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BSAVA ECC > Ophthalmology Module 1 > Flashcards

Ophthalmology Module 1 Flashcards

1
Q

What CN nerves are used in PLRs

A

CN 2 & 3

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2
Q

What cranial nerves are involved in menace reponse

A

CN 2 & 7

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3
Q

What cranial nerves are involved in the dazzle reflex

A

CN 2 & 7

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4
Q

What cranial nerves are involved in the palpebral reflex

A

CN 5 & 7

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5
Q

What is proptosis

A

Acute forward displacement of the globe with entrapment of the eyelids

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6
Q

What can cause proptosis

A

Blunt trauma, bite on the head, brachycephalics (predisposed due to shallow orbits)

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7
Q

What are prognostic indicators with proptosis

A

Good: If there is movement of the eye, if PLRs are present (posterior segment of eye intact)
Bad: 2 or more avulsed muscles, compromised globe due to scleral rupture

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8
Q

What are methods for fixing proptosis

A

Lubricate, cleanse, temporary tarsorrhaphy and may need lateral canthotomy

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9
Q

What aftercare should be give post temporary tarsorraphy?

A

Antibiotics (chloraphenicol, triple abs, oxytet), broad spectrum abs, systemic corticosteroids at anti-inflam doses, remove sutures

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10
Q

complications for proptosis

A

blindness (20-28% regain vision due to stretching of optic nerve), strabismus, sensory deficit to cornea, KCS, exposure kertatitis, cataract formation, lens luxation, phthisis bulbis

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11
Q

What is ophthalmia neonatorum?

A

Neonatal conjunctivitis - syndrome of acute conjunctival inflammation in neonates - FHV -1 in cats, staph, fecal contaminants

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12
Q

How do you treat ophthalmia neonaturum?

A

Irrigate with saline or dilute iodine, BS antibiotics 4-6 times daily and constant lubrication

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13
Q

how can ulcers be classified

A

depth of corneal involvement, superficial, stromal, descemetocele, perforation

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14
Q

What are the basics of superficial ulcer management

A
  1. Treat inciting cause
  2. Topical abs - flora on epithelium not present on stroma so will sent up infection
  3. Pain control: conreal pain receptor stimulation can results in uveitis (tropicainamide, atropine)
  4. E-collar
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15
Q

Stromal ulcer management

A
  1. Ab therapy - fluoroquinolone + chloramphenicol every 4 hrs
  2. Topical atrophine (one dose per 12-24 hrs for 1-2 days)
  3. Topical anti-proteinase - anti-collagenase - 1-2 hrs till healing under way and then 4-6 hrs
  4. Systemic pain relief
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16
Q

Corneal perforation management

A
  1. E-collar
  2. Systemic abs and pain relief
  3. topical abs
  4. Surgery - flaps v. enucleation
17
Q

What does corneal laceration treatment depend on?

A

If less than 50% - Treat as an ulcer
If more than 50% surgical management and referral

18
Q

What is glaucoma?

A

A group of ocular diseases that result in progressive retinal ganglion cell death and optic nerve degeneration

19
Q

How is IOP determined?

A

IOP is determined by AH production verse outflow

20
Q

Where and how is the aqueous humor produced?

A

It is produced in the posterior segment by the non-pigmented epithelium of the ciliary body. Circulates from ciliary body to pupil and then to anterior chamber

  1. Principle mechanism of AH formation is through active secretion (80-90% of AH) this is catalysed by carbonic anhydrase (50-60%)
  2. Diffusion
  3. Ultrafiltration
21
Q

Ways of AH outflow

A

Conventional outflow: Travels from anterior chamber to iridiocorneal angle and ciliary cleft to reach the venous system

Unconventional outflow: small percentage of AH is also drained by stroma of iris, ciliary body and choroids to reach the venous system

22
Q

Glaucoma classifications

A
  1. Congenital - development abnormalities in AH flow route
  2. Primary - changes in iridiocorneal angle - hereditary/bilateral (open/close/narrow) 4-10yrs presentation
  3. Secondary - disease that blocks iridiocorneal angle
23
Q

Acute glaucoma treatment

A
  1. Prostaglandin analogues (Latanoprost, Travoprost) - not if lens luxation or secondary to anterior uveitis
  2. CAIs - first line in cats
  3. Timolol - topical beta-blocker to use in cobo with CAI
  4. Mannitol
24
Q

What is uveitis? what types are possible?

A

Inflammation fo uveal tract - iris, ciliary body and choroid
Anterior uveitis
Posterior uveitis
Pan uveitis
also acute, subacute and chronic

25
Q

If untreated what can result due to acute uveitis?

A

development of permanent structural lesions that may result in - secondary glaucoma, cataracts, retinal detachments

26
Q

What are DDX for red, painful eyes

A

glaucoma, corneal ulceration, scleritis, uveitis

27
Q

How to treat uveitis?

A
  1. Topical AI therapy - steroids once ulcer ruled out 3-6 times daily (pred acetate)
  2. Topical AI therapy - NSAIDs (can be used concurrently) 6-12hr - can be used with ulcers if concurrent uveitis
  3. parasympathlytic drygs - atropine, tropicamide
28
Q

Why is atropine useful for uveitis?

A

Pain relief: Paralyses ciliary body and causes mydriasis
Minimises posterior synchiae forming (adhesions between vitrous and lens capsule)
Decreses intraocular inflammation by blocking acetylcholine
not for glaucoma

29
Q

Causes of hyphema

A

Trauma
Infection/uveitis
neoplasia
immune-mediated
coagulopathy
congenital ocular disease

30
Q

Lens luxation classification

A
  1. Congeital - lens instability caused by abscence of zonular gibers
  2. Primary luxation: inherited zonular defect, 3-6yrs old, bilatearly disorder
  3. secondary: caused by hypermature cataracts, chronic glaucoma, neoplasia
  4. Feline lens luxation: secondary to uveitis or glaucoma
31
Q

Lens luxation treatment - anterior worst

A
  1. Topical CAI
    anterior lens lux - AVOID prostaglandin analogues
  2. removal of lens surgically
  3. if not surgical dilate pupil and drop lense into posterior chamber
32
Q

Causes of acute blindness

A
  1. Lesions that produce opacification of the ocykar media
  2. Lesions that cause failure of the retina to process the image
  3. Lesions that impede transmission or relay of message through the visual pathways
  4. Lesions that cause failure of the final processing of the image in the visual cortex

BSAVA ECC (31 decks)

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