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Step 3 > Ophthalmology High Yield Questions > Flashcards

Ophthalmology High Yield Questions Flashcards

1
Q

Presbyopia (also known as age-related nearsightedness

) is 2/2 what?

A
  • 2/2 loss of elasticity of the crystalline lens
  • results in decreased accommodating power when seeing objects at arm’s length or closer
  • image focuses behind the retina
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2
Q

Amblyopia (strabismus: MC; Refractive error 2nd MC)

Tx question?

A
  • Patching or optic penalization
  • patching: occluding the “better” eye to encourage use of the amblyopic eye
  • optic penalization: atropine, a cycloplegic (i.e. anticholinergic therefore dilator), is added to the “better” eye
  • both are equally effective
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3
Q

Lens dislocation direction is a/w what etiology?

Superior?
Inferior?
Variable?

A

superior dislocation: Marfan syndrome

inferior dislocation: homocystinuria

variable dislocation: Alport’s Syndome

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4
Q

Pterygium (Fleshy benign growth from conjunctiva onto the nasal side of the cornea a/w wind, sand, sun, dust)

Higher incidence in what countries?

A

countries closer to equator

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5
Q

Subconjunctival Hemorrhage

Tx?

A

Observation b/c typically resolves in 24-48 hours

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6
Q

Viral Conjunctivitis

Tx?

A

Treatment: self limited; warm compresses for symptomatic relief; no medical treatment

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7
Q

Allergic conjunctivitis

Presentation/hallmark symptoms

A

painless
marked puritis (ITCHY=Hallmark)
bilateral watery eyes

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8
Q

Herpes Simplex Keratoconjunctivitis (Corneal involvement is often precipitated by topical or systemic corticosteroid treatment)

Evaluation?
Tx?

A
  • Fluoroscein stain examination
  • exam exhibits a shallow ulcer with a dendritic appearance and irregular borders

Tx: Topical antivirals: idoxuridine, vidarabine, trifluridine

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9
Q

Trachoma: Caused by Chlamydia trachomatis serotype A-C and PE demonsrates a pannus formation on cornea

Constant corneal irritation results in …?

Treatment?

A
  • Constant corneal irritation results in conjunctivitis and **neovascularization

Tx:

  • *1. topical tetracycline
    2. oral azithromycin
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10
Q

Uveitis
Caused by…
Tx?

A
  • Autoimmune Disorders
    1. alkylosing spondylitis
    2. juvenile rheumatoid arthritis
    3. inflammatory bowel disease
    4. sarcoidosis
  • *5. trauma or ophthalmic surgery can cause a similar condition sympathetic ophthalmia
  • Infection
    1. cytomegalovirus
    2. syphillis
    3. tuberculosis

Tx: roids

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11
Q

Endophthalmitis

What is it?
Tx?

A
  • infection on the vitreous fluid that classically follows an eye operation

Tx: intravitreal antibiotics

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12
Q

Cataracts
Symptoms?
Physical exam?

A

Symptoms**
- painless, progressive, and slow vision loss
- Physical exam
absent red reflex

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13
Q

Diabetic Retinopathy

Proliferative? TX?

A
  • result of vessel growth in the retina (neovascularization)**

TX:

  • medical: VEGF inhibitors (bevacizumab)
  • surgical: pan retina laser treatment
  • tight glucose control
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14
Q

Diabetic Retinopathy

Non-Proliferative? TX?

A
  • result of ischemic and edema damage to the retina

TX:

  • surgical: focal retina laser treatment
  • tight glucose control
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15
Q

Dry Age-Related Macular Degeneration (ARMD)

Treatment ?

A

zinc and antioxidant vitamins

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16
Q

Wet Age-Related Macular Degeneration

Treatment?

A

wet-ARMD
VEGF inhibitors (e.g., bevacizuzmab)
photodynamic therapy
zinc and antioxidant vitamins

17
Q

Retinal Detachment

A
  • ***painless sudden vision loss
  • photopsia (sudden flashes or light)
  • “floaters” in the visual field
    (the extent of retinal detachment can be assessed by the number of floaters present)

Physical exam
- gray, elevated retina

18
Q

Retinal Artery Occlusion

when is it termed Amaurosis Fugax?

A

If the plaque is small and vision spontaneously returns with passage of the clot, it is termed amaurosis fugax

19
Q

Retinal Artery Occlusion/ Amaurosis Fugax

Symptoms and Diagnostic test

A
  • sudden, painless, and complete loss of vision in one eye

- must evaluate the carotid artery: options are Doppler or CTA/MRA

20
Q

Retinal Artery Occlusion/Amaurosis Fugax

Non-surgical tx option if surgical intervention is not readily available?

A
  • digital massage of globe
  • CO2 rebreathing & ocular massage
  • both function to dilate retinal vessels in an attempt to pass the clot into a distal segment of the occluded vessel
21
Q

CMV Retinitis: Painless vision loss

  • Seen most commonly in HIV positive patients with CD4+ counts < 50; these patients are also at risk for HSV retinitis which presents similarly but is associated with eye pain

Fundoscopy exam show?
Tx?

A
  • yellowish-white patches of retinal opacification
    note that in HSV retinitis the findings include peripheral lesion and central necrosis of the retina

Tx: valgancyclovir

22
Q

Open Angle Glaucoma Sx

A
  • usually asymptomatic

- insidious onset of peripheral vision loss

23
Q

Close (angle-closure) Glaucoma

Sx?
Evaluation?

A
  • acute onset of blurry vision
  • painful
  • halos around lights
  • ↓ vision (photophobia/blurry vision)
  • perform a Gonioscopy: gold standard for angle-closure glaucoma
24
Q

Close (angle-closure) Glaucoma

Tx?

A
  • iridotomy
  • topical β-blockers and α2-agonists
  • oral carboanhydrase inhibitors (acetazolamide)

** Contradicted: epinephrine b/c alpha 1 α1-agonism causes mydriasis

25
Q

Optic Neuritis: inflammation of optic nerve

2/2

A

*** ethambutol -TB drug

highly a/w Multiple sclerosis

26
Q

Chalazion

Sx?
Eval?

A
  • swelling on conjunctival surface of eyelid
  • not associated with pain

Evaluation:
- histopathologic examination required to rule out mallignancy

27
Q

Hordeolum (stye)

A
  • Inflammation of external sebaceous gland of the eyelid caused most commonly by S. aureus infection
  • I+D if warm compress doesn’t treat w/I 48 h
28
Q

Orbital Cellulitis: infection of the orbit (posterior to the orbital septum)

what Physical exam findings distinguishes It from preorbital cellulitis?

A
  • Eye pain
  • opthalmoplegia
  • proptosis
  • decreased visual acuity
29
Q

Dacryocystitis

A
  • inflammation and tenderness of nasal aspect of lower lid

- purulent discharge may be present

30
Q

chronic dacryocystitis

tx?

A

Dacryocystorhinostomy for chronic dacryocystitis

31
Q

Intraocular Foreign Body

first exam?

A
  • a slit-lamp examination with fluorescein stain is performed
  • followed by a CT

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