ophthalmology Flashcards
1
Q
Describe afferent defect in the pupils
A
- No direct response, therefore no consensual response in contralateral eye
- Consensual response intact
- Dilation on moving light from normal eye to abnormal eye
2
Q
Cause of afferent defect in pupil
A
CN II lesion
3
Q
What is a relative afferent pupillary defect
A
- marcus gunn pupil
- minor constriction to direct light
- dilation on moving light from normal eye to abnormal eye
4
Q
causes of RAPD?
A
optic neuritis (maybe MS) optic atrophy retinal disease (detachment)
5
Q
symptoms of efferent defect
A
- dilated pupil does not react to light
- initiates consensual response in contralateral pupil
- ophthalmoplegia (paralysis of the muscles) and ptosis
6
Q
causes of efferent defect
A
3rd nerve palsy
7
Q
symptoms of a 3rd nerve palsy
A
ptosis down and out dilated pupil (often spared in a vascular lesion e.g. DM) as pupillary fibres run in the periphery
8
Q
causes of 3rd nerve palsy
A
vascular
DM
compression (tumour, coning)
9
Q
differential of a fixed dilated pupil
A
mydriatics e.g. atropine
iris trauma
acute glaucoma
CN3 compression (tumour, coning)
10
Q
symptoms of Holmes Adie pupil
A
- young woman with sudden blurring of near vision
- dilated pupil has no or sluggish constriction response to light (accommodation)
- starts unilaterally then is bilateral
- then constricted pupils stays constricted for a long time
11
Q
investigation of holmes adie tonic pupil
A
slit lamp
iris shows spontaneous wormy movements and iris streaming
12
Q
cause of holmes adie tonic pupil
A
- damage to post ganglionic parasympathetic fibres
- viral
13
Q
what is holmes adie syndrome
A
holmes adie pupil (tonic) + absent knee/ankle jerks + decreased BP
14
Q
symptoms of Horners syndrome
A
PEAS ptosis enophthalmos anhydrosis small pupil (miosis)
15
Q
causes of horners syndrome
A
- central - MS, Wallenbergs lateral medullary syndrome
- pre ganglionic (neck) - pancoasts tumour (T1 nerve root lesion), trauma (from CVA insertion of CEA)
- post ganglionic - cavernous sinus thrombosis (usually 2ary to spreading facial infection via the ophthalmic veins, CN 3,4,5,6, palsies), carotid artery dissection
16
Q
investigations in horners
A
CT/MRI head for stroke
17
Q
symptoms of argyll robertson pupil
A
- small, irregular pupils
- accommodate but don’t react to light
- atrophied and depigmented iris
18
Q
cause of argyll robertson pupil
A
DM
quaternary syphillis
19
Q
function of the parasympathetic and sympathetic nervous system in the pupils
A
SNS - causes dilation (therefore issue is horners causes miosis)
PNS - causes constriction (therefore issue is adies tonic pupil causing dilation)
20
Q
what is miosis and mydriasis
A
miosis = small mydriasis = big
21
Q
causes of bilateral miosis pupils
A
opiates and central pontine haemorrhage
22
Q
causes of bilateral mydriasis pupils
A
sympathetics (cocaine), antihcolinergics, topical mydriatics (atropine and tropicamide)
23
Q
symptoms of optic neuritis / neuropathy
A
- reduced acuity
- reduced colour vision (esp red) [dyschromotopia]
- central scotoma (sudden LOV over hours to days)
- pale optic disc
- RAPD
- pain on eye movement
24
Q
causes of optic neuropathy
A
CCAC VISION
C - common - MS, glaucoma
C - congenital - Leber’s, Friedrichs ataxia, DIDMOAD, retinitis pigmentosa
A - alcohol [and other toxins], lead, ethambutol, B12 def
C - compression - neoplasia, glaucoma, pagets
V - vascular - DM, GCA, thromboembolic
I - inflammatory - MS
S - sarcoid
I - infectious - herpes zoster, TB, syphilis
O - papilloedema
N - neoplastic - lymphoma, leukaemia
25
investigations in optic neuritis
fundoscopy - pale optic disc, optic atrophy
if MS - MRI shows plaques, CSF shows oligoclonal bands, visual evoked potentials shows increased time between visual stimulus and brain response
26
treatment of optic neuritis
