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Opthalmology Flashcards

1
Q

What is a glaucoma ?

A
  • Optic neuropathies caused by an increase in intraocular pressure = damages the optic nerve
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2
Q

What are the 7 RF for open angle glaucoma ?

A
  • Increasing age
  • FHx
  • Afro-Carbibbean ethnicity
  • Myopia (nearsightedness)
  • DM
  • HTN
  • Corticosteroids
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3
Q

What are the presenting features of open angle glaucoma ?

A

Gradual onset peripheral vision loss

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4
Q

Findings on fundoscopy in open angle glaucoma

A
  1. Optic disc cupping (Cup-to-disc ratio >0.7)
  2. Optic disc pallor
  3. Bayonetting of vessels
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5
Q

What is the management of open angle glaucoma ?

A
  • First line = Laser : 360 degrees trabeculoplasty If IOP >=24mmHg
  • Second = Medical management : prostaglandin analogue eye drops (Latanoprost)
  • Third : BB (Timolol).
  • Surgery : Trabeculectomy in refractory cases
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6
Q

What are the RF for acute angle closure glaucoma ?

A
  • Hypermetropia (long-sightedness)
  • Pupillary dilatation
  • Cataracts
  • Increasing age
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7
Q

What are the presenting features of acute angle closure glaucoma ?

A
  • Sudden onset severe pain : may be ocular or headache
  • Painful red eye.
  • Blurred vision
  • Halos around lights
  • N&V.
  • Symptoms worse with mydriasis (e.g. watching tv in a dark room).
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8
Q

What are the 6 features seen on examination in acute angle closure glaucoma ?

A
  • Red eye
  • Hazy cornea
  • Decreased visual acuity
  • Semi-dilated non-reacting pupil
  • Fixed size pupil
  • Hard eyeball on gentle palpation
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9
Q

What is the management of acute angle closure glaucoma ?

A
  • Immediate admission and referral to ophthalmologise (keep pt supine without a pillow)
  • Combination of eye drops : Pilocarpine 2%, Timolol, and apraclonidine.
  • IV Acetazolamide
  • Definitive : laser peripheral iridotomy
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10
Q

How does latanoprost work and what are its SE?

A
  • Prostoglandin analogue
  • Increases uveoscleral outflow (aqueous humour)
  • Once daily
  • SE : brown pigmentation of iris, increased eyelash length
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11
Q

How does timolol work and what is a contraindication ?

A
  • BB
  • Reduces aqueous humour production
  • Avoided in asthmatics and pts with heart block
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12
Q

How does apraclonidine work, when is it avoided and what is an adverse effect ?

A
  • Alpha-2 receptor agonist
  • Reduces aqueous humur production & increases uveoscleral outflow.
  • Avoided if taking MAOI or tricyclic antidepressant
  • Adverse effect : hyperaemia
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13
Q

How does Dorzolamide work ?

A
  • Carbonic anhydrase inhibitor
  • Redices aqueous humur production
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14
Q

What is the mechanism of action of pilocarpine and its adverse effects ?

A
  • Muscarinic receptor agonist
  • Increases uveoscleral outflow
  • Adverse effects : constricted pupil, headache and blurred vision
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15
Q

What happens to the macula in ARMD ?

A
  • Frequent and larger Drusen
  • Atrophy of the retinal pigment epithelium
  • Degeneration of photoreceptors
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16
Q

What happens specifically in wet ARMD?

A
  • Neovascularisation
  • New blood vessels develop in the choroid and grow into the retina
  • When they leak fluid / blood = oedema and faster vision loss
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17
Q

RF for ARMD

A
  • Older age (>75)
  • Smoking
  • FHx
  • Other cardiovascular RF (HTN, DM, dyslipidaemia).
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18
Q

What are the features of ARMD ?

A
  • Loss of CENTRAL vision : gradual in dry ARMD, Subacute in wet ARMD
  • Crooked or wavy appearance to straight lines (metamorphopsia).
  • Deterioration in vision at night
  • Flashing lights
  • Fluctuations in visual disturbance that varies from day to day
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19
Q

What is seen on examination in ARMD ?

A
  • Reduced visual acuity on a Snellen chart
  • Scotoma
  • Distortion of straight lines assessed with Amsler grid test
  • Drusen on fundoscopy
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20
Q

What investigations are done in ARMD

A
  • Initial : Slit lamp -> view of retina and macula.
  • Optical coherence tomography : for diagnosing and monitoring
  • Fluorescein angiography : shows oedema and neovascularisation in wet AMD
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21
Q

How is ARMD managed ?

A
  • Slow / reduce progression
  • Avoid smoking
  • Control BP
  • Vitamin supplementation
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22
Q

What specific medication can be used in wet ARMD ?

A
  • Anti-VEGF medications (Ranibizumab)
  • Target Vascular endothelial growth factor which stimulates the development of new blood vessels in the retina
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23
Q

Causes of an acutely red PAINLESS eye

A
  • Conjunctivitis
  • Episcleritis
  • Subconjunctival haemorrhage
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24
Q

7 causes of an acutely PAINFUL red eye

A
  • Acute angle-closure glaucoma
  • Anterior uveitis
  • Scleritis
  • Corneal abrasions or ulceration
  • Keratitis
  • Foreign body
  • Traumatic or chemical injury
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25
Q

PAINLESS red, bloodshot eye
Purulent discharge
Itchy / gritty sensation

Diagnosis and management

A
  • Bacterial conjunctivitis
  • Often staph aureus (or gonococcus if STI)
  • If needed : chloramphenicol / fusidic acid eye drops (pregnant women)
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26
Q

PAINLESS red, blood shot eye
Clear discharge
Tender preauricular lymph nodes
Coryzal symptoms

A

Viral conjunctivits
Often adenovirus

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27
Q
  • Bilateral swelling of conjunctival sac and eyelid
  • Prominent itch
  • Watery discharge

Diagnosis and management

A
  • Allergic conjunctivits
  • Oral or topical antihistamines (cetirizine)
  • Topical mast-cell stabilisers (sodium cromoglicate) can be given 2nd line
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28
Q

What is anterior uveitis

A
  • Inflammation of the middle layer of the eye
  • Choroid, ciliary body and iris
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29
Q

What are the presenting features of anterior uveitis

A
  • ACUTELY painful, red eye
  • Photophobia
  • Blurred vision
  • Excessive lacrimation
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30
Q

What is seen on examination in anterior uveitis?

A
  • Miosis +/- irregulalry shaped pupil
  • Ciliary flush
  • Hypopyon
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31
Q

What is anterior uveitis associated with ?

A
  • HLA-B27
  • Seronegative spondyloarthropathies
  • Behcet’s disease
  • Sarcoidosis
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32
Q

How is anterior uveitis managed ?

A
  • Urgent ophthalmologist referral
  • Steroids (eye drops, oral or IV)
  • Cycloplegics / mydriatic (e.g. cyclopentolate or atropine eye drops = antimuscarinis)
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33
Q

How do cycloplegics work in anterior uveitis ?

A
  • Antimuscarinins
  • Paralyse the ciliary muscles = dilates the pupil and reduces pain
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34
Q

what kind of pupil is seen in neyrosyphilis ?

A
  • Argyll-Robertson pupil
  • Small, irregular pupils
  • Accommodates but
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35
Q
  • Asymmetrical slow reduction in visual acuity.
  • Fading of colours
  • Halos around lights
  • Glaring of lights / “starbursts” around lights
A

Cataracts

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36
Q

What is cataracts and what 2 investigations are done to diagnose

A
  • Progressively opacification of the lens
  • Slit lamp : shows cataracts
  • Opthalmoscope : shows loss of red reflex with normal optic nerve and fundus
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37
Q

Conservative and definitive management of cataracts

A
  1. conservative : glasses
  2. Definitve : surgery - surgical replacement with artificial lens
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38
Q

What are the diffferentials for sudden, painless vision loss ?

A
  • Retinal detachment
  • Central retinal artery occlusion
  • Central retinal vein occlusion
  • Vitreous haemorrhage due to diabetic retinopathy
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39
Q

what is seen on fundoscopy in central retinal artery occlusion

A
  • Pale retina
  • ‘Cherry red spot on retina’
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40
Q

What is a key sign of central retinal artery occlusion ?

A

Relative afferent pupillary defect

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41
Q

What are the features of retinal vein occlusion

A

Sudden, painless reduction or loss of visual acuity

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42
Q

what is seen on fundoscopy in retinal vein occlusion

A
  • Widespread hyperaemia
  • Severe retinal haemorrhages -> ‘Stromy sunset’
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43
Q

How is retinal vein occlusion managed ?

