Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 5 > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

Two types of age related macular degeneration

A

Dry (90%) - characterised by drusen, and degeneration of photoreceptors in the macula
Wet (10%) - characterised by neovascularisation, new vessels growing from the choroid layer into the retina. These vessels can leak fluid or blood causing oedema and rapid vision loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for age related macular degeneration

A 
Age 
Smoking 
Female sex 
Family history 
Cardiovascular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation of age related macular degeneration

A

Gradual worsening of central visual field loss
Reduced visual acuity
Wavy appearances to straight lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs of wet age related macular degeneration

A

Loss of vision over days

Full visual loss is over 2-3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is ARMD diagnosed

A

Slit lamp fundus examination

Fluorescein angiography - useful to show up any oedema and neovascularisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of Dry ARMD

A

No specific treatment
Focus on lifestyle management to slow progression:
- avoid smoking
- control blood pressure
- vitamin supplementation with zinc and anti oxidant vitamins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of wet ARMD

A

Anti Vascular endothelial growth factors (VEGF) - this stops formation of new blood vessels

Injections of this into the vitreous chamber once a month

Examples: ranibizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is glaucoma?

A

Optic nerve damage caused by a significant rise in intraocular pressure

This is caused by a blockage in the aqueous humour trying to escape the eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Two types of glaucoma and what happens in each

A

Open angle - resistance of drainage of aqueous humour through the trabecular meshwork, causing slow gradual increase in pressure
Closed angle - bulging of iris sealing off the trabecular meshwork from the anterior chamber, preventing aqueous humour from being able to drain. This causes rapid continual build up of pressure and is an ophthalmology emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Risk factors for open angle glaucoma

A

Increasing age
Family history
Black ethnic origin
Myopia (near sightedness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Presentation of open-angle glaucoma

A

Often asymptomatic - and diagnosed by routine screening when attending for an eye check
Loss of peripheral vision
Gradual onset of fluctuating pain, headaches, blurred vision and halos around lights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How would you assess the intraocular pressure when diagnosing glaucoma

A

Using Goldman application tonometry
Fundoscopy - looking for optic disc cupping
Visual field assessment - check for peripheral field loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Medications used in management of open angle glaucoma and how they work

A

1st line - prostaglandin analogue eye drops (e.g, latanoprost), these increase uveoscleral outflow

2nd line - all eye drop drugs reduce aqueous humour production
Beta blockers e.g timolol
Carbonic anhydrase inhibitors e.g, dorzolamide, acetazolamide
Sympathomimetics e.g, brimonidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What other options are available for management of open angle glaucoma when eye drops are ineffective

A

Trabeculaectomy surgery - involves creating a new channel from the anterior chamber through the sclera to a location under the conjunctiva (bleb). From here it can be reabsorbed into general circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which medications can precipitate an acute angle-closure glaucoma

A

Noradrenaline
Anticholinergic medications - oxybutynin
Tricyclic antidepressants e.g, amitriptyline (these have anticholinergic effects)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Presentation of acute angle closure glaucoma

A 
Severely red painful eye 
Blurred vision 
Halos around lights 
Headache 
Nausea 
Vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What examination findings may you find on a patient with closed angle glaucoma

A 
Red eye 
Hazy cornea 
Decreased visual acuity 
Dilation of affected pupil 
Firm eyeball on palpation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of acute closure angle gluacoma

A

Urgent same day assessment by ophthalmologist

Can give pilocarpine eye drops whilst awaiting ambulance - this acts to constrict the pupil which allows a pathway for the flow of aqueous humour from the ciliary body

IV acetazolamide (carbonic anhydrase inhibitor) initial therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a cataract

A

Where the lens in the eye becomes cloudy and opaque leading to reduced visual acuity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Presentation of cataracts

A

Asymmetrical
Slow reduction in vision
Progressive blurring of vision
Change of colour vision - colours becoming more brown or yellow
“Starbursts” can appear around lights, particularly at night time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the key sign of cataract on examination

A

Loss of red reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Management of cataracts

A

Conservative in early stages

Cataract surgery in later stages - replacement with artificial lens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the main complication of cataract surgery to be aware of?

A

Endophthalmitis - inflammation of the inner contents of the eye, usually caused by infection post surgery

It can lead to loss of vision and loss of the eye itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a Marcus-Gunn pupil

A

Relative Afferent papillary defect (RAPD)

Sign of asymmetrical optic nerve disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Differential diagnosis for painless red eye
Conjunctivitis Episcleritis Subconjunctival haemorrhage
26
Differential diagnosis for painful red eye
``` Glaucoma Anterior uveitis Scleritis Corneal abrasions or ulceration Keratitis Foreign body ```
27
Presentation of conjunctivitis
Red bloodshot eyes Itchy or gritty sensation May be purulent discharge from the eye in bacterial causes
28
Management of conjunctivitis
Usually resolves in 1-2 weeks Advice on good hygiene to avoid spreading disease e.g, avoid sharing towels and encourage hand washing after rubbing eyes Can clean eyes using cooled boiled water and cotton wool Avoid wearing contact lens Chloramphenicol abx eye drops - if bacterial cause
29
What do you need to consider in neonatal conjunctivitis
Gonococcal infection from pregnancy | This can cause loss of sight and requires urgent ophthalmology review
30
Allergic conjunctivitis management
1st line - Topical antihistamines eye drops | 2nd line - topical mast cell stabilisers e.g, sodium cromoglicate
31
What is keratitis
Inflammation of the cornea
32
What is the most common cause of keratitis
Herpes simplex infection - called herpes simplex keratitis
33
How does herpes simplex keratitis usually present
``` Painful red eye Photophobia Foreign body sensation in eye Reduced visual acuity Dendritic corneal ulcer ```
34
What is anterior uveitis
Inflammation in the anterior part of the uvea - involving the iris, ciliary body and choroid
35
How does anterior uveitis usually present
``` Dull, aching painful red eye Ciliary flush - ring of red spreading from the cornea outwards Reduced visual acuity Photophobia Miosis (constricted pupil) Pain on movement Excessive lacrimation Hypopyon - collection of WCC in the anterior chamber ```
36
What is blepharitis?
Inflammation of the eyelid margins
37
Presentation of blepharitis
Gritty, itchy dry eyes | Red inflamed eyelids
38
Management of blepharitis
Hot compress and gentle cleaning of the eyelid margins with baby shampoo Lubricating eye drops can be used to relieve symptoms
39
What is a stye
Hordeolum externum Inflammation of the meibomian glands in the eyelids Causing red tender lump along the eyelid which may contain pus
40
Difference between a stye and a chalazion
Stye’s are typically painful | Chalazion are typically painless
41
Difference between orbital and periorbital cellulitis
With periorbital cellulitis - normal visual acuity, and no pain with eye movements Orbital cellulitis (ophthalmic emergency) - severe ocular pain and visual disturbance
42
What the most common causes of central retinal artery occlusion?
Where there is something that blocks the flow of blood through the central retinal artery This is most commonly caused by atherosclerosis It can also be caused giant cell arteritis - where vasculitis affecting the ophthalmic or central retinal artery causes reduced blood flow
43
Features of central retinal artery occlusion
Sudden painless loss of vision | Relative afferent pupillary defect
44
Fundoscopy findings on central retinal artery occlusion
Pale retina - due to lack of perfusion | Cherry red spot - which is the macula that shows the red colour choroid below and contrasts with the pale retina
45
What happens in central retinal vein occlusion?
Blockage of the retinal vein causes pooling of blood into the retina This results in leakage of fluid and blood causing macular oedema and retinal haemorrhages This damage to the retina causes the release of VEGF - which stimulates the development of new blood vessels (neovascularisation)
46
Presentation of central retinal vein occlusion
Painless loss of vision
47
Fundoscopy findings on central retinal vein occlusion
Flame and blot haemorrhages Optic disc swelling Macula oedema
48
What happens in retinal detachment
Where the retina separates from the choroid underneath Usually due to a retinal tear which allows vitreous fluid to get under the retina and fill the space between the retina and the choroid
49
Why is retinal detachment a ophthalmic emergency?
The retina relies on the choroid for blood supply As it detaches from the choroid during retinal detachment This makes it a sight threatening emergency
50
How does retinal detachment usually present
Painless Peripheral vision loss - like a shadow coming down on vision Blurred or distorted vision Flashes and floaters
51
What is posterior vitreous detachment
Common condition particularly in elderly patients | Where the vitreous gel comes away from the retina
52
Presentation of posterior vitreous detachment
Painless Floaters Flashing lights Cobweb across vision
53
Management of posterior vitreous detachment
Referral - to rule out retinal detachment Conservative - symptoms improve over time as brain adjusts If there is associated retinal tear or detachment then they may need surgery
54
Fundoscopy findings of hypertensive retinopathy
Silver wiring - thickened sclerosed arterioles AV nipping - where arterioles cause compression of veins where they cross due to sclerosis and hardening of arterioles Cotton wool spots - caused by dead nerve fibres Hard exudates - due to leaking lipids into retina Retinal haemorrhages - damaged vessels bleeding into retina Papillodema- caused by ischaemia to the optic nerve causing swelling
55
Keith-Wagener Staging of hypertensive retinopathy
Stage 1 - mild narrowing of arterioles Stage 2 - constriction/sclerosis of blood vessels and AV nicking Stage 3 - cotton wool spots, exudates and haemorrhages Stage 4 - papillodema
56
Pathophysiology of diabetic retinopathy
Hyperglycaemia leads to damage to the retinal small vessels and and endothelial cells Increased vascular permeability leads to blood vessels to leak. This causes the formation of microaneurysms, blot haemorrhages and hard exudates
57
Pathophysiology of cotton wool spots
Damage to nerve fibres
58
Difference between non proliferative and proliferative diabetic retinopathy
Whether new blood vessels have developed or not Non proliferative/pre proliferative can develop into proliferative
59
Classification of non-proliferative diabetic retinopathy
Mild - microaneuryms present Moderate - microaneuryms, blot haemorrhages, hard exudates, cotton wool spots and venous beading Severe - blot haemorrhages plus microaneuryms in 4 quadrants, venous beading in 2 quadrants
60
Complications of diabetic retinopathy
Retinal detachment | Vitreous haemorrhage
61
What is diabetic maculopathy
Condition which is separate from pre proliferative/proliferative retinopathy Based on location of disease rather than severity Occurs with macula oedema and ischaemia More common in type II diabetics
62
What is retinitis pigmentosa
Congenital inherited condition where there is degeneration of rods and cones in the retina In most cases the rods degenerate more than the cones, leading to night blindness
63
Features of retinitis pigmentosa
Night blindness Tunnel vision - due to loss of peripheral retina Fundoscopy - multiple black bony spicule shaped pigmentation Family history is often positive
64
Features of horner’s syndrome
Miosis (small pupil) Ptosis Enophthalmos Anhidrosis (loss of sweating on one side)
65
How can you tell the difference between the causes of horner’s syndrome?
Central lesion cause - anhidrosis of face, arm and trunk All the S’s - stroke, syringomyelia, MS Pre-ganglionic lesion cause - anhidrosis of face only All the T’s - pancoast Tumour, Thyroidectomy, Trauma Post-ganglionic lesion - no anhidrosis All the C’s - Carotid artery dissection, Carotid aneurysm, Cavernous sinus thrombosis, Cluster headache
66
What is Argyll-Robertson pupil?
Small irregular pupil seen in patients with syphilis Patients have an absent pupillary reflex but accommodation reflex is still present
67
Causes of 6th nerve palsy
Raised ICP Vasculitis Cavernous sinus thrombosis
68
Significance of pupil dilation in 3rd nerve palsy
Parasympathetic system travels along outside of CN3 pathway If there is exterior compression causing CN3 palsy, it will also be causing pupil dilation due to compression of parasympathetic nervous system Cause is more likely due to an aneurysm or tumour/mass if this is the case Urgent MRI is needed
69
Causes of 3rd nerve palsy
Vasculitis - e.g, diabetes/hypertension Aneurysms Mass e.g, tumour
70
Why can aneurysms in the brain cause 3rd nerve palsy?
Path of CN3 travels very close to circle of willis where berry aneurysms are common The aneurysm then pushes on nerve causing palsy and parasympathetic compression (pupil dilation)
71
Common cause of 4th nerve palsy
Congenital - lots of children born with it Vasculitis Mass
72
Ophthalmic presentation of myasthenia gravis
Bilateral drooping of eyelids (ptosis) Diplopia No abnormalities in eye movements
73
Management of anterior uveitis
Steroid eye drops (prednisolone acetate) - reduce infection | Mydriatic eye drops (cyclopentolate) - dilate pupil to reduce pain

Year 5 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions