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Medicine Year 4 > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

Management of anterior uveitis

A

Urgent referral

Treated with steroid and cycloplegic eye drops

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2
Q

Treatment of herpes simplex keratitis

A

Topical aciclovir

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3
Q

Ptosis and dilated pupil

Ptosis and constricted pupil

A

Dilated: Third nerve palsy
Constricted: Horners

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4
Q

What eye condition can be present in cases of seborrhoeic dermatitis

A

Blephritis

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5
Q

Catarscts

A

Endopthalmitis

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6
Q

Ciliary flush and painful red eye with photophobia and reduced vision

A

Anterior uveitis

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7
Q

Failure to correct childhood quints may lead to…

A

Amblyopia

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8
Q

Reduction in aqueous secretion and induction of pupillary constriction

A

Acute angle closure glaucoma

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9
Q

3 presentations of horners syndrome

A

head, arm, trunk = central lesion: stroke, syringomyelia
just face = pre-ganglionic lesion: Pancoast’s, cervical rib
absent = post-ganglionic lesion: carotid artery

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10
Q

Paipilloedema

A

Grade 4

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11
Q

What does macular degeneration NOT cause

A

Tunnel vision

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12
Q

What condition are dursen found in

A

Dry macular degeneration

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13
Q

Squint management

A

Refer to opthalmology

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14
Q

Known precipitant of acute angle closure glaucoma

A

Mydriatic drops

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15
Q

Sudden painless loss of vision with a dense shadow starting peripherally and progressing centrally with spider webs and flashing lights

A

Retinal detacthment

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16
Q

Sudden painless loss of vision with severe retinal haemorrhages on fundoscopy

A

Central retinal vein occlusion

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17
Q

What is hutchinsons sign

A

Vesicles extending to the tip of the nose

Strongly associated with ocular involvement in shingles

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18
Q

Difference between vessels in episcleritis and scleritis

A

Episcleritis: vessels are mobile when gently pressure is applied on the sclera
Scleritis: vessels are deeper so they do not move

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19
Q

Painless, transient monocular blindness together with the description of a ‘black curtain coming down’

A

amaurosis fugax

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20
Q

Difference between acute angle closure glaucoma and primary open angle closure glaucoma

A

Acute: hypermetropia
Primary: myopia

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21
Q

Contraindication for a lumbar puncture

A

Raised ICP

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22
Q

Relevant afferent pupillary deficit and central scotoma

A

Optic neuritis (MS)

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23
Q

Decreasing vision over months with metamorphopsia and central scotoma

A

Wet age related macular degeneration

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24
Q

Presentation of ‘red eye’ in glaucoma and uveitis

A

Glaucoma: severe pain, haloes, ‘semi-dilated’ pupil
Uveitis: small, fixed oval pupil, ciliary congestion

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25
Q

Side effect of steroid eye drops

A

Fungal infections which can cause corneal ulcers

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26
Q

Emergency management of primary open angle glaucoma

A 
Direct parasympathomimetic (pilocarpine) to contract ciliary muscle
Beta blocker (TIMOLOL) to reduce aqueous production 
Alpha 2 agonist (apraclonidine)

IV acetazolamide

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27
Q

Blunt ocular trauma with associated hyphema is a high risk scenario of what?

A

Raised intraocular pressure

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28
Q

Management of contact lens wearers with a painful red eye

A

Referred to eye casualty to exclude microbial keratitis

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29
Q

Side effects of Lantanoprost

A

Increases eyelash length, iris and periocular pigmentation

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30
Q

Contact lenses during conjunctivitis?

A

Do not wear

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31
Q

Screen for childhood squint?

A

Corneal light reflection test

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32
Q

Definite treatment for acute angle closure glaucoma

A

Laser peripheral iridotomy

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33
Q

Management of a patient with an organic foreign body in their eye (eg grass seed)

A

Immediate referral to opthalmology for assessment (due to infection risk)

34
Q

Dark spots in vision with no pain and PMHx T2DM

A

Vitreous haemorrhage

35
Q

Red eye which is not painful

A

Episcleritis

36
Q

Test for age related macular degeneration

A

Amsler grid testing

37
Q

What do drusen look like?