A
  • Refer to opthalmologist
  • Anti-VEGF (renibizumab) = macular oedema
  • Laser photocoagulation = neorevascularisation
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44
Q

What is Blepharitis : presentation and management

A
  • Inflammation of the eyelid margins
  • Bilateral grittiness/discomfort with swollen and red eyelids
  • Hot compress twice daily / cooled boiled water and baby shampoo on cotton wool
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45
Q

What are the 2 types of stye, presentation and management

A
  • Hordeolum externum : infection of sebaceous or sweat glands
  • Hordeolum internum : infection of meibomian glands
  • Tender, red lump on eyelid
  • Hot compress and analgesia
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46
Q

Chalazion : what, features, management

A
  • Blocked and swollen meibomian gland (cyst)
  • Firm, painless lump in eye
  • Warm compress and gentle massage
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47
Q

Entropion : what and management

A
  • Eyelid turned inwards
  • Tape down eyelid with regular lubticating drops
  • Definitive = surgery
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48
Q

Ectropion. : what and management

A
  • Eyelid turned outwards
  • Regular lubricating eyedrops
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49
Q

Trichiassis : what and management

A
  • Inward growth of eyelashes
  • Remove affected eyelashes
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50
Q

Periorbital cellulitis : causes and features

A
  • Eyelid and skin infection IN FRONT of orbital septum
  • Most frequently : staph aureus
  • Swollen, red, hot skin around the eyelid and eye
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51
Q

How is periorbital cellulitis distinguished from orbital cellulitis ?

A
  • Contrast CT
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52
Q

How is periorbital cellulitis managed ?

A
  • Urgent opthalmology referral
  • Oral co-amoxiclav
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53
Q

What is orbital cellulitis ?

A

Infection around the eyeball involving tissues BEHIND the orbital septum

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54
Q

What are the features of orbital cellulitis ?

A
  • Redness and swelling around the eye
  • Severe ocular pain
  • Visual disturbance
  • Proptosis -> eye bulges forwards
  • Opthalmoplegia / pain with eye movements
  • Eyelid oedema and ptosis
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55
Q

How is orbital cellulitis managed ?

A

IV antibiotics

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56
Q

Features of corneal abrasions

A

Eye pain
Foreign body sensation
Photophobia
Watering eye : epiphora
Red eye

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57
Q

How can corneal abrasions be visualised

A
  • Fluorescein stain -> yellow-orange colour that collects in abrasions / ulcers highlighting them, especially when viewed under cobalt blue light
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58
Q

What are lubricating eye drops based on ?

A
  • Hypromellose -> least viscous (effects last 10 mins)
  • Polyvinyl alcohol drops -> middle viscous
  • Carbomer -> most viscoius (last 30-60 mins)
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59
Q

What is keratitis

A

Inflammation of the cornea

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60
Q

What can cause keratitis ?

A
  • Viral infection - HSV (most common) = herpes simplex keratitis
  • Bacterial infection - pseudomonas (contact lens wearers) or staphylococcus
  • Fungal infection - candida or aspergillus
  • Contact lens-induced acute red eye (CLARE)
  • Exposure keratitis - caused by inadequate eyelid coverage (e.g ectropion)
61
Q

How does keratitis present ?

A
  • Red eye : pain and erythema
  • Photophobia
  • Foreign body, gritty sensation
  • Hypopyon may be seen
62
Q

How is keratitis managed ?

A
  • Same day referral to rule out bacterial keratitis = Slit lamp
  • Fluorescein staining shows a dendritic corneal ulcer
  • Topical or oral antivirals (aciclovir, ganciclovir if viral)
63
Q

What is seen on fundus examination in background diabetic retinopathy

A
  • Microaneurysms
  • Retinal haemorrhages
  • Hard exudates
  • Cotton wool spots
64
Q

What is seen on fundoscopy in pre-proliferative diabetic retinopathy ?

A
  • Venous bleeding
  • Multiple blot haemorrhages - - Intraretinal microvascular abnormality (IRMA).
65
Q

What is seen on fundoscopy in proliferative diabetic retinopathy

A
  • Neovascularization and vitreous haemorrhage.
66
Q

What is seen on fundoscopy in diabetic retinopathy

A
  • Exudates within macula and macular oedema.
67
Q

How is non proliferative diabetic retinopathy managed ?

A

Close monitoring and careful diabetic control

68
Q

How is proliferative diabetic retinopathy managed ?

A
  • Pan-retinal photocoagulation (SE = decrease in night vision)
  • Anti-VEGF
  • Surgery (vitrectomy) in severe disease
69
Q

How is hypertensive retinopathy classified ?