high dose methyl-pred IV for 72hrs
| then oral pred for 11 days
27
symptoms of MS
optic neuritis - sudden LOV, pain on eye movement, dyschromotopia, RAPD, swollen pale optic disc
UMN signs - spasticity, weakness, brisk reflexes, increased tone
Uthoffs phenomenon - symptoms worse on heat
Lerhmittes sign - voluntary flexing of the head leads to shock sensation down limb
fatigue
28
treatment of MS
acute - steroids
prevent relapse - B-IFN
symptoms - baclofen
29
pathophysiology of optic neuritis in MS
inflammatory demyelination of the optic nerve and oedema in the myelinated nerve sheaths
30
pathophysiology of acute close angle glaucoma
blocked drainage in trabecular meshwork of aqueous humour from anterior chamber via canal of Schlemm
31
risk factors of acute close angle glaucoma
- hypermetropia (longsighted)
- shallow anterior chamber
- female
- FH
- age
- drugs that cause dilation = sympathetics (cocaine), anticholinergics, topical mydriatics (atropine and tropicamide), antihistamines
32
symptoms of acute closed angle glaucoma
- hazy/dull cornea
- red and painful eye
- reduced acuity and blurred vision (peripheral vision loss)
- N + V
- prodrome of rainbow haloes around lights (due to swelling of cornea)
- dilated pupil
- photophobia
33
investigations in acute closed angle glaucoma
- fundoscopy = cloudy cornea with circumcorneal injection, fixed/dilated/irregular pupil
- tonometry = increase IOP >40mmHG
- gonioscopy = examines anterior angle and trabecular meshwork is not visible
- slit lamp = large cup, pale optic disc, optic disc atrophy, vertical thinning and notching of neural rim, disc haemorrhage
34
treatment of acute closed angle glaucoma
- carbonic anhydrase inhibitor = IV acetazolamide to decrease aqueous formation
- topical BB = timolol to decrease aqueous formation
- topical cholinergic = pilocarpine to constrict pupil
- bilateral laser iridotomy = puts hole in iris to bypass pupil and allow aqueous humour flow once IOP has decreased
35
complications of acute closed angle glaucoma
blindness
| reoccurrence
36
pathophysiology of chronic open angle glaucoma
increase IOP >21mmHg leads to decreased blood flow and increases pressure on retina and optic nerve to cause damage and optic disc changes
37
symptoms of chronic open angle glaucoma
peripheral vision loss with temporal crescent (tunnel vision), presentation is delayed until optic nerve damage is irreversible
38
risk factors of chronic open angle glaucoma
>40years, Afro Caribbean, FH, steroids, DM, HTN, migraines, myopia
39
optic disc changes in chronic open angle glaucoma
pale optic disc
optic disc atrophy
vertical thinning and notching of neural rim
disc haemorrhage
40
investigations of chronic open angle glaucoma
tonometry = IOP >21mmHg
fundoscopy = optic disc changes
visual field assessment = peripheral loss
41
treatment of chronic open angle glaucoma
```
1 = BB - timolol to reduce aqueous production
2 = prostaglandin analogues - latanoprost to increase uveoscleral outflow
3 = alpha agonist - brimonidine/apraclonidine to increase outflow and reduce production
4 = carbonic anhydrase inhibitor - azetazolamide
5 = mitotics - pilocarpine
6 = laser trabeculoplasty
7 = surgical trabeculotomy
```
42
function of aqueous humour
produced by ciliary bodies to maintain eye shape and nourish the avascular lens and cornea
43
what is anterior uveitis
uvea = pigmented part of the eye, made up of the iris, ciliary body and choroid
iris + ciliary body = anterior uvea
iritis inflammation involves ciliary body too
44
symptoms of anterior uveitis
- acute painful red eye
- blurred vision due to precipitates in the aqueous
- small pupil then irregular oval shape
- circumcorneal injection
- hypopyon (pus in anterior chamber)
- white keratic precipitates on back of cornea due to lymphocytes
- talbots test +ve (pain on convergence and constriction)
- unilateral photophobia
45
causes of anterior uveitis
- HLA B27 seronegative arthropathies e.g. anky spon, IBD, psoriatic arthritis, Reiters
- autoimmune - sarcoidosis, Behcets
- malignancy - NH lymphoma, leukaemia
- infection - TB, syphilis, HSV, CMV, toxoplasmosis
- stills/JIA
46
investigations in anterior uveitis
slit lamp shows cloudy anterior chamber and hypopyon and keratic precipitate at back of cornea
47
treatment of anterior uveitis
- ensure not keratitis then give steroids (prednisone drops)
| - cyclopentolate (or tropicomide?) to dilate pupil and prevent adhesions between iris and lens (synechiae)
48
complication of anterior uveitis
reoccurrence
49
differentials of red eye
glaucoma, uveitis, scleritis, episcleritis, keratitis, conjunctivitis, orbital cellulitis, allergies, endopathalmitis, foreign body, subconjunctival haemorrhage, blepharitis, chalazion
50
what is episcleritis and scleritis
```
e = inflammation below conjunctiva in the episclera
s = vasculitis of the sclera
```
51
symptoms of episcleritis
local reddening, painless, mild discomfort, acuity preserved
52
causes of episcleritis
idiopathic, RA, SLE
53
treatment of episcleritis
topical or systemic NSAIDs or artificial tears
54
symptoms of scleritis
- red eye
- severe pain
- pain on eye movement
- conjunctival oedema (chemosis)
- lacrimation
- photophobia
55
causes of scleritis
RA, SLE, Wegener's, SLE, vasculitis
56
treatment of scleritis
specialist input, NSAIDs, oral or topical corticosteroids/immunosuppressants
57
complications of episcleritis and scleritis
```
e = can become s
s = scleromalacia (thinning) which leads to globe perforation
```
58
how to differentiate between episcleritis and scleritis
give phenylephrine drops, blanches in e, stays red in s
59
symptoms of each type of conjunctivitis
bacterial - sticky and purulent
viral - watery and sticky
allergic - watery
chlamydia (ophthalmia neonatorium)
sore, itchy, red eye with no acuity change
60
causes of each type of conjunctivitis
bacterial = staph aureus, chlamydia, gonococcus
viral = adenovirus
allergic
61
treatment of each type of conjunctivitis
```
bacterial = chloramphenicol (fusidic acid if pregnant)
viral = self limiting, cold compress, analgesic
allergic = antihistamine e.g. emedastine
```
62
complications of conjunctivitis
can become bilateral
63
pathophysiology of a corneal abrasion
trauma causes an epithelial breech (no keratitis)
64
symptoms of corneal abrasion
pain, photophobia, blurred vision
65
investigations in corneal abrasion
slit lamp with fluorescein to stain defect green
66
treatment of corneal abrasion
chloramphenicol ointment for infection prophylaxis
| analgesia
67
causes of a corneal ulcer/keratitis
bacterial, herpetic, fungal, protozoa, vasculitic (RA), trauma from contact lens
68
symptoms of corneal ulcer/keratitis
pain, photophobia, conjunctival hyperaemia, reduced acuity, white corneal opacity
69
investigation of corneal ulcer/keratitis
slit lamp with fluorescein green
70
treatment of corneal ulcer/keratitis
- refer to specialist
- take smears and cultures
- Abx eye drops/acyclovir
- mydriatics to ease photophobia
NO STEROIDS
71
complications of corneal ulcer/keratitis
scarring
blind
amoebic ulcer if given steroids
72
what causes a dendritic ulcer
HSV
73
causes of a subconjunctival haemorrhage
trauma, contact lens, warfarin, spontaneously in the elderly
74
presentation of subconjunctival haemorrhage
sudden, bright red blood with distinct border which resolves spontaneously
75
investigations in foreign body in eye
- xray orbit if metal
| - fluorescein may show corneal abrasion
76
management of foreign body in eye
- chloramphenicol to prevent infection
- eye patch
- cycloplegia drops to decrease pain (tropicamide/cyclopentolate)
77
what is ophthalmic shingles
