Ophthalmology - Facts from PassMed Questions Flashcards
Hypermetropia is associated with:
a) Primary open-angle glaucoma
b) Acute angle closure glaucome
b)
Due to their eyes being smaller, having shallower anterior chambers and their angles being narrower
(Myopia and primary open angle are linked)
Pathophysiology of a squint
Imbalance of extrocular muscles
How to detect a squint
Corneal light reflection test - hold a light source 30cm away from child and see if light hits the pupils symmetrically
Management of a squint
Refer to ophthalmology - they may give an eye patch
Investigation into nature of squint
Cover test - cover one eye and see how the other moves
Management of anterior uveitis
Urgent review by optho
Cycloplegics - dilates pupil to help relieve pain and photophobia e.g. atropine
Steriod eye drops
Herpes Zoster Ophthalmicus Mx
Oral antiviral treatment started within 72 hrs - giev for 7-10 days
IV used for severe infection
Topical steroids - used to treat secondary inflammation of eye
Urgent ophtho review - if ocular involvement (Hutchinson’s sign)
What do cotton wool spots represent
Areas of retinal infarcion - pre capillary arteriolar occulsion
Investigations for Macular degeneration
Slit lamp
Fluorescein angiogrpahy - this can guide intervention eith anti-VEGF therapy
Ocular coherence tomography - used to visulaise the retina
Macular degenration Mx
Zinc and antioxidant treatment
anti-VEGF treatment - e.g. ranibizumab. 4 weekly injections
Laser photocoagulation - use if new vessel formation
Pathophysiology of Age-related macular degenration
Degeneration of retinal photoreceptors that reulst in the formation of drusen - seen on fundoscopy
Difference between episcleritis and scleritis - vessel mobility and pain
In episcelritis, the injected vessels are mobile when gentle pressure is applied on the sclera.
In scleritism vessels are deeper, hence do not move
Epi - no pain (little pain)
Scler - painful
What condition presents with night blindness and tunnel visison
Retinitis Pigmentosa (Retinal = Re 'Tunnel' vision and Tunnel's are dark ...night blindness
What is alport’s syndrome?
Kidney disease + Hearing loss + Eye anbnormality
Hypertensive retihnopathy Grading
I - Arteriole narrowing and tortuosity. Increased light reflex - silver wiring
II - Arteriovenous nipping
III - Cotton wool exudates. Blot haemorrhages
IV - Papilloedema
What form of metabolic disruption predisposes someone to cataract formation
Hypocalceamia
Signs of blepharitis
Bilateral red sore eyelids
Dry gritty eyes
Mx of blepharitis
Hot compress & mechanical removal of lid debris
Artificial tears
Pathophysiology behind belpharitis
Inflammation of eyelid margins.
Due to meibomian gland dysfunction - they secrete oil onto the eye surface so any condition that affects these, will cause dry eyes
High Co2 / Low Ca2 = …
Papilloedema
Purulent discharge and crusting of eyelids in newly born baby - what do you do?
Urgent swabs for micro investigation - it is common but it may indicate severe infection (chlamydia or gonococcus) so you must investigate
Start systemic abx treatment for possible infection while awaiting lab results
Features of Horner’s syndrome
Miosis
Ptosis
Enophthalmos (sunken eye)
+/- anhidrosis (loss of sweating on affected side)
What disease is associated with anterior uveitis
Crohn’s disease
What is used to investigate a refractive error as a cause of blurred vision?
Pin hold occluder
Contact lense wearers presenting with a red eye
Refer for same day ophtho assessment - at risk of microbial keratitis