A

Keith-wagener classification

  • I = arteriolar narrowing and increased light reflex = sliver wiring
  • II = AV nipping
  • III = ‘Cotton wool exudates, flame and bot haemorrhages
  • IV = papilloedema
70
Q

How does episcleritis and scleritis differ in presentation ?

A
  • Episcleritis : PAINLESS red eye, often laterally.
  • Scleritis : PAINFUL red eye, watering and photophobia, reduced visual acuity, blue sclera
71
Q

what test can help differentiate between episcleritis and scleritis ?

A
  • Phenylephrine eye drops -> in episcleritis, this will cause the redness to disappear. In scleritis it will have no effect.
72
Q

Give 4 RF for scleritis

A
  • RA
  • SLE
  • Sarcoidosis
  • Granulomatosis with polyangiitis
73
Q

How is scleritis managed ?

A
  • Same day assessment by ophthalmologist
  • First line = oral NSAIDs
  • More severe = oral glucocorticoids
74
Q

Give 5 predisposing factors to subconjunctival haemorrhage

A
  • HTN
  • Bleeding disorders (e.g thrombocytopenia)
  • Whooping cough
  • Medications (antiplatelets, DOACS, warfarin)
  • Non-accidental injury
75
Q

How does a subconjunctival haemorrhage present ?

A
  • Patch of BRIGHT RED blood underneath the conjunctiva
  • PAINLESS
  • No effect on vision
76
Q

what is posterior vitreous detachment and how does it present ?

A
  • Separation of the vitreous membrane from the retina
  • Sudden appearance of floaters
  • Flashing lights
  • Blurred vision
  • Cobweb across vision
77
Q

What is seen on opthalmoscopy in posterior vitreous detachment and what does it predispose people to ?

A
  • Weiss ring
  • Retinal tears and retinal detachment
78
Q
  • Sudden onset painless peripheral vision loss (shadow coming across vision)
  • Blurred or distorted vision
  • New onset floaters and flashes
A

Retinal detachment

79
Q

what occurs in retinal detachment and what is it often due to ?

A
  • Neurosensory tissue of retina separates from underlying pigment epithelium.
  • Often due to retinal tears allowing vitreous fluid to get under the neurosensory retina
80
Q

how is a retinal tear managed ?

A
  • Create adhesions between retina and choroid
  • Laser therapy / cryotherapy
81
Q

How is retinal detachment managed ?

A
  • Reattach retina and reduce traction / pressure to prevent recurrence
  • Vitrectomy, scleral buckling or pneumatic retinopexy
82
Q

Initial night blindness, followed by peripheral vision loss (tunnel vision)

A

Retinitis pigmentosa

83
Q

what is retinitis pigmentosa ?

A

Genetic condition causing the degeneration of the photoreceptors (particularly rods) in the retina.

84
Q

what is seen on fundoscopy in retinitis pigmentosa ?

A
  • Black bone spicule-shaped pigmentation in the peripheral retina
  • Mottling of the retinal pigment epithelium
85
Q

Give 3 systemic diseases associated with retinitis pigmentosa

A
  • Usher syndrome
  • Bassen-Kornwig syndrome
  • Refsum disease
86
Q

Give 8 causes of a dilated pupil

A
  • Congenital
  • Stimulants (e.g. cocaine)
  • Anticholinergics (e.g oxybutynin)
  • Trauma
  • Third nerve palsy
  • Holmes-Adie syndrome
  • Raised ICP
  • Acute angle-closure glaucoma
87
Q

Give 6 causes of a constricted pupil

A
  • Horner syndrome
  • Cluster headaches
  • Argyll-Robertson pupil (neurosyphilis)
  • Opiates
  • Nicotine
  • Pilocarpine
88
Q

What are the 3 features of a third nerve palsy ?

A
  • Ptosis
  • Dilated, non reactive pupil
  • ‘Down and put’ eye position
89
Q

If the pupil is NOT affected in a third nerve palsy, what does it suggest about the underlying cuase ?

A
  • It is microvascular as the parasympathetic fibres are spared
  • Examples : DM, HTN, Ischaemia
90
Q

If a third nerve pasly DOES affect the pupil, what does it suggest about the underlying cause ?

A
  • There is compression of the nerve as the parasympathetic fibres are affected
  • Examples : Tumour, Trauma, Cavernous sinus thrombosis , Posterior communicating artery aneurysm, Raised ICP
91
Q

what are the 4 possible features of Horner’s syndrome ?

