Opthalm Flashcards
two types of ARMD
dry
wet (neovascularization, leakage of fluid)
what do you see in dry vs wet ARMD
dry: drusen (yellow spots)
wet (red patches of haemorrhage)
Mx for wet ARMD
anti-VEGF
bacterial keratitis
most common cause, Px, Mx
bacterial infection of the cornea
assoc. with contact lens wearers (pseudomonas!!!!) /corneal abrasion
red eye, lacrimation, feeling of foreign body in eye
Mx: topical ABs
blepharitis and MX
chronic eyelid inflammation
Mx: lid hygiene,
carotid cavernous fistula
Px
connection made between cavernous sinus and carotid artery
Px: pulsatile exophthalmos; conjunctival injection, optic bruit
cherry red spot on a pale retina
central retinal artery occlusion
stormy sunset
describe it and what causes it q
flame haemorrhages, cotton wool spots
central retinal vein occlusion
chronic open angle glaucoma and Px
increased resistance to trabecular meshwork = less drainage of aqueous humour.
gradual vision loss, tunnel vision
Mx of COAG
- surgical: selective laser trabeculoplasty
- if they don’t want SLT: latanoprost
headache, nausea, vomiting
severe eye pain, red eye, blurry vision
what is this? Mx
acute angle closure glaucoma
Mx: pilocarpine; acetazolamide; timolol
peripheral iridotomy
pupil presentation in angle closure glaucoma
fixed-dilated
3rd nerve palsy, eyes rest at what position
down adn out
scleritis vs episcleritis
both present w red eye
scleritis is more severe pain on eye movement
episceral vessels blanch when pressed, scleral do not
endopthalmitis
Px and Mx
infection inside the eye presenting with severe eye pain, vision loss
happens after cataract surgery
Mx: intravitreal vancomycin
dendritic ulcers are pathognomic for:
herpes simplex keratitis
Argyll-robertson pupil
bilaterally small pupils
constrict when focused on a near object, do not constrict upon bright light
neurosyphilis!!!!!!
optic neuritis triad and Mx
ocular pain
vision loss
colour blindness
IV methylprednisolone
swollen, red, painful eye
recently had a sinus infection
what is it? and Mx
orbital cellulitis
IV antibiotics
newborn baby, acute red eye, mucopurulent discharge bilaterally
what is it? and Mx
gonorrhoeal conjunctivitis (passed vertically through delivery)
Mx: cefotaxime
gold standard Ix for orbital cellulitis
CT sinus and orbits
post cataract surgery, progressive blurring of vision
what is it and Mx?
posterior capsule opacification
YAG laser capsulotomy
Px of anterior uveitis 4 points and Mx
redness, pain, photophobia, reduced visual acuity
Assoc with HLA B27 (ankylosing spondylitis, IBD)
Mx: dexamethason drops
any eye problem with neovascularization do….
pan-retinal photocoagulation
any eye problem with macular edema do….
anti-VEGF intravitreal
what is occlusion therapy in strabismus
covering the normal eye with a patch. forces the kid to use the abnormal eye and strengthens the msucles
ABs for orbital cellulitis
adults: pip taz
children: cefotaxime + metronidazole
Holmes Adie pupil px and ix
unilateral dilated pupil, reduced constriction upon light
positive pilocarpine test
corneal ulcer vs corneal abrasion
corneal abrasion does not cause vision loss
macular star
exudates lining up like a star
retinal blood vessels leaking fluid -> macular star
seen in hypertensive retinopathy
what is the surgery used to remove cataracts
phacoemulsification
normal intraocular pressure
12-22mmHg
1st and 2nd line treatment for conjunctivitis
topical chloramphenicol drops
topical fusidic acid drops
what treatment for conjunctivitis is contraindicated in pregnancy, what is used instead
topical chloramphenicol contraindicated
topical fusidic acid used instead
difference between bacterial, viral and allergic conjunctivitis
bacterial: discharge on waking up, grittiness, redness
viral: associated with URTI, bilateral, itchiness, pre auricular lymph nodes
allergic: redness, itchiness, check history!
how to confirm anterior uveitis
slit lamp
2 meds for anterior uveitis and MOA
topical corticosteroids (reduce inflammation)
cycloplegic myadriatic ( cyclopentane 1% )
to paralyse the ciliary muscles and relieve the pain caused by contraction of these muscles
prevent adhesions between the iris and the anterior lens capsule
management schedule for different stages of diabetic retinopathy
R0 (no retinopathy) → annual check up
R1 (background retinopathy) → annual check up
R2 (pre proliferative) → non-urgent opthalm (see in 13 weeks, monitor every 4-6 months)
R3 (proliferative) → urgent opthalm
M1 (maculopathy) → urgent opthalm
symptoms of proliferative retinipathy
blurred vision
floaters
what is diabetic maculopathy
when any features of diabetic retinopathy exist at the macula
e.g. ring of exudates and a dot haemorrhage at the fovea (macular centre)
what anatomical region creates the blind spot
optic disc
retinal detachment:
if the symptoms are from an inferotemporal side, the detachment will be from the….
superonasal side
phenylephrine causes resolution of symptoms, what was the condition
episcleritis
If the inflammation is localized to the episcleral tissue, then the vessels will blanch with the phenylephrine, and the eye will be relatively white and asymptomatic
posterior vitreous detachment
precursor to retinal detachment
associated with myopia
px flashes and floaters
no horseshoe tear seen on dilated fundoscopy
how to differentiate between HSV ulcer and non HSV ulcer
HSV ulcer = dendritic ulcer. stain very brightly with floeurescein + has a terminal bump (even brighter)
non HSV ulcer e.g. acanthomeba or VZV = pseudodendritic ulcer. no terminal bulbs
complication of pan retinal photocoagulation
decreased night vision
what Ix is used to confirm wet ARMD
flourescein angiography
Mx of HSV keratitis
Topical aciclovir drops
Mx of corneal abrasion
topical antibiotic drops
Mx of herpes zoster opthalmicus
oral aciclovir
2 risk factors for retinal detachment
myopia
type 2 diabetes mellitus
risk factor for acute angle closure glaucoma
hypermetropia (long sightedness)
Ix for vitreous haemorrhage
red blood cells in the anterior chamber
what to use to test for refractive error
pin hole occluder
treatment of dry AMD
High dose of beta-carotene, vitamins C and E, and zinc can be given to slow deterioration of visual loss
difference between argyll robertson pupil and holmes adie pupil
holmes adie constricts slowly upon light, but argyll Robertson does not constrict at all
