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AMK > Ophthalmology Pathology > Flashcards

Ophthalmology Pathology Flashcards

1
Q

what is it

Papilloedema

A

swelling of the optic disc due to increased intracranial pressure

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2
Q

what is it

Optic neuritis

A

-inflammation damages the optic nerve

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3
Q

what is it

Central retinal vein occlusion

A

PAINLESS loss of vision
Stormy sunset appearance
sudden loss of vision with relative afferent pupillary defect (when the affected eye won’t constrict when light is shone through)

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4
Q

what is it

Central retinal artery occlusion

A

Pale retina
Cherry red spot on macula

causes: thrombus, which can be causing blockage in the blood supply through the retinal artery

do carotid doppler to detect exactly where it is

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5
Q

what is hypopyon

A

fluid in the cornea

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6
Q

what is corneal arcus

A

white, blue or opaque ring

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7
Q

what is a Kayser-fleischer ring

A

copper ring around the cornea

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8
Q

what is posterior synechiae

A

irregular looking pupil

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9
Q

keratitis - what is it

A

white collection in the cornea

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10
Q

what is retinal detachment

A

when blood vessels bleed in the eye and cause scarring
blood pools in the retina causing it to detach

causes new onset loss of vision

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11
Q

what can cause retinal detachment

A

diabetes mellitus

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12
Q

patient recently had cataract surgery,
now there is inflammation in their eye redness and blurred vision

A

endophthalmitis

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13
Q

red macula
sudden painless loss of vision

A

central retinal artery occlusion

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14
Q

what are Roth spots

A

retinal haemorrhages with a white spot
found in infective endocarditis

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15
Q

what are the symptoms found in retinal detachment

A

flashes and floaters
reduced visual acuity and ‘curtain falling down’§

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16
Q

patient has one sided headache
jaw claudation
reduced visual acuity
raised ESR and CRP
swollen, chalky white optic disc

what is the most likely cause

A

anterior ischaemia optic neuropathy

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17
Q

what is anterior ischaemia optic neuropathy

A

infarction of the posterior ciliary arteries which supply the optic nerve head

common mechanism of visual loss in giant cell arthritis

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18
Q

what is giant cell arthritis

A

Giant cell arteritis causes inflammation of certain arteries, especially those near the temples. The most common symptoms of giant cell arteritis are head pain and tenderness — often severe — that usually affects both temples.

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19
Q

episcleritis

A

benign cause behind redness in the episclera
presents with deep pain in the eye that wakes the patient up at night
associated with rheumatoid arthritis

can cause blindness
COMMON IN YOUNGER PATIENTS

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20
Q

scleritis

A

redness in the sclera
deep pain in the eye
COMMON IN OLDER PATIENTS
photophobia
blurred vision

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21
Q

what is oribital cellulitis

A

infection of the eyeball and tissues around it
common in younger children

red, hot eye
eye pain
ophthalmoplegia - paralysis of the extraoccular muscles that control movements of the eye
ptosis - drooping of the eyelids
loss of vision

CLINICAL EMERGENCY

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22
Q

what is a chalazion

A

one of the glands in the eye gets blocked and so becomes swollen
- pain-free swollen gland
- more chronic
- use antibiotics and then excision and drainage

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23
Q

what is a stye

A

when the sebaceous glands inside the eyelids get swollen - they are the eyelash glands
-painful lump along the lid margin
- acute inflammation
- pull the eyelash to drain the pus

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24
Q

what are pan coast tumours

A

pan coast tumours are tumours that occur in the apex of the lung (top of the lung)
- when this gets bigger it can spread and affect the nerves of the eye
- this causes Horners syndrome
- this can cause weakness of the upper lid and ptosis

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25
Q

what is Horners syndrome

A

nervous supply to the eye is done like this:
three neurone pathway from the hypothalamus to the eye
- damage to any part of the pathway causes Horners syndrome
- symptoms consist of:
1. ptosis
2. constricted pupil
3. enophthalmos

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26
Q

what are the risks of being severely myopic

A
  • eye ball changes shape to be like a rugby ball
  • this can cause the retina to stretch and cause tears in the retina
  • the tears in the retina causes:

bright flashing lights
flashers and floaters
curtain falling

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27
Q

what is an ocular migraine

A

brief attacks of blindness or visual impairment
flashing lights are seen

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28
Q

eye symptoms in an TIA

A

seems like a curtain is falling
blood supply to the brain is affected
and also causes hemi-paralyses

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29
Q

risks of being hyperopic

A
  • acute angle closure glaucoma is very common
    due to the eyeball being really small
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30
Q

what is giant cell arthritis

A

inflammation of the lining of the arteries
effects the temples
common in older patients
causes loss of vision and jaw claudication

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31
Q

what is optic neuritis

A

when inflammation goes onto damaging the optic nerve bundle
painful eye movements and temporary loss of vision in one eye
associated with multiple sclerosis

