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ENT + ophthalmology > ophtho questions > Flashcards

ophtho questions Flashcards

1
Q

investigations angle-closure glaucoma

A
  • gonioscopy (assesses angle between iris and cornea)
  • tonometry
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1
Q

investigations angle-closure glaucoma

A
  • gonioscopy (assesses angle between iris and cornea)
  • tonometry
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2
Q

presentation acute angle closure glaucoma

A
  • severely painful red eye
  • blurred vision
  • halos around lights
  • associated headache, nausea and vomiting
  • pupil in fixed dilated position
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3
Q

presentation cataracts

A

gradual onset:
- reduced vision
- faded colour
- glare
- halos around lights
- defect in red reflex

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3
Q

presentation cataracts

A

gradual onset:
- reduced vision
- faded colour
- glare
- halos around lights
- defect in red reflex

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4
Q

what is hutchinson’s sign in opthalmology

A
  • rash seen in herpes zoster
  • on tip or side of nose -> strong risk factor for ocular involvement
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5
Q

main cause optic neuritis

A
  • multiple sclerosis
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6
Q

presentation retinal detachment

A
  • painless
  • peripheral vision loss - ‘curtain over visual field’
  • blurred or distorted vision
  • flashes and floaters
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7
Q

risk factors retinal detachment

A
  • diabetes mellitus
  • myopia (short sighted)
  • age
  • previous surgery for cataracts
  • trauma
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8
Q

management anterior uveitis

A

steroid + cycloplegic eyedrops

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9
Q

presentation optic neuritis

A
  • visual loss
  • periocular pain
  • reduced colour vision
  • pain on eye movement
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10
Q

grading - diabetic retinopathy

A
  • non-proliferative
    • mild - microaneurysms
    • moderate - microaneurysms, blot haemorrhages, hard exudates, cotton wool spots, venous beading
    • severe - blot haemorrhages + microaneurysms in 4 quadrants, venous beading in 2 quadrants, IMRA in any quadrant
  • proliferative
    • neovascularisation
    • vitreous haemorrhage
  • diabetic maculopathy
    • macular oedema
    • ischaemic maculopathy
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11
Q

presentation primary open angle glaucoma

A
  • tunnel vision
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12
Q

what are drusen?

A

yellow deposits of protein and lipids on the macula
high numbers seen in ARMD

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13
Q

which is more common - wet vs dry ARMD

A

dry
characterised by drusen

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14
Q

management dry AMRD

A

avoid smoking
control blood pressure
anti-oxidant vitamin supplementation + zinc

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15
Q

pathophysiology OAG

A

increase resistance in trabecular meshwork, aqueous humour can’t exit eye

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16
Q

risk factors POAG

A

raised IOP
myopia
afro-caribbean
steroids
diabetes

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17
Q

presentation OAG

A

superior before inferior vision loss -> tunnel vision

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18
Q

cup:disk ratios (normal + definition cupping)

A

normal <0.3
cupping >0.7

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19
Q

investigations POAG

A

golfmann applanation tonometry - gold standard
non-contact tonometry (puff of air)
fundoscopy

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20
Q

management POAG

A

first line - surgical - 360 degree laser trabeculoplasty
latanoprost - increase uveoscleral outflow
beta-blockers e.g. timolol
carbonic anhydrase inhibitors e.g. dorzolamide
sympathomimetics e.g. brimonidine

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21
Q

risk factors AACG

A

increasing age
female
east asian
fhx
long sightedness/hypermetropia

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22
Q

presentation AACG

A

severe painful red eye
blurred vision
halos around lights
ass. headache, nausea and vomiting
pupil in fixed dilated position

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23
Q

investigations AACG

A

gonioscopy - assess angle between iris and cornea
goldmann applanation tonometry

24
Q

management AACG

A

eye drops - parasympathomimetic (pilocarpine), beta-blockers, alpha-2 agonist (brimonidine)
IV acetazolamide
laser peripheral iridotomy

25
Q

presentation blepharitis

A

bilateral
gritty, itchy, dry
sticky eyes in morning
styes + chalazions more common

26
Q

presentation cataracts

A

painless loss of vision - asymmetrical
starbursts around lights, at night
loss of red reflex

27
Q

complications cataract surgery

A

endophthalmitis

28
Q

management endophthalmitis

A

vancomycin

29
Q

what is the central retinal artery a branch of?

