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Surgery c > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

What is seen mainly in background DR

A

HMA

Dot and blot haemorrhage and microanuerysms

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2
Q

What is seen in pre proliferative DR

A

Denser HMA

Cotton wool spots

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3
Q

What is seen in proliferative diabetic retinopathy

A

HMA

Cotton wool spots and hard exudates

Neovascularisation at disk and elsewhere

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4
Q

What is seen in HTN retinopathy and what is the Pathophys of each

A

Silver / copper wiring = hardening and sclerosing of arterioeles

AV nipping - scleroses arterioles cause compression of veins

Cotton wool spots due to infarction of nerve fibres

Hard exudates due to damaged vessels leaking lipids

Papilloedema due to is he is of optic nerve

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5
Q

What are important complications of diabetic retinopathy

A

Retinal detachment

Vitreous haemorrhage

Optic neuropathy

Cataract

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6
Q

Staging of HTN retinopathy

A

Called Keith wagener classification

1- narrowing of arteiroles
2- focal constriction of blood vessels and AV nipping
3-cotton wool patches, exudates and haemorrhages similar to DM
4- Papilloedema

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7
Q

Risk factors for open angle glaucoma

A

Increasing age and family history
Black ethnic origin
Myopia

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8
Q

Risk factors for closed angle glaucoma

A

Age and family history
Females are more affected
Chinese and East Asian people

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9
Q

Pathophys of open angle glaucoma

A

Increase in resistance of aqueous humour outflow through trabecular meshwork

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10
Q

Presentation of open angle glaucoma

A

Peripheral vision loss over time

May have pain, headaches and blurred vision

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11
Q

Pathophysiology of close angle glaucoma

A

Iris bulges forward and blocks flow of aqueous humour through trabecular meshwork

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12
Q

Presentation of closed angle glaucoma

A

Acute history of severely painful red eye
Blurred vision with reduced visual acuity
Halos around lights and nausea and vomiting

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13
Q

Managment of closed angle glaucoma

A

Must have same day referral for opthalomology

Primary care- lie patient on the back without a pillow
Give pilocarpine eye drops (2% for blue eyes 4% otherwise)
Acetazolamide 500 mg oral and analgesia and anti emetic

Secondary care: combination of eye drops is pilocarpine, timolol and apraclonidine
IV acetozalomide and hyperosmotic agent like mannitol

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14
Q

Definitive treatment of closed angle glaucoma

A

Laser iridotomy

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15
Q

What is acetazolamide and what does it do

A

Carbonic anhydride inhibitor which reduces the production of aqueous humour

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16
Q

What is pilocarpine and what does it do

A

Miotic agent/muscarinic receptor antagonist which opens up outflow of aqueous humour

17
Q

What do beta blockers do for eyes

A

Reduce aqueous humour production

18
Q

What do carbonic anhydrase inhibitors do

A

Reduce aqueous humour production

19
Q

What is brimondine and what does it do

A

Sympathomimetic/alpha agonist which reduces aqueous humour production and increases uveosacral outflow

20
Q

What is the Pathophysiology of age related macular degeneration

What about wet ARMD

A

Deposition of drusen (yellow deposits of protein and lipid) between retinal pigment and Bruch membrane

Wet involves neovascularisation from choroid to retina

21
Q

Risk factors for ARMD

A

Age, FH, white or Chinese, smoking and cardiovascular risk

22
Q

What is the presentation of ARMD

A

Central vision loss, reduced visual acuity and crooked appearance to straight lines

23
Q

What ix are used for AMRD

A

Snellen chart for visual acuity
Amsler grid test for straight lines
Fundoscopy to find drusen

Slit lamp bio microscopic funds examination is gold standard

24
Q

Risk factors for hypocalciemia

A

Age
Smoking
Alcohol
Diabetes
Steroids
Hypocalciemia

25
Q

Presentation of cataract

A

Very slow reduction and blurring of vision
Change in colour vision to colours becoming more brown and yellow
Starburst

Loss of red reflex

26
Q

What conditions are associated with HLA-B27

A

Ankylosis spondylitis
IBD
Reactive arthritis

27
Q

What is the presentation seen in Ant Uveitis

A

Dull aching red eye
Ciliary flush
Reduce visual acuity
Floaters and flashes

Pain on movement

Abnormally shaped pupil
Hypopyon (white level in anterior chamber

28
Q

Presentation of retinal detachment

A

Painless loss of peripheral vision
Sudden shadow comes down across vision
Blurred or distorted
Flashes and floaters

Straight lines appeared curved

29
Q

Presentation of pos vitreous haemorrhage

A

Painless spots of vision loss
Spider wen or curtain coming down

30
Q

Presentation of vitreous haemorrhage

A

Painless visual loss and lowered visual acuity
Red hue I’m vision
New floaters

31
Q

Risk factors for retinal detachment

A

Pos vitreous detachment
Diabetic retinopathy
Myopia

32
Q

Causes of vitreous haemorrhage

A

Proliferative diabetic retinopathy
Posterior vitreous detachment

33
Q

Example of prostaglandin analogue, MOA and side effects

A

Latanoprost

Iincreases uveosacral outflow

Hypertrichosis (long eyelashes)
Hyperpigmentation

Surgery c (6 decks)

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