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Clinical Medicine > Opthalmology 👁 > Flashcards

Opthalmology 👁 Flashcards

1
Q

Which HLA protein is anterior uveitis associated with

A

B27

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2
Q

What conditions are associated with anterior uveitis

A

IBD
reactive arthritis
Ankylosis spondylitis
Sarcoidosis
Behçet’s disease

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3
Q

Symptoms of anterior uveitis

A

Red eye
Acute inset eye pain
Small irregular pupil
Photophobia
Blurred vision
increased lacrimation

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4
Q

Mx anterior uveitis

A

Urgent review by ophthalmology
Steroid eye drops

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5
Q

Symptoms of conjunctivitis

A

Purelent discharge
Sticky eyes
Viral = clear discharge may follow an URTI
allergic = itchy swollen eyes

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6
Q

Symptoms of episcleritis

A

Red eye
Classically not that painful
Watering photophobia

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7
Q

Symptoms of scleritis

A

Red eye
A lot more pain
Gradual decreased vision
Watering
Photophobia

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8
Q

Ix of episcleritis and scleritis

A

Phenylephrine drops

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9
Q

Mx of scleritis

A

NSAID
corticosteroids

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10
Q

Symptoms central retinal artery occlusion

A

Sudden unilateral vision loss
Painless

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11
Q

Characteristic finding of central retinal artery occlusion

A

Cherry red spot

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12
Q

Symptoms of central retinal vein occlusion

A

Sudden unilateral painless vision loss

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13
Q

On fundoscopy what would u see for central retinal vein occlusion

A

Stormy sunset

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14
Q

Symptoms of retinal detachment

A

Black curtain peripherally and moving into central vision
Flashers (photopsia) and floaters
Central vision loss painless

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15
Q

Symptoms of vitreous haemorrhage

A

Floaters / dark spots in Vision
Painless visual loss/haze

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16
Q

Symptoms of dry macular degeneration

A

Reduction in visual acuity esp for close objects
Poor night vision and dark adaptation
Flickering or flashing lights

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17
Q

On fundoscopy for DARMD

A

Drusen

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18
Q

Symptoms of wet macular degeneration

A

Sudden vision loss

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19
Q

Fundoscopy for WARMD

A

red patches

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20
Q

Mx for WARMD

A

Anti- VEGF

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21
Q

Symptoms of acute angle closure glaucoma

A

Severe ocular pain or headache
Nausea and vomiting
Decreased acuity
Fixed-dilated non reacting pupil
Red eye

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22
Q

Mx acute angle closure glaucoma

A

Eye drop combo to improve outflow
Beta blocker to decrease humour production
If acetazolamide decreased secretion
Laser iridotomy definitively

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23
Q

Symptoms of temporal arthritis

A

Headache
Jaw Claudia turn
Tender palpable temporal artery
Virtual disturbance - bad sign however
Acute onset