A
  • Ptosis
  • Miosis
  • Anhidrosis
  • Possible enophthalmos = sunken eye
92
Q

What are the 4 central lesions that can cause horner’s syndrome and what is the site on anhidrosis ?

A
  • S: Stroke
  • S : multiple Sclerosis
  • S : Swelling (tumours
  • S: Syringomyelia (cyst in spinal cord)

FACE, ARM AND TRUNK

93
Q

what are the 4 preganglionic lesions that can cause horner’s syndrome and where does the anhidrosis occur ?

A
  • T : Tumour (pancoast)
  • T : Trauma
  • T : Thyroidectomy
  • T : Top rib

FACE

94
Q

What are the 4 postganglionic lesions that can cause Horner’s syndrome and where does the anhidrosis occur ?

A

C : Carotid aneurysm
C : Carotid artery dissection
C : Cavernous sinus thrombosis
C : Cluster headache

NO ANHIDROSIS

95
Q

what is congenital Horner’s syndrome assocatiated with ?

A
  • Heterochromia (difference in iris colour on affected eye)
96
Q

How can Horner’s syndrome be tested for?

A
  • Cocaine eye drops
  • Stops noradrenaline reuptake at NMJ.
  • This causes a normal eye to dilate.
  • In Horner’s, the nerves do not release noradrenaline and so there is no pupil reaction.
97
Q

what are the features of Holmes-Adie pupil ?

A
  • Dilated : damage to postganglionic parasympathetic nerve fibres
  • Sluggish to react to light
  • Responsive to accommodation (the pupil constricts when focusing on a near object)
  • Slow to dilate following constriction (“tonic” pupil)
98
Q

what is seen in Holmes-Adie syndrome ?

A
  • Holmes Adie pupil
  • Absent ankle and knee reflexes
99
Q

what is herpes zoster opthalmicus ?

A
  • Reactivation of the varicella-zoster virus in the area supplied by the opthalmic division of the trigeminal nerve
100
Q

How does herpes zoster opthalmicus present ?

A
  • Vesicular rash around the eye
  • Hutchinson’s sign = rash on the trip or side of the nose. Indicates nasociliary involvement
101
Q

How is herpes zoster opthalmicus managed ?

A
  • Oral antiviral Tx for 7-10 days started within 72 hrs.
102
Q

what is the most common cause of a persitent watery eye in an infant and how is it managed ?

A
  • Nasolacrimal duct obstruction
  • Teach parents to massage the lacrimal duct
103
Q

what is hyphema, management of complication (in the context of trauma)

A
  • Definition : Blood in the anterior chamber of the eye.
  • Management : Strict bed rest and urgent lateral canthotomy
  • Complication : glaucoma
104
Q

what are the 4 features of orbital compartment syndrome and how is it managed ?

A
  • Eye pain/swelling
  • Proptosis
  • ‘Rock hard’ eyelids
  • Relevant afferent pupillary defect
  • Urgent lateral canthotomy
105
Q

what are the causes of a relative afferent pupillary defect ?

A
  • Retina: detachment
  • Optic nerve: optic neuritis e.g. multiple sclerosis
106
Q

Common presentation of vitreous haemorrhage

A
  • Painless visual loss or haze (commonest)
  • Red hue in the vision
  • Floaters or shadows/dark spots/cobwebs in the vision
107
Q

who is often affected by vitreous haemorrhage ?

A

Diabetics

108
Q
  • Post renal transplant
  • Blurred vision
  • Fundoscopy : cotton-wool spots, infiltreates and haemorrhages
A

Cytomegalocirus retinitis

109
Q

Investigations done in open angle glaucoma

A
  • Automated perimetry : asses visual field
  • Slit lamp examination with pupil dilatation to assess optic nerve and fundus for a baseline
  • Applanation tonometry to measure IOP
  • Gonioscopy to assess peripheral anterior chamber configuration and depth
110
Q

Does the iris cover the trabecular meshwork in open-angle glaucoma

A

NO
Iris is clear on the meshwork

111
Q

Investigations done in acute angle closure glaucoma

A
  1. Tonometry -> look for elevateed IOP
  2. Gonioscopy
112
Q

Is the peripheral iris covering the trabecular meshwork in acute closed angle glaucome ?

A
  • YES
  • This leads to a narrowing of the anterior chamber, impairing aqueous outflow and causing a sudden rise in IOP = sight threatening
113
Q

An elderly female smoker presents with reduced visual acuity, complaining of ‘blurred’ vision. On examination there is a central scotoma and fundoscopy reveals multiple drusen. Likely diagnosis ?

