Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CCFP EM > Ophtho > Flashcards

Ophtho Flashcards

1
Q

4 borders of the orbit

A

sup: frontal sinus
medial: ethmoid bone (lamina papyracea “paper thin”)
inferior: maxillary sinus
laterally: zygomatic bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

eye exam

A

-adnexa
-acuity
-visual fields
-pupils
-EOM
- inspect globe
-retinal exam with fundoscope
- slit lamp –> ant chamber
- fluorescein
- IOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

test for corneal laceration?

A

Seidel’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

normal IOP? contraindication to checking IOP with tonopen?

A

10-20 mm Hg
-suspected globe rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

to examine cornea, slit lamp should be?

A

bright, thin, 45 degree angle (allows assessment of anterior chamber)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

common triggers for preseptal cellulitis?
most common age?
most common bugs?

A

URTI, sinusitis, chalazion, hordeolum, insect bites and trauma. mostly in ppl <10
staph, strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

triggers for orbital cellulitis?

A

-paranasal sinusitis (esp ethmoid)
-trauma, intraorbital fb, postop, spread for preseptal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

presentation of orbital cellulitis?

A

URI, facial pressure, fever, pain with EOM, photophobia, abn pupillary response, decrease visual acuity,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

rare but highly m&m complication of orbital cellulitis?

+ other ones?

A

cavernous sinus thrombosis, presents with HA and deficit of CN 3, 4, 6

meningitis, encephalitis, epidural abcess, brain abcess.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

dx and tx of orbital cellulitis?

A

dx: clinical + CT can also make dx
tx: IV ABX, ophtho consult, lateral canthotomy if inc IOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

abx for orbital cellulitis secondary to sinusitis?

A

ctx and flagyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is stye/hordeolum?
how is it managed

A

acute bacterial infection from blockage of glands. think “pig stye”, “whoredeolum”, therefore dirty compared with chalazion

usually loacted at lid margin/las line

tx: warm compress, erythro ointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is chalazion?
how is it managed

A

acute or chronic inflammation, no infection.
warm compress
ophtho if not resolving or if vision affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

blepharitis, most common cause and tx

A

overgrowth of s epidermidis
tx: lid hygiene (wipes) abx oint if severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 rule outs in bacterial conjunctivitis

A

corneal ulcer (look before fluorescein) then, abraision and herpetic lesions (with fluorescein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how long for viral conjunctivitis to resolve?

A

1-3 weeks, very contagious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

triggers for sub conjunctival hemm?
how long to resolve?

A

trauma, valsalva, HTN, spontaneous
about 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Herpes simplex vs herpes zoster fluorescein finding?

A

Dendritic lesion, compared to HZO which has pseudodendrite (poorly staining mucous plaque), no actual erosion which true dendrite has

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

herpes zoster ophatlmicus treatment

A

Oral antivirals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

corneal ulcer etiologies

A

Exposure kerstitis (eg Bell’s palsy)
Trauma
Direct microbial invasion
Contact lenses that
Ocular surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

corneal ulcer signs/symptoms

A

Redness swelling if lids and conjunctiva
Discharge
Ocular pain
Fb sensation
Photophobia
Blurred vision
You see a corneal opacification with slit lamp and flare and cells in ant chamber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

corneal ulcer mgmt

A

Emergent ophtho consult
Start cipro drops; usually after cultures taken by ophtho so just call them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Hutchinson sign?

A

Shingles lesions at top of nose, predicts corneal involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Mgmt HSV keratocomjunctivitis

A

Topical antivirals: topical acyclovir, ganciclovir or trifluridine
Can also add oral antivirals
Defs add oral if there are lesions on the adnexa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What nerve is involved in HZO

A

V1 (ophthalmic nerve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Some organisms that cause corneal ulcer

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is ultraviolet keratitis

A

Damage to cornea from ultraviolet light. A.k.a. snow blindness or welders arc. Can also be from tanning beds. Symptoms of pain developed 6 to 12 hours later. Can have photophobia. Resolve on its own and 24 to 36 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Anterior uveitis is synonymous with?

