Opthalmology Flashcards
What is present in background diabetic retinpathy
Microaneurysms, blot hemorrhages, hard exudates, cotton wool spots
What questions should be asked when taking an opthalmic history?
- Did the problem start suddenly or gradually?
- Painful or painless?
- Transient of persistent?
- Unilateral or bilateral?
- Is the vision blurred: centerally or both centerally and peripherally
- Is there and associated distortion or double vision
- Are the symptoms there all the time?
Causes of an acute red eye?
Conjuntivities
Scleritis
Keratitis
Anterior uveitis
Corneal forigen body
Episcleritis
Subconjunctival haemorrhage
An acute red eye is usually painful or uncomfotable, what might be the cause if it is not?
Subconjunctivial haemorrhage
Vision in conjunctivitis?
Normal
Vision in scleritis?
Either normal or reduced
Vision in keratitis?
Reduced
Vision in anterior uveitis?
Normal or reduced
Vision in episcleritis?
Normal
Will a corneal forigen body reduce vision?
Sometimes, depedning on where the FB is
Vision in subconjuncitival haemorrhage?
Normal
What might be the cause of reduced vision and red eye in a patient found to have normal IOP?
Corneal abrasion
Keratitis
Endophthalmitis
What might be the cause of reduced vision and red eye in a patient found to have increased IOP?
Acute glaucoma
Anterior uveitis
What might cause a sudden, painless loss of vision, of a few seconds of duration?
Unilateral:
Giant cell arteritis
Optic disc swelling (infectious, inflammatory)
Impending central retinal vein occlusion
Bilateral:
Disc swelling due to idiopathic intracranial hypertension (visual obscurations)
What might cause a sudden, painless loss of vision, of a few minuites of duration?
Unilateral:
Amaurosis fugax
Giant cell arteritis
Bilateral:
Vertebrobasilar artery insufficiency
How long might visual loss from migraine aura last?
Up to 1 hour
What is visual obscurations?
Disc swelling due to idiopathic intracranial hypertension
What might cause a painful sudden loss of vision?
CORNEAL ABNORMALITY - Keratitis
DISC ABNORMALITY - optic neuritis
UVEA ABNORMALITIY - anterior uveitis
NORMAL FUNDUS - retrobulbar optic neuritis
Generalised causes of gradual visual loss?
Refractive error
Cataract
Central causes of gradual visual loss?
Abnormal macula (e.g. age related macular degeneration, macula oedema, diabetic maculopathy)
Abnormal optic disc (optic neuritis)
Peripheral or pathy causes of gradual loss of vision?
Abnormal choroid/retina (e.g. posterior uveitis)
Abnormal optic disc (e.g. glaucoma)
Causes of monocular diplopia?
Due to pathology from affectsed eye
Abnormal refraction
Abnormal cornea
Abnormal lens
Abnormal iris
(Normal examination - not diplopia)
e.g. cataract, corneal abrasion, eyelid cyst
What might cause binocular diplopia?
Pathology in the nerves, neurmuscular junction or muscles
Intermittent/variable:
Myasthenia gravis (NMJ)
Intranuclear opthalmoplegia
Giant cell arteritis
Persistent:
Neurogenic - cranial nerve palsies
Myogenic - congenital (rare) or acquired (e.g. thyroid)
Ocular clinical features of myasthenia gravis?
Variable diplopia/pstosis - usually worsening towards evening/with exercise