A

Yellow deposits in the retina

38
Q

Management and presentation of orbital cellulitis

A

Swelling and painful red eye with fever and limited ocular movements
Admit for IV antibiotics

39
Q

2 complications of orbital cellulitis

A

Cavernous sinus thrombosis

Intracranial spread

40
Q

Wet age related macular degeneration on fundoscopy

A

Well demarcated red pathces

41
Q

Treatment of wet age related macular degeneration

A

anti-VEGF

42
Q

Herpes simplex keratitis on examination with stain

A

Dendritic ulcer

43
Q

What investigation is used to guide treatment for age related macular degeneration

A

Fluorescein angiography

44
Q

Anisocoria worse in bright light - where is the problem

A

In the pupil which is dilated

45
Q

Parasympathetic and sympathetic - what do they each do to the pupils?

A

Parasympathetic causes pupil constriction (ciliary ganglion)

Sympathetic causes pupil dilation

46
Q

Risk factor for vitreous haemorrhage

A

Warfarin and other blood thinning agents

47
Q

What investigation is used to identify refractive errors

A

Use of a pin hole occluder

48
Q

Presentation of acute closed-angle glaucoma

A

Fixed dilated pupil, conjunctival infection, halos around lights, blurry vision, headaches, vomiting, dull cornea

49
Q

What are cotton wool spots?

A

Pre-capillary arteriolar occlusion (areas of retinal infarction)

50
Q

Treatment for allergic conjunctivitis

A

First line: Topical or systemic antihistamines

Second line: Topical mast cell stabilisers e.g. sodium cromoglicate and nedocromil

51
Q

Risk factors for anterior uveitis

A

Ankylosing spondylitis

Crohns

52
Q

Organism in contact lens keratitis

A

Pseudomonas aeruginosa

53
Q

Sudden painless loss of vision with a red spot and pale retina on fundoscopy

A

Central retinal artery occlusion

54
Q

Definite management of acute angle closure glaucoma

A

Laser peripheral iridotomy

55
Q

Management of primary open angle glaucoma

A

Latanoprost (prostaglandin analogue) to increase outflow

56
Q

Pain out of proportion of clinical presentation, contact lens and recent freshwater swimming

A

Acanthamoebic keratitis

57
Q

4 features of horners

A

miosis (small pupil)
ptosis
enophthalmos* (sunken eye)
anhidrosis (loss of sweating one side)

58
Q

Screening if a FHx of glaucoma

A

Annual screening from age 40 years

59
Q

Sudden onset visual loss with flashers and floaters

A

Posterior viterous detachment

60
Q

Blurry vision for a few months with halos surrounding light with PMHx T2DM

A

Cataract

61
Q

Carbon dioxide and ICP

A

Raised CO2 may cause raised ICP (therapeutic hyperventilation to induce hypocapnia used in emergencies)

62
Q

Define mydriatic

A

Dilated pupil

63
Q

What is argull-Robertson pupil

A

Seen in neurosyphilis

Small irregular pupils, no response to light but response to accommodation

64
Q

Give 4 causes of dilated pupils

A

Third nerve palsy
Atropine
Holmes-Adie pupil
Traumatic iridoplegia

65
Q

Trau

A
66
Q

Risk factor for subscapular cataracts

A

Steroid use

67
Q

Two stages of diabetic retinopathy

A

Pre-proliferative

Proliferative: neovascularisation, vitreous haemorrhage

68
Q

3 features of keratitis

A

Red eye, photophobia, gritty sensation

69
Q

1st line treatment for blepharitis

A

Hot compress and mechanical removal of debris

70
Q

What is a holmes adie pupil?

A

Viral or bacterial infection damages the parasympathetic nerves

71
Q

What condition is diagnosed by the swinging light test

A

Marcus-Gunn Pupil

72
Q

What is chalazion

A

A meibomian cyst presents as a firm painless lump in the eyelid

73
Q

Presentation of optic neuritis

A

Visual loss, eye pain and red desaturation

74
Q

central scotoma

A
75
Q

Visual field loss in macular degeneration vs primary open angle glaucoma

A

Macular degeneration: central field loss

Primary open angle glaucoma: peripheral field loss

76
Q

Blurry vision with wavy/crooked lines and central visual field loss

A

Age related macular degeneration

77
Q

Does calcium affect cataract development?

A

Yes, hypOcalcemia increases the risk of cataracts

78
Q

4 risk factors for cataracts

A

Downs
Diabetes
Steroids
Uveitis

79
Q

Retinopathy presentation

A

Painless reduction in visual acuity

80
Q

Episcleritis vs Scleritis

A

Episcleritis is painless

Scleritis is painful

Medicine Year 4 (13 decks)

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