Opthalmology :/ Flashcards

1
Q

Causes of leukocoria?

A

Leukocoria = white pupil
- Cataracts- most common cause
- Chorioretinal coloboma
- Coats disease (yellow tinge): accumulation of lipid/telangectasia, unilateral, M- 5-9yrs- visual disturbance/strabismus
- Retinal detachment

Malignancy
- Retinoblastoma: leukocoria <5yrs (60% presenting Sx), AD inheritance
- Leukemia

DDx- vitreous hemorrhage= pallor in optic disc (hemorrage in newborn, severe ROP, trauma, leukemia)

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2
Q

Causes of amblyopia?

A

Strabismic (50%)
- Due to a deviated eye
- Abnormal interaction between two foveas 🡪 different + unfusable images
- Visual cortex suppresses the image from one eye

Refractive/ ametropic (15-20%)
- Unequal refractive errors 🡪 one eye not focused on the fovea
- Most common in hyperopic patients, but MAY occur in myopia / astigmatism

Anisometropic - unequal need for vision correction

Derivational (<5%)
- Congenital cataracts
- Vitreous haemorrhage
- Severe refractory error

15-20% is combined

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3
Q

What vitamin deficiency causes night blindness (nyctalopia)?

A

Vitamin A deficiency

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4
Q

Abnormalities of pupil
- aniridia
- coloboma
- microcoria
- mydriasis
- dyscoria
- anisocoria
- corectopia

A

Aniridia: Hypoplastic iris tissue
- Genetic, 2/3rds AD (PAX6, WAGR)
- 75% develop glaucoma

Coloboma: hole in pupillary margin, AD, most inferior

Microcoria: small unreactive pupil, AD/sporadic

Mydriasis: dilated and do not constrict

Dyscoria = abnormal shape of pupil

Corectopia = abnormal position of pupil

Anisocoria= inequality of pupil

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5
Q

Abnormalities of pupil
-Dilated Fixed Pupil
-Tonic Pupil
-Paradoxical Pupil Reaction
-Persistent Pupillary Membrane
-Marcus Gunn
-Leukocoria
-Heterochromia

A

-Dilated Fixed Pupil
Tonic Pupil: large/no reaction to light (CMT)

Paradoxical Pupil Reaction: constriction in darkness etc- seen in albinism/retinitis pigmentosa

Persistent Pupillary Membrane: remnant of embryology, involutes but can cause vision impairement if persistent

Marcus Gunn: RAPD

Leukocoria: white pupil- cataracts, retinoblastoma, coloboma
Heterochromia: different colour iris, simple AD, Waardernburg (AD, lateral canthi, SNHL)

Horners: miosis, ptosis, anhydrosis (1st hyporthalamus, 2nd cervical chain, 3rd- CN)

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6
Q

Childhood glaucoma- causes/Rx?

A

> 50% primary- congenital open angle, abnormality of drainage of eye
- Assoc syndromes: Sturge Weber, NF, Stickler, MPS

Secondary: traumatic, Ca, steroid induced, maternal rubella, infection

Triad Sx:
1. Epiphoria (tearing/watery)
2. Photophobia (sensitivity to light)
3. Blepharospasm (eyelid squeezing)

Rx: BB, Alpha agonist, carbonic anhydrase inhibitor

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7
Q

Complications of Myopia

A

Myopia = near sightedness
- Increasing prevalence, more time on screens/indoors

Complications
- Retinal detachment
- Glaucoma (^ IOP)
- Cataracts
- Macular degeneration

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8
Q

Vernal keratoconjunctivitis - Sx/Cx?

A
  • Severe bilateral chronic
    inflammatory process of the upper tarsal conjunctival surface
  • Increased in atopic kids, M>F, Asian/African background
  • Severe ocular itching/photophobia/lacrimation

Cx:
- Giant papillae
- Corneal shield ulcer

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9
Q

Eye abnormalities associated with: Sturge Weber?

A

Glaucoma, choroidal haemangiomas

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10
Q

Eye abnormalities associated with: OI

A

Blue sclera, keratoconus

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11
Q

Eye abnormalities associated with: Marfans

A

Upward lenticonus, keratoconus

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12
Q

Eye abnormalities associated with: Downs syndrome

A

strabismus, high refractive error, keratoconus, accommodative insufficiency, cataracts, nasolacrimal duct obstruction, blepharitis, and nystagmus.

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13
Q

Eye abnormalities associated with: JIA

A

Uveitis - JIA most common cause (up to 50%)
- Females
- Oligo-arthritis <4yrs onset
- ANA positive

Glaucoma, cataracts = smaller percentage

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14
Q

CN3 palsy
ALL 3 SO4 LR6

A

CN3 = oculomotor
- Superior, inferior & medial rectus, inferior oblique
- Elevation, depression, adduction, in/extorsion
- Eyelid levator

Palsy = ptosis, down and out eye

Mostly congenital
Trauma
Compression
Myasthenia may mimic

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15
Q

CN4 palsy
ALL 3 SO4 LR6

A

CN4= trochlear (dorsal exit from brainstem)
Superior oblique
- incyclotorsion

Cavernous sinus:
Vertical diplopia

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16
Q

CN6 palsy
ALL 3 SO4 LR6

A

CN6 = Abducens
- Lateral rectus
- Abduction abducens

Cavernous sinus: Horizontal diplopia; esotropia (inward deviation