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Medicine Year 5 > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

older person presenting with painless sudden loss of vision with severe retinal (flame) haemorrhages and cotton wool spots

A

central retinal vein occlusion

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2
Q

3 causes of central retinal vein occlusion

A

glaucoma, hypertension and polycythaemia

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3
Q

sudden loss of vision with afferent pupillary defect and cherry red spots on a pale retina

A

central retinal artery occlusion

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4
Q

2 causes of central retinal artery occlusion

A

thromboembolism (from atherosclerosis)
arteritis (e.g. temporal)

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5
Q

sudden vision loss with dark spots and floaters and a red hue

A

vitreous haemorrhage
severity of bleed depends on sx

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6
Q

3 causes of vitreous haemorrhage

A

diabetes, bleeding disorders, anticoagulants (e.g. warfarin)

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7
Q

sudden painless loss of vision with a dense shadow starting peripherally which progresses towards the centre like a veil/curtain
straight lines also appear curved

A

retinal detachment

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8
Q

what can precede retinal detachment

A

posterior vitreous detachment

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9
Q

blurred vision with progressive peripheral field loss, flashes of light in peripheral vision and floaters on the temporal side

A

posterior vitreous detachment

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10
Q

management of new onset flashers and floaters

A

urgent ophthalmology review within 24 hours

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11
Q

painless transient monocular blindness with a black curtain coming down

A

amaurosis fungax

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12
Q

night blindness and tunnel vision with FHx

A

retinitis pigmentosa

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13
Q

firm painless lump in the eyelid

A

meibomian (chalzion) cyst

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14
Q

itchy eyes associated with seborrhoeic dermatitis

A

blepharitis

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15
Q

non painful red and watery eye with mild photophobia and mobile vessels

A

epislceritis

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16
Q

painful red eye with vessels that do not move

A

scleritis

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17
Q

acutely painful red eye with small pupils, photophobia and reduced visual acuity

A

anterior uveitis

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18
Q

what is a hypopyon and what is it associated with

A

pus in the anterior chamber
anterior uveitis

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19
Q

management of anterior uveitis

A

steroid and cycloplegic (mydriatic) drops

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20
Q

what is hutchinsons sign

A

vesicles extending to the tip of the nose
indicates ocular involvement in shingles

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21
Q

what is herpes zoster opthalmicus

A

vesicular rash around/into the eye in shingles

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22
Q

management of herpes zoster

A

oral aciclovir

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23
Q

what is associated with ocular involvement in shingles

A

anterior uveitis

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24
Q

red eye with photophobia and a gritty sensation

A

keratitis

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25
Q

burning, excessive tearing and photophobia

A

herpes simplex keratitis

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26
Q

management of herpes simplex keratitis

A

topical aciclovir

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27
Q

investigation for herpes simplex keratitis

A

fluorescein stain
indicates epithelial defects/dendritic ulcers

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28
Q

name one cause of herpes simplex keratitis

A

steroid eye drops cause corneal ulcers which can progress to herpes simplex keratitis

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29
Q

painful red eye associated with contact lenses

A

microbial keratitis

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30
Q

bacteria associated with microbial keratitis

A

pseudomonas (acanthamoeba)