A

Iritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Causes of anterior uveitis

A

Systemic inflammation: ulcerstive colitis, ankylosing spondylitis, bechets, sarcoid

Infections: tuberculosis, Lyme disease, HSV, syphilis

Malignancy: leukemia, lymphoma, melanoma

Trauma, foreign body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Signs and symptoms of anterior uveitis

A

Red eye, photophobia, decreased visual acuity.

Findings of associated systemic disease.

Perilimbal flush, a.k.a. ciliary flush, usually no discharge

Cells and flare

consensual photophobia is highly suggestive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

3 causes, in order, of endopthalmitis (infection of vitreous or aqueduct humour)

A

Post eye surgery
Penetrating trauma
Hematogenous spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Signs and symptoms endopthalmitis

A

Pain, redness, discharge

Hypopion, photophobia, ciliary flush

Can have adnexal swelling

RF of surgery or fb paramount

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Symptoms of vitreous hem/detachment

A

Painless vision loss, flashers floaters, haziness
Usually send to ophtho to r/o retinal detachment after doing full eye exam

34
Q

And for corneal abrasion, contact wearer vs non-contact wearer

A

Non: erythro ointment
Wearer cipro ointment, ofloxacin ointment

35
Q

Similar to corneal abrasion and laceration there is…..

A

Conjunctival. Similar exam, usually less symptoms. Mgmt is the same

36
Q

Why abx in corneal abrasion

A

Prevent iritis, they are a must!

37
Q

Relief of pain with topical anesthetics is almost diagnostic for?

A

Corneal abrasion
Very painful, pain can be delayed by a few hours after injury,

38
Q

Best analgesics for corneal abrasion

A

Simple oral analgesics, nsaids best

39
Q

Exam finding ls for corneal laceration

A

Misshapen iris, hyphema, Seidel test shallow anterior chamber

40
Q

If clinical suspicion for penetrating eye injury or severe blunt trauma do?

A

Consult ophtho and get ct of orbit. Even if ct normal need to consult

41
Q

corneal FB removal?

A

anesthetize eyes (somtimes freezing both helps):
NS rinse
moist cotton applicator
25 g needle

42
Q

when does rust ring appear

A

when metal fb present for more than a few hours

43
Q

when to be worried about globe rupture from fb?

A

hyphema, seidel sign or seen to be deeply embedded on slit lamp

44
Q

is it necessary to remove rust ring in the ED?

A

no, can refer to ophtho, but should still try and get fb out

45
Q

criteria for ophtho to see lid lacerations

A

lid margin, 6-8 mm from medial canthus, involving lacrimal duct, inner surface of lid, ptosis or involving tarsal plate and most full thickness

so basically all of them….?

46
Q

in full thickness lacerations what needs to be ruled out?

A

globe rupture/corneal laceration

47
Q

how to know if canalicular system is cut

A

put fluorescein in eye and if it comes out the wound, its cut

48
Q

which type of lid lacerations are the ones repaired in ED and how

A

partial thickness not meeting criteria:

lid margin, 6-8 mm from medial canthus, involving lacrimal duct, inner surface of lid, ptosis or involving tarsal plate and most full thickness

use 6 or 7-0 soft suture. can try and hold ends down with subsequent suture

49
Q

If lid margin lac cannot be repaired by optho, describe how to do it

A

Note not necessary if less than 1mm

50
Q

how to get eyelids open in blunt eye trauma

A

eye speculum or can use paperclips bent in proper way

51
Q

if restricted EOM in blunt ocular trauma think?

A

orbital blowout fracture, need to get CT facial bones/orbits

52
Q

things to check in blunt ocular trauma

A

acuity, glove integrity, IOP, EOM

53
Q

two most common spots for orbital blow out fracture

A

inferior wall (maxillary sinus)
medial wall (lamina papyracea aka ethmoid)

54
Q

how to manage suspected or confirmed golobe rupture?

A

HOB 45 degrees, cover eye with paper cup, broad spectrum IV abx, immediate ophtho consult

55
Q

signs of globe rupture? none are overly sens or specific

A

large sub con hemm, chemosis (raised sub con hemm) ,seidel’s sign, shallow anterior chamber, hyphema, tear drop shaped pupil, decreased acuity

56
Q

imaging to detect occult globe rupture?

