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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
Q

Mx temporal arthritis

A

High dose steroid

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26
Q

Describe CN3 palsy

A

Ptosis
Eye down and out
Pupil may be dilated
Supplies 4/6 main intrinsic eye muscles

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27
Q

Describe CN4 palsy

A

Diplopia
Subjective tilting of objects £ patient may develop a head tilt to compensate
Eye deviated up and out
Supplies superior oblique

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28
Q

Describe CN6 palsy

A

Results in defective abduction
Horizontal diplopia
Supplies lateral rectus

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29
Q

CN5 palsy

A

Afferent branch of corneal reflex

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30
Q

what ocular side effects can steroids have

A

raised intraocular pressure
glaucoma
accelerated cataract formation

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31
Q

risk factors for ARMD

A

AGE
male
smoking
family hx
cardiovascular risk factors

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32
Q

symptoms of ARMD

A

reduced visual acuity
poor vision at night
photopsia - perceived flickering of lights
glare

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33
Q

what is bacterial keratitis

A

bacterial infection of cornea
often precipitated by minor trauma, contact lens use or ocular surgery

34
Q

symptoms of bacterial keratitis

A

pain
foreign body sensation
tearing or purulent discharge
red eye
corneal ulcer

35
Q

mx bacterial keratitis

A

referral to ophthalmologist immediately

36
Q

what is bell’s palsy

A

idiopathic syndrome affecting the facial nerve

37
Q

what are the characteristic features of bells palsy

A

acute onset
unilateral
lower motor neuron facial weakness sparing extraocular muscles and muscles of mastication

38
Q

Corneal Arcus

A

White blue or opaque ring

39
Q

Differentiating scleritis from episcleritis

A

Scleritis will have painful ocular movement
Severity of pain
Nonblanching vessels

40
Q

What is retinitis pigmentosa

A

INHERITED condition causing retinal degeneration

41
Q

Clinical features of retinitis pigmentosa

A

Pts often present at a young age with tunnel vision
Also classically complain of reduced visual acuity in dim light

42
Q

Fundoscopy findings for retinitis pigmentosa

A

Peripheral pigment deposits
Optic disc pallor
Retinal vessel attenuation

43
Q

What is corneal abrasion

A

Defined as a defect in the corneal epithelium

44
Q

What is orbital cellulitis

A

Infection of the structures behind the orbital septum

45
Q

Risk factors for orbital cellulitis

A

Trauma
Surgical - ocular, adnexal or sinus
Sinus disease - ethmoid sinus is most common site of infection
Other facial infections

46
Q

Symptoms of orbital cellulitis

A

Periocular pain and swelling
Fever
Malaise

47
Q

Signs of orbital cellulitis

A

Erythematous, swollen and tender eyelid
Chemosis
Proptosis
Restricted eye movements +/- diplopia

48
Q

Management of orbital cellulitis

A

Admission for IV abx and close monitoring

49
Q

What is pre septal cellulitis

A

Infection of tissue anterior to orbital septum
Much more common than orbital cellulitis
Less severe

50
Q

Risk factors for preseptal cellulitis

A

Trauma
Infection of adjacent facial structures

51
Q

Clinical features of preseptal cellulitis

A

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
Q

Management preseptal cellulitis

A

Young or systemically unwell should be admitted for IV abx
Otherwise outpatient treatment with abx

53
Q

What is optic neuritis

A

Inflammation of the optic nerve
Mostly occurs in adult women and people who live in high latitude

54
Q

Causes of optic neuritis

A

Demyelinating lesions (MS most common)
Autoimmune disorders
Infectious conditions

55
Q

Clinical features of optic neuritis

A

Clinical diagnosis consists of the classic triad of
Visual loss
Periocular pain
Dyschromatopsia

56
Q

Treatment of optic neuritis

A

First line is IV methylprednisolone

57
Q

myopia

A

short-sightedness

58
Q

stereopsis

A

depth perception

59
Q

amblyopia

A

lazy eye

60
Q

hypermetropia

A

longsightedness

61
Q

what is ischaemic optic neuropathy

A

broad term that describes optic nerve damage due to a lack of blood supply

62
Q

clinical features of ischaemic optic neuropathy

A

generally, patients present with sudden onset monocular vision loss and colour blindness

o/e relative afferent pupillary defect is often elicited

63
Q

fundoscopy findings with ischaemic optic neuropathy

A

optic disc swelling in the acute phase

pale optic disc in chronic phase that suggests optic atrophy

64
Q

photopsia

A

a flash of light or something that appears to float in the eye

65
Q

clinical features of posterior vitreous detachment

A

patients may present complaining of photopsia and floaters

very similar presentation to retinal detachment so fundoscopy is key

66
Q

investigating optic neuritis

A

MRI head

67
Q

what is chronic open angle glaucoma

A

refers to optic neuropathy with the death of optic nerve fibres with or without raised intraocular pressure

68
Q

risk factors for chronic open-angle glaucoma

A

raised IOP
hypertension
diabetes mellitus
corticosteroids

69
Q

fundoscopy findings of chronic open-angle glaucoma

A

pale optic disc
optic disc cupping

70
Q

aim of management of chronic open-angle glaucoma

A

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
Q

first line mx chronic open-angle glaucoma

A

surgical : 360 degree selective laser trabeculoplasty (SLT)

72
Q

second line mx chronic open-angle glaucoma

A

medical therapy when SLT is not possible
starts with prostaglandin analogues with topical beta blockers as the next step

73
Q

first-line mx chronic open-angle glaucoma

A

surgical: 360-degree selective laser trabeculoplasty (SLT)

74
Q

what visual field defect indicates glaucoma

A

arcuate visual field defect

75
Q

what is a carotid cavernous fistula

A

an abnormal communication between the carotid artery and the cavernous sinus

76
Q

presentation of carotid cavernous fistula

A

the eye is usually proptosed (protuded) with an injected conjunctiva and may be pulsatile

red eye

“whooshing noise”

77
Q

visual defect when optic nerve is affected

A

monocular visual loss

78
Q

visual defect when the optic tract is affected

A

contralateral homonymous hemianopia

79
Q

visual defect when the optic chiasm is affected

A

bitemporal hemianopia

80
Q

visual defect when the optic radiation is affected

A

contralateral homonymous hemianopia

81
Q

3 most important differentials of red eye

A

acute angle-closure glaucoma
anterior uveitis
scleritis

82
Q

definitive test for diagnosing acute angle closure glaucoma

A

gonioscopy

Clinical Medicine (26 decks)

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