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Finals > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

What is anterior uveitis?

A

Also referred to as iritis. It is an inflammation of the anterior portion of the urea (iris and ciliary body).

It is associated with HLA-B27.

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2
Q

What are the features of anterior uveitis?

A 
Acute onset
Pain
Pupil small +/- irregular
Photophobia
Blurred vision
Red eye
Lacrimation
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3
Q

What is the management of anterior uveitis?

A

Urgent review by ophthalmology
Cycloplegics (dilate pupil to ease pain) - atropine, cyclopentolate
Steroid eye drops

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4
Q

What is the difference between retinal artery and retinal vein occlusion s?

A

Central retinal vein occlusion:

  • more common than arterial
  • causes: glaucoma, polycythaemia, hypertension
  • severe retinal haemorrhages seen on fundoscopy

Central retinal artery occlusion:

  • due to thromboembolism or arteritis
  • features include affront pupillary defect, cherry red spot on pale retina
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5
Q

What is blepharitis?

A

Inflammation of the eyelid margin either due to meibomian gland dysfunction or seborrhoeaic dermatitis or infection.

More common in people with rosacea

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6
Q

What are the features of blepharitis

A

Bilateral
Gritty eyes
Stick in the morning
Swollen eyelids

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7
Q

What is open angle glaucoma

A

It is an increase in the intraocular pressure due to blockage of the aqueous humour.

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8
Q

what are the risk factors of open-angle glaucoma?

A
  • increasing age
  • myopia
  • family history
  • black ethnic origin
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9
Q

Describe the presentation of open-angle glaucoma

A
  • halos around light (usually worse at night)
  • peripheral vision loss
  • fluctuating pain
  • headaches
  • blurred vision
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10
Q

What are the investigations for open-angle glaucoma?

A
  1. Non-contact tonometry

2. Goldmann applanation tonomertry

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11
Q

What is the diagnosis of open-angle glaucoma?

A
  1. Goldmann applanation tonometry
  2. Optic disc cupping on fundoscopy
  3. Peripheral vision loss
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12
Q

What is the management of open-angle glaucoma?

A
  1. Prostaglandin analogues e.g. latanoprost
  2. Topic beta-blockers e.g. timolol
  3. Carbonic anhydride inhibitors e.g. dorzolamide
  4. Sympathomimetics e.g. brimonidine

Surgery (trabeculectomy)

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13
Q

What is acute angle closure glaucoma

A

Increased intraocular pressure due to iris bulging forward and blocking the trabecular network meaning that aqueous humour cannot get out.

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14
Q

What are the risk factors for acute angle closure glaucoma?

A
  • increasing age
  • female
  • East Asian/Chinese ethnicity
  • family history
  • shallow anterior chamber
  • hypermetropia

Medications: adrenergic (NA), Antcholinergics (oxybuynin), TCA (amitriptyline)

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15
Q

What is the presentation of acute angle-closure glaucoma?

A
  • systemically unwell appearance
  • halos around light
  • severely painful red eye
  • blurred vision
  • associated nausea, headache and vomiting
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16
Q

Describe the examination findings of acute angle closure glaucoma

A
  • hazy cornea
  • red eye
  • pupil fixed and dilated
  • teary eye
  • decreased visual acuity
17
Q

What is the initial management of acute angle closure glaucoma in primary care

A

Same day referral to opthalmology (ambulance)

  • lie them on their back with no pillow
  • pilocarpine Eye drops
  • acetazolomide 500mg
  • analgesics
  • anti-emetics
18
Q

What is the secondary care management of acute angle closure glaucoma?

A
  • pilocarpine eye drops
  • azetazolamide
  • hyperosmotic agents
  • carbonic anhydride inhibitor (dorzolamide)
  • beta blocker (timolol)
  • sympathomimetic (brimonidine)

Gold standard surgery: laser iridotomy

19
Q

What are the opthalmological features of Graves’ disease?

A
  • increasing Diplopia on looking up
  • lid retraction and proposes (one sided)
  • reduced gaze in one eye
20
Q

What is seen on fundoscopy for non-proliferative diabetic retinopathy?

A

MILD: microaneurysms

MODERATE: Cotton wool spots, Microaneurysms, Hard exudate, Blot haemorrhages and venous beading.

SEVERE: blot haemorrhages plus microaneurysms in 4 quadrants venous beading in 2 quadrants

21
Q

What is seen on fundoscopy in proliferative diabetic retinopathy?

A

Neovascularisation and virteous haemorrhage

22
Q

What is seen on fundoscopy in diabetic maculopathy?

A

macular oedema and ischaemic maculopathy

23
Q

What is the management of diabetic retinopathy?

A

Lasar photocoagulation
Anti-VEGF medicaitons such as ranibizumab
Viteroretinal surgery

24
Q

What is the presentation of cataracts?

A

Assymetrical:

Very slow reduction in vision
Progressive blurring of vision
Change of colour of vision with colours becoming more brown or yellow
STARBURTS can appear around lights

No red reflex

25
Q

What is the presentation of age related macular degeneration?

A

Gradual worsening central visual field loss
Reduced visual acuity
Crooked or waxy appearance to straight lines

26
Q

What is the presentation of retinal detachment?

A

Peripheral vision loss (sudden and like a shadow)

Blurred or distorted vision

FLASHES and FLOATERS

27
Q

What is the diagnosis and management of retinal detachment?

A

Vitrectomy
Scleral buckling
Pneumatic retinopexy

US B-Scan for diagnosis

28
Q

What is the presentation of scleritis?

A 
Acute onset of symptoms:
Severe pain
Pain with eye movement
Photophobia
Eye watering
Reduced visual acuity
Abnormal pupil reaction to light
Tenderness to palpation of eye
29
Q

What is the management of scleritis?

A

Same day ophthalmologist assessment.

NSAIDs
Steroids
Immunosuppression

30
Q

What is the presentation of optic neuritis?

A

Unilateral reduced vision developing over hours to days. Key features:

  • central scotoma
  • pain on eye movement
  • impaired colour vision
  • relative afferent pupillary defect
31
Q

What is the difference between episcleritis and scleritis?

A

Scleritis is painful

32
Q

Vision worse going down the stairs = which nerve palsy?

A

Superior oblique therefore Trochlear nerve SO4

33
Q

What does dendritic ulcers on fluorescein stain suggest?

A

Herpes simplex keratitis

Finals (20 decks)

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