A

CT of eye

57
Q

what is post septal hemorrhage

A

aka orbitla hematoma
secoanr to trauma, causes orbitla compartment syndrome

58
Q

clinical features of post septal hemorrhage?

A

eye pain, proptosis, impaired EOM, elevated IOP, decrease acuity

can also get oribital CT scan if unsure

59
Q

indications for lateral canthotomy and cantholysis

A

retrobulbar hemm with IOP > 40, if IOP < 40 but dx is suspected get a CT

or retrobulbar hemm with RAPD, ophthalomoplegia, cherry red macula, optic nerve head pallor or severe pain in affected eye

60
Q

walk through steps of lateral canthotomy and cantholysis

A

go!

61
Q

retinal ischemic time in orbital compartment syndrome

A

90-120 mins

62
Q

only contraindication to lateral canthotomy and cantholysis

A

globe rupture

63
Q

mgmt in chemical ocular injury

A

-Morgan lens and wash with 1-2 L of NS, then examine (washout before testing visual acuity)
-can check pH first
-irrigate until pH is between 7 and 7.4, re-check 30 mins after irrigation and continue to irrigate if pH is out of range

64
Q

how to get super glue out of eye

A

apply tons of erythro ointment, which loosens it, remove what comes off easily. tell pt to keep applying erythro ointment and arrange ophtho f/u

65
Q

treatment for acute angle closure glaucoma?

A

TAPAM

timolol drops 1 drop bid
acetazolamide 500 po/iv
pilocarpine drops
analgesics (opiods lower pressure)
mannitol if refractory (ie IOOP > 40 after 1 hour)

check re check IOP hourly

66
Q

basic pathophys of acute angle closure

A

lens or iris blocks trabecular meshwork stopping aqueous humor from exiting eye

67
Q

what usually triggers acute angle closure glaucoma?

A

anything that dilates pupil (anticholinergics, sympathomimetic, emotional stress, dim lighting)

68
Q

signs and symptoms of acute angle closure glaucoma?

A

symp:
HA, decreased vision, eye pain, n/v

signs: raised IOP, fixed, mid dilated pupil, hzy cornea, conjunctival injection, eye is “rock hard”

69
Q

is optic neuritis painful

A

usually mild to mod pain, but can be painless

70
Q

timeline of optic neuritis?

A

vision loss over days or hours, usually unilateral can be profound or just bluriness

71
Q

CRAO:
what is it?
epidemiology
s/s
mgmt

A

-central retinal artery occlusion - ischemic embolic stroke of eye (1st branch off ICA is ophthalmic artery)
-quite rare, age > 50, same rf as stroke
-sudden painless vision loss (monocular); pale retina (pale bc no flow) with cherry red spot
-ophthalmic emergency, consult ophtho stat, irreversible vision loss after 4 hours

72
Q

CVAO:
what is it?
epidemiology
s/s
mgmt

A

central retinal vein occlusion - thrombus of vein
- same rf as stroke
-“blood and thunder” ie diffuse retinal hemorrhage, presents as rapid painless monocular vision loss
-no consensus treatment, consult ophtho

73
Q

important initial distinction for “flashers and floaters”

A

monocular vs binocular
bi: intracranial
mono: ocular

74
Q

mgmt for ?retinal vs vitreous detachment

A

ophtho consult for dilated exam

75
Q

symptoms/signs of retinal detach

A

flasher/floaters, curtain over field of vision, visual field deficit, decreased central or peripheral visual acuity

76
Q

age at which to consider GCA?

A

> 50

77
Q

symptoms GCA

A

HA, jaw claudication, fever, myalgias, decreased vision, temporal artery tenderness

78
Q

blood test to r/o GCA

A

CRP or ESR

79
Q

if you suspect GCA what do you do

A

high dose steroids, arrange biopsy with ophtho

80
Q

What is a pcomm artery aneurysm until proven otherwise?

A

Acute cranial nerve 3 palsy (down and out) with ipsilateral pupillary dilatation

81
Q

what is horner’s syndrome triad? what causes it?

A

ptosis, miosis, anhidrosis
causes: stroke, tumor, ICA dissection, HZV, trauma

if neck pain and horners = carotid dissection

CCFP EM (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions