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Opthalmology Flashcards

1
Q

In what eye pathology is colour vision affected?

A

Optic neuritis

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2
Q

What is the most common ophthalmological manifestation of sarcoidosis?

A

Bilateral anterior uveitis

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3
Q

Which is painful - episcleritis or scleritis?

A

Scleritis

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4
Q

By what age does congenital lacrimal duct obstruction, causing recurrent watery/sticky eye, tend to resolve by?

A

1 year

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5
Q

What is mydriasis?

A

Dilatation of the pupil

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6
Q

What opthalmic feature is seen in congenital Horner’s syndrome?

A

Heterochromia

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7
Q

What are the features of Horner’s syndrome?

A

Miosis (small pupil)
Ptosis
Anhidrosis
Enophthalmos (sunken eye)

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8
Q

How do you distinguish between Horner’s and a third-nerve palsy?

A

Third nerve palsy = ptosis + DILITATION of the pupil

Horner’s = ptosis + CONSTRICTION of the pupil

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9
Q

If anhidrosis affects the face, arm and trunk, where is the lesion most likely to be in Horner’s syndrome?

A

S’s

Stroke
Syringomyelia
Multiple sclerosis
Tumour
Encephalitis
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10
Q

If anhidrosis only affects the face, where is the lesion most likely to be in Horner’s syndrome?

A

T’s

Pancoast tumour
Thyroidectomy
Trauma
Cervical rib

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11
Q

If there is no anhidrosis (but other features of Horner’s) where is the lesion most likely to be?

A

C’s

Carotid artery dissection
Carotid aneurism
Cavernous sinus thrombosis
Cluster headache

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12
Q

Which opthalmic pathology is the most common cause of floaters?

A

Posterior vitreous detachment

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13
Q

What is seen on fundoscopy in central retinal vein occlusion?

A

Retinal haemorrhages

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14
Q

What is seen on opthalmic imaging in central retinal artery occlusion?

A

A ‘cherry red spot’ on a pale retina

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15
Q

What are the causes of Argyll-Robertson pupil?

A

Neurosyphillis

DM

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16
Q

What should be checked in patients with subconjunctival haemorrhage, that are also on warfarin?

A

INR

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17
Q

How does retinitis pigmentosa present on fundoscopy?

A

Black bone-spicule pigmentation

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18
Q

What is the mot common cause of orbital cellulitis in children?

A

Ethmoidal sinusitis

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19
Q

How do you distinguish between orbital and preseptal cellulitis?

A

Proptosis
Decreased visual acuity and ocular motility

^^don’t usually occur in preseptal cellulitis

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20
Q

What are the characteristics of retinitis pigmentosa?

A

Night blindness and tunnel vision

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21
Q

What diseases are associated with retinitis pigmentosa?

A 
Refsum disease: cerebellar ataxia, peripheral neuropathy, deafness, ichthyosis
Usher syndrome
Abetalipoproteinemia
Lawrence-Moon-Biedl syndrome
Kearns-Sayre syndrome
Alport's syndrome
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22
Q

What is diabetic maculopathy?

A

Any structural abnormality due to diabetes affecting the macula

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23
Q

What is NPDR?

A

Non-proliferative diabetic retinopathy

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24
Q

What defines mild NPDR?

A

1 or more microaneurysm

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25
What defines moderate NPDR?
Microaneurysms Blot haemorrhages Hard exudates Cotton wool spots, venous beading/looping and intraretinal microvascular abnormalities (IRMA) less severe than in severe NPDR
26
What defines severe NPDR?
Blot haemorrhages and microaneurysms in 4 quadrants Venous beading in at least 2 quadrants IRMA in at least 1 quadrant
27
What are the causes of chorioretinitis?
``` Syphilis Cytomegalovirus Toxoplasmosis Sarcoidosis Tuberculosis ```
28
How does toxoplasmosis retinitis classically present?
White focal retinitis with overlying vitreous inflammation
29
What is the first line treatment in glaucoma?
Prostaglandin analogue (PGA) eyedrop - e.g. latanoprost
30
What is the second line treatment in glaucoma?
Beta-blocker, carbonic anhydrase inhibitor, or sympathomimetic eyedrop
31
What are the adverse effects of miotics (e.g. pilocarpine)?
Pupil constriction, blurred vision and headaches
32
Symapathomimetics - e.g. brimonidine - should not be taken with which drugs?
MAOI or tricyclic antibiotics
33
How do prostaglandin analogues work in the treatment of glaucoma?
Increases uveoscleral outflow
34
How do beta-blockers work in the treatment of glaucoma?
Reduces aqueous production
35
How do sympathomimetics work in the treatment of glaucoma?
Reduces aqueous production and increases outflow
36
How do carbonic anhydrase inhibitors work int he treatment of glaucoma?
Reduces aqueous production
37
How should bacterial conjunctivitis be treated in pregnancy?
Fuscidic acid eye drops
38
What is a Holmes-Adie pupil?
Benign condition most commonly seen in women. Dilated pupil - unilateral in 80% of cases Once the pupil has constricted it remains small for an abnormally long time Slowly reactive to accommodation but very poorly (if at all) to light
39
What is Holmes-Adie syndrome?
Association of Holmes-Adie pupil with absent ankle/knee reflexes
40
What does Keith-Wagener classification system classify?
Degrees of hypertensive retinopathy
41
What is a stage I hypertensive retinopathy?
Arteriolar narrowing and tortuosity | Increased light reflex - silver wiring
42
What is a stage II hypertensive retinopathy?
Arteriovenous nipping
43
What is a stage III hypertensive retinopathy?
Cotton-wool exudates | Flame and blot haemorrhages
44
What is a stage IV retinopathy?
Papilloedema
45
What is proliferative retinopathy?
Retinal neovascularisation - may lead to vitrous haemorrhage | It's more common in T1DM, with rates of blindness being 50% within 5 years
46
What are the features of papilloedema on fundoscopy?
Venous engorgement: usually the first sign Loss of venous pulsation: although many normal patients do not have normal pulsation Blurring of the optic disc margin Elevation of optic disc Loss of the optic cup Paton's lines: concentric/radial retinal lines cascading from the optic disc
47
How is anterior uveitis?
Steroid + cycloplegic (mydriatic) eye drops
48
What is the most common ocular presentation of RA?
Keratoconjunctivitis sicca - characterised by dry, burning and gritty eyes caused by decreased tear production
49
What can cause blurred vision several years after cataract surgery?
Posterior capsule opacification
50
When should you refer a child with a squint to secondary care?
>3/12 - intermittent squint at 3/12 is normal and does not need investigating
51
Where do drusen accumulate in the eye in AMD?
Bruch's membrane and the retinal pigment epithelium
52
What are hard exudates?
Lipoprotein leaked from blood vessels Seen in DM and HTN Well-defined, yellow-white, often in rings
53
What are soft exudates?
Look like cotton-wool Occur in infarcted retina Due to swelling in the axons in the nerve fibre layer of the retina
54
What are the first/second/third line options for glaucoma?
``` First = Latanoprost Second = Timolol Third = Brimonidine or Brinzolamide ```
55
How does central retinal artery occlusion present?
Pale+++ retina and 'cherry red spot'
56
What type of visual field defect is classical to glaucoma?
Arcuate scotoma
57
What type of visual field defect is classic of disease affecting the macula?
Central scotoma
58
What type of visual field defect is classic in toxic neuropathy?
Centrocaecal scotoma
59
What type of visual field defect is seen in retinitis pigmentosa?
Ring scotoma
60
What are the causes of cataracts?
``` Myotonic dystrophy Ageing DM Rubella/CMV/Syphillis Steroids Radiation Trauma ```
61
Which drug should be co-prescribed when ethambutol is prescribed for TB to reduce the risk of optic neuritis?
Pyridoxine (vitamin B6)
62
When should laser trabeculoplasty be considered in glaucoma?
When there has been x2 unsuccessful trials of pharmacological agents
63
How may optic neuritis be treated?
IV methylprednisolone
64
What type of lesion is Bell's palsy?
Lower motor neurone problem
65
When should you suspect an UMN lesion with a Bell's palsy-like presentation?
When the forehead is unaffected. Forehead will be affected in true Bell's palsy
66
What is the criteria for the certification of blindness (severely sight-impaired)?
<3/60 with a full visual field, whilst wearing glasses as prescribed
67
What might aqueous flare indicate?
Anterior uveitis
68
What diagnosis should be suspected in paediatric proptosis?
Rhabdomyosarcoma
69
What test may improve VA in cataracts?
Pinhole test

MSRA (18 decks)

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