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24
Q

Ix temporal arthritis

A

CRP raised
Temporal artery biopsy - skip lesion

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25
Mx temporal arthritis
High dose steroid
26
Describe CN3 palsy
Ptosis Eye down and out Pupil may be dilated Supplies 4/6 main intrinsic eye muscles
27
Describe CN4 palsy
Diplopia Subjective tilting of objects £ patient may develop a head tilt to compensate Eye deviated up and out Supplies superior oblique
28
Describe CN6 palsy
Results in defective abduction Horizontal diplopia Supplies lateral rectus
29
CN5 palsy
Afferent branch of corneal reflex
30
what ocular side effects can steroids have
raised intraocular pressure glaucoma accelerated cataract formation
31
risk factors for ARMD
AGE male smoking family hx cardiovascular risk factors
32
symptoms of ARMD
reduced visual acuity poor vision at night photopsia - perceived flickering of lights glare
33
what is bacterial keratitis
bacterial infection of cornea often precipitated by minor trauma, contact lens use or ocular surgery
34
symptoms of bacterial keratitis
pain foreign body sensation tearing or purulent discharge red eye corneal ulcer
35
mx bacterial keratitis
referral to ophthalmologist immediately
36
what is bell's palsy
idiopathic syndrome affecting the facial nerve
37
what are the characteristic features of bells palsy
acute onset unilateral lower motor neuron facial weakness sparing extraocular muscles and muscles of mastication
38
Corneal Arcus
White blue or opaque ring
39
Differentiating scleritis from episcleritis
Scleritis will have painful ocular movement Severity of pain Nonblanching vessels
40
What is retinitis pigmentosa
INHERITED condition causing retinal degeneration
41
Clinical features of retinitis pigmentosa
Pts often present at a young age with tunnel vision Also classically complain of reduced visual acuity in dim light
42
Fundoscopy findings for retinitis pigmentosa
Peripheral pigment deposits Optic disc pallor Retinal vessel attenuation
43
What is corneal abrasion
Defined as a defect in the corneal epithelium
44
What is orbital cellulitis
Infection of the structures behind the orbital septum
45
Risk factors for orbital cellulitis
Trauma Surgical - ocular, adnexal or sinus Sinus disease - ethmoid sinus is most common site of infection Other facial infections
46
Symptoms of orbital cellulitis
Periocular pain and swelling Fever Malaise
47
Signs of orbital cellulitis
Erythematous, swollen and tender eyelid Chemosis Proptosis Restricted eye movements +/- diplopia
48
Management of orbital cellulitis
Admission for IV abx and close monitoring
49
What is pre septal cellulitis
Infection of tissue anterior to orbital septum Much more common than orbital cellulitis Less severe
50
Risk factors for preseptal cellulitis
Trauma Infection of adjacent facial structures
51
Clinical features of preseptal cellulitis
Typical patient is a child with an erythematous swollen eyelid, mild fever and erythema surrounding the orbit Important findings that suggest pre septal rather than orbital No proptosis Normal eye movements No chemosis Normal optic nerve function
52
Management preseptal cellulitis
Young or systemically unwell should be admitted for IV abx Otherwise outpatient treatment with abx
53
What is optic neuritis
Inflammation of the optic nerve Mostly occurs in adult women and people who live in high latitude
54
Causes of optic neuritis
Demyelinating lesions (MS most common) Autoimmune disorders Infectious conditions
55
Clinical features of optic neuritis
Clinical diagnosis consists of the classic triad of Visual loss Periocular pain Dyschromatopsia
56
Treatment of optic neuritis
First line is IV methylprednisolone
57
myopia
short-sightedness
58
stereopsis
depth perception
59
amblyopia
lazy eye
60
hypermetropia
longsightedness
61
what is ischaemic optic neuropathy
broad term that describes optic nerve damage due to a lack of blood supply
62
clinical features of ischaemic optic neuropathy
generally, patients present with sudden onset monocular vision loss and colour blindness o/e relative afferent pupillary defect is often elicited
63
fundoscopy findings with ischaemic optic neuropathy
optic disc swelling in the acute phase pale optic disc in chronic phase that suggests optic atrophy
64
photopsia
a flash of light or something that appears to float in the eye
65
clinical features of posterior vitreous detachment
patients may present complaining of photopsia and floaters very similar presentation to retinal detachment so fundoscopy is key
66
investigating optic neuritis
MRI head
67
what is chronic open angle glaucoma
refers to optic neuropathy with the death of optic nerve fibres with or without raised intraocular pressure
68
risk factors for chronic open-angle glaucoma
raised IOP hypertension diabetes mellitus corticosteroids
69
fundoscopy findings of chronic open-angle glaucoma
pale optic disc optic disc cupping
70
aim of management of chronic open-angle glaucoma
primary aim of mx is to reduce IOP by reducing aqueous production or increasing uveoscleral outflow treatment is recommended if IOP is >24 mmHg
71
first line mx chronic open-angle glaucoma
surgical : 360 degree selective laser trabeculoplasty (SLT)
72
second line mx chronic open-angle glaucoma
medical therapy when SLT is not possible starts with prostaglandin analogues with topical beta blockers as the next step
73
first-line mx chronic open-angle glaucoma
surgical: 360-degree selective laser trabeculoplasty (SLT)
74
what visual field defect indicates glaucoma
arcuate visual field defect
75
what is a carotid cavernous fistula
an abnormal communication between the carotid artery and the cavernous sinus
76
presentation of carotid cavernous fistula
the eye is usually proptosed (protuded) with an injected conjunctiva and may be pulsatile red eye "whooshing noise"
77
visual defect when optic nerve is affected
monocular visual loss
78
visual defect when the optic tract is affected
contralateral homonymous hemianopia
79
visual defect when the optic chiasm is affected
bitemporal hemianopia
80
visual defect when the optic radiation is affected
contralateral homonymous hemianopia
81
3 most important differentials of red eye
acute angle-closure glaucoma anterior uveitis scleritis
82
definitive test for diagnosing acute angle closure glaucoma
gonioscopy

Clinical Medicine (26 decks)

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