Ophthalmology Flashcards
- Sudden painless loss of vision
- Severe retinal haemorrhages
- Cherry red spot ‘cheese and tomato pizza’
Central retinal vein occlusion
Difference between periorbital and orbital cellulitis
Periorbital (preseptal) vs Orbital cellulitis: Absence of painful movements, diplopia and visual impairment indicates the former
What does pilocarpine do?
It is a miotic (a myscarinic receptor agonist) -
Adverse effects include a constricted pupil, headache and blurred vision
In papilloedema what would you see?
- Venous engorgement
- Loss of venous pulsation
- Blurring of the optic disc margin
- Elevation of optic disc
- Loss of optic cup
What is the management of acute angle-closure glaucoma?
reducing aqueous secretions with acetazolamide and inducing pupillary constriction with topical pilocarpine
What is acute angle-closure glaucoma?
Raised IOP secondary to impairment of aqueous outflow
Factors predisposing is: hypermetropia (long-sightedness), pupillary dilation, lens growth associated with age, mydriatic drops
Features: severe pain, decreased visual acuity, symptoms worse with mydriasis (watching TV in a dark room), hard, red-eye, haloes around eyes, peripheral vision loss
Age related macular degeneration investigations?
2st line - slit lamp microscopy
If neovascular ARMD is suspected - fluorescein angiography
The combination of age, gradual loss of vision, blurring of small words and straight lines appearing ‘curvy’ suggests,,,
Age-related macular degeneration
Neovascularisation is characteristic of wet age-related macular degeneration.
Diabetic retinopathy
Asymptomatic for significant time before symptoms such as floaters, blurring and distortion occur
What is Hutchinson’s sign?
Suggestive of? Tx of this?
Rash on the tip or side of the nose. Indicates nasociliary involvement and is a strong risk factor for ocular involvement
Sign for HERPES ZOSTER OPHTHALMICUS
Management
oral antiviral treatment for 7-10 days
ideally started within 72 hours
+ urgent ophthal review
Investigation for orbital cellulitis
Contrast enhanced CT scan of the obrits, sinuses, brain
How to treat anterior uveitis
A steroid + cycloplegic (mydriatic) drops
Management of infective conjunctivitis?
Usually settles without tx within 1-2 weeks
Topical antibiotic therapy is commonly offered to patients e.g. chloramphenicol
Bilateral grittiness worse in the mornings with sticky eyes? …
Worse at end of the day…
1) Blepharitis
2) Dry eye
Sudden unilateral vision loss
Features: cherry red spot on pale retina
Central retinal artery occlusion
