Opthalm Flashcards
what is the aetiology of closed angle glaucoma
drainage angle is blocked > raised IOP > optic nerve damage
what are risks factors for acute closed angle glaucoma
female
hypermetropria
old age
S/S closed angle glaucoma
reduced visual acuity
N&V
halo around light
severe pain
headache
Ix closed angle glaucoma
fundoscopy (cloudy cornea, fixed and dilated pupil)
Gonioscopy with slit lam
Mx for closed angle glaucoma
refer
medical mx (ATP)
surg: laser peripheral iridiotomy of both eyes (essentially drill small hole through iris > do this on both eyes as other eye is likely to be affected)
what is anteror uveitis
inflammation of the anterior uvea (iris, ciliary)
sx anterior uveitis
acute pain
photophobia
blurred vision
pus in anterior chamber
what do you see on fundoscopy for anterior uveitis
irregular small pupil
explain the different types of conjunctivitis
viral: watery, bilateral OR unilateral
Bacterial: sticky purulent, always unilateral
allergic: pruritic, bilateral
mx of conjunctivitis if contant wearer
if contact lens wearer > refer to same day opthalm review as difficult to deetermine difference between conjunctivtis and microbial keratitis > prompt tx required
mx for different types of conjunctivitis
bacterial: chlorpenicol drips
allergic: histamine drips
viral: nil
what is corneal abrasion
scratch to epithelium of eye
ix corneal abrasion
slit lamp fluoroscein staining defect green
mx corneal abration
infection prophylaxis (chlorphenicol ointment)
what is a corneal ulcer / keratitis caused by
Bacterial e.g. s aureus, p aeroginosa (contact lenses)
Fung
Amoeba
Viiral - HERPES SIMPLEX KERATITIS (dendtritic ulcer)
S/S corneal ulcer
pain photophobia blurred vision
visible defect, grittiness,
white corneal opacity
corneal ulcer complications
scarring
visual loss
ix for corneal ulcer
slit lamp fluorescin stain
what is opthalmic shingles / activation of herpe zoster opthalmicus
CN v1 reactivation of VZV
how does opthalmic shingles present
pain
blistering rash
how do you manage opthalmic shingles
refer > oral aciclovir > topical corticosteroids
causes of sudden loss of vision
optic neuritis
vitreus haemorrhage
retinal detachment
retinal vessel occluson
sx optic neuritis
Central scotoma
RAPD
acuity loss (central vision, colour vision)
pain on movement
causes of optic neuritis
MS
DM
drugs
infection e.g. lyme, VZV
whatr is a viteus haemorrhage caused by
angiogenesis (DM)
retinal tear, detachment, trauma (e.g. warfarin)
retinal detachment cause
separation of retinal layers > decreased blood supply and oxygen to retina
sx retinal detachment
floaters
flashes
field loss
fall in acuity
mx retinal detachment
needs urgent surgery
explain age related macular degen
MOST COMMON CAUSE OF BLINDNESS in <60
ssx ARMD
central vision loss
old age
blurring of small words
straight liness appear curvy
what is catarach
clouing of the lens of the eye
causes of cataract
age
steroids
smoking
DM
S/S catARACT
myopia
blurred vision, gradual vision loss
dazzling in bright lights, night vision loss
halos
mx cataract
- glasses, sunglassses, glycaemic control
- medical: mydriadic eye drops (tropicamide)
- surg: cataract surgery (laser)
stages of diabetic retinopathy
- Background
- Pre-proliferative
- Proliferative
Describe background diabetic retinopathy
- venodilation
- microaneurysm (red dots)
- hard exhudates
describe pre-proliferative diabetic retinopatthy
soft exhudates (COTTON WOOL SPOTS) = ischaemia in retina (will lead to angiogenic factor release and new vessel formation later)
describe proliferative diabetic retinopathy
new vessel growth!!! may burst and cause haemorrhage in vitreus
what are the four stages of hypertensive retinopathy
- Arteriolar narrowing, silver wiring
- AV nipping
- Flame-shaped haemorrhages, cotton wool spots
- Papilloedema
how do you treat pre-prolif / prolif diabetic nephropathy?
pan retinal laser photocoagulation
