Ophthalmology Pathology Flashcards
what is it
Papilloedema
swelling of the optic disc due to increased intracranial pressure
what is it
Optic neuritis
-inflammation damages the optic nerve
what is it
Central retinal vein occlusion
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)
what is it
Central retinal artery occlusion
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
what is hypopyon
fluid in the cornea
what is corneal arcus
white, blue or opaque ring
what is a Kayser-fleischer ring
copper ring around the cornea
what is posterior synechiae
irregular looking pupil
keratitis - what is it
white collection in the cornea
what is retinal detachment
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
what can cause retinal detachment
diabetes mellitus
patient recently had cataract surgery,
now there is inflammation in their eye redness and blurred vision
endophthalmitis
red macula
sudden painless loss of vision
central retinal artery occlusion
what are Roth spots
retinal haemorrhages with a white spot
found in infective endocarditis
what are the symptoms found in retinal detachment
flashes and floaters
reduced visual acuity and ‘curtain falling down’§
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
anterior ischaemia optic neuropathy
what is anterior ischaemia optic neuropathy
infarction of the posterior ciliary arteries which supply the optic nerve head
common mechanism of visual loss in giant cell arthritis
what is giant cell arthritis
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.
episcleritis
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
scleritis
redness in the sclera
deep pain in the eye
COMMON IN OLDER PATIENTS
photophobia
blurred vision
what is oribital cellulitis
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
what is a chalazion
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
what is a stye
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
what are pan coast tumours
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
what is Horners syndrome
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
what are the risks of being severely myopic
- 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
what is an ocular migraine
brief attacks of blindness or visual impairment
flashing lights are seen
eye symptoms in an TIA
seems like a curtain is falling
blood supply to the brain is affected
and also causes hemi-paralyses
risks of being hyperopic
- acute angle closure glaucoma is very common
due to the eyeball being really small
what is giant cell arthritis
inflammation of the lining of the arteries
effects the temples
common in older patients
causes loss of vision and jaw claudication
what is optic neuritis
when inflammation goes onto damaging the optic nerve bundle
painful eye movements and temporary loss of vision in one eye
associated with multiple sclerosis
symptoms of acute primary angle closure glaucoma
headache
red watery eye and mid-dilated pupil
scleritis
when the white layer of the eye gets inflamed and turns red
common in rheumatoid arthritis
virtesous haemorrhage
boat shaped bleed in the eye
caused by type 2 diabetes
neovascular glaucoma
- 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
what is hypopyon
pus in the anterior chamber
bacterial keratitis
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
hyperlipidemia causes what?
corneal arcus - which is green/yellow deposits on the cornea
this is due to lipid deposits in the cornea
thyroid eye disease
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
orbital compartment syndrome
- 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
Amblyopia - what is it
‘lazy eye’ which happens in young children
what is dacryocystitis
infection of the lacrimal sac of the eye - the tear duct gets blocked
causes pain and watering of the eye
anterior uveitis is associated with what?
eye pain, swelling of the eye
photophobia
blurring vision
and - patient also have ankylosing sponditis - which is back stiffness and backache
optic neuritis
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
herpes simplex keratitis
painful red eye
photophobia
causes a dendritic ulcer - green defect in the shape of the dendrite
what is primary open angle glaucoma
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
what is a glaucoma
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
symptoms of open angle glaucoma
loss in peripheral vision
the outer rim of the nerve is damaged
central vision can be lost too
close angle glaucoma
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
scleritis - symptoms
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
acute angle closure glaucoma
nausea and headaches
blurred vision and halos
fixed-dilated pupil
anterior uveitis
red eye
pain
blurred vision
photophobia
corneal ulcer
pain
photophobia
watery eyes
can be due to use of contacts
cluster headache
pain around the eye
blood-shot eye
comes in clusters
swelling
watery eyes
optic neuritis
ocular pain on movement
common symptom of multiple sclerosis
corneal abrasion
damage to the corneal epithelium
pain
photophobia
reduced visual acuity
can be due to injury
keratitis
corneal inflammation
infective or non-infective
painful red eye
photophobia
white density around the cornea
keratitis
corneal inflammation
infective or non-infective
painful red eye
photophobia
white density around the corneae
Chorioretinitis - what is it
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
when a patient is given prednisolone for GCA but then they get an infection what do you do with the dosage of the steroids?
you double the dose as during infection, steroid levels are lower, so many of the steroids will be excreted
Subconjunctival haemorrhage - what is it
bleeding under the conjunctiva
it is painless
can be due to trauma, straining etc
management of chalzaion
warm compress
unless they get really big and cause Vision issues then use incision and curretage
- what is - Dry age related macular degeneration (Dry AMD)
thinning of the macula
common in older patients
it is the gradual loss of vision
what is relative afferent pupillary defect
- when light is shown in one eye, but both eyes respond differntly
what is endophthalmitis
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
what are the symptoms of anterior uevitis
- 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.
closed angle glaucoma symptoms
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
open angle glaucoma symtpms
It is characterised by decreased visual acuity, loss of peripheral vision and high intraocular pressure.
keratitis presents with what kind of lesions?
they present with branched - dendritic lesions and also have a white acculumilation around the cornea
Cotton wall spots on the eyes associated with diabetes is seen in which eye condition
Retinal infarction
What abnormality is seen in the eye in diabetic retinopathy
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
management for anterior uveitis
urgent specialist referral
closed angle glaucoma management
- pilocarpine eye drops
irodotomy - cutting of the iris - to release pressure
open angle glaucoma management
- use laser SLT
- prostaglandin analogues - latanoprost
what is wet age related macular degeneration characterised by
- it is rapid onset
- followed by Dry ARMD
- fundocsopy shows hard lipid exudates
- formation of new blood vessels that can then bleed easily
difference between wet ARMD and diabetic retinopathy
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
Features of diabetic, retinopathy, mild, moderate and severe
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
What is a feature of diabetic retinopathies, oppose to hypertensive retinopathies
venous beading
management for end stage wet AMD
Intravitreal injection with vascular endothelial growth factor inhibitors (anti-VEGF)
what is a characteristic feature of dry AMD
yellow deposits on the fundoscopy
pre septal cellutlis - symptoms
inferior pain
eyelid refraction
red swollen eye life and oedema
orbital cellulitis - symptoms
recent URTI
posterior
hard eye
very painful
reduced visual acuity
pain on eye movements
immediate hospital admission
Cytomegalovirus Retinitis
- what is it?
- it is a viral infection of the eyes which causes inflammation
what are the symptoms seen in Cytomegalovirus Retinitis?
Reduced visual acuity,
‘flashes and floaters’ in vision
what fundoscopy findings are seen in Cytomegalovirus Retinitis ?
retinal haemorrhages and retinal necrosis
with ‘pizza pie’ appearance
Cytomegalovirus Retinitis is associated with which virus?
HIV
what is Endophthalmitis?
it is an inflammation of the intraoccular fluids of the eye
common after cataract surgery
what does flourosescein do? What is the purpose of it?
it helps identify any defects in the corneal epithelium
management of subconjunctival haemorrhage?
wait and watch, is self resolving
S_____ cause raised intraoccular pressure of the eye
steroids
white/blue/opaque ring around the eye is called c_______
corneal arcus
Dry ARMD can cause deposits of what on the retina?
P_____
it can cause the eyes to have yellow deposits on the retina - protein
symptoms of optic neuritis
Painful loss of vision
Abnormal perception of colours
increased lacrimation
central vision loss
associated with MS
common in young females
investigation for optic neuritis
do MRI head to investigate
