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#passmed 2023 > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

What condition does MS increase the risk of?

A

Optic neuritis

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2
Q

What other conditions increase risk of Optic neuritis? (3 things)

A
  1. DM
  2. MS (investigate w MRI brain)
  3. Syphilis
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3
Q

What are the CF of Optic Neuritis? (5 things)

A
  1. Unilateral visual acuity reduction (over hours / days)
  2. Central scotoma
  3. Poor colour discrimination
  4. Pain @ eye movement
  5. RAPD
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4
Q

What is a Scotoma?

A

Part of vision occluded by dark blodge

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5
Q

What is Central Scotoma assoc w?

A

Optic neuritis

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6
Q

How do you investigate for Optic Neuritis?

A

MRI of brain + orbits with contrast

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7
Q

What are the Mx options for Optic Neuritis?

A

High dose steroids
(4-6 weeks to recover)

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8
Q

What is Anterior Uveitis aka?

A

Iritis

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9
Q

What is Anterior Uveitis assoc w?

A

UC / Crohns / Ankylosing spondylitis

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10
Q

What are the CF of Ant Uveitis? (6 things)

A
  1. Pain
  2. Red eye
  3. Blurred vision
  4. Constricted oval shaped pupil
  5. Photophobia (intense)
  6. Hypopyon (pus in ant chamber, you can see fluid level in eye)
  7. Lacrimation
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11
Q

What are the Mx options for Ant Uveitis? (3 things)

A
  1. Urgent ophthalmology review
  2. Steroid eye drops
  3. Atropine (aka mydriatics to dilate pupil)
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11
Q

What are the Mx options for Ant Uveitis? (3 things)

A
  1. Urgent ophthalmology review
  2. Steroid eye drops
  3. Atropine (aka mydriatics to dilate pupil)
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12
Q

What does dilating pupil w Atropine in Ant Uveitis help reduce? (2 things)

A
  1. Pain
  2. Photophobia
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13
Q

What condition can give you Horners syndrome, but instead of Sweating you get Pain behind the eye?

A

Carotid artery dissection
(still get miosis and ptosis)

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14
Q

What is the immediate Mx of Acute CA Glaucoma? (3 things)

A
  1. Immediately admit
  2. Eye drops combo (3 things)
  3. IV acetazolamide
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15
Q

What eye drops combo can you give in Acute CA Glaucoma initial Mx? (3 things)

A
  1. Pilocarpine
  2. Beta blocker (Timolol)
  3. Alpha agonist (Apraclonidine)
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16
Q

How does Pilocarpine work in Acute CA Glaucoma initial Mx? (3 steps)

A
  1. Contracts ciliary muscle
  2. Opens trabecular meshwork
  3. Increase flow of aqueous humour
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17
Q

How do Alpha agonists, Beta blockers, and IV acetazolamide work in Acute CA Glaucoma initial Mx?

A

Decrease aqueous humour prod / secretion

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18
Q

What is the definitive Mx of Acute Glaucoma?

A

Laser peripheral iridotomy
(hole in peripheral iris –> aq humour flows to angle)

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19
Q

What are the Mx options for Primary Open-Angle glaucoma? (3 things)

A
  1. Prostaglandin analogue (PGA) eyedrop (FIRST LINE)
  2. Beta blockers / Carbonic anhydrase inhibitor / Sympathomimetic eye drops
  3. Surgery
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20
Q

How do you remember MOA of Glaucoma meds?

A
  • Any Inhibitors / Blockers / Antagonists = INHIBIT aq production
  • Any Agonists = INCREASE uveoscleral flow
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21
Q

What is an example of Carbonic anhydrase inhibitor?

A

Dorzolamide

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22
Q

What are the initial CF of OA glaucoma?

A

Reduced peripheral vision

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23
Q

What are the side fx of Prostaglandin analogue (PGA) eyedrops used in Primary open-angle glaucoma? (2 things)

A
  1. Increased eye lash length
  2. Iris + Periocular pigmentation
    (Prostaglandins make you Pretty n Pigmented)
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24
Q

What is the difference in RF for CA vs OA Glaucoma?