herpes zoster virus in the ophthalmic division of the trigeminal nerve (CNV1)
78
symptoms of ophthalmic shingles
- pain in dermatome precedes a blistering rash
- Hutchinson's sign (nose to tip zoster due to involvement of nasociliary branch, can mean an increase change of globe involvement as nasociliary nerve also supplies globe)
- ophthalmic involvement - keratitis and corneal ulceration
79
treatment of ophthalmic shingles
oral/IV antivirals, topical corticosteroids or ophthalmology review if ocular involved
80
causes of sudden LOV
AION, optic neuritis, vitreous haemorrhage, CRAO, CRVO, retinal detachment
81
key questions in sudden LOV
HELLP
headache = GCA
eye movements hurt = optic neuritis
lights/flashes preceding = detached retina
like curtain descending = TIA, GCA
poorly controlled DM = vitreous bleed from new vessels
82
what is anterior ischaemic optic neuropathy (AION)
optic nerve damaged if posterior ciliary arteries blocked by inflammation or atheroma
83
causes of AION
```
arteritic = GCA
non arteritic (atherosclerotic) = HTN, DM, increased lipids, cholesterol
```
84
causes of a vitreous haemorrhage
new vessels from DM, retinal tears/ detachment, trauma, bleeding disorder, myopia (short sighted)
85
symptoms of vitreous haemorrhage
small bleeds = small black dots/ring floaters
| large bleeds = total vision loss, no red reflex and retina can't be visualised
86
investigations of vitreous haemorrhage
- B scan US to identify cause
- fundoscopy
- slit lamp (shows peeling away from retina)
87
treatment of vitreous haemorrhage
- spontaneous absorption
- positional (lie flat if superior, sit at 30 degrees if inferior)
- vitrectomy if dense
- laser for small tears
88
what causes a posterior viteous haemorrhage
age causes the posterior vitreous to shrink and detach from retina leading to flashers/photopsia in peripheral and floaters in temporal
89
symptoms of AION
altitudinal field defects
90
treatment of AION
treat the cause
91
investigation of AION
fundoscopy - pale and swollen optic disc
92
causes of retinal detachment
holes in retina, cataracts surgery, trauma, DM
93
symptoms of retinal detachment
4Fs
```
floaters, (spider web)
flashes
field loss (central loss if macula involved, peripheral loss if macula not involved)
fall in acuity (curtain)
painless
```
RAPD
94
investigations of retinal detachment
fundoscopy - grey, opalescent retina, ballooning forward (Schaffer's sign)
95
treatment of retinal detachment
urgent surgery for fixation (vitrectomy and gas tamponade with laser coagulation to secure the retina)
need visual acuity of 6/12 combined to drive
96
causes of transient visual loss
TIA, migraine, MS, subacute glaucoma, papilloedema
97
causes of papilloedema
overweight, female, young, idiopathic inter cranial HTN, SOL, hypercapnia, hydrocephalus - all lead to increases inter cranial pressure
98
symptoms of papilloedema
headache
| visual disturbance
99
investigation in papilloedema
CT head
| fundoscopy - pale and swollen optic disc, loss of optic cup, patrons line, blurred optic disc margin
100
treatment of papilloedema
lose weight, treat cause, mannitol, ventricle shunt
101
pathophysiology of CRAO
GCA, thromboembolism, DM, HTN, AF causes blockage of retinal artery (basically stroke of retinal artery, TIA is amaurosis fugax)
102
symptoms of CRAO
sudden painless LOV in seconds, RAPD, pale retina and cherry red spot macula (as you can see through retina onto choroid)
103
treatment of CRAO
- if <6 hr aim to increase retinal blood flow by decreasing IOP with ocular massage, surgical removal of aqueous and antihypertensive
- check FBC for ESR in case of GCA
- IV acetazolamide
- CT head for stroke
- prevention = aspirin
- CO2 rebreathe mask to increase Co2 and vasodilate
104
risk factors of amaurosis fugax
male, smoking, alcohol, DM, strokes, GCA
