Optha Flashcards
Central Retinal Artery occlusion (CRAO)
causes n mx
atherosclerosis
GCA
emergency -> refer
if GCA get ESR n temp art bx to tx w steriods bc reversible
Keratitis path and organisms
Presentation
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
Iritis (anterior uveitis) path and presentation
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*
Iritis diagnosis and tx
Clx = slit lamp, autoimmune HLAB27 Prednisone drops every one hour and cylopentate Only systemic if refractory
Keratitis diagnosis and tx
Slit lamp
Fluresceine dye : HSV/VZV = dendritic pattern , abrasion, ulcer
Viral = self limiting
Antibacterial drops if bacteria
Acanthamoebic keratitis
Pain out of proportion
Contact lens wearer
Recent freshwater swimming
Scleritis path and associations
Autoimmune
Association RA and `SLE
More common in females
Scleritis presentation and dx
Gradual onset unilateral painful red eye (ciliary flush)
Tender on palpation
Violacoeus hue in ambient light
Slit lamp
And RF and anticcp
Scleritis management
Drops and systemic corticosteroids
NSAIDs
Methotrexate for RA
If not RA or methotrexate not tolerated
6mercapto
Azathioprine
Cyclophosphamide
Root cause of both style and chalazion and 1st line tx for both
Tarsal gland obstruction
1st line
Warm compress
Eye massage
Eye hygiene
Style path
Presentation
When to I&D
Tarsal gland obstruction-> mini abscess
More painful than chalazion
> 2weeks = I&D
Chalazion path
Pt
I&D
Granulomatous rxn
Slower and bigger but less painful
> 4weeks = I&D
Why do you cyclopentoate in iritis
Ciliary muscle spasm and contraction (=pupil constriction) painful
= give muscranic agonist
What is ciliary flush
Ring of red or violet spreading out from around the cornea
Organism causes of viral conjunctivitis
N present
Adenovirus
Coxsackie
Enterovirus
Uni->bi eyes
Watery discharge
May have preauricular LN
URI
Causes of bacterial conjunctivitis
Presentation
Tx
Staph in adults
Strep Pneumoniae in kids
Unilateral purulent discharge
Stuck eyes in morning
Maybe preceding illness
Chloramohenicol
Hygiene towels pillows etc
Conjunctivitis to watch out for
N. Gonorrhea in neonatal = can be vision threatening
C. Trachomatour world wide = leads to blindness bc recurrent conjunctivitis = scarring
Epislceritis presentation
Sudden onset unilateral painful eye
Red eye all over (injection) - NOt ciliary flush
Lasts 7-10days
NSAIDs and time
Risk of not properly caring for corneal abrasion
Ulcer
Risk with corneal abrasion and contact lens wearer with poor hygiene
Ie sleeps w lenses
Not frequently changing
= pseudomonas
Proph w and drops
Diagnosis of corneal abrasion
Flourosceine = yellow stained abrasion (de-epithilised surface)
Visualised better w cobalt blue filter on woods lamp or opthalmoscope
primary open angle glaucoma risk factors
myopia (shortsighted)
increasing age
afro carib
htn
sm
corticosteroids
primary open angle glaucoma long sighted or short
myopia
hypermetropia which glaucoma
acute angle closure glaucoma
causes of tunnel vision
papilloedema
glaucoma
retinitis pigmentosa
choroidoretinitis
optic atrophy secondary to tabes dorsalis
hysteria
horners triad
miosis
ptosis
enopthalmos
horners anyhdrosis head arm and trunk
= central lesion ie stroke syringomyelia
horners anhyrdosis face only where is the lesion
pre gang lesion = pancoast , cervical rib
anhydrosis absent in horners where is lesion
lesion is post ganglionic = carotid artery
SE prostaglandin analogues
inc eyelash lenght
iris pigmentation
periocular pigmentation
what eye drops may have caused corneal ulcer
steroid eye drops –> lead to fungal infections, which in turn cause corneal ulcer
causes of red eye
conjuctinvitis
acute angle closure glaucoma
anterior uvetitis
scleritis
episcleritis
subconjuctival haemorhage
bilateral red itchy with sticky exudate in neonate
chlamydia trachomatis
diabetec retinopathy retinal findings
microanuerysms
blot/flamed shaped haemorrhages
hard exudates
cotton wool spots
neovasculrisation (proliferative)
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
diabetic retinopathy - maculopathy
hard exudates and other ‘background’ changes on macula
check visual acuity
more common in Type II DM
diabetic pts inc risk of which eye conditions other than diabetic retinopathy
cataracts
glaucoma
vit haemorhage
retinal detachment
infection
