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AHP Semester > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What are the 3 layers of the eyeball?

A

1) Outer fibrous (cornea + sclera)
2) Vascular (uvea): iris + pupil + ciliary body + choroid
3) Inner neural layer (retina: rods + cones)

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2
Q

What is the blind spot?

A

Site where optic nerve exits back of eyeball. There are no photoreceptors here, hence it is a ‘blind’ spot

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3
Q

Define amblyopia

A

Impaired vision despite a structurally normal eye, due to abnormal visual development. Also known as a ‘lazy eye’

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4
Q

Myopia is (near/far)-sightedness and occurs due to a (short/long) eyeball axial length. It requires a (positive/ negative) and (convex/ concave) lens to correct the refractive error.

A

Near-sightedness
Long eyeball
Negative (concave) lens

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5
Q

Hyperopia is (near/far)-sightedness and occurs due to a (short/long) eyeball. It requires a (positive/ negative) and (convex/ concave) lens to correct the refractive error.

A

Far-sightedness
Short eyeball
Positive (convex) lens

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6
Q

OD stands for ______ and indicates the (right/ left) eye whilst OS stands for _______ and indicates the (right/ left) eye

A

Oculus dexter = right eye

Oculus sinister = left eye

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7
Q

The gold standard of measuring intraocular pressure (IOP) is ________

A

Goldmann tomometry

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8
Q

The gold standard of angle measurement is ________

A

Gonioscopy

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9
Q

True or false: cataracts will cause a RAPD

A

False

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10
Q

Cocaine will cause pupil (constriction/ dilatation) and opioids will cause pupil (constriction/ dilatation)

A

Cocaine - dilatation

Opioids - constriction

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11
Q

In an abducted position, which muscle is responsible for controlling upwards movement?

A

Superior rectus

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12
Q

Which 2-3 eye drops are used to dilate the pupil? How does each act?

A

1) Local anaesthetic (Proparacaine i.e. Alcaine)
2) Tropicamide (Mydriacyl) - anticholinergic, causes relaxation of circular sphincter muscle
3) ± phenylephrine (Minims) - sympathomimetic, causes contraction of radial dilator muscle

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13
Q

A pale optic disc may be a sign of ______ or _____

A

Optic neuritis or ischaemia

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14
Q

Cotton wool spots may be a sign of _____ or ______

A

Diabetics retinopathy or hypertensive retinopathy

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15
Q

A cherry red spot is a sign of _____

A

Central retinal artery occlusion

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16
Q

AV nipping and silver wiring are signs of _______. What is the mechanism?

A

Hypertensive retinopathy
AV nipping due to small arteriole crossing small venule & causing compression due to high pressures
Silver wiring due to vessel wall hyperplasia & thickening

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17
Q

(Myopia/ hyperopia) is a risk factor for retinal detachment?

A

Myopia (esp the high type)
The risk is 5-6X greater with high myopia comparedto low mypopia. High myopic eyes are elongated, which means the retina is more stretched and therefore prone to peripheral tears.

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18
Q

Gas bubbles inserted into the vitreous cavity will be slowly absorbed over _____ weeks

A

2-6 weeks

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19
Q

True or false: an epiretinal membrane will usually cause metamorphopsia

A

True

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20
Q

___% of epiretinal membranes are progressive

A

20%

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21
Q

Homocystinuria & Marfan’s syndromes are associated with what ocular complications (2)?

A

Lens subluxation and retinal degeneration

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22
Q

Ankylosing spondylitis is most commonly associated with which eye disease?

A

Acute iritis

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23
Q

What is keratoconjunctivitis sicca more commonly known as?

A

Dry eyes

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24
Q

List 6 complications of cataract surgery

A 
Posterior capsular opacification (10%)
Endophthalmitis
Corneal decompensation
Dropped nucleus
Retinal detachment
Macular oedema
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25
Q

What is the cause of a chalazion and stye, respectively?

A

Chalazion = blocked meibomian gland forming a cyst. PAINLESS firm nodule

Stye = blocked eyelash hair follicle (sebaceous gland). PAINFUL small red nodule

Both have similar appearances

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26
Q

The central retinal artery comes off what vessel?

A

Ophthalmic artery (1st branch of internal carotid artery)

27
Q

Conjugate eye movements are controlled by _____________

A

The medial longitudinal fasciculus (MFL)

28
Q

The dilator pupillae is _____ (structure) smooth muscle and supplied by the SNS/PNS.
The sphincter pupillae is _____ (structure) smooth muscle supplied by the SNS/PNS

A

Dilator - radial SM, supplied by SNS

Sphincter - circular SM, supplied by PNS

29
Q

How many layers does the retina have?

A

10

30
Q

Aqueous humor from the anterior cavity of the eye drains out through the Canal of _______

A

Schlemm

31
Q

What is the most common primary orbital malignancy in children?

A

Rhabdomyosarcoma

32
Q

What is dacryocystitis? How is it treated (in adults and children)

A

Infection or inflammation of the nasolacrimal sac usually secondary to nasolacrimal duct blockage.
In children it usually spontaneously resolves, in adults it usually requires surgery

33
Q

What are 2 causes of leukocoria in an infant?

A

Congenital cataract
Retinoblastoma
**MUST NOT MISS CONDITION

34
Q

A 3rd cranial nerve palsy can be associated with what vascular lesion?

A

Posterior communicating artery aneurysm

35
Q

What is the most common intraocular malignancy in adults?

A

Choroidal melanoma

36
Q

Retinitis pigmentosa is an inherited retinal condition characterised by _____

A

Painless, progressive vision loss beginning with night blindness (rods affected first) and loss of peripheral vision. Usually bilateral

37
Q

Retinitis pigmentosa mostly (and initially) affects which photoreceptors?

A

Rods

38
Q

A stye is also known as a ____

A

Hordeolum

39
Q

Allergic conjunctivitis is typically (uni/ bilateral) and characterised by _____

A

Bilateral

Cobblestone appearance d/t conjunctival papillae

40
Q

What eye conditions are associated with albinism? (4)

A

1) Poor vision
2) Nystagmus
3) Strabismus
4) Hypoplastic/ under-developed maculae, fovea blunting

Also optic disc atrophy , photophobia

41
Q

What are 3 causes of proptosis?

A

1) Graves’ thyroid disease
2) Tumours (rhabdomyosarcoma, optic nerve glioma, neurofibroma, neuroblastoma, lymphoma)
3) Papilloedema

42
Q

Herpes zoster ophthalmicus will show up as a _____ corneal ulcer with fluorescein stain

A

Pseudodendritiform (no terminal end bulbs)

43
Q

What virus typically causes viral conjunctivitis?

A

Adenovirus

44
Q

True or false: conjunctivitis usually impairs vision

A

False - usually normal vision with clear cornea unless severe

45
Q

In neonates, (Chlamydial or gonorrhoeal) infection produces a more severe conjunctivitis?

A

Gonorrhoea (risk of perforation of cornea)

46
Q

_____ is characterised by severe eye pain and deep violaceous injections. 50% of cases are associated with systemic disease

A

Scleritis

47
Q

What are the most common causes of endophthalmitis? (2)

A 
Intraocular surgery (esp cataracts)
Penetrating trauma
48
Q

Topical steroids can be given for Herpes (simplex or zoster)?

A

Zoster

DO NOT GIVE STEROIDS TO HERPES SIMPLEX WITH DENDRITIC ULCER

49
Q

Which type of keratitis is associated with a ‘ring ulcer’

A

Acanthamoeba (protozoan)

50
Q

What organisms typically cause dacryocystitis in a) children and b) adults

A

a) Staph aureus, ß-haemolytic strep

b) S. epidermidis, S. aureus

51
Q

What eye complication is associated with toxoplasmosis?

A

Chorioretinitis

52
Q

Hyperopia predisposes to ____

A

Acute angle closure glaucoma

53
Q

____ (type of refractive state) is normal in neonates

A

Hyperopia (small eyeball)

54
Q

What is the normal optic cup to disc ratio

A

0.3

55
Q

List some risk factors for cataracts

A

Acquired

  • Older age
  • Smoking
  • EtOH
  • Excessive sunlight
  • Prolonged corticosteroids
  • Diabetes
  • Trauma
  • Infection

Congenital

  • Classic galactosaemia
  • Galactokinase deficiency
  • Trisomy 13, 18, 21
  • ToRCHS infections
  • Marfan syndrome
  • Alport syndrome
  • NF2
  • Myotonic dystrophy
56
Q

With regard to CNIII damage:
Motor output has fibres (centrally/ peripherally) is primarily affected by _______
Parasympathetic output has fibres (centrally/ peripherally) that are first affected by _____

A

Motor output - central fibres, affected by vascular disease (e.g. diabetes, HTN) d/t poor diffusion of O2 and nutrients

PNS - peripheral fibres, affected by compression (e.g. PComm aneurysm, uncal herniation, tumour)

57
Q

In glaucoma, intraocular pressure is >___ mmHg

A

> 21

58
Q

What is the pharmacological management for glaucoma?

A

1) Increase aqueous fluid outflow with pilocarpine (muscarinic agonist) or PG analogues
2) Decrease aqueous humor production with ß-blockers or CAi (acetazolammide aka Diamox)
3) Combined: alpha-AR agonists

59
Q

In dry ARMD (soft/ hard) drusen have a higher risk

A

Soft

60
Q

What visual field defect is classically present in glaucoma?

A

Superior actuate defect

61
Q

Myasthenia gravis can cause what eyelid condition

A

Ptosis

62
Q

Horner’s syndrome - What underlying cause do you need to rule out in children and adults respectively?

A

Children - neuroblastoma

Adults - carotid artery dissection

63
Q

The ‘morning glory optic disc’ is associated with _______

A

Basal encephalocele

AHP Semester (4 decks)

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