OPHTHALMOLOGY Flashcards
Transient Monocular Vision Loss/Sudden painless loss of vision causes
Vascular/Ischaemic (CRAO/CRVO)
VH
RD
RM
Causes of TUNNEL VISION
Papilloedema Retinitis Pigmentosa Optic Atrophy secondary to tabes dorsalis Choroidoretinitis Glaucoma Hysteria
RA Ocular manifestations are
Keratoconjunctibitis sicca (B/L + Drying Burning Itching) Episcleritis Scleritis (Pain) Corneal Ulceration Keratitis
CATARACT CAUSES
Age Alcohol Smoking Trauma DM/MD Long Term Steroids Radiation Hypocalcemia
Orbital cellulitis is infection of 1)__. It arises from a spreading 2)__ and is a medical emergency due to risk of 3)__ and it warrants 4)__
Periorbital cellulitis is infection of 5)__. It arises from 6)__ and may progress to 7)__.
Both present with 8)__. However orbital cellulitis has specific features like 9)__.
1 - fat and muscles posterior to orbital septum
2 - Sinusitis/Periorbital Cellulitis
3 - Optic nerve damage/CST/Intracranial spread
4 - Urgent hospital admission for IV antibiotics
5 - superficial tissue anterior to orbital septum
6 - chalazion/insect bite
7 - Orbital cellulitis
8 - pain,redness,swelling around the eye/ptosis
9 - Proptosis/Ophthalmoplegia/Reduced visual activity
Acquired causes of Optic atrophy = 1
Congenital Causes of Optic atrophy = 2
1 = MS
Papilloedema
Raised IOP
Retinal damage
Toxin - Tobacco/Arsenic/Lead/Quinine/Methanol
Ischaemia
Nutrition - VIT 1/2/6/12
2 = Friedrich ataxia/Mitochondrial disorder/DIDMOAD or Wolfram
syndrome
POAG/Chronic simple glaucoma risk factors = 1)—
Rx of choice = 2)—
Acute Open angle Glaucoma risk factors = 3)—
Rx of choice is 4)—
1 = Age (>40y)/Genetics (First degree relatives)/Ethnicity (Black)
DM/Myopia/HTN/Steroids
2 = Prostaglandin analogue ED (Latanoprost)
Beta blocker (timolol, betaxolol)/CA inh (Dorzolamide)/
Sympathomimetic ED (Brimonidine)/Mitotics (Pilocarpine)
3 = Hypermetropia/Pupillary dilation (Anticholinergic,TCA)/Lens growth
associated with age
4 = Topical Pilocarpine + IV Acetazolamide
Posterior Vitreous detachment is characterised by 1)—
Retinal Detachment is characterised by 2)—
VH is characterised by 3)—
1 = Flashes of light and floaters in peripheral visual field
2 = Dense shadows in peripheral visual field
3 = floaters (small bleeds)/dark spots (moderate bleeds)/sudden LOV
(large bleeds)
Keratitis is 1)— and presents with 2)—
There are various pathogenic causes but a common risk factor is 3)—
1 = Inflammation of the cornea
2 = Red eye/Photophobia/FB or Gritty sensation/Hypopyon/
Normal pupillary reaction
3 = Contact lens
ARMD Risk Factors = 1)—
Initial investigation is 2)— and 3)— is done when wet ARMD is suspected.
Rx of choice in dry ARMD is 4)— and in wet ARMD is 5)—
1 = AGE/SMOKING/FAMILY HISTORY
Others - Risk of IHD (DM/HTN/Dyslipidaemia)
2 = Slit-lamp Microscopy
3 = Fluorescin Angiography
4 = Antioxidant therapy ( Zn + Vit A/C/E)
5 = Anti VEGF inj (Ranibizumab/Bevacizumab/pegaptanib)
Angioid retinal streaks seen fundoscopically are caused by 1)—
1 = Pseudoxanthoma elasticum (skin changes first sign)
Paget’s disease
Sickle cell anaemia
Ehlers - Danlos Syndrome
AcromegalyMarcus Gunn Pupil is also known as 1)—
It is diagnosed by 2)—
Cause - 3)—
ARP is a 4)—
Holmes-Aide’s pupil is a 5)— and is associated with 6)—
1 = Relative Afferent Pupillary Defect
2 = Swinging Light Test wherein the affected and normal eye both appear
to dilate when light is shown on the affected
3 = Lesion anterior to optic chinasma = Retina (Retinal detachment)/
Optic Nerve (Optic Neuritis)
4 = Constricted pupil with ARP + PRA
5 = Dilated Pupil with poor AR + PR
6 = Absent Ankle/Knee reflexes
Amaurosis fugax is treated as 1)-
1 = TIA —> Aspirin 300 stat
Features of CRVO are = 1)—
Causes of CRVO = 2)—
1 = TVML/severe retinal haemorrhages/RAPD/cherry red spot on
retina
2 = Thromboembolism (atherosclerosis)/arteritis (temporal arteritis)
Optic neuritis is characterised by 1)— and is caused by 2)—
1 = U/L decrease in visual activity/Central Scotoma/RAPD/Red
desaturation - poor discrimination of colours/Pain on eye
movement
2 = MS/DM/Syphilis
Retinitis Pigmentosa is characterised by 1)— and is caused by 2)—
1 = Night blindness/Tunnel or funnel vision/black bone spicule-
shaped pigmentation in peripheral retina and mottling of
Retinal pigment epithelium
2 = Refsum disease
Usher syndrome
Lawrence-Moon-Biedl syndrome
Kearns - Sayre Syndrome
Alport syndrome/Abetalipoproteinemia
Horner syndrome is characterised by 1)—
Anhidrosis of face/arm/trunk indicate a 2)— lesion and is caused by 3)—
Anhidrosis of face indicate a 4)— lesion and is caused by 5)—
No Anhidrosis indicates a 6)— lesion and is caused by 7)—
Heterochromia reveals 8)—
9) — eye drop confirms a Horner’s pupil by causing 10)— as opposed to 11)— in normal eye.
12) — is used to distinguish between 1/2/3 order neurons. Pupil will dilate in case of 13)—
1 = Ptosis
Anhidrosis
Miosis
Enophthalmos
2 = Central Lesion
3 = Stroke/Syringomyelia/Multiple Sclerosis/Tumor/Encephalopathy
4 = Pre-Ganglionic Lesion
5 = Tumor (Pancoast)/Trauma/Thyroidectomy/Cervical Rib
6 = Post-Ganglionic Lesion
7 = Carotid Artery Dissection/Carotid Aneurysm/Cavernous Sinus
Thrombosis/Cluster Headache
8 = Congenital Horner Syndrome
9 = Apraclonidine
10 = Pupillary dilation
11 = Pupillary constriction
12 = Hydroxyamphetamine eye drops
13 = Normal pupil/ 1/2 order neuron affection
Blepharitis is 1)—
It presents as 2)—
It is caused by 3)—
Rx is 3)—
1 = Inflammation of eyelids
2 = B/L sore and gritty eyelids, red eyelid margins, dry,sticky eyes
3 = Meibomian gland dysfunction
Acne Rosacea
Seborrhoea dermatitis/Staph inf
4 = hot compress (softens eyelid margins)/lid hygiene - mech removal
of debris from lid margins/Artificial tears for dry eyes
DIABETIC RETINOPATHY
Background Retinopathy characteristics = 1)—
Pre-Proliferative Retinopathy characteristics = 2)—
Proliferative Retinopathy characteristics = 3)—
Maculopathy charcteristics= 4)
Proliferative retinopathy warrants 5)—
1 = Dot (Microaneurysms) & Blot Haemorrhages (<=3)/Hard
Exudates
2 = Blot Haemorrhages (>3)/cotton wool spots (soft exudates)/Deep or
dark cluster haemorrhages/venous beading or looping
(commoner in T1DM)
3 = retinal neovascularisation —> VH/fibrous tissue anterior to retinal
disc (commoner in T1DM)
4 = Hard Exudates + Background changes on Macula (commoner in
T2DM)
5 = Urgent Panretinal Photocoagulation
HYPERTENSIVE RETINOPATHY
It follows 1)— Classification
Stage 1 = 2)—
Stage 2 = 3)—
Stage 3 = 4)—
Stage 4 = 5)—
1 = Keith-Wagener
2 = Arteriolar narrowing and tortuosity/Increased light reflex - silver
wiring
3 = Arterio-Venous nipping
4 = Cotton-wool exudates/Flame and blot haemorrhages
5 = Papilloedema
MYDRIATIC PUPIL CAUSES
Phaeochromocytoma Holmes-Adie pupil CN 3 palsy Congenital Traumatic Iridoplegia Drugs —> Tropicamide-Atropine/Amphetamine-Cocaine/TCA
HZO presents as 1)—
Strongest risk factor for ocular involvement is 2)—
Rx is 3)—
1 = Vesicular Rash around the eye
2 = Hutchinson sign — Rash on tip/side of nose —> indicative of
nasociliary involvement
3 = Oral acyclovir for 1-2 weeks and later on topical steroids for 2ary
inflammation
PAPILLOEDEMA CAUSES
SOL HTN (Malignant/Intracranial hypertension) Hydrocephalus Hypercapnia Hypocalcaemia Hypoparathyroidism Vitamin A toxicity
Dacrocystitis presents as
Watering eye (Epiphora) Swelling/Erythema in inner canthus