A

ophthalmic artery, branch of internal carotid

30
Q

presentation central retinal artery occlusion

A

sudden onset painless loss of vision
relative afferent pupillary defect
cherry red spot on fundoscopy

31
Q

causes central retinal artery occlusion

A

atherosclerosis
giant cell arteritis

32
Q

management central retinal artery occlusion

A

ocular massage
removing fluid from anterior chamber
inhaling carbogen
sublingual isosorbide dinitrate

33
Q

what is ophthalmia neonatorum

A

infection of conjunctiva contracted by neonates due to chlamydia or gonorrhoea passed from mother

34
Q

causes keratitis

A

viral - herpes simplex
bacterial - pseudomonas (contact lenses) or staph
fungal - candida
exposure keratitis

35
Q

presentation bacterial keratitis

A

painful red eye
foreign body sensation
corneal ulcer

36
Q

presentation herpes keratitis

A

painful red eye
foreign body sensation
vesicles around eye

37
Q

diagnosis herpes keratitis

A

stain with fluorescin
corneal swabs or scrapings isolate virus

38
Q

treatment optic neuritis

A

IV methylprednisolone

39
Q

investigations peri-orbital/orbital cellulitis

A

CT orbit
blood tests

40
Q

peri-orbital vs orbital cellulitis

A

peri-orbital
- no proptosis
- normal eye movements
- no chemosis
- normal optic nerve function

41
Q

presentation retinal detachment

A

painless
peripheral vision loss - curtain over visual field
blurred or distorted vision
flashes and floaters

42
Q

risk factors retinal detachment

A

DM
myopia
age
previous cataract surgery

43
Q

investigation retinal detachment

A

ultrasound

44
Q

management retinal detachment

A

urgent referral to opthalmology
laser therapy
reattach retina

45
Q

presentation retinal vein occlusion

A

painless loss of vision or visual field defect
more gradual than CRAO
on fundoscopy - stormy sunset

46
Q

presentation scleritis

A

painful red eye
pain on eye movement
worse at night
eye watering
ass. with rheum conditions

47
Q

risk factors scleritis

A

rheumatoid arthritis
SLE
sarcoidosis
granulomatosis with polyangiitis

48
Q

management scleritis

A

NSAIDs
corticosteroids for severe/necrotising scleritis

49
Q

episcleritis presentation + management

A

segmental redness
mild/no pain
manage with analgesia, cold compress, safety netting

50
Q

what treatment is contraindicated in thyroid eye disease?

A

radioactive iodine ablation therapy

51
Q

what is in uveal tract

A

choroid
ciliary body
iris

52
Q

presentation anterior uveitis/iritis

A

painful red eye - dull pain
photophobia
blurred vision
floaters and flashers
lacrimation
posterior synechiae pull iris into abnormal shapes
cloudiness aqueous humour

53
Q

management anterior uveitis

A

ophthalmologist referral
cycloplegic mydriatic drops

54
Q

features hypertensive retinopathy

A

arteriovenous nipping - arteries crossing veins
hard exudates - lipids leaked into retina
retinal haemorrhages
cotton wool spots - ischaemia in retina damaging nerve fibres
papilloedema

55
Q

features diabetic retinopathy

A

blot haemorrhages + hard exudates
venous beading
cotton wool spots
neovascularisation

56
Q

management orbital cellulitis

A

IV cefotaxime or clindamycin

57
Q

indications for referral to ophthalmology RE foreign body

A

high velocity injury
sharp object
significant orbital or peri-ocular trauma
chemical injury
organic material e.g. seed, doil
red flags

58
Q

management proliferative diabetic retinopathy

A

laser photocoagulation
intravitreal VEGF inhibitors e.g. ranibizumab

ENT + ophthalmology (2 decks)

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