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Year 4 - Special Senses > Ophthalmology - Other > Flashcards

Ophthalmology - Other Flashcards

1
Q

What is the function of eyelids?

A

Prevent the eye from drying out.

Protect the eye from foreign bodies and excessive light.

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2
Q

What is the function of meibomian glands?

A

Modified sebaceous glands that produce the lipid outer layer of tear film.

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3
Q

What is blepharitis?

A

Inflammation of the eyelid, causing dry eye disease.

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4
Q

Aetiology of blepharitis.

A

Congestion and inflammation of eyelash follicles and meibomian glands.

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5
Q

Presentation of blepharitis.

A

Bilateral symptoms:
- ocular irritation
- foreign body sensation
- burning
- redness
- crusting
- watering of the eye

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6
Q

Treatment and prevention of blepharitis.

A

Lid hygiene:
- warm compression of eyelids
- eyelid massage
- cleaning eyelids with cotton wool

Topical antibiotic ointment can be applied to reduce bacterial colonisation.

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7
Q

Aetiology of a stye.

A

Staphylococcal infection of an eyelash follicle.

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8
Q

Presentation of a stye.

A

Tender, red eyelash follicle swelling.

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9
Q

Management of stye.

A

Often resolves spontaneously; encourage lid hygiene:
- warm compression of eyelids
- eyelid massage
- cleaning eyelids with cotton wool

Other treatments may include:
- removal of eyelash
- incisional drainage
- topical antibiotics

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10
Q

What is chalazion?

A

Granulomatous inflammatory lesion forming in an obstructed meibomian gland.

NOT infective.

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11
Q

Presentation of chalazion.

A

PAINLESS red eyelid cysts, in the internal eyelid.

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12
Q

Management of chalazion.

A

Often resolves spontaneously; encourage lid hygiene:
- warm compression of eyelids
- eyelid massage
- cleaning eyelids with cotton wool

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13
Q

What is entropion?

A

Age-related inward turning of the eyelid.

Inward-turning eyelashes may irritate the cornea, causing ulceration and risking sight loss.

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14
Q

Management of entropion.

A
  • examination for corneal abrasion / keratitis
  • frequent lubrication eyedrops
  • referral to ophthalmology for surgical correction
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15
Q

What is ectropion?

A

Age-related outward turning of the eyelid*.

This causes a disruptive tear drainage, resulting in a sore and watery red eye.

*associated with CNVII palsy (Bell’s palsy)

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16
Q

Management of ectropion.

A
  • lubricating eye drops
  • taping the eyes shut
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17
Q

What is trichiasis?

A

Eyelashes grow inwards due to damage eyelash follicles, irritating the cornea:
- corneal ulceration (keratitis)
- sight loss

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18
Q

Management of trichiasis.

A

Often resolves spontaneously; encourage lid hygiene:
- warm compression of eyelids
- eyelid massage
- cleaning eyelids with cotton wool

Electrolysis or laser ablation can destroy the lash follicle and may provide a permanent solution.

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19
Q

What is the purpose of topical mydriatics?

A

Dilating eye drops to facilitate examination of the eye with an ophthalmoscope or slit lamp.

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20
Q

Which topical mydriatics are used most commonly?

A

Tropicamide and phenylephrine - dilatory effects wear off sooner.

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21
Q

What is the purpose of fluoresceine sodium 1% eyedrop?

A

Fluorescent dye applied in slit-lamp examination to allow visualisation of corneal defects.

22
Q

What is the purpose of anaesthetic eyedrops?

A
  • ophthalmic surgery
  • intraocular pressure measurement (Goldmann applanation tonometer)
  • examination of eye
23
Q

What classes of medications are used to reduce intra-ocular pressure in the context of glaucoma?

A
  • alpha agonists
  • beta-blockers
  • carbonic anhydrase inhibitors
  • prostaglandin analogues
  • cholinergics
24
Q

Alpha agonist eye drops.

a) examples

b) MOA

c) side effects

A

a) iodipine

b) decrease production of aqueous humour in anterior chamber, reducing IOP.

c) headache; dry mouth; dry nose

25
Q

Beta-blocker eye drops.

a) examples

b) MOA

c) side effects

A

a) timolol maleate

b) decrease production of aqueous humour in anterior chamber, reducing IOP.

c) hypotension; bradycardia; bronchospasm; reduced libido; depression

26
Q

Contraindications to beta blocker eyedrops.

A

Bronchospasm: asthma; COPD

Bradycardia: heart failure

27
Q

Carbonic anhydrase eye drops.

a) examples

b) MOA

c) side effects

A

a) acetazolamide

b) decrease production of aqueous humour in anterior chamber, reducing IOP.

c) paraesthesia

28
Q

Prostaglandin analogue eye drops.

a) examples

b) MOA

c) side effects

A

a) latanoprost; bimatoprost

b) increase aqueous outflow of the eye, reducing IOP.

c) long eyelashes; hyperpigmentation

29
Q

Cholinergic eye drops.

a) examples

b) MOA

c) side effects

A

a) pilocarpine

b) miosis stops crowding of trabecular meshwrok, opening the angle (used in AACG)

c) blurred vision; flushing

30
Q

What is the role of artificial tear eyedrops?

A

Sooth burning, gritty sensation of the eye and associated blurring of vision.

Helps to keep the eye hydrated.

31
Q

What is strabismus?

A

AKA squint.

Eyes do not properly align with each other when focusing to look at an object.

32
Q

Causes of strabismus.

A

Primary:
- idiopathic
- congenital

Secondary:
- CN palsy
- intracranial infection
- space occupying lesion
- myopathies
- orbital fracture

33
Q

Risk factors for strabismus.

A
  • family history
  • low birth weight
  • prematurity
  • maternal smoking
34
Q

Red flags of strabismus.

A
  • recent trauma
  • symptoms of raised intracranial pressure
  • new strabismus in school-age child
35
Q

What is anisocoria?

A

Unequal size of pupils.

36
Q

Causes of a constricted pupil.

A
  • RAPD
  • trauma
  • Horner’s syndrome
  • anterior uveitis
  • pharmacological (opioids)
37
Q

Causes of Horner’s syndrome.

A
  • stroke
  • MS
  • Pancoast tumour
  • thyroid mass
  • cervical rib
  • carotid artery dissection
  • cavernous sinus thrombosis
  • cluster headache
38
Q

Patient presenting with an acute history of Horner’s syndrome, neck pain and dysphagia.

A

Urgent MRI to investigate for carotid artery dissection.

39
Q

Causes of a dilated pupil.

A
  • Aide’s pupil
  • oculomotor nerve palsy
  • pharmacological (atropine, MDMA, ecstacy, beta blockers)
40
Q

What is Aide’s pupil?

A

A benign condition secondary to infection of the ciliary ganglion.

Results in a poor light reflex, and a slow accommodation reflex.

41
Q

Features of thyroid eye disease.

A

NO SPECS

No signs or symptoms
Occular irritation (dryness, gritty)
Soft tissue involvement (conjunctival oedema, injection)
Proptosis
Extraocular muscle involvement
Corneal exposure
Sight loss

42
Q

Laboratory investigations for thyroid eye disease.

A
  • TFTs
  • antibody testing (TSH-receptor antibodies, anti-TPO antibodies)
43
Q

Imaging for thyroid eye disease.

A
  • ultrasound scan (?extraocular muscle enlargement)
  • CT orbit (?optic nerve involvement)
44
Q

Management of thyroid eye disease.

A

In severe cases, steroids given to reduce inflammation and swelling.

45
Q

Complications of thyroid eye disease.

A

-loss of sight
- eye popping out
- gaze abnormalities
- raised IOP

46
Q

What is amblyopia?

A

Lazy eye - a reduction in visual acuity due to an insult in the visual pathway during the critical period of visual development.

47
Q

What period is considered to be critical for visual development?

A

Birth to three months of age.

Visual development continues in some capacity until the age of 7.

48
Q

Causes of amblyopia.

A

Ocular pathology (e.g. squint, high refractive error) interferes with normal cortical visual development.

This results in reduced visual acuity with no structural eye problem.

49
Q

Management of amblyopia.

A
  • eliminating obstacle to vision (e.g. cataracts)
  • correcting refractive error
  • forcing the use of the poorer eye (patching)
50
Q

Complications of amblyopia.

A

Permanent reduced visual acuity.

Poor co-operation with patching is common; can give atropine eyedrops to weaken good eye.

Year 4 - Special Senses (17 decks)

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