opthalmology Flashcards
What is an open angle Glaucoma?
Optic nerve damage caused by raised intraocular pressure
What are the componenets of the vitrous chamber?
Anterior - Cornea and iris
Posterior chamber- lens and iris
What is the nomral size of the optic disc and cup
optic cup is half the size of the optic disk
What is a risk factor for acute angle closure glaucoma?
nearsightedness Myopia
How does opan angle glaucoma present?
Gradual increase in intraoccular pressure picked up at screening.
headaches, blurred periheral vission, halos around lights
How do you investigated suspected open angle glaucoma?
check pressure
fundoscopy
visual field assesment
How do you treat open angle glaucoma?
prostaglandin eye drops - latanoprost
betablockers- timololH
reduce pressure below 24mmhg
How does acute angle closure glaucoma present?
Hot painful eye
blurred vission
halos around lights
headache, nausea and vomiting
fixed dilated pupil
firm eyeball
How do you manage acute angle closure glaucoma?
emergancy opthalmology referal
pilocarpine eye drops
acetazolamide oral
Describe age related macular degeneration?
The macula is a concentration of vision cells at the back of your eye. This disease causes degeneration of the effectiveness of those cells resulting in progressive loss of vision. Very common
How do you treat wet macular degenertation?
ANTI VEGF
How does macular degeneration present?
gradual worseining of central vission field
reduced visual acquity
wavy lines
How do you manage suspected age related macular degeneration?
avoid smoking, control bloodpressure
refer to opthalmology
How does diabetic reinopathy present on fundoscopy?
blot haemorrhages
Hard exudates
venous beading
neovascularisation
fluffy wool sorts (nerve damage)
What are the two classes of diabetic retinopathy?
Proliferative or non proliferative.
e.g new vessle formation or not
How is diabetic retinopathy treated?
control blood sugar levels
laser photocoagulation
anti-VEGF
What are cataracts
the lens of the eye becomes cloudy and opaque resulting in reduced visual acquity
What will be absent in a catartact?
Red light reflex
How is cataract treated and what are the risks?
Cataract surgery.
risk that the cataract is masking retinopathy.
Risk of endophalmitis, infllamation of the inner eye.
What causes pupil constriction?
parasympathic nerve fibres traveling down the oculomotor nerve using acetylhcholine as a transmitter cause pupil constriction
What causes pupil dilation?
dilator muscles stimulated by smypathetic nervous system using adrenalin cause pupil dilation
What are the causes of Mydriasis?
Dilated pupils
Oculomotor nerve palsy
Stimulant drugs
anticholinergic drugs
Raised ICP
What causes miosis?
Horners syndrome
Opiates
Nicotine
cluster headaches
How does a third nerve palsy, oculor motor palsy present?
Ptosis
no reactive mydriasis
down and out pupil
What is horner syndrome?
Ptosis, Miosis, anhydrosis caused by damage to the sympathetic supply to the face.
How do you treat Horner syndrome?
check for causes
stroke, tumours, trauma, aneurysm, cluster headaches
What is the medical name for a dilated pupil?
Mydriasis
What is the medical name for a constricted pupil?
Miosis
what is the opposite of miosis
mydriasis
what is the medical term for loss of sweating
Anhidrosis
What is the medical term for a dilated pupil
Mydriasis
What is blepharitis?
inflammation of eyelide margins
How does blepharitis present?
gritty, dry and itchy eyes
How do you manage blepharitis?
Hot compress and gentle cleaning
What is a stye?
infection of the glands of Zeis
What is a chalzion?
infection of meibomian glands
What do glands of zeis do and what do meibomian glands do?
Glands of zeis - eyelashes
meibomian glands - lipids for the eye
What is an entropion and how is it managed?
occourns where eyelid turns inwards and lashes scrape agaisnt the eye.
Tape eyelid open and cover
same day referal to opthalmology
What is an ectropion?
Lashes turning out. Same day referal if risk to sight
How do you tell the difference between pre-orbital and orbital cellulitis?
CT scan
Orbital cellulitis will have pain on eye movement, vsion changes, abnormal pupil reactions
What is the conjuctiva?
thin layer of skin whch covers the inside of the eyelids and sclera of the eye
How does conjunctivitis present?
gritty red eye
normal vision
not painful
What is anterior uveitis?
inflamation of iris, ciliary body and chorcoid
How does anterior uveitis present and how do you treat it?
aching red ee
ciliary flush
floaters and flashes
visible white cells
photophobia
immediate opthalmology referral
What is episclertitis and how is it managed?
imflammation of episclera. Inflammatory disorder
unilateral watery red eye, mild pain
self limiting in 1-4 weeks
What is sclertis and how is it managed?
inflammation of the full thickness of the sclera.
Severe eye pain
red hot eye
watery
photophobia
reduced visual acquity
Same day opthalmolgy referreal
How do you diagnose a corneal abrasion?
fluorescine stain under slit lamp
How is corneal abstrasion managed?
cholramphenicol eye drops
lubricating eye drops
saftey net, re see patient after 1 week
How do you investigate herpes keratitis?
Slit lamp examination and
corneal swab for PCR
How is herpers keratitis treated?
aciclover gel
How does posterior vitreous detatchment present?
Painless floaters and flashing lights
What is retinal detatchment?
retina sperates from the choroid and fills with blood of vitrous fluid
How does retinal detatchment present?
sudden peripheral vission loss
flashes and floaters
How are retinal tears and vitreous detatchements managed
Emergency referral to opthalmologhy
How does retinal vein occulsion present?
Sudden loss of vision in one eye
What does retinal vein occlusion look like on fundoscopy?
flame and blot haemorrhages
optic disc oedeoma
