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GP Year 4 > Opthal > Flashcards

Opthal Flashcards

1
Q

purulent discharge, eyelashes stuck together in the morning, blurring of vision clears with blinking

A

bacterial conjunctivitis

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2
Q

17 y/o girl, hay fever history, no discharge and itchiness, conjunctival injection. Glassy appearance

A

atopic conjunctivitis

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3
Q

treatment of allergic conjunctivitis

A

mast cell stabilizers: olopatadine

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4
Q

what eye condition is associated often with seborrhoeic dermatitis and/or rosacea? What is the treatment for it?

A

blepharitis.
Tx: lid hygiene (clean eyelid with warm water and wash away crusting on the lashes and eyelid margins) + topical lubricants. Oral tetracyclines - can give for 2 - 3 months in severe cases

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5
Q

gritty uncomfortable eyes when straining eyes (reading, watching TV, driving). what is it and how do we treat it?

A

dry eyes

tx: w/ artificial teardrops

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6
Q

spontaneous, painless, normal vision, retinal bleeding (in patches)

A

sub conjunctival hemorrhage - harmless, reassure and will resolve
tx: may be associated with HTN and heavy coughing/straining

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7
Q

what not to give during corneal abrasion and why?

A

topical anesthesia - because it reduces wound healing and it is toxic to the epithelium

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8
Q

what is the treatment for recurrent corneal abrasion?

A

use lubricating eye ointment at night and tear drops during the day

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9
Q

what is wearing lenses associated with

A

corneal ulcer - often assoc. with wearing lenses on too long

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10
Q

eye pain and wearing contact lenses. what is the next most important form of investigation

A

fluorescein staining of the eye

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11
Q

What treatment do you NOT give when patient presents with possible HSV viral keratitis. Why?

A

no steroid drops - may cause perforation

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12
Q

painful eye (boring pain), mild photophobia, redness localized around the limbus (edge of cornea), reduced visual acuity, 35 y/o man

A

iritis, anterior uveitis, irido-cyclitis

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13
Q

what are the gene assoc. w/ iritis?

A

HLA-B27 - only worth investigating with recurrent episodes

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14
Q

posterior synechiae (irregular shaped pupil) with slight redness. what is it?

A

iritis - late sign of iritis.

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15
Q

what are some recurrent eye disease?

A

iritis
herpes simplex
corneal abrasion

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16
Q

what is the treatment of iritis?

A

topical steroids

topical cyclopentolate

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17
Q

82 y/o, acute eye pain behind the eye, radiates to forehead, abdominal pain and vomiting, impaired vision

A

acute closed angle glaucoma - emergency

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18
Q

risk factors for acute glaucoma?

A 
age older than 40 - 50 y/o 
female 
positive fmhx 
hx of acute glaucoma 
hypermetropia/long sightedness
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19
Q

acute eye pain, mid dilated, fixed pupil, abdominal pain and vomiting

A

acute closed angle glaucoma

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20
Q

what is the treatment of acute glaucoma?

A

reduce aqeous secretion with IV acetazolamide
pupillary constriction w/ pilocarpine drops
surgical/laser iridotomy

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21
Q

78 y/o women with 3 day Hx of painful rash on the RHS side of forehead. RHS eye is inflamed and photophobic.

A

shingle (herpes zoster opthalmicus)

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22
Q

what is the organism usually associated with a stye/

A

s. aureus

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23
Q

what is the treatment of a stye?

A

hot compresses w. flannel 3 - 4 times daily, ease pain and draw pus to head
no real treatment

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24
Q

superifical tissue swelling around eye, painful eye movement, slight proptosis, quite unwell

A

orbital cellulitis - often caused by existing sinusitis

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25
Q

Bilateral eye swelling aroudn the periorbital area. most possible dx?

A

allergy - most commonly chloramphenicol

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26
Q

what are some eye conditions that require urgent referral?

A 
corneal ulcer 
iritis 
acute closed angle glaucoma 
herpes zoster opthalmicus w/ orbital involvement 
hyphaema d/t injury 
penetrating eye injury - high speed injury, welding etc. 
severe chemical burns 
orbital cellulitis 
any patient w/ SEVERE eye pain
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27
Q

what are some high risk factors for eye conditions in history taking?

A

metal welding
contact lens wearers
haloes, vomiting, pain
past medical history (corneal abrasion, iritis, herpes simplex keratitis)

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28
Q

what symptoms should we refer for patients?

A

pain
photophobia
blurred vision

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29
Q

young child with squinting eye, what important ddx to rule out?

A

retinoblastoma

neurofibromatosis

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30
Q

what are the important diagnoses to consider in the unilateral red eye?

A

FUGIT: foreign body, ulcer, glaucoma, iritis, trauma

31
Q

management of foreign body (post care)

A

put gauze over eye
uniocular - cannot drive
use chloramphenicol drops + ointment - 2 hours
see daily - fluorescein stain

32
Q

management of chemical injury

A

1st aid: irrigation for 20 minutes -buffered normal saline

referral to opthalmo

33
Q

what is the fundoscopy finding of a patient w/ glaucoma?

A

increased cup to disc ratio

Asymmetry of the cup:disc ratio in the optic nerve between 2 eyes

34
Q

ddx: painless LOV w/ loss of direct pupil response (Marcus Gunn)

A

optic neuritis
central retinal artery occlusion
temporal arteritis

35
Q

ddx: LOV that is corrected by 1mm pinhole

A

refractive error

36
Q

dangerous ddx of the unilateral red eye

A

foreign body, penetrating eye injury
corneal ulcer
acute glaucoma
iritis

37
Q

complication of eyelid ulcer?

