Optha Flashcards

1
Q

Central Retinal Artery occlusion (CRAO)

causes n mx

A

atherosclerosis
GCA

emergency -> refer
if GCA get ESR n temp art bx to tx w steriods bc reversible

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2
Q

Keratitis path and organisms

Presentation

A

Inflammation of the cornea bc infection

HSV , VZV, bacterial (abrasion->ulcer)

Sudden onset unilateral painful red eye (ciliary flush)
Photophobia
Gritty sensation
Esp contact lense wearers

Keratin precipitates (white spots on cornea =inflamm cells)

If VZV ie shingles = vesicles on erythematous base in cn5 distribution

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3
Q

Iritis (anterior uveitis) path and presentation

A

Autoimmune HLA B27, males w ank spondylitis

Sudden onset unilateral painful
Bright red eye all over (ciliary flush)
Tender
Constricted pupil (miosis) and
Severe photophobia
Hypopeon

  • threat to vision*
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4
Q

Iritis diagnosis and tx

A

Clx = slit lamp, autoimmune HLAB27 Prednisone drops every one hour and cylopentate Only systemic if refractory

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5
Q

Keratitis diagnosis and tx

A

Slit lamp
Fluresceine dye : HSV/VZV = dendritic pattern , abrasion, ulcer

Viral = self limiting
Antibacterial drops if bacteria

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6
Q

Acanthamoebic keratitis

A

Pain out of proportion
Contact lens wearer
Recent freshwater swimming

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7
Q

Scleritis path and associations

A

Autoimmune
Association RA and `SLE
More common in females

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8
Q

Scleritis presentation and dx

A

Gradual onset unilateral painful red eye (ciliary flush)
Tender on palpation
Violacoeus hue in ambient light

Slit lamp
And RF and anticcp

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9
Q

Scleritis management

A

Drops and systemic corticosteroids
NSAIDs
Methotrexate for RA

If not RA or methotrexate not tolerated
6mercapto
Azathioprine
Cyclophosphamide

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10
Q

Root cause of both style and chalazion and 1st line tx for both

A

Tarsal gland obstruction

1st line
Warm compress
Eye massage
Eye hygiene

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11
Q

Style path

Presentation

When to I&D

A

Tarsal gland obstruction-> mini abscess

More painful than chalazion

> 2weeks = I&D

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12
Q

Chalazion path

Pt

I&D

A

Granulomatous rxn

Slower and bigger but less painful

> 4weeks = I&D

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13
Q

Why do you cyclopentoate in iritis

A

Ciliary muscle spasm and contraction (=pupil constriction) painful

= give muscranic agonist

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14
Q

What is ciliary flush

A

Ring of red or violet spreading out from around the cornea

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15
Q

Organism causes of viral conjunctivitis

N present

A

Adenovirus
Coxsackie
Enterovirus

Uni->bi eyes
Watery discharge
May have preauricular LN
URI

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16
Q

Causes of bacterial conjunctivitis

Presentation

Tx

A

Staph in adults

Strep Pneumoniae in kids

Unilateral purulent discharge
Stuck eyes in morning
Maybe preceding illness

Chloramohenicol
Hygiene towels pillows etc

17
Q

Conjunctivitis to watch out for

A

N. Gonorrhea in neonatal = can be vision threatening

C. Trachomatour world wide = leads to blindness bc recurrent conjunctivitis = scarring

18
Q

Epislceritis presentation

A

Sudden onset unilateral painful eye
Red eye all over (injection) - NOt ciliary flush
Lasts 7-10days

NSAIDs and time

19
Q

Risk of not properly caring for corneal abrasion

20
Q

Risk with corneal abrasion and contact lens wearer with poor hygiene

A

Ie sleeps w lenses
Not frequently changing

= pseudomonas

Proph w and drops

21
Q

Diagnosis of corneal abrasion

A

Flourosceine = yellow stained abrasion (de-epithilised surface)

Visualised better w cobalt blue filter on woods lamp or opthalmoscope

22
Q

primary open angle glaucoma risk factors

A

myopia (shortsighted)
increasing age
afro carib
htn
sm
corticosteroids

23
Q

primary open angle glaucoma long sighted or short

24
Q

hypermetropia which glaucoma

A

acute angle closure glaucoma

25
causes of tunnel vision
papilloedema glaucoma retinitis pigmentosa choroidoretinitis optic atrophy secondary to tabes dorsalis hysteria
26
horners triad
miosis ptosis enopthalmos
27
horners anyhdrosis head arm and trunk
= central lesion ie stroke syringomyelia
28
horners anhyrdosis face only where is the lesion
pre gang lesion = pancoast , cervical rib
29
anhydrosis absent in horners where is lesion
lesion is post ganglionic = carotid artery
30
SE prostaglandin analogues
inc eyelash lenght iris pigmentation periocular pigmentation
31
what eye drops may have caused corneal ulcer
steroid eye drops --> lead to fungal infections, which in turn cause corneal ulcer
32
causes of red eye
conjuctinvitis acute angle closure glaucoma anterior uvetitis scleritis episcleritis subconjuctival haemorhage
33
bilateral red itchy with sticky exudate in neonate
chlamydia trachomatis
34
diabetec retinopathy retinal findings
microanuerysms blot/flamed shaped haemorrhages hard exudates cotton wool spots neovasculrisation (proliferative)
35
diabetic retinopathy tx
good sugar control non prolif = watch and wait maculopathy and change in visual acuity = intravitrial VEGF inhib prolif panretinal coagulation intravit VEGF inhib
36
diabetic retinopathy - maculopathy
hard exudates and other 'background' changes on macula check visual acuity more common in Type II DM
37
diabetic pts inc risk of which eye conditions other than diabetic retinopathy
cataracts glaucoma vit haemorhage retinal detachment infection
38