105
symptoms of GCA
amaurosis fugax, scalp tenderness, jaw claudication , polymyalgia rheumatica, fever, pale optic disc on fundoscopy due to ischaemia
106
treatment of amaurosis fugax
if GCA - ESR and prednisone and PPI and temporal artery biopsy
if stroke - do CT head then aspirin if ichaemic (antiplatelet) and ABCD2 score, may need carotid endarterectomy
107
pathophysiology of CRVO
- raised IOP - due to glaucoma or HTN
- hyper viscosity - due to polycythaemia
- vessel wall disease - due to DM or sarcoidosis
108
symptoms of CRVO
```
sudden painless LOV + RAPD
fundoscopy
- stormy sunset
- tortuous dilated vessels
- cotton wool spots
- swollen optic disc
- retinal flame haemorrhages
```
109
investigations in CRVO
RAPD
| fundoscopy angiography to establish retinal non perfusion and foveal circled integrity
110
complications of CRVO
glaucoma and neovascularisation (treat this with laser photocoagulation)
111
treatment of CRVO
treat cause, TRIAMANTRISOLVE, anti vegf therapy, dexamethasone implant
112
causes of gradual vision loss
diabetic retinopathy, ARMD, cataracts, open angle glaucoma (rare = retinitis pigmentosa, hypertension, optic atrophy)
113
risk factors of ARMD
smoking, age, genetic, cardiovascular, female
114
symptoms
```
central vision loss
decreased night vision
photopsia (flick and flash)
glare
distortion in line perception
```
115
investigations in ARMD
fundoscopy
OCT (optical coherence tomography)
fluorescein angiography
Amsler grid
116
pathophysiology of dry ARMD
degeneration of macula leading to drusen deposition
117
pathophysiology of wet ARMD
choroidal neovascularisation into retina, has quicker decline than dry
118
fundoscopy in ARMD
drusen or neovascularisation
macular haemorrhage leading to scarring
macular oedema
sub retinal haemorrhage
119
treatment of ARMD
dry = zinc and antioxidant vitamins A/C/E in early
wet = laser photodynamic therapy,, intravitreal VEGF inhibitors e.g. ranibizumab
smoking cessation
120
what is retinitis pigmentosa
inherited degeneration of the macula (AR, AD (best), X linked (worst)
121
symptoms of retinitis pigmentosa
night blindness
tunnel vision (due to loss in peripheral retina)
blind by mid 30s
(night -> peripheral -> colour -> tunnel)
122
fundsocopy on retinitis pigmentosa
pale optic disc due to optic atrophy
black bone spicule in peripheral macula
peripheral retina pigmentation spares the macula
123
what is retinitis pigmentosa associated with
friedrichs ataxia
refuses disease
kearns sayre syndrome
ushers syndrome
124
treatment of retinitis pigmentosa
refer to opthalmology
genetic counselling
DVLA
vit A
125
what is tobacco-alcohol amblyopia
caused by the toxic effects of cyanide radicals when combined with thiamine deficiency, leads to optic atrophy, loss of red/green discrimination and scotomata (vitamins may help)
126
types of eye disease in diabetes
cataracts
retinopathy
cranial nerve palsies may occur
127
pathophysiology of cataracts in diabetes
lens absorbs glucose which is converted to sorbitol by aldose reductase, accelerating cataracts formation
128
pathophysiology of retinopathy in diabetes
leads to microangiopathy, which causes occlusion
occlusion leads to ischaemia with new vessel formation in retina, bleeds and vitreous haemorrhage, retinal detachment, cotton wool spots, oedema and lipid exudates vascular leakage, blot haemorrhage due to rupture of micro aneurysms
129
what is involved in diabetic eye screening
annual screening with fundus photography, and refer those with maculopathy, non proliferative and proliferative to ophthalmology
130
what does background retinopathy show on fundoscopy
LEAKAGE
dots - micro aneurysm
blot haemorrhage
hard yellow lipid exudates
131
what does pre proliferative retinopathy show on fundoscopy
```
ISCHAEMIA
cotton wool spots (infarcts)
venous bleeding
dark haemorrhages
intra retinal microvascular abnormalities
```
132
what does proliferative retinopathy show on fundoscopy
new vessels
pre retinal or vitreous haemorrhage
retinal detachment
133
what does maculopathy show on fundoscopy
MACULAR OEDEMA
| decreased acuity with hard exudates within one disc width of macula
134
investigations in diabetic retinopathy
```
fundoscopy
fluorescein angiography to assess damage
B scan
snellens test for acuity
optical coherence tomography
```
135
treatment of diabetic retinopathy
good BP, glycemic control, treat co-morbidities
laser photocoagulation (maculopathy =focal/grid and proliferative = pan retinal as macula spared)
antivegf
136
what is vegf
expressed in hypoxia and promotes vascular endothelial cell mitosis and increases retinal capillary permeability
137
6th cranial nerve palsy symptom and pathophysiology
abducent nerve - controls lateral rectus and unable to abduct the eye so medially deviated and diplopia in horizontal plane
138
3rd cranial nerve palsy symptom and pathophysiology
oculomotor nerve - controls lateral rectus and superior oculomotor so appears down and out and fixed dilated pupil
139
causes of cataracts
diabetes, age, steroids, congenital, uv light
140
congenital causes of cataracts
rubella, wilsons, myotonic dystrophy
141
symptoms of cataracts
blurred vision, increasing myopia, cloudy lens, faded colours, dazzling in bright lights, monocular diplopia
142
pathophysiology of cataracts
opacification of the lens
143
investigations in cataracts
```
DILATED fundoscopy
snellens for visual acuity
tonometry
blood glucose to exclude DM
slit lamp shows defected red reflex and visible cataracts
```
144
treatment of cataracts
glasses, sunglasses, mydriatic drops
| surgery - phaecoemulsion and lens implant
145
complications of cataracts surgery
anterior uveitis, vitreous haemorrhage, retinal detachment, secondary glaucoma, endopthalmitis, post op capsule thickening, post op eye irritation
146
things to look at when looking at optic disc
colour, contour, cup
147
pathophysiology of retinoblastoma
intraocular tumour in tumour, AD
148
symptoms of retinoblastoma
stabismus
leukocoria (white pupil)
no red reflex
can leads to osteosarcoma and rhabdomyosarcoma
149
treatment of retinoblastoma
depends on size, chemo/radio/enucleation
150
what is a stye
an abscess/infection in a lash follicle which points outward
151
treatment of stye
fusidic acid or regular warm swelling
152
what is a chalazion
abscess of the meibomian glands which points inwards onto conjunctiva (sebaceous gland of eyelid)
153
what is blepharitis
chronic inflammation of eyelid leading to red eyes, gritty/itchy, scales on lashes
154
causes of blepharitis
seoborrhoeic dermatitis, staphs, rosacea
155
treatment of blepharitis
fusidic acid drops, regular warming, lubricants, lid hygiene
156
what is an entropion
lid INversion leading to corneal irritation and degeneration of lower lid fascia
157
what is an ectropion
low lid Eversion leading to watering and exposure keratitis
158
treatment of entropion
surgical correction
159
causes of exophthalmos
graves, orbital cellulitis, trauma, wegeners, neoplasm
160
pathophysiology of orbital cellulitis
infection from local spread (paranasal sinuses, eyelid, external eye) - staphs, pneumococcus
161
symptoms of orbital cellulitis
```
child with inflammation of orbit and lid swelling
painful eye movements
exophthalmos
systemic signs
tender sinuses
```
162
treatment of orbital cellulitis
IV antibiotics
163
complications of orbital cellulitis
```
local extension (meningitis and cavernous sinus thrombosis)
blindness due to optic nerve pressure
```
164
symptoms of cavernous sinus thrombosis
fever and orbital cellulitis, loss of eye movements
165
what is lagophthalmos, pinguecula, pterygium, carotico caervnous fistula
?
166
treatment / cause of myopia (short sight)
concave lenses as distant objects are focussed too far fowards (caused by genetics or excessive close work in early decades)
167
whats astigmatism
cornea or lens does not have the same degree of curvature in horizontal and vertical planes causing image of object to be distorted - need correcting lenses
168
treatment / cause of hypermetropia (long sight)
eye is too short so when eye is relaxed and not accommodating, objects are focussed behind the retina - need convex lens
169
what is presbyopia
with age, lens becomes stiff and less easy to deform, need convex lens
170
what is an esotropia
a convergent squint (towards nose) - idiopathic or hypermetropia
171
what is an exotropia
a divergent squint (towards temporals)
172
2 types of squint
paralytic - paralysis of extraocular muscles
| concomitant - imbalance in extra ocular muscles
173
diagnosis of non paralytic squint
corneal reflection and cover test
174
management of non paralytic squint
3 O's
optical - correct refractive errors
orthoptic - patching good eye encourages use of squinting eye
operations - resection and recession of rectus muscles
175
causes of cranial nerve palsies
diabetes, MS, infarction, increased ICP, compression, vascular, SOL, cavernous sinus thrombosis
176
symptoms of cranial nerve 4 palsy
diplopia on going down stairs, head tilt and can't depress in adduction
177
causes of floaters
retinal detachment
vitreous haemorrhage
diabetic retinopathy
old retinal branch vein occlusion
178
causes of flashes
migraine
| retinal detachment
179
causes of haloes
acute glaucoma
cataracts
corneal oedema
migraines
180
treatment of allergic eye disorders
```
remove allergen
cold compress
artificial teats
oral antihistamines
topical antihistamines (eye drops)
mast cell stabilizers
steroids
saids (diclofenac)
```
181
```
allergic eye disease
trachoma
onchocerciasis (river blindness)
xerophthalmia
keratomalacia
```
?
182
symptoms of Miller fisher
ophthalmoplegia, ataxia an areflexia
183
symptoms of intranuclear ophthalmoplegia
nystagmus as can't abduct affected eye
184
causing on hypertensive retinopathy
```
uncontrolled HTN
phaechromocytoma
renal artery stenosis
cushings
conns
```
185
symptoms of hypertensive retinopathy
poor acuity
| eye floaters
186
fundoscopy in hypertensive retinopathy
1) tortuosity and silver wiring
2) av nipping
3) flame haemorrhages
soft/cotton wool spots
4) papilloedema
187
eye defects depending on lesion location
```
scotoma - tunnel vision
optic nerve - unilateral vision loss
optic chasm - bitemporal hemianopia
optic tract - homonymous hemianopia
optic radiation - homonymous quadrantopia
```
188
what are photoreceptors
in the retina rods and cones
rods = outer retina for night vision
cones = central retina for colour vision and acuity
189
treatment of hypertensive retinopathy
control HTN
manage stroke risk
regular eye check
don't drop BP too quick
190
eye disease in granulomatous disorders
TB, sarcoid, toxo, leprosy all can cause uveitis and choroidoretinitis
191
systemic inflammatory disease causing conjunctivitis
SLE, reactive arthritis, IBD
192
systemic inflammatory disease causing scleritis
RA, vasculitis, SLE, IBD
193
systemic inflammatory disease causing iritis
anky spon, IBD, sarcoid
194
systemic inflammatory disease causing retinopathy
dermatomyositis
195
symptoms of CMV retinitis
pizza pie fundus and flames
196
symptoms of HIV retinopathy
cotton wool spots
197
examples of mydriatics
tropicamide
198
examples of mitotics
pilocarpine
199
orbital blowout fracture
intra ocular haemorrhage
chemical injury
?
200
blood supply of the eye
ophthalmic artery
| central retinal artery
