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Year 6 > Opthal > Flashcards

Opthal Flashcards

1
Q

how do we test for visual acuity?

A

snellen chart

6/6 means, at 6metres they can see what normal eyes can see

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2
Q

what are the components of the opthal history?

A

ask about visual acuity- usaul and at presentation - is there a reduction?

Redness
Pain - + SOCRATES
Photophobia - urgent

Visual loss:

  • Transient: amarosis faux
  • Persistent: cataract, most other things

Contact lense use

Tearing, Itching, Discharge

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3
Q

what are the components of the opthal exam

A

CN1 exam mainly:
visual acuity, accommodation
eye movement, pupillary reflexes
corneal reflex if can

slit lamp

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4
Q

what are referall pathways in optimal

A

urgent - same day

non-urgent - 2 weeks+
eg cataract

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5
Q

list the causes of redness of the eye

A 
blepharitis
conjunctivitis
scleritis
chemical injury - emergency
acute glaucoma
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6
Q

painful red eye, wears contacts, next steps?

A

History:
are they old, use eye drops?
do they sleep in them?
any trauma whilst wearing them?

examine

see opthalmologists same day

contacts can cause corneal ulcers

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7
Q

give examples of vision threatining presentations that hurt

A

eg
acute glaucoma
corneal ulcers
chemical burns

these are emergencies

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8
Q

how does scleritis present?

A

idiopathic cause

pain very bad that wakes them at night
very red eye - deep injection
EMERGENCY - need same opthal review

episcleritis - mild discomfort. non-urgent

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9
Q

how do we tell difference between hayfever eye sx and conjunctivitis?

A

conjunctivitis - eye is not itchy but is red

season - eg presents in winter rather than summer

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10
Q

how do we treat conjunctivitis?

A

viral - usually nothing

bacterial - abx

see paeds notes

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11
Q

how do we identify corneal ulcers?

A

Slit lamp with a drop of fluoriscine in the eye

corneal sensation usually reduced

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12
Q

what is orbital cellulitis?

A

true infection of orbit

staph aureus most common cause

vision threatening, life threatening

Need admission, IV Abx

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13
Q

patient has cataract surgery 2 days ago, now vision has dropped, eye looks cloudy, looks buldgy and inflammed - most likely cause?

A

Endopthalmitis!

occurs after intraocular surgery

EMERGENCY - NEED REVEIW IN 1 HOUR

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14
Q

what causes IOP>40mmhg?

A

acute angle CLOSURE glaucoma

open angle closure with 2ndary causes

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15
Q

sudden catastrophic unilateral visual loss, painless.
pupil nonreactive in affected eye.
hx CVD, sickle cell, diabetes.
dilated eye exam: cherry red spot on retina

likely ddx?

A

central retinal artery occlusion

risk of strokes afterwards

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16
Q

central retinal vein occlusion looks like what on retina?

A

look on google

messy unlike the artery occlusion

17
Q

how do we mx chemical injury of eye?

A

local anaesthetic drop in eye
irrigate with lots of saline to neutralise eye ph

irrigate under eye lids
recheck ph
keep irrigating

mayyy need corneal transplant

18
Q

pt presents saying “something went into my eye”, what do you do?

A

Hx: what were you doing, hammering, welding etc?

usually extraocular foreing body
can be insect etc
can leave rust deposit on fluorescien stain

no change to visual acuity

19
Q

how do we ivx blows to eye socket eg suspected fx?

which MDT should be involed?

A

CT Orbit - so we can look at soft tissues too

MDT: opthal, maxfax

note; when there is the fracture, eye movement in the affected eye can be restricted, usually maxfax needs to release the muscle

20
Q

retinal disc swelling could indicate what?

A

Papilloedema - Raised ICP

Arterial ischaemia -Giant cell arthritis

21
Q

how does orbital cellulitis present?

A

Swollen eyelid, red
sometimes shut
ptosis

22
Q

what is hyphon and hyphen?

A

hyphon - pus within iris

hyphema - blood within iris

23
Q

what do the following terms mean in visual acuity:

6/6, 6/60, 6/5

A

6/6: individual can see at 6metres what a normal person can see at 6metres (US equivalent 20/20 in feet)

6/60: individual can see at 6metres what a normal person can see at 60metres. meaning poorer eyesight. the bigger the denominator the worse the vision.
DVLA requires 6/12 in the good eye to drive.

6/5: individual can see at 6metres what a normal person can see at 5metres. better than average vision.

24
Q

mx of background retinopathy?

A

inform them about changes

lifestyle changes

good diabetic control

monitor closely

25
Q

most common cause of Central retinal artery occlusion?

A

Temporal arteritis

26
Q

cataract vs acute glaucoma difference in appearance?

A

cataract - clouded lens

glaucoma - corneal haze

Year 6 (17 decks)

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