A
  • Hypermetropia (long sightedness) –> CA
  • Myopia (short sightedness) –> OA
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25
Q

What are some CF of Retinal detachment that you didn’t know? (3 things)

A
  1. Flashes in peripheral field, followed by…
  2. Sudden painless LOV
  3. Loss of Red Reflex
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26
Q

What are the RF for Retinal detachment? (5 things)

A
  1. DM
  2. Myopia (short sightedness)
  3. Age (40+)
  4. Previous cataract surgery
  5. Trauma
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27
Q

What are the CF / investigation results of Chronic open-angle glaucoma? (4 things)

A
  1. Slow onset peripheral LOV (patient barely even notices it)
  2. NORMAL intraocular pressure
  3. NORMAL gonioscopy (drainage test)
  4. Increased cup-to-disc ratio
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28
Q

What is the most common cause of Flashers and Floaters?

A

Posterior vitreous detachment

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29
Q

What does Posterior vitreous detachment happen with?

A

Normal with ageing
(75% ppl over 65)

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30
Q

Is any Tx required for Posterior vitreous detachment?

A

No

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31
Q

If you don’t correct a childhood squint (aka exotropia), what can the child develop?

A

Amblyopia (aka lazy eye)

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32
Q

How can you prevent Exotropia (aka squint) from developing into Amblyopia (aka lazy eye)?

A

Eye patches

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33
Q

How do you differentiate between Episcleritis and Scleritis?

A
  • Epi = Painless // Scleritis = painful
  • Epi = vessels are mobile @ gentle pressure // Scleritis = vessels deeper so immobile
  • Epi = redness improves with Phenylephrine
34
Q

What are the Mx options for Episcleritis? (2 things)

A
  1. Conservative
  2. Artificial tears (sometimes)
35
Q

What are the Mx options for Scleritis? (2 things)

A
  1. Refer for same day ophthalmology assessment
  2. NSAIDs (first line)
36
Q

What are the complication of Scleritis? (5 things)

A
  1. Perforation of the globe (in severe necrotising scleritis)
  2. Glaucoma (bc Raised IO pressure)
  3. Cataracts
  4. Retinal detachment
  5. Uveitis
37
Q

What are the RF for Cataract development? (6 things)

A
  1. DM
  2. Long term steroids
  3. HypOcalcaemia
  4. Smoking / alcohol
  5. Downs syndrome
  6. Scleritis
38
Q

What are the types of ARMD? (2 things)

A
  1. Dry ARMD
  2. Wet ARMD
39
Q

What are the CF of ARMD? (2 things)

A
  1. Straight lines appear wavy
  2. Colours less strong
40
Q

What CF suggest Dry ARMD is progressing to Wet ARMD? (2 things)

A
  1. Central vision loss (esp nearby objects)
  2. Flashing lights
41
Q

What would fundoscopy show if Dry ARMD is progressing to Wet ARMD?

A

Choroidal neovascularisation

42
Q

What fundoscopy findings can you find in both Dry AND Wet ARMD

A

Drusen (yellow deposits)

43
Q

What are the Tx options for Dry / Wet ARMD?

A
  • Dry = nothing
  • Wet = regular anti-VEGF inj (to stop neovasc)
44
Q

What are the CF of Keratitis? (3 things)

A
  1. Painful red eye
  2. Photophobia
  3. Gritty sensation
45
Q

What should you do with Contact lens wearers who present w Painful red eye + gritty?

A

Refer for same day ophthalmology assessment (to exclude Microbial keratitis)

46
Q

What are the CF of Herpes Simplex Keratitis? (3 things)

A
  1. Painful red eye
  2. Photophobia
  3. Dendritic corneal ulcer @ exam
47
Q

What are the RF for Herpes Simplex Keratitis?

A

Recent course of steroids

48
Q

What is the Tx for Herpes Simplex Keratitis?

A

Topical antivirals (e.g aciclovir)

49
Q

What investigation tells you if a person has a Refractive error, as their cause of blurred vision?

A

Pinhole occluder
(if vision improves with occluder = they have a refractive error)

50
Q

In addition to anti-VEGF, what can you use to treat Proliferative Diabetic Retinopathy?

A

Panretinal laser photocoagulation

51
Q

What is the Dx of a painful lump at edge of eyelid?

A

Stye (pus filled abscess)

52
Q

What is a Stye?