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32
Q

symptoms of acute primary angle closure glaucoma

A

headache
red watery eye and mid-dilated pupil

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33
Q

scleritis

A

when the white layer of the eye gets inflamed and turns red
common in rheumatoid arthritis

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34
Q

virtesous haemorrhage

A

boat shaped bleed in the eye
caused by type 2 diabetes

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35
Q

neovascular glaucoma

A
  • high pressure in the eye
  • artery and vein is occluded
  • this means that there is less blood flow to the frontal arteries
  • causes inflammation
  • and therefore increased pressure in the eye
  • can be a result of type 2 diabetes
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36
Q

what is hypopyon

A

pus in the anterior chamber

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37
Q

bacterial keratitis

A

bacterial infection of the cornea due to staph aureus or Pseudomonas aeruginosa

it is found in people who wear contact lenses and then are exposed to contaminated water
this causes the amoebae to enter

  • causes eye pain and redness
  • reduced visual acuity
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38
Q

hyperlipidemia causes what?

A

corneal arcus - which is green/yellow deposits on the cornea

this is due to lipid deposits in the cornea

39
Q

thyroid eye disease

A

eye muscles, eye lids and tear glands become inflamed - this causes the eyes to become red, pushed forward (proptosis) and lagophthalmos - cannot fully close the eye lids

40
Q

orbital compartment syndrome

A
  • happens due to acute rise in intraoccular pressure
  • if not managed immediately it can cause severe damage to the retina and optic nerve
  • emergency treatment is - lateral canthotomy
  • this involves exposing the lateral cantonal tendon to release the intraoccular pressure
41
Q

Amblyopia - what is it

A

‘lazy eye’ which happens in young children

42
Q

what is dacryocystitis

A

infection of the lacrimal sac of the eye - the tear duct gets blocked
causes pain and watering of the eye

43
Q

anterior uveitis is associated with what?

A

eye pain, swelling of the eye
photophobia
blurring vision

and - patient also have ankylosing sponditis - which is back stiffness and backache

44
Q

optic neuritis

A

an inflammatory demylienation of the optic nerve
- due to the activation of the T cells that cause hypersensitivity reaction

  • can be due to multiple sclerosis or autoimmune conditions

The clinical diagnosis of ON consists of the classic triad of:

Visual loss
Periocular pain
Dyschromatopsia

MRI head is done to investigate

45
Q

herpes simplex keratitis

A

painful red eye
photophobia
causes a dendritic ulcer - green defect in the shape of the dendrite

46
Q

what is primary open angle glaucoma

A

when the IOP is >21mmHg
and the anterior chamber angle is open
or if the IOP is normal but the glaucoma is due to optic nerve damage
- the drainage system is clogged
- slowly
- so gradual onset
- the angle between the iris and cornea is open

47
Q

what is a glaucoma

A

pressure in the eye increases, if this is not managed then it can press against the optic nerve and damage it

the drainage system that runs in the anterior chamber for fluids that lubricate the eye gets blocked - increasing pressure

48
Q

symptoms of open angle glaucoma

A

loss in peripheral vision
the outer rim of the nerve is damaged
central vision can be lost too

49
Q

close angle glaucoma

A

the angle between the cornea and iris is closed - it is too small for the fluid to drain
- this causes the drainage to be blocked
- rapid increase in pressure

sudden onset
- redness
eye pain
blurry vision and headache

50
Q

scleritis - symptoms

A

severe pain in the orbit and pain on eye movement
severe inflammation of the sclera
worse at night
common in those with rheumatoid arthritis

does not blanch
steroids and NSAIDs are used to manage

51
Q

acute angle closure glaucoma

A

nausea and headaches
blurred vision and halos
fixed-dilated pupil

52
Q

anterior uveitis

A

red eye
pain
blurred vision
photophobia

53
Q

corneal ulcer

A

pain
photophobia
watery eyes
can be due to use of contacts

54
Q

cluster headache

A

pain around the eye
blood-shot eye
comes in clusters
swelling
watery eyes

55
Q

optic neuritis

A

ocular pain on movement
common symptom of multiple sclerosis

56
Q

corneal abrasion

A

damage to the corneal epithelium
pain
photophobia
reduced visual acuity
can be due to injury

57
Q

keratitis

A

corneal inflammation
infective or non-infective
painful red eye
photophobia
white density around the cornea

58
Q

keratitis

A

corneal inflammation
infective or non-infective
painful red eye
photophobia
white density around the corneae

59
Q

Chorioretinitis - what is it

A

it is the inflammation of the choroid, which is a lining of the retina deep in the eye.

it can be caused by Cytomegalovirus due to injecting drugs

60
Q

when a patient is given prednisolone for GCA but then they get an infection what do you do with the dosage of the steroids?

A

you double the dose as during infection, steroid levels are lower, so many of the steroids will be excreted

61
Q

Subconjunctival haemorrhage - what is it

A

bleeding under the conjunctiva
it is painless
can be due to trauma, straining etc

62
Q

management of chalzaion

A

warm compress

unless they get really big and cause Vision issues then use incision and curretage

63
Q
  • what is - Dry age related macular degeneration (Dry AMD)
A

thinning of the macula
common in older patients
it is the gradual loss of vision

64
Q

what is relative afferent pupillary defect

A
  • when light is shown in one eye, but both eyes respond differntly
65
Q

what is endophthalmitis

A

It is a common complication of a cataract surgery, which presents after a few days

It is an inflammation of the anterior cavity of the eye, mainly due to infection, causes a red painful eye

66
Q

what are the symptoms of anterior uevitis

A
  • It is the information of the iris, and ciliary bodies which causes pause and redness in the anterior chamber.
  • It can present with photophobia and pus, pain and gradual vision loss.
67
Q

closed angle glaucoma symptoms

A

there is a rise in intraocular pressure secondary to an impairment of aqueous outflow. It is characterised by severe eye pain, a hard, red eye and a non-reactive pupil

generally starts off asymptomatic until a little more advanced

fixed mid-dilated pupil

68
Q

open angle glaucoma symtpms

A

It is characterised by decreased visual acuity, loss of peripheral vision and high intraocular pressure.

69
Q

keratitis presents with what kind of lesions?

A

they present with branched - dendritic lesions and also have a white acculumilation around the cornea

70
Q

Cotton wall spots on the eyes associated with diabetes is seen in which eye condition

A

Retinal infarction

71
Q

What abnormality is seen in the eye in diabetic retinopathy

A

Persistent hyperglycaemia can lead to damaged retinal vessels, leading to this chronic and progressive condition, that has the potential to cause loss of eyesight.

Due to this new blood vessels or form which are a lot weaker and can break very easily, which is what causes bleeding in the eye

72
Q

management for anterior uveitis

A

urgent specialist referral

73
Q

closed angle glaucoma management

A
  1. pilocarpine eye drops

irodotomy - cutting of the iris - to release pressure

74
Q

open angle glaucoma management

A
  1. use laser SLT
  2. prostaglandin analogues - latanoprost
75
Q

what is wet age related macular degeneration characterised by

A
  • it is rapid onset
  • followed by Dry ARMD
  • fundocsopy shows hard lipid exudates
  • formation of new blood vessels that can then bleed easily
76
Q

difference between wet ARMD and diabetic retinopathy

A

In the wet ARMD there are fatty deposits and its progressive progresses from dry ARMD, and the deposit thought of lipid.

In the diabetic retinal apathy, they’re haemorrhages and neovascularisation generally seen in poorly controlled diabetes, cotton wool sports

77
Q

Features of diabetic, retinopathy, mild, moderate and severe

A

In mild, there are only microaneurysms seen

moderate there are haemorrhages and cotton wool spot or Venus beading

severe either four quadrants have haemorrhages or 2 veins have changes

78
Q

What is a feature of diabetic retinopathies, oppose to hypertensive retinopathies

A

venous beading

79
Q

management for end stage wet AMD

A

Intravitreal injection with vascular endothelial growth factor inhibitors (anti-VEGF)

80
Q

what is a characteristic feature of dry AMD

A

yellow deposits on the fundoscopy

81
Q

pre septal cellutlis - symptoms

A

inferior pain
eyelid refraction
red swollen eye life and oedema

82
Q

orbital cellulitis - symptoms

A

recent URTI
posterior
hard eye
very painful
reduced visual acuity
pain on eye movements

immediate hospital admission

83
Q

Cytomegalovirus Retinitis
- what is it?

A
  • it is a viral infection of the eyes which causes inflammation
84
Q

what are the symptoms seen in Cytomegalovirus Retinitis?

A

Reduced visual acuity,
‘flashes and floaters’ in vision

85
Q

what fundoscopy findings are seen in Cytomegalovirus Retinitis ?

A

retinal haemorrhages and retinal necrosis
with ‘pizza pie’ appearance

86
Q

Cytomegalovirus Retinitis is associated with which virus?

A

HIV

87
Q

what is Endophthalmitis?

A

it is an inflammation of the intraoccular fluids of the eye

common after cataract surgery

88
Q

what does flourosescein do? What is the purpose of it?

A

it helps identify any defects in the corneal epithelium

89
Q

management of subconjunctival haemorrhage?

A

wait and watch, is self resolving

90
Q

S_____ cause raised intraoccular pressure of the eye

A

steroids

91
Q

white/blue/opaque ring around the eye is called c_______

A

corneal arcus

92
Q

Dry ARMD can cause deposits of what on the retina?

P_____

A

it can cause the eyes to have yellow deposits on the retina - protein

93
Q

symptoms of optic neuritis

A

Painful loss of vision
Abnormal perception of colours
increased lacrimation
central vision loss

associated with MS
common in young females

94
Q

investigation for optic neuritis

A

do MRI head to investigate

AMK (27 decks)

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