Opthal Flashcards
What are the causes of Central Retinal artery occlusion
Thromboembolism
Arteritis
What are the causes of central retinal vein occlusion
Glaucoma
Polycythemia
Hypertension
What are the causes of papillodema
Hypertension (malignant) Hypertension (intracranial) Hypertension (in the CSF space - hydrocephalus) SOL Hypercapnia
What is dacryocytis?
Inflammation of the lacrimal sac which presents as swelling and erythema at the inner canthus, with epiphora (watery eye)
treated with antibiotics
can sometimes be caused by congenital lacrimal duct obstruction of the structures but usually resolves by age 1
What are the common side effects of lantaprost?
eye lash growth
iris pigmentation
perioccular pigmentation
What is the mechanism of action of lantoprost?
prostaglandin which increased the uveoscleral outflow of aqueous humour
this works in the same way as muscarinic recepter agonists
how do beta blockers work in glaucoma?
reduce the amout of aqeuous humur produced
wierdly so do alpha agonists - but they also let it out more too - increased uveoscleral outflow
What are the causes of argyl robertson pupil?
pin point pupils which accomodate but do not contrict to light
prostitutes pupil
neurosyphylis
diabetic neuropathy - developing world
how does macular degeneration present?
reduced acuity
blurring of vision
central loss before peripheral
Dry - drusen
Wet - retinal haemorrhage due to neovascularisation of the retina from choroid
What is the treatment for dry mac deg?
none - conservative only
stop smoking - high dose vitamins - CE Zinc beta carotene (antioxidant dietary supps - shouldnt take beta arotene if you smoke - Lung ca)
What is the treatment for wet mac deg?
photocoagulation
anti vegf therapy
Risk factors for macular degeneration?
family history Age smoking caucasians women high cumulative sunlight exposure
hypermetropia is associated with which type of glaucoma?
acute angle closure glaucoma
myopia is associated with which type of glaucoma?
acute primary open angle glaucoma
What would you see on fundoscopy of someone with Primary open angle glaucoma (POAG)
disc cupping
disc pallor - optic atrophy
bayonnetting of vessels - breaks as they disappear and reappear
disc haemorrages and cup notching
What is retinitis pigmentosa?
abnormal pigmentation of the peripheral retina causing loss of peripheral vision
black spicule shaped pigmentation on the retina
assocaited with:
refsums disease
alports
What are the signs of refsums disease?
cerebellar ataxia peripheral neuropathy retinitis pigmentosa deafness ichthyosis - dry scaly skin
CAuses of a sudden painless loss of vision?
central retinal artery or vein occlusion
retinal detachment
vitreous haemoorhage
ischemic optic neuropathy - arteritis/atherosclerosis
central retinal artery occulsioin
caused usually by embolism - atherosclerosis /arteritis
cherry red spot on pale retina
causes of an optic neurtis?
MS diabetes drugs - ethambutol/chloramphenicol vitamin deficiency infection: zoster/lyme
what are the presenting symptoms of an optic neuritis?
decreased colour vision
reduced acuity (unilateral)
spain on eye movements
What is the treatment for optic neuritis?
hgh dose IV methylpred followed by oral pred
Differentials for a red eye?
Glaucoma haloes with hazy cornea
conjuctivitis - discharge (clear or cloudy)
anterior uveitis - fixed oval pupil
scleritis - no eyelid invovlement
subconjuctival haemorrhage - trauma hx or straining
periorbital cellulitis
What are normal intraocular pressures?
10-21
is glaucoma painful
closed angle yes. open angle no
treatment particularly for closed angle glaucoma
pilocarpine - constricts the pupil
What symptoms does cataract present with
glare when looking at bright lights and reduced acuity which comes on over a long time - diabetics and steroids
elderly
What is a holmes adie pupil
does not constrict for light but does for accomodation
therefore is a large dilated pupil
causes of a hypopyon
keratitis
anterior uveitis
what is keratitis
inflammation of the cornea
produces: photophobia, painful eye, associated with contact lens use(pseudamonas). foreign body gritty sensation
What is dorzolamide?
carbonic anydrase inhibitor - reduces aqueous production
can be used as a diuretic and in gout
common first line drug in acute glaucoma
acetozolamide
with pilocarpine
Causes of horners syndrome?
SSSTTTCCCC
stroke
syringomyelia
MS
Trauma
thyroidectomy
Tumour(pancoats)
cervial rib
carotid artery dissection
cavernous sinus thrombosis
cluster headache
carotid aneurysm
Causes of a marcus gunn?
central retinal artery occlusion
