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Fifth Year Medicine > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What are the extraocular muscles?

A

Superior, inferior, medial and lateral rectus.

Superior and inferior oblique.

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2
Q

What is the conjunctiva?

A

The white outer coat of the eye.

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3
Q

What is the cornea?

A

The clear front window of the eye which transmits and helps to focus light.

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4
Q

What is the function of the lens?

A

To focus light rays onto the retina.

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5
Q

What is the vitreous?

A

Clear gel filling central cavity of the eye.

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6
Q

What are the photoreceptors on the retina?

A

Rods and cones

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7
Q

What is the choroid?

A

Layer at the back of the eye between the retina and sclera. It contains blood vessels and is associated with macular degeneration.

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8
Q

What is the macula?

A

An area near the centre of the retina responsible for detailed central vision. It deteriorates with age.

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9
Q

Which cranial nerve is the optic nerve?

A

2nd cranial nerve.

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10
Q

How far does your visual field extend?

A

Horizontally to 60 degrees nasally to 100 degrees temporally.
Vertically approximately 60 degrees above and 75 degrees below the horizontal meridian.

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11
Q

What are the parts of the visual pathway?

A 
Optic nerve
Optic chiasm
Lateral geniculate nucleus
Optic radiation
Visual cortex
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12
Q

Where do the optic nerves join?

A

The optic chiasm

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13
Q

What do the numerator and denominator in a snellen chart represent?

A 
Numerator = the distance at which the patient can see the observed line.
Denominator = the distance at which a normal healthy eye could see the same line.
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14
Q

Name some causes of traumatic red eye.

A

Corneal abrasion/foreign body
Subconjunctival haemorrhage/conjunctival laceration
Chemical injury
Penetrating ocular trauma

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15
Q

Name some causes of non-traumatic red eye.

A 
Conjunctivitis
Subconjunctival haemorrhage
Keratitis
iritis
Episcleritis, scleritis
Acute glaucoma
Cellulitis
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16
Q

What are the signs of conjunctivitis?

A 
Papillae
Redness
Follicles
Chemosis
Purulent discharge
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17
Q

What are papillae?

A

Vascular response.

Coblestone arrangement of flattened nodules with central vascular cores. Can be large in size (>1mm) - giant papillae.

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18
Q

What are follicles?

A

Lymphoid hyperplasia. Small done-shaped nodules without a prominent central vessel.

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19
Q

How can you distinguish between papillae and follicles?

A

Papilla clinically appears more red on its surface and more pale at its base, a follicle appears more pale on its surface and more red at its base.

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20
Q

What is chemosis?

A

Swelling or oedema of the conjunctiva.

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21
Q

Is viral conjunctivitis more likely to present with follicles or papillae?

A

Follicles

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22
Q

What is the treatment for bacterial conjunctivitis?

A

Topical antibiotics

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23
Q

What is the most common infectious cause of blindness?

A

Trachoma

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24
Q

What causes trachoma?

A

Repeated episodes of infection with chlamydia trachomatis in childhood.

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25
Q

What is trachoma?

A

Severe conjunctival inflammation, scarring and potentilly blinding in-turned eye lashes in later life.

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26
Q

Where does trachoma occur?

A

In resource poor areas with inadequate hygiene and crowding.

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27
Q

How does a corneal ulcer differ from a corneal abrasion?

A

A corneal ulcer involves the stroma.

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28
Q

What are the risk factors for corneal ulcers?

A 
Trauma
Contact lens use
Ocular surface disease e.g. dry eyes, blephritis
Lid disease
Systemic disease e.g. RA
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29
Q

What are the clinical features of corneal ulcers?

A 
Pain
Foreign body sensation
Redness
Photophobia
Tearing
Discharge
Reduced vision
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30
Q

What are the acute complications of corneal ulcers?

A

Scleral extension
Corneal perforation
Endophthalmitis

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31
Q

What are the long term complications of corneal ulcers?

A

Corneal scarring - if central can affect vision.

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32
Q

What are the investigations for corneal ulcers?

A

Corneal scrapes
If contact lens wearer send lenses, solution and case for culture.
Swabs - viral PCR

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33
Q

Which virus can cause a dendritic corneal ulcer?

A

Herpes simplex keratitis

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34
Q

What is the treatment of herpes simplex keratitis?

A

Aciclovir ointment

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35
Q

What are the features of acanthamoeba?

A

Pain disproportionate to clinical findings, ring shape infiltrates, perineurla infiltrates.

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36
Q

What is the treatment for corneal ulcers?

A

Unless clinically very suggestive of a certain cause, usually antibacterial therapy is started until culture results are back. Broad spectrum cover e.g. cephalosporin and gentamicin (amnoglycoside).

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37
Q

What are the symptoms of scleritis?

A 
Acute red eye
Pain on eye movement
Globe tenderness
SEVERE pain
Rare: associated with RA and GPA.
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38
Q

What is the management of scleritis?

A

Oral steroids

Investigation for underlying cause or vasculitis.

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39
Q

What is episcleritis?

A

Diffuse or sectoral red eye
Mild pain
Self limiting

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40
Q

What is the management of episcleritis?

A

Topical NSAIDs
Topical steroids
Not always required.

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41
Q

What is uveitis?

A

Inflammation of the uveal tract and often neighbouring structure e.g. retina, vitreous and optic nerve.

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42
Q

What is the uveal tract comprised of?

A

Iris
Ciliary body
Choroid

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43
Q

What are the causes of uveitis?

A 
Idiopathic
Trauma
Infectious
Autoimmune
Masquerade
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44
Q

What are the symptoms of uveitis?

A

Anterior: photophobia, redness, watering, pain, reduced vision.
Intermediate: reduced vision, floaters, photopsia
Posterior: reduced vision, photopsia, floaters, scotoma

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45
Q

What are the signs of anterior uveitis?

A 
Limbal injection
Anterior chamber cells
AC flare
Poserior synechiae
Keratitic precipitates
Fibrin and hypopyon
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46
Q

What are the signs of intermediate and posterior uveitis?

A

Vitreous haze
Snowballs
Multicfocal choroiditis
Retinitis

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47
Q

What are the complications of uveitis?

A

Raised intraocular pressure
Cataract
Cystoid macular oedema
Optic neuropathy

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48
Q

What is the treatment of uveitis?

A

Treat cause.
Anterior: topical steroids
Intermediate: topical steroids.
Posterior: systemic steroids.

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49
Q

What are the risks of angle closure glaucoma?

A

Older
Hypermetrope (long sighted)
Phakic

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50
Q

What are the symptoms of angle closure glaucoma?

A

Pain (severe)
Headache
Photophobia
Reduced vision

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51
Q

What are the signs of angle closure glaucoma?

A

Red eye
Hazy cornea
Fixed, mid dilated pupil
Iris bombe

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52
Q

What is the management of acute angle closure glaucoma?

A 
Urgent referral 
Reduce intraocular pressure:
IV acetazolamide/mannitol
Pilocarpine to constrict pupil
Topical steroid
Topical pressure lowering drops
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53
Q

What is a corenal abrasion?

A

A scratch on the eye - defect in epithelium.

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54
Q

What is the management of a corneal abrasion?

A

Chloramphenicol ointment

QDS 3 days

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55
Q

What is the management of a foreign body in the eye?

A

Remove foreign body

Chloramphenicol ointment for 3 days

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56
Q

What is the management of chemical injuries to the eye?

A

Irrigate immediately - at least 2L, evert eyelids.

pH after irrigation, then 5 mins and 20 mins

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57
Q

What are the symptoms of globe rupture?

A 
Pain +++
Obvious penetrating injury
Suspicious mechanism of injury
Irregular pupil
360 degrees subconj haem
Flat AC
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58
Q

What is the management of suspected globe rupture?

A 
Don't press on it! 
Measure VA
Slit lamp/pupils if able
 - analgesia
 - antibiotics
 - tetanus
CT (thin slice)
Call opthalmology
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59
Q

What is the clinical presentation of a retrobulbar haemorrhage?

A 
Reduced vision
RAPD
Raised pressure
Pain
Proptosis
Reduced motility
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60
Q

What is the most common type of orbital fracture?

A

Floor fracture

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61
Q

What is the management of orbital cellulitis?

A

IV antibiotics

CT

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62
Q

What is Hutchinson’s sign in shingles?

A

Nasociliary nerve involvement.

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63
Q

What is the treatment for shingles?

A

PO aciclovir

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64
Q

How does cataract present?

A 
Gradual onset
Reduced vision
Usually bilateral (but asymmetric)
Can also cause:
Glare
Monocular diplopia
Progressive myopia
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65
Q

What are the triad of features of glaucoma?

A

Raised IOP
Optic nerve changes
Visual field loss

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66
Q

What are the typical symptoms of age related macular degeneration?

A

Gradual blurring of central vision
Difficulty reading
Sudden deterioration if develops ‘wet’ disease

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67
Q

What are the risk factors for developing macular degeneration?

A 
Smoking
Family history
Female > Male
Caucasian
Diet
Cardiovascular disease
Hypermetropia
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68
Q

What are the clinical signs of dry age related macular degeneration?

A 
Progressive atrophy
Loss of RPE and photoreceptors
Thickening of Bruch's membrane
Drusen
Pigment clumping
Atrophy
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69
Q

What is the pathophysiology of wet ARMD?

A

Neovascular growth of capillaries from choroid into subretinal space
Leads to leakage and bleeding

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70
Q

What is the management of wet ARMD?

A

Intravitreal injections - anti VEGF
VEGF-A - induces pathological angiogenesis
Anti-VEGF: reduces vascular permeability, reduce fluid leakage, halt progression of neovascularisation.

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71
Q

What are the clinical features of retinal tear and detachment?

A 
Rapid onset
Associated flashes and floaters
Curtain coming down
Unilateral
Painless
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72
Q

What are the possible causes of flashes and floaters?

A

Retinal detachment
Posterior vitreous detachment
Vitreous haemorrhage (proliferative diabetic retinopathy)
Migraine (coloured lights)

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73
Q

Describe vitreous.

A

Gel-like consistency
Provides shape, cushions eye
Water (99%), collagen

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74
Q

What are the possible complications related to the vitreous degenerating with age?

A

Posterior vitreous detachment

Rhegmatogenous retinal detachment

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75
Q

What are the risk factors for retinal detachment?

A 
Age
Trauma
Myopia
Previous cataract surgery
Previous laser refractive surgery
Family history
Fellow eye (1 in 10)
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76
Q

What are the management options for a retinal detachment?

A

Vitrectomy (remove the traction)
Laser/cryo (seal the hole)
Gas/oil (tamponade the break)

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77
Q

What is the typical presentation of central retinal artery occlusion?

A

Sudden onset, painless loss of vision

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78
Q

What are the signs of central retinal artery occlusion?

A

VA <6/60
RAPD
Pale/swollen retina
Cherry red spot

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79
Q

What other pathology is central retinal artery occlusion associated with?

A

Giant cell arteritis

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80
Q

Which further investigations should be carried out in the case of central retinal artery occlusion?

A 
TIA referral
Carotid dopplers
CT head
Aspirin/clopidogrel
No driving for 1 month
81
Q

What is the typical presentation of a central retinal vein occlusion?

A

Sudden onset, painless loss of vision.

82
Q

What are the clinical features of central retinal vein occlusion?

A 
Tortuous vessels
Disc swelling
Flame haemorrhages
Cotton wool spots
Macular oedema
May have RAPD
83
Q

What is the management of central retinal vein occlusion?

A 
Address vascular risk factors:
BP
Lipids
Diabetes
Smoking

Macular oedema:
Anti-VEGF
Intra-vitreal steroids

84
Q

How do you test the function of the optic nerve?

A 
Visual acuity
Colour vision
Pupils (check for RAPD)
Visual fields
Optic nerve appearance
85
Q

What are the two main pathologies associated with the optic nerve that could cause acute visual loss?

A

Optic neuritis

Ischaemic optic neuropathy

86
Q

What is the presentation of optic neuritis?

A

Reduced vision - gradual over 2 weeks.
Unilateral
Patchy/variable
Pain on eye movements

87
Q

What are the clinical signs of optic neuritis?

A 
Reduced optic nerve function
Disc swelling (sometimes)
88
Q

What is the clinical course of optic neuritis?

A

Gets worse for two weeks
Gradually resolves over 3 months
IV steroids hasten recovery but don’t change outcome

89
Q

Which disease is optic neuritis associated with?

90
Q

What can cause atypical optic neuritis?

A 
Infection (TB/syphilis)
Inflammation (vasculitis/uveitis etc.)
Neuromyelitic optica
Anterior ischaemic optic neuropathy
Neoplastic
Leber's hereditary optic neuropathy
91
Q

Which arteries is the optic nerve head supplied by?

A

Posterior ciliary arteries

92
Q

What causes anterior ischaemic optic neuropathy?

A

Interruption to the blood supply of the posterior ciliary arteries.

93
Q

What is the clinical presentation of ischaemic optic neuropathy?

A 
Reduced vision
RAPD
Reduced colour vision
Visual field defect (altiduinal)
Disc swelling
94
Q

What causes arteritic anterior ischaemic optic neuropathy?

A

Giant cell arteritis

Temporal arteritis

95
Q

What are the risk factors for GCA/temporal arteritis?

A 
Age >55
Headache
Jaw claudication
Scalp tenderness
Raised ESR/CRP
Cranial nerve palsies
96
Q

What is the management of giant cell arteritis/temporal arteritis?

A

Urgent IV methylprednisolone.

97
Q

What is the cause of non-arteritic anterior ischaemic optic neuropathy?

A

Atherosclerosis

98
Q

What are the risk factors for non-arteritic anterior ischaemic optic neuropathy?

A 
Age >55
Vascular risk factors
No symptoms associated with GCA
Normal inflammatory markers
Altitudinal visual field defect
99
Q

What is the management of non-arteritic anterior ischaemic optic neuropathy?

A

There is no treatment.
Less severe visual loss.
More common than arteritic anterior ischaemic optic neuropathy.

100
Q

What is a cataract?

A

Clouding of the lens
Develops gradually with age.
Leading to blurred vision for distance for distance and near vision.

101
Q

Where is the nutrition to the lens derived from?

A

Aqueous fluid

102
Q

How dose the lens accommodate?

A

Ciliary body contraction
Zonules relax
Lens higher power

103
Q

What is presbyopia?

A

The gradual loss of your eyes ability to focus on nearby objects.

104
Q

What does phakic mean in relation to the lens?

A

Natural lens

105
Q

What does pseudophakic mean in relation to the lens?

A

Natural lens removed and artifical lens inserted.

106
Q

What does aphakic mean in relation to the lens?

A

Natural lens removed but not replaced.

107
Q

How does the lens develop a cataract?

A

Proteins accumulate inside the lens, they obstruct light and cause a haziness in the lens. This haziness is the cataract.

108
Q

What are the risk factors for developing a cataract?

A

Diabetes
Steroid use
Age related
Can get congenital cataracts

109
Q

What are the symptoms of a cataract?

A

Gradual onset painless blurred vision for near and distance.
Glare, especially driving at night.
Myopic shift.

110
Q

When is cataract surgery required?

A

When the patient becomes symptomatic.

When the patient’s lifestyle is affected e.g. driving or watching tv.

111
Q

When may cataract surgery be required other than due to the effects of a cataract?

A

To treat angle closure glaucoma.

To improve visualisation of the retina to manage co-pathology e.g. diabetic retinopathy.

112
Q

What is the postential intraoperative complication of cataract surgery?

A

Posterior capsular rupture

113
Q

What are the potential postoperative complications of cataract surgery?

A 
Endophthalmitis
Uveitis
Cystoid macular oedema
Retinal detachment
Posterior capsular opacification
114
Q

When might endophthalmitis occur in relation to cataract surgery?

A

3-5 days after surgery

115
Q

What are the symptoms of endophthalmitis?

A

Rapidly progressive pain
Red eye
Ocular discharge
Blurring

116
Q

What are the signs of endophthalmitis?

A 
Decreased visual acuity
Lid swelling
Hypopynon
Vitreous inflammation
Dullling of red reflex
117
Q

What is the treatment for endophthalmitis?

A

Urgent intravitreal antibiotics.

118
Q

How does posterior capsular opacification occur?

A

Residual lens epithelial cells migrate along posterior capsule and opacify.

119
Q

What is glaucoma?

A

Optic neuropathy with characteristic loss of optic nerve fibres leading to visual field loss.
Intraocular pressure is the only modifiable risk factor

120
Q

What are the visual changes in the optic nerve in a patient with glaucoma?

A

Increased cup:disc ratio
Splinter haemorrhages
Pallor
Peripapillary atrophy

121
Q

What is the pathogenesis of chronic primary open angle glaucoma?

A

Elevated IOP

Altered vascular supply to the optic nerve.

122
Q

What are the risk factors for chronic primary open angle glaucoma?

A

Elevated intraocular pressure
Myopia
Family history
Afro-Caribbean descent

123
Q

What are the signs of glaucoma?

A 
IOP >21mmHg
Optic disc:
Gradual thinning of neurosensory rim superiorly and inferiorly
Nerve fibre layer defect
Optic disc rim notching and cupping
Cup:disc ratio enlarged/asymmetrical
Visual field changes
Gonioscopy - open angle
124
Q

What are the treatment options for glaucoma?

A

Prostaglandin analogue
Beta blocker
Carbonic anhydrase inhibitor
Alpha 1 agonist

125
Q

Give an example of a prostaglandin analogue?

A

Latanoprast

126
Q

Give an example of a beta blocker?

127
Q

Give an example of a carbonic anhydrase inhibitor.

A

Brinzolamide

128
Q

Give an example of an alpha 1 agonist.

A

Brimonidine

129
Q

What is the method of action of prostaglandin anglogues?

A

Inceases uveoscleral outflow.

130
Q

What is the method of action of beta blockers?

A

Decreases aqueous humour production.

131
Q

What is the method of action of carbonic anhydrase inhibitors?

A

Decreases aqueous humour production

132
Q

What is the method of action of alpha 1 agonists?

A

Decreases aqueous humour production and incrreases uveoscleral outflow

133
Q

What are the side effects of prostaglandin analogues?

A

Eyelash growth

Iris pigmentation

134
Q

What are the side effects of beta blockers?

A

Bradycardia

Bronchoconstriction

135
Q

What are the side effects of carbonic anhydrase inhibitors?

A

Metallic taste

Malaise

136
Q

What are the side effects of alpha 1 agonists?

A

Allergy

Dry mouth

137
Q

What are the laser treatments for glaucoma?

A

Selective laser trabeculoplasty

Cyclodiode laser

138
Q

What is the possible surgical treatments for glaucoma?

A

Trabeculectomy with mitomycin C

139
Q

What are the complications of trabeculectomy?

A

Hypotony
Infection
Cataract
Bleb leakage

140
Q

What are the symptoms of acute angle closure glaucoma?

A 
Sudden onset severely painful eye
Blurred vision
Halos around lights
Headache
Nausea, vomiting
141
Q

What are the signs of acute angle closure glaucoma?

A 
Visual acuity reduced
Red eye
Cornea hazy
Pupil - mid dilated and fixed
Digitally high IOP
Gonioscopy - closed iridocorneal angle
142
Q

What is the treatment for acute angle closure glaucoma?

A

Medically:
Topical - pilocarpine, intraocular pressure reduction
Systemic - IV acetazolamide - carbonic anhydrase inhibitor

YAG laser iridotomy: both eyes - prophylactic to second eye

143
Q

What are the clinical features of congenital glaucoma?

A 
Watering photophobic eyes
Large eyes - buphthalmos
Increased corneal diameter
Cloudy cornea
Reduced vision
Raised intraocular pressure
144
Q

What is the treatment for congenital glaucoma?

A

Goniotomy

Trabeculectomy

145
Q

What is neovascular glaucoma caused by?

A

Diabetic retinopathy

Retinal vein occlusion

146
Q

What is neovascular glaucoma?

A

Neovascularisation of the iris
Fibrous membrane over trabecular meshwork.
Membrane contracts and closes drainage angle.

147
Q

What is the treatment for neovascular glaucoma?

148
Q

What happens in pigment dispersion syndrome?

A

Pigmented iris rubs against zonules.

Pigment is shed and clogs trabecular meshwork.

149
Q

Who is at risk of pigment dispersion syndrome?

A

Young caucasian myopic males.

150
Q

What happens in pseudoexfoliation syndrome?

A

Pigment is rubbed off iris and clogs trabecular meshwork.

151
Q

What are the effects of diabetes on the eyes?

A 
Increased susceptibility to infection
Dry eyes and keratitis
Anterior uveitis
Cataract
Diabetic papillitis
Diabetic retinopathy
Cranial nerve palsies
152
Q

What is diabetic retinopathy?

A

Disease of the retinal microvasculature associated with prolonged hyperglycaemia.

153
Q

What are the features of diabetic retinopathy?

A 
Microaneurysms
Blot/dot haemorrhages
Hard exudates
Cotton-wool spots
New vessels
154
Q

What is the management of diabetic retinopathy?

A

Screening programme
Education - diabetic control.
Proliferative diabetic retinopathy - panretinal photocoagulation laser.

155
Q

What is the ocular manifestation of sjogren’s syndrome?

156
Q

What is the ocular manifestation of juvenile idiopathic arthritis?

157
Q

What is the ocular manifestation of HLA-B27 disease?

A

Anterior uveitis

158
Q

What is the ocular manifestation of rheumatoid arthritis?

159
Q

What is the ocular manifestation of giant cell arteritis?

A

Ischaemic optic neuropathy

Cranial nerve palsies

160
Q

What are the features of anterior uveitis?

A

Mildly painful eye
Typically doesn’t wake patient from sleep
Painful to look at light

161
Q

What are the features of scleritis?

A 
Very red eye
Wakes patient up
Deep, boring pain
Tender globe
Doesn't blanche with phenylephrine
162
Q

What is the treatment of scleritis?

A

Oral steroids

163
Q

What are the clinical features of giant cell arteritis?

A 
>50 years old
Scalp tenderness
Jaw claudication
Visual loss (fleeting/permanent)
Stroke/cranial nerve palsies
164
Q

What are the investigations of giant cell arteritis?

A

ESR/CRP
Temporal artery biopsy
MRI
USS

165
Q

What is the management of giant cell arteritis?

A

High dose steroids

166
Q

What are the features of raised intracranial pressure?

A

Swollen optic nerves

Enlarged blind spots

167
Q

What are the differentials for raised intracranial pressure?

A

Space occupying lesion

Idiopathic intracranial hypertension

168
Q

What are the opthalmic features of MS?

A 
Optic neuritis
Internuclear ophthalmoplegia
Isolated visual field defects
Uveitis (intermediate)
Nystagmus
169
Q

What are your eyes like at birth?

A

Spherical lens
Immature macula
Vision is black and white

170
Q

At what age can a snellen chart be used to test a child’s sight?

171
Q

How do you visually assess a newborn?

A

Red reflex

172
Q

How do you visually assess a 6 week old?

A

Fixing and following

Eye occlusion

173
Q

How do you visually assess a 2 year old?

A

Kay pictures

174
Q

How do you treat amblyopia?

A

Spectacle
Patching
Atropine

175
Q

How do you treat problems with lacrimal drainage?

A

Bathe the eyes

Antibiotics if the eye is raised

176
Q

What is the investigation of orbital cellulitis?

177
Q

What is the management of orbital cellulitis?

A

Immediate antibiotics

178
Q

What is eye discharge in the first week of life?

A 
Gonococcal (day 1-3)
Chlamydial conjunctivitis (day 4-28)
179
Q

What are the complications of gonococcal infection in newborns?

A

Corneal damage

180
Q

What does leukocoria mean?

A

White pupil

181
Q

What can leukocoria indicate?

A

Retinoblastoma
Congenital cataract
Retinal detachment

182
Q

What are the indications for surgery in a congenital cataract?

A 
Severe cataract
Central 3mm opacity
VA <6/24 (older baby)
Strabismus
Poor visualisation of fundus
183
Q

What are possible complications post congenital cataract surgery?

A

Visual axis opacities
Glaucoma
Inflammation
Endophthalmitis

184
Q

What are the investigations of suspected retinoblastoma?

A

EUA
Fluorescein
Ultrasound
If optic nerve not seen then MRI (CT avoided due to increased incidence of secondary malignancies)

185
Q

What is the treatment for retinoblastoma?

A

Chemotherapy
Focal laser therapy
Enucleation

186
Q

What is retinopathy of prematurity?

A

In premature babies peripheral retina is not vascularised at birth.
There is growth of new vessels and scarring.

187
Q

What are the risk factors for retinopathy of prematurity?

A

Low gestational age <32 weeks.

Low birth weight <1501g

188
Q

What is the classification of retinopathy of prematurity?

A

Stage 1: Demarcation line
Stage 2: Ridge
Stage 3: Extraretinal fibrovascular proliferation
Stage 4: Partial retinal detachment (4a - extrafoveal, 4b - foveal)
Stage 5 - total retinal detachment

189
Q

What is the treatment of retinopathy of prematurity?

A

Laser photocoagulation of peripheral retina

Without laser, retinal detachment/blindness

190
Q

What are the ocular features of hypertension?

A 
Arteriolar narrowing and A-V nicking
Cotton wool spots
Retinal haemorrhages
Optic nerve swelling
Retinal ischaemia and neovascularisation
191
Q

What is thyroid eye disease?

A

An orbital inflammation affecting up to 40% of patients with autoimmune thyroid gland disease.

192
Q

What are the clinical features of thyroid eye disease?

A 
Swelling of lids
Chemosis of conjunctiva
Exposure of cornea 
Pronounced exophthalmos/proptosis
Restricted eye movements
Optic neuropathy
193
Q

What is the treatment of thyroid eye disease?

A 
Artifical tears and lubrication
Stop smoking
Oral selenium 
Systemic steroids if sight threatening
External beam radiation
194
Q

What is the surgery for thyroid eye disease?

A

Orbital decompression surgery
Eye muscle surgery
Eye lid surgery

195
Q

What is the definition of papilloedema?

A

Bilateral optic disc swelling secondary to raised ICP

196
Q

How can papilloedema cause visual loss?

A

Optic atrophy

197
Q

What are the further investigations of papilloedema?

A

CT
LP
Venogram

198
Q

What are the ocular signs of Marfan’s syndrome?

A 
Ectopia lentis
Flattened cornea
Keratoconus
Myopia
Amblyopia
Strabismus
Retinal detachment

Fifth Year Medicine (9 decks)

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