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31
Q

management of microbial keratitis

A

urgent referral

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32
Q

management of infective conjunctivitis

A

topical chloramphenicol
do not wear contact lenses

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33
Q

reduced visual acuity, proptosis and pain on eye movements

A

orbital cellulitis

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34
Q

management of orbital cellulitis

A

IV ABx in hospital

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35
Q

2 complications of orbital cellulitis

A

cavernous sinus thrombosis and intracranial spread

36
Q

less concerning type of cellulitis

A

periorbital/preseptal cellulitis

37
Q

red desaturation with a central scotoma and relevant afferent pupillary defect

A

optic neuritis

38
Q

most common cause of optic neuritis

39
Q

red a=eye and reduced vision after intra ocular surgery

A

endopthalmitis

40
Q

most common visual field defect in glaucoma

A

peripheral

41
Q

ocular pain, reduced visual acuity and haloes around lights

A

acute angle closure glaucoma

42
Q

hypermetropia and myopia
which is open / closed angle glaucoma

A

acute angle closure: hypermetropia
primary open angle: myopia

43
Q

emergency treatment of acute angle closure glaucoma

A

IV acetyazolamide

44
Q

3 eye drops used in acute angle closure glaucoma

A

pilocarpine
timolol
brimonide

45
Q

moa of pilocarpine

A

pupillary constriction

46
Q

2 side effects of pilocarpine

A

headaches and blurred vision

47
Q

moa of timolol

A

reduces aqueous production

48
Q

definite management of acute angle closure glaucoma

A

laser peripheral iridotomy

49
Q

class of lantanoprost

A

prostaglandin analogue

50
Q

moa of lantanoprost

A

increases uvoscleral outflow

51
Q

first line medication for glaucoma in asthma/heart block

A

lantanopost

52
Q

side effect of lantanoprost

A

brown iris

53
Q

screening if positive FHx of glaucoma

A

annual from the age of 40

54
Q

glaucoma but normal intraocular pressure

A

normal tension glaucoma

55
Q

one cause of increased intraocular pressure in glaucoma

A

blunt ocular trauma

56
Q

glaucoma v uveitis
‘red eye’

A

glaucoma: severe pain, halos, hazy cornea and semi dilated pupil
uveitis: small fixed oval pupil and cilary flush

57
Q

reduced vision over months with central scotoma and metamorphopsia

A

wet age related macular degeneration

58
Q

field loss in macular degeneration

59
Q

investigation for macular degeneration

A

amsler grid testing
checks for distortion of line perception

60
Q

RF of macular degeneration

61
Q

which macular degeneration are dursen found in

62
Q

management of wet macular degeneration

A

anti vascular endothelial growth factor

63
Q

management of dry macular degeneration

A

beta carotene
vitamin C + E
zinc

no cure but these slow down visual deterioration

64
Q

5 causes of cataracts

A

downs
dm
hypiocalcaemia
uveitis
steroids (supcapular)

65
Q

dilated pupil with slow reaction to light and reduced accommodation in a female with absent knee and ankle reflexes

A

aide pupil

66
Q

cause of aide pupil

A

viral or bacterial damage to the parasympathetic innervation

67
Q

relative afferent pupillary defect during the swinging light exam causing an apparent pupillary dilation

A

marcus gunn pupil

68
Q

cause of marcus gunn pupil

A

damaged optic nerve or severe retinal disease

69
Q

unilateral dilated pupil which is unresponsive to light

A

hutchinsons pupil

70
Q

cause of a hutchinsons pupil

A

compression of the ipsilateral oculomotor nerve due to mass (tumour/haematoma)

71
Q

bilateral small pupil unresponsive to light but does accommodate

A

argyll-robertson pupil

72
Q

cause of argyll-robertson pupil

A

neurosyphilis or diabetes

73
Q

4 features of horners

A

miosis: pupil constriction
ptosis: droopy eyelid
enophthalmos: inset eyeball

+/- anhydrosis: reduced sweating

74
Q

cause of horners

A

damage to the ipsilateral sympathetic trunk

75
Q

distinguish between the 3 causes of horners

A

anhydrosis!

head/arm/trunk: central lesion (stroke)
face: pre-ganglionic (pancoast/cervical rib)
none: post ganglionic (carotid artery)

76
Q

unequal pupil size

77
Q

cause of aniscoria

A

problem in the contralateral ciliary ganglion

78
Q

finding in papilloedema

A

blurring of the optic disc on fundoscopy

79
Q

why is LP contraindicated if papilloedema

A

indicates raised ICP

80
Q

screening for childhood squint

A

corneal light reflection test

81
Q

failure to correct childhood squint

A

amblyopia (lazy eye)

82
Q

recurrent watery/sticky eye that resolves by 1 year

A

congenital lacrimal duct obstruction

83
Q

examination finding in diabetic retinopathy

A

cotton wool spots indicate areas of retinal infarction

84
Q

treatment of proliferative retinopathy

A

panretinal laser photocoagulation

85
Q

what can a pinhole occluder identify

A

refractive errors (blurred vision)

86
Q

stages of hypertensive retinopathy

A
  1. arteriolar narrowing and increased light reflex (silver wiring)
  2. AV nipping
  3. cotton wool spots, flame and blot haemorrhages, macular star
  4. papilloedema

Medicine Year 5 (27 decks)

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