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Year 2 > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What is Presbyopia?

A

eye has reduced ability to focus on near objects because of age

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2
Q

What is hypermetropia?

A

long sightedness

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3
Q

What is myopia?

A

short sightedness

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4
Q

Which muscles are innervated by the occulomotor nerve?

A

Medial rectus
inferior rectus
superior rectus
inferior oblique

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5
Q

Which muscle is innervated by abducent nerve?

A

Lateral rectus

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6
Q

What muscle is innervated by trochlear nerve?

A

superior oblique

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7
Q

What is a third nerve palsy?

A

it is caused by an aneurysm which affect the occulomotor nerve. It causes fixed, mid-dilated pupil and ptosis

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8
Q

What causes a 6th nerve palsy?

A

Increased intracranial pressure

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9
Q

What are the signs of a 6th nerve palsy?

A

diplopia, patient sits with head tilted down, failure of eye to abduct on downward gaze

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10
Q

Which direction does the eye move by the superior oblique muscle?

A

inferomedially (down and in)

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11
Q

Which direction does the eye move by the inferior oblique muscle?

A

superiomedially (up and in)

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12
Q

What is the cornea?

A

The clear, transparent part of the eye that covers the iris, pupil and anterior chamber and provides most of the eyes optical power (too flat: hyperopia, too steep: myopia)

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13
Q

What is the function of the anterior chamber?

A

filled with aqueous humour which fills the space between the back surface of the cornea and the font surface of the vitreous bathing the lens. The function is to nourish the lens, cornea and iris and removing waste products. It also maintains intraocular pressure

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14
Q

How does the pupil become constricted?

A

It occurs when the pupil size is reduced to constriction of the iris sphincter or relaxation of the iris dilator muscle

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15
Q

What is the triad of Horner’s syndrome?

A

Miosis, ptosis and enopthalmos

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16
Q

Which eye condition is linked to red desaturation?

A

Optic neuritis

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17
Q

What is entropion?

A

in turning of the eyelids

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18
Q

What is ectropion?

A

out turning of the eyelids

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19
Q

What is the treatment for herpes zoster opthalmicus?

A

oral aciclovir

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20
Q

What is the most common cause of watery eye in children?

A

Nasolacrimal duct obstruction

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21
Q

What would a pale retina be indicative of?

A

Central retinal artery occlusion

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22
Q

What is the first line treatment for primary angle open glaucoma?

A

Prostaglandin analogs such as latanoprost

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23
Q

What is the mechanism of action of prostaglandin analogs?

A

They increase uveoscleral outflow

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24
Q

What is the ciliary body?

A

tissue between the choroids and the iris that is involved in intraocular pressure and lens shape

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25
Q

Where are cones found?

A

the fovea of the macula

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26
Q

What is the macula?

A

it is the area of acute central vision

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27
Q

What are the outer layers of the eye?

A

Retina -> choroid ->sclera (outermost)

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28
Q

What produces aqueous humour?

A

The ciliary body

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29
Q

Where does aqueous humour drain?

A

The trabecular meshwork situated in the angle between the iris and the cornea into the canal of schlemm

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30
Q

What is normal intraocular pressure?

A

<21mmHg

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31
Q

What are direct and consensual responses?

A

light being shone into an eye will cause constriction (direct) as well as constriction of the other eye (consensual)

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32
Q

What does parasympathetic innervation do to the pupil size?

A

Constriction

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33
Q

What kind of drug is pilocarpine and how does it work?

A

it is a miotic that constricts the pupil

34
Q

What kind of drug is Atropine?

A

It is a mydriatic and causes dilation of the pupil

35
Q

What are causes of sudden visual loss?

A 
VARICOSE
Vascular occlusion/vitreous haemorrhage]
Age related macular degeneration (wet)
Retinal detachment
Ischaemic optic neuropathy
Closed angle glaucoma
Optic neuritis
Stroke
36
Q

What is Wet macular degeneration?

A

it is sudden painless loss of vision with new blood vessels growing under the retina- leakage causes fluid to build up which leads to scarring

37
Q

How does wet ARMD affect sight?

A

there is blurred central vision which becomes worse over time as cones degenerate, metamorphopsia (straight lines look wavy)

38
Q

What is the treatment for wet ARMD?

39
Q

What is indicative of flashes and floaters?

A

Retinal detachment

40
Q

What are the features of central retinal artery occlusion?

A

pale retina, cherry red spot, engorged vessels, painless, sudden loss of vision

41
Q

What is the treatment of central retinal artery occlusion?

A

ocular massage (to convert CRAO to BRAO- less severe)

42
Q

How does central retinal vein occlusion present?

A

Severe retinal haemorrhages that gives a stormy sky appearance on fundoscopy. It presents with sudden, painless loss of vision often on waking

43
Q

What is the cause of acute closed angle glaucoma?

A

raise in IOP due to closure of the angle between the iris and cornea which can damage the optic disc

44
Q

Does acute closed angled glaucoma typically occur in the long or short sighted?

45
Q

What is halo around the eyes indicative of?

A

closed angle glaucoma

46
Q

Is glaucoma painful?

A

yes- very painful

47
Q

What are the symptoms of acute closed angled glaucoma?

A

unilateral acute onset of red painful eye, headache, nausea and vomiting, clouding of the cornea, pupil is fixed and mid-dilated

48
Q

What is the treatment of acute closed angled glaucoma?

A

IV acetazolamide, pilocarpine and topical steroids

49
Q

What is optic neuritis?

A

inflammation of the optic nerve

50
Q

What are the symptoms of optic neuritis?

A

eye pain which is worse on moving the eye and colour desaturation

51
Q

What is the treatment for optic neuritis?

A

methylprednisolone

52
Q

What are the causes of gradual visual loss?

A 
CARDIGAN
Cataracts
ARMD (dry)
Refractive error
Diabetic retinopathy
inherited disease
Glaucoma
53
Q

What are the symptoms of cataract?

A

cloudiness of the lens, loss of red reflex, loss of colour contrast

54
Q

What is the management of cataracts?

A

Pharmacoemulsification of the lens with insertion of the intra-ocular lens

55
Q

What would the presence of drusen on fundoscopy be indicative of?

56
Q

What is Dry ARMD?

A

damage to the cells of the macula as a result of build up of waste product called drusen

57
Q

What is the treatment for Dry ARMD?

A

there is no treatment

58
Q

What is the difference between proliferative and non-proliferative diabetic retinopathy?

A

neovascularisation signals proliferative

59
Q

What would be seen on fundoscopy in pre-prepoliferative diabetic retinopathy?

A

cotton wool spots, hard exudates, dot, blot and flame haemorrhages

60
Q

What is the treatment for diabetic retinopathy?

A

photocoagulation

61
Q

What are the symptoms of Chronic open angle glaucoma?

A

loss of peripheral vision over time

62
Q

What is the cause of chronic open angle glaucoma?

A

Myopia, old age, diabetic- damage to the optic nerve from increased IOP

63
Q

What is the treatment of chronic open angle glaucoma?

A

Prostaglandin analogue e.g. latanoprost, beta blockers, carbonic anhydrase inhibitors e.g. Dorzolamide

64
Q

What is the mechanism of carbonic anhydrase inhibitors?

A

Reduce IOP by reducing the fluid level in the eye

65
Q

What is described as a curtain coming down for less than 5 minutes?

A

Amaurosis fugax

66
Q

What is uveitis?

A

inflammation of the uvea (iris, cillary body, choroid)

67
Q

What is chororetinitis?

A

It is a form of posterior uveitis and is associated with cytomegalovirus and toxoplasmosis

68
Q

What are the causes of uveitis?

A

HLA-B27 (reiters), infective (syphillis, herpes zoster, herpes simplex)

69
Q

What causes pain, photophobia and a red eye?

70
Q

What is hypopyon and what condition is it related to?

A

yellow exudate of inflammatory cells in the lower part of the anterior chamber - linked to anterior uveitis

71
Q

What is the treatment of anterior uveitis?

A

corticosteroid eye drops, corticosteroid injection

72
Q

What are the common causes of conjunctivitis in babies?

A

Chlamydia trachomatis, Neisseria gonorrhoea

73
Q

What are the features of conjunctivitis?

A

Acute onset of red gritty eyes with purulent discharge that causes the eyes to stick together

74
Q

What is the treatment of conjunctivitis?

A

topical chloramphenicol

75
Q

What are the side effects of chloramphenicol?

76
Q

What is the difference between bacterial and viral conjunctivitis?

A

bacteria- sticky eye, more likely to spread

Virus- watery eye, pain on movement

77
Q

What is keratitis?

A

inflammation of the cornea

78
Q

What can be caused by viral keratitis?

A

HSV can cause dendritic ulcers- appears green on fluroscein staining

79
Q

What are the symptoms of Keratitis?

A

needle like pain, photophobia, reduced visual acuity, epiphora (excess lacrimation)

80
Q

What is the treatment for keratitis?

A

ofloxacin eye drops, gentamicin, steroids

81
Q

What is endophthalmitis?

A

inflammation of the intraocular space occupied by the vitreous

82
Q

What are the causes of endophthalmitis?

A

staph epidermidis, after cataract surgery, injury, contact lenses

Year 2 (10 decks)

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