A

BCC

38
Q

treatment of penetrating eye injury

A

sterile pad - do not use eye drops or ointments
NBM
if treatment has to be delayed, give ttetanus, systemic antibiotics
give analgesics, anti-emetics, and sedation if required
urgent referral

39
Q

what is the treatment of chemical burns

A

irrigation with saline or water for 15 minutes
instill local anesthetic to evert and swab the eyelids
urgent referral to ED

40
Q

what is the sign of hutchinson’s sign and its significance?

A

Herpes zoster opthalmicus involvement of the nose (nasociliary nerve) which means that there is very likely to be involvement of the eye
requires early systemic treatment and assessment by the opthalmologist

41
Q

spot diagnosis: LOV w/ flashing lights

A

retinal detachment

posterior vitreous detachment

42
Q

spot diagnosis: LOV w/ colored haloes around

A

glaucoma

43
Q

spot diagnosis: LOV w/ zigzag lines

A

migraines

44
Q

spot diagnosis: central scotoma and LOV

A

macular disease

optic neuritis

45
Q

spot dx: LOV with repeated walking into a side of the vision

A

homonymous hemiapnoia

bitemporal hemiapnia

46
Q

spot dx: peripheral LOV first

A

glaucoma

47
Q

spot dx: LOV w/ headache

A

temporal arteritis
migraine
benign intracranial HTN

48
Q

spot dx: distortion, wavy straight lines on the Amsler chart

A

Macular degeneration (wet, dry)

49
Q

what are some iatrogenic cause of LOV

A

ethambutol
quinine/chloroquinine
amiodarone

50
Q

spot dx: LOV w/ problems with glare while driving

A

cataracts

51
Q

common causes of LOV in a child

A

cortical blindness
optic atrophy
choroidoretinal degeneration
cataracts

52
Q

urgent referrals required for children?

A 
strabismus 
nystagmus 
wandering eyes 
lack of fixation or following of movements 
photophobia
opacities
53
Q

ddx acute loss of vision less than 1h

A 
amaurosis fugax 
CVA 
acute glaucoma 
migraine 
central retinal artery occlusion 
vitreous hemorrhage
54
Q

ddx slow gradual loss (chronic) of vision

A 
compression of visual pathways 
chronic glaucoma (open angle) 
cataracts 
diabetic maculopathy 
retinitis pigmentosa 
macular degeneration 
refractive errors
55
Q

difference between wet and dry macular degeneration

A

dry (mostly painless, develops slowly)
wet (acute, neovascularization of mebrane under the retina of the macular area, serious disorder that requires urgent referral)

56
Q

signs of optic neuritis?

A

central scotoma
discomfort while eye movement
afferent pupillary defect on affected eye

57
Q

treatment of optic neuritis?

A

IV steroids - hasten recovery and protective effect against development of further demyelinating episodes

other management steps: test visual field of other eye, use MRI

58
Q

what is normal ocular pressure? what is glaucoma ocular pressure?

A

12 - 22 mmhg. glaucoma > 40

59
Q

opthalmoscopy finding of retinal vein thrombosis

A

multiple retinal hemorrhages w/ stormy sunset apperance

swollen optic disc

60
Q

what are the associations with retinal vein thrombosis?

A 
HTN 
DM 
Anemia 
Glaucoma 
Hyperlipidemia
61
Q

afferent pupillary defect is found in?

A

optic neuritis
central retina artery occlusion
temporal arteritis

62
Q

what does myopia predispose you to?

A

retinal detachment

63
Q

treatment of chronic open angled glaucoma?

A 
acetazalomide 
timolol drops 
pilocarpine drops
latanodrops 
dipivefrine drops
64
Q

treatment of central retinal artery occlusion

A

massage eye area through closed eyelids (rhythmic massage)
rebreathe CO2 in bag
IV acetazolamide 500mg
urgent referral

65
Q

findings of diabetic retinopathy (prolif and non prolif)

A

prolif: neovascularization, hard exudates, vitreous hemorrhage
non prolif: cotton wool spots, dot and blot hemorrhages, microaneurysms

66
Q

eye condition assoc. wiht ank spond

A

anterior uveitis

67
Q

treatment of diabetic retinopathy

A

most pt do not need treatment
preventive treatments:
modify risk factors and good diabetic control

68
Q

ddx: acute LOV in the painless eye

A 
amaurosis fugax 
CVA 
optic neuritis 
retinal artery occlusion 
retinal vein occlusion 
wet acute macular degeneration 
vitreous hemorrhage
69
Q

ddx: acute painful red eye

A 
glaucoma 
iritis 
corneal ulceration/abrasion 
foreign body, penetrating injury
scleritis/episcleritis
conjunctivitis 
herpes zoster opthalmicus, herpes simplex 
endopthalmitis
70
Q

ddx: eyelid bump and lump

A 
stye
chalazion 
lipoma
preseptal, orbital cellulitis 
molluscum contagiosum 
dacryocysititis 
neoplasm: BCC 
blepharitis
71
Q

ddx: chronic LOV in quiet eye

A 
corneal scarring - trachoma 
cataracts
diabetic retinoathy
open angled glaucoma 
posterior vitreous detachment 
macular degeneration (dry) 
optic atrophy 
optic chiasm pathology
iatrogenic cause: drugs
72
Q

ddx: things in the eye

A 
conjunctivitis 
scleritis/episcleritis 
entropion
keratoconjunctivitis secca (dry eyes) 
foreign body
corneal ulcer, abrasion 
bell's palsy
herpes simplex keratitis
73
Q

ddx: flashes and floaters

A 
posterior vitreous detachment
retinal detachment 
migraines 
optic neuritis 
retinal artery occlusion 
vitritis 
diabetic retinopathy

GP Year 4 (14 decks)

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