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PACES > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Retinal features of retina pigmentosa

A
  1. Bone-spicule pigmentation - peripheral, follows veins, spares the macula
  2. Pale optic disc - optic atrophy secondary to neuronal loss
  3. Thin arterioles
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2
Q

Associated syndromes of retina pigmentosa

A
  1. Refsum’s disease - autosomal recessive inborn error of lipid metabolism: ataxia, deafness, nystagmus
  2. Usher’s disease - blindness + deafness
  3. Kearns-Sayre syndrome - mitochondrial disease: blindness, ophthalmolplegia, heart block (may have PPM)
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3
Q

Name 4 stages of diabetic retinopathy and findings of fundoscopy

A
  1. Background retinopathy: microaneurysms + hard exudates
  2. Pre-proliferative: cotton wool spots + haemorrhage
  3. Proliferative: new vessel formation
  4. Post laser photo coagulation
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4
Q

Indications for laser photocoagulation in diabetic retinopathy

A
  1. Maculopathy

2. Pre-proliferative + proliferative diabetic retinopathy

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5
Q

Hypertensive retinopathy - 4 stages with retinal features

A
  1. Stage 1: silver wiring
  2. Stage 2: AV nipping
  3. Stage 3: cotton wool spots + flame haemorrhage
  4. Stage 4: papillodema, macular star
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6
Q

Complications of proliferative diabetic retinopathy

A
  1. Vitreous haemorrhage
  2. Retinal detachment
  3. Neovascular glaucoma
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7
Q

4 causes of tunnel vision

A
  1. Papilloedema
  2. Glaucoma
  3. Choroidoretinitis
  4. Migraine
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8
Q

Optic atrophy - causes

A

Pressure - tumour, glaucoma, Pagets
Ataxia - Friedrich’s Ataxia
Leber’s - hereditary optic neuropathy
Dietary - B12 deficiency. Degernative - retinitis pigmentosa
Ischaemia - central retinal artery occulusion
Syphilis + other infections (CMV, Toxo)
Cynaide + other toxins (alcohol, lead, tobacco)
Sclerosis - MS

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9
Q

Optic atrophy - findings on fundoscopy

A
  1. Disc pallor

2. Relative afferent pupil defect

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10
Q

Retinal findings for Branch Retinal Vein Occlusion

A
  1. Engorged retinal veins
  2. Flame haemorrhages in only one quadrant
  3. Ghost vessel - white vessel - obliterated vein
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11
Q

Causes of flame haemorrhages in all 4 quadrants

A
  1. Central retinal vein occlusion

2. Grade 4 hypertensive retinopathy

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12
Q

Causes of loss of red reflex

A
  1. Cataracts
  2. Retinal detachment
  3. Retinoblastoma
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13
Q

Clinical features of age related macular degeneration

A
  1. Drusen - extracellular material
  2. Geographic atrophy
  3. Fibrosis
  4. Neovascularisation
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14
Q

Cataracts - associated diseases

A
  1. Congenital Rubella
  2. Turners syndrome
  3. Old age
  4. Chronic steroid use
  5. Diabetes
  6. Myotonic dystrophy (bilateral ptosis)
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15
Q

Cause of small pupil

A
  1. Loss of sympathetic innervation
    - Horner’s Syndrome
  2. Argyll Robertson pupil
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16
Q

Features of Horner’s Syndrome

A

P - Ptosis - levator palpebrae is partially supplied by sympathetic fibres
E - enophthalmos
A - anhydrosis
S - small pupil (miosis)

17
Q

Causes of Horner’s Syndrome

A
  1. Central cause
    - MS - Wallenberg’s syndrome (lateral medullary syndrome) - SOL - synringomyelia
  2. Pre-ganglionic
    - Thyroid cancer - Pancoast’s tumour - Trauma to neck - Thoracic aortic aneurysm
  3. Post ganglionic
    - cluster headache - carotid artery dissection/aneurysm - cavernous sinus thrombosis - middle ear infection
18
Q

3rd nerve palsy - occulomotor

- clinical features

A
  1. Ptosis
  2. Dilated pupil (if surgical 3rd nerve palsy)
  3. Ophthalmoplegia - “down and out”
19
Q

3rd nerve palsy - causes

  • medical
  • surgical
A 
Medical
M - mononeuritis multiplex e.g. diabetes
M - midbrain infarction e.g. Weber's 
M - midbrain demyelination e.g. MS
M - migraine

Surgical
C - communicating artery aneursym
C - carvernous sinus pathology - thrombosis/tumour/fistula
C - cerebral uncus herniation

20
Q

Causes of loss of visual accommodation

A
  1. Congenital - rare
  2. Isolated accommodation insufficiency - Presbyopia
  3. Associated with primary ocular disease - uveitis (viral induced), metastases to suprachoroidal space damaged ciliary plexus, trauma to globe,
  4. Associated with Neuromuscular Disorders - myasthenia gravis, botulism, myotonic dystrophy
  5. Associated with neurological disorders - midbrain lesions, encephalitis, hydrocephalus, Wilson’s disease.
  6. Associated with systemic disorders - diabetes, diphtheria,
21
Q

Causes of central scotoma

A
  1. Damage to optic nerve (PALEDISCS)
    - Demyelination - MS (retrobulbar neuritis)
  2. Damage to retina
    - HTN
    - toxins: ethambutol, quinine, methyl alcohol
    - Abx: streptomycin
  3. Bilateral scotoma - bitemporal heminaopia due to pituitary tumour
  4. Pre-eclampsia

PACES (8 decks)

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