dendrite might be seen in keratitis when due to HSV1
Talbot’s test is positive in anterior uveitis

105
Q

What is Talbot’s test?

A

Pain increases as the eyes converge and pupils constrict (ask the patient to watch their finger approach their nose)
Specific for anterior uveitis

106
Q

How do you treat anterior uveitis?

A

Steroid eye drops (decreases inflammation)

Cyclopentolate (dilates pupil and prevents iris sticking to lens)

107
Q

What is the pathology behind acute closed-angle glaucoma?

A

Sudden rise in intra-ocular pressure due to lens pushing up against iris and preventing flow of aqueous humour (pupillary block)
Closure of iridocorneal angle preventing drainage
Raised intra-ocular pressure leads to fixed dilated pupil and axonal death

108
Q

What is the presentation of acute closed-angle closure?

A

Extremely red and painful eye
Nausea and vomiting
Glare, halos around lights
Blurred vision

109
Q

What is the management of acute closed-angle glaucoma?

A

IV Carbonic anhydrase inhibitors eg acetazolamide
Topical:
B blockers eg timolol
Steroids
Mitotic eg pilocarpine (constricts pupil to open angle)

110
Q

What investigations are used to diagnose acute closed-angle closure?

A

Fundoscopy
Slit-lamp examination
Tonometry
Gonioscopy (measures angle)

111
Q

What is seen in fundoscopy for acute closed-angle glaucoma?

A

Pale cupped optic disc

112
Q

What are the 5 differentials for sudden loss of vision?

A 
Central retinal artery occlusion
Central retinal vein occlusion
Retinal detachment
Giant cell arteritis
Amourosis Fugax
113
Q

How do you differentiate between ischaumic and non-ischaemic retinal vein occlusion?

A

Fluorescein angiography

114
Q

Complications of ischaemic central retinal vein occlusion

A

Neovascular glaucoma

Retinal detachment

115
Q

Visual acuity is improved with pinhole when it is due to what cause?

A

Refractive error

116
Q

What is seen on fundoscopy for central retinal artery occlusion?

A

Cherry red spot

117
Q

What is the management of central retinal artery occlusion?

A 
Occular massage (<100 mins)
IV Acetazolamide
118
Q

What is seen on funcodscopy for central retinal vein occlusion?

A

Widespread haemorrhages
Swollen optic disc
Stormy sunset appearance

119
Q

What is the treatment of central retinal vein occlusion?

A

Anti-VEGF agents

Laser treatment if ischaemic

120
Q

What are the complications of ischaemic central retinal vein occlusion?

A

Neovascular glaucoma

Retinal detachment

121
Q

What is the presentation of retinal detachment?

A

Sudden loss of vision preceded by flashing lights, floaters and visual field defects

122
Q

What are the risk factors for retinal detachment?

A

Trauma
Diabetic retinopathy
Myopic individuals
Previous eye surgery

123
Q

Which artery supplies the optic nerve?

A

Central retinal artery

124
Q

What is anterior and posterior synechia?

A

Posterior synechia - iris sticking to lens

Anterior synechia - iris sticking to cornea

125
Q

What complications of intra-ocular surgeries causes a red eye?

A

Endopthalmitis

Specialties (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions