Ophthalmology Flashcards
What do these red flags of diplopia suggest?
- Pupil involvement in CNIII
- Affects 2 or more of lip, pupil and eye
- Multiple CN palsies
- Weakness or fatigue
- New-onset headache and scalp tenderness
- Papilloedema
- Posterior communicating artery aneurysm
- Horner’s e.g. carotid dissection or inflammatory
- Tumour
- Myasthenia gravis
- GCA
- Raised ICP
What are some causes of diplopia? (4 categories)
Cornea and lens e.g. cataracts, corneal scarring
Eye muscles e.g. myasthenia, Grave’s
Nerves e.g. MS, GBS, diabetes, inflammation
Brain e.g. SOL, stroke
What are the signs of:
- Oculomotor palsy (3)
- Trochlear nerve palsy (3)
- Abducens nerve palsy (1)
- Ptosis, fixed pupil dilation, eye looking down and out
- Cannot look down and in, head may be tilted, symptoms worse going down stairs
- Eye medially deviated
What is the management for diplopia? (2)
Stop driving - can restart if corrected
Refer to orthoptist e.g. patches, prisms, surgery
What is the management of conjunctivitis? (4)
How long should it take to resolve?
Topical lubricants, avoid contact lenses, avoid sharing towels, good hand hygiene
1-2 weeks
What is episcleritis associated with? (2)
Rheumatoid arthritis
IBD
How long do subconjunctival haemorrhages take to resolve?
2 weeks
What specific symptom would differentiate the following?
- Anterior uveitis
- Acute closed angle glaucoma (2)
- Scleritis
- Keratitis
- Herpes zoster opthalmicus
- Irregular shaped pupil
- Fixed pupil, systemic upset
- Severe “boring” dull ache
- Vesicles around eye
- Vesicular rash going to tip of nose
What is the management of:
- Anterior uveitis?
- Acute closed angle glaucoma? (2)
- Scleritis?
- Steroids, mydriatic cyclopegic drops
- Acetazolamide peripheral iridotomy
- NSAIDs and steroids
What are some causes of central retinal artery occlusion? (5)
What shouldn’t you forget???
Atherosclerosis Embolism Inflammatory e.g. GCA Infection Medication e.g. OCP, cocaine
ESR for GCA!
What is the management of retinal detachment? (2)
Cryotherapy/laser photocoagulation
Vitrectomy
Which eye drops cause?
- Dilation of pupil? (6)
- Constriction of pupil? (1)
- Cyclopentolate, atropine, tropicamide (CAT), phenylephrine, adrenaline, dipivefrine (PAD)
- Pilocarpine
What are the investigations for age-related macular degeneration? (3)
Slit lamp
Colour fundus photography
Ocular coherence tomography (OCT) - cross section of retina
What type of vision loss does glaucoma tend to present with?
What will be found on examination? (2)
Loss of peripheral vision (tunnel vision)
Reduced peripheral fields, cupping of optic disc
What investigations do you need to diagnose glaucoma? (5)
Slit lamp IOP measurement e.g. tonometry Corneal thickness Measure of angle e.g. gonioscopy Measure visual fields e.g. perimetry