A

Infection of glands of eyelids

53
Q

What are the Mx options for Stye?

A

Warm steaming / soaking with warm flannel
(don’t need to drain this abscess)

54
Q

What is the classical presentation of Blepharitis? (2 things)

A
  1. Bilateral grittiness
  2. Eyes stuck together in morning
55
Q

What are the CF of Central Retinal Vein occlusion? (2 things)

A
  1. Sudden painless LOV
  2. Severe retinal haemorrhages @ fundoscopy
56
Q

What are the CF of Orbital cellulitis? (3 things)

A
  1. Eye erythema
  2. Pain
  3. Pain @ eye movements
57
Q

What is special about Orbital cellulitis?

A

Medical emergency

58
Q

Why is Orbital cellulitis a Medical emergency? (2 things)

A

Risk of:
1. Cavernous sinus thrombosis
2. Intracranial spread

59
Q

What is the Mx for Orbital cellulitis?

A

Hospital admission for IV abx

60
Q

What is a CI for Lumbar puncture?

A

Raised ICP (aka papilloedema @ fundoscopy)

61
Q

What are the causes of Tunnel vision? (4 things)

A
  1. Papilloedema
  2. Glaucoma
  3. Retinitis pigmentosa
  4. Hysteria
62
Q

What is the Dx?

A

Macular degeneration
(drusen seen around macula)

63
Q

What drops can lead to Corneal ulcers

A

Steroid drops –> fungal infections –> Corneal ulcer

64
Q

What is the Dx of swollen gritty eye, and whats the Tx?

A
  1. Blepharitis
  2. Compress and clean
65
Q

What are Mydriatic drops a risk factor for?

A

Acute CA glaucoma

66
Q

What happens to the optic disc in Primary OA glaucoma?

A

Cupping, due to chronic raised IOP

67
Q

What is the Dx of this, they had sudden painless LOV?

A

Central retinal vein occlusion
(looks like exploding sun / cheese n tomato pizza)

68
Q

What is the Dx of this, they had sudden painless LOV?

A

Branch retinal vein occlusion
(haemorrhage confined to limited area of retina like a patch)

69
Q

What are the CF or common picture of Idiopathic Intracranial HTN? (5 things)

A
  1. Optic disc blurring
  2. Young woman
  3. High BMI
  4. Headache
  5. Visual symptoms worse @ bending over
70
Q

If someone on the phone has new flashers / floaters what should you do?

A

Same day ophthalmology assessment bc could be retinal detachment

71
Q

What is route of administration for Tx of Orbital cellulitis?

A

IV abx (admit them) bc risk of cavernous sinus + intracranial spread

72
Q

What are Argyll-Robertson pupils? (3 things)

A
  1. Small pupils bilaterally
  2. They accommodate
  3. But don’t constrict to light
    (Robinson never saw the light)
73
Q

What is a RF for Subconjunctival haemorrhage?

A

Constipation

pressure min al ja3ba laman 3iyoonak takub dam

74
Q

What is the cause of painful red eye and reduced vision after eye surgery?

A

Endopthalmitits

75
Q

What is the cause of painful red eye and reduced vision after eye surgery?

A

Endopthalmitits

76
Q

What condition has ciliary flush?

A

Ant uveitis

77
Q

How do you differentiate between CA glaucoma and Ant uveitis?

A
  • Ant uveitis: Small pupil
  • CA glaucoma: fixed dilated pupil
78
Q

What is an eye manifestation of RA, that presents with PAINFUL red eye?

A

Scleritis
(remember that Scl antibody thing in rheumatology?)

79
Q

What is an eye manifestation of RA, that presents with PAINLESS red eye?

A

Episcleritis
(remember that Scl antibody thing in rheumatology?)

80
Q

What Dx gives you pale retina?

A

Central retinal Artery occlusion
(pAle retina = Artery occlusion)

81
Q

What are the CF of Central retinal artery occlusion? (4 things)

A
  1. Sudden painless LOV
  2. RAPD
  3. Cherry red spot
  4. Pale retina
82
Q

What are the Dx for Central vs Peripheral LOV?

A
  • Middle loss = Macula degeneration
    * Peripheral loss = Primary glaucoma

#passmed 2023 (39 decks)

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