A

Macular degeneration

114
Q

An elderly patient with a history of atrial fibrillation presents with a sudden painless loss of vision in one eye. Fundoscopy reveals a ‘cherry red’ spot on a pale retina.

A

Central retinal artery occlusion

115
Q

An elderly short-sighted man presents with flashing lights which are worse on eye movement and are located in the temporal visual field. He also describes some upper visual field loss ‘like a curtain coming down’ is a stereotypical history of:

A

Retinal detachment

116
Q

An elderly man presents an acute, painful red eye associated with decreased visual acuity. His symptoms are worse in the dark. On examination he has a semi-dilated non-reacting pupil

A

Acute angle closure glaucoma

117
Q

A man who is on treatment for HIV presents with a painful, vesicular rash on the right side of his face around the eye. Fluorescein staining reveals multiple small defects on the right cornea

A

Herpes zoster opthalmicus

118
Q

An elderly man with a long history of diabetes presents with sudden visual loss in one eye. For the past few days he had been experiencing floaters and ‘cobwebs’. Visual acuity is reduced to sensing light is a stereotypical history of

A

Vitreous haemorrhage

119
Q

what is the mechanism of action of pilocarpine

A

Muscarinic receptor antagonist
Direct parasympathomimetic

120
Q

A young man presents with an acute, painful red eye associated with photophobia and blurred vision. On examination the pupil is small and irregular is a stereotypical history of

A

Anterior uveitis

121
Q

An elderly patient with a history of chronic glaucoma and hypertension presents with a sudden painless loss of vision in one eye. Fundoscopy reveals multiple flame-shaped haemorrhages and optic disc oedema is a stereotypical history of

A

Central retinal vein occlusion

122
Q

An elderly patient with a history of hypertension presents with decreasing visual acuity and peripheral visual field loss. Fundoscopy reveals optic disc cupping is a stereotypical history of:

A

Primary open angle glaucoma

123
Q

A woman with a history of rheumatoid arthritis presents with severe, constant pain in her right eye. On examination the right eye is red and there is a degree of photophobia. Visual acuity is normal is a stereotypical history of :

A

Scleritis

124
Q

A patient presents with a ‘droopy eyelid’. On examination they have unilateral miosis, ptosis and narrow palpebral aperture giving the appearance of enophthalmos is a stereotypical history of:

A

Horner’s syndrome

125
Q

A woman with a history of rheumatoid arthritis presents after developing a red right eye. There is no pain, discharge or photophobia although the eye is tearing. Visual acuity is normal

A

Episcleritis

126
Q

A patient presents with an acute, painful red eye associated with photophobia and epiphora. Fluorescein staining reveals a ragged area on the cornea (epithelial ulcer)

A

Herpes simplex keratitis

127
Q

A 30-year-old man presents with visual problems. His vision is much worse in the dark and he has now started to lose peripheral vision. He has a family history of similar problems

A

retinitis prigmentosa = YOUNG

128
Q

A woman is noted to have a unilateral mydriatic pupil which is minimally reactive to light

A

Holmes-Adie pupil

129
Q

An elderly short-sighted man presents with a floater on the temporal field of vision. Visual acuity is normal for the patient is a stereotypical history of

A

Posterior vitreous detachment

130
Q

2 features of an Argyll-Robertson pupil

A
  • Small, irregular ppupils
  • Accommodates but does not react to light
131
Q

Mnemonic for Argyll-Robertson pupol

A

ARP = Accommodation Reflex Present (ARP) but Pupillary Reflex Absent (PRA)

132
Q

2 causes of ARP

A

DM
Syphilis

133
Q

5 RF for orbital cellulitis

A
  • Childhood
  • Previous sinus infection
  • Lack of Hib vaccination
  • Recent eyelid infection / insect bite of eyelid (preorbital cellulitis)
  • Ear or facial infection
134
Q

Presentation of herpes simplex keratitis

A
  • Red, painful eye
  • Photophobia
  • Epiphora
  • Decreased visual acuity
  • Fluorescein staining may show epithelial ulcer
135
Q

Management of herpes simplex

A

Immediate opthalmology referral
Topical aciclovir

136
Q

What is seen on fundoscopy in retinitis pigmentosa

A

Black bone spicule-shaped pigmentation in the peripheral retina

137
Q

what is a complication of blunt ocular trayma with associated hyphema ?

A
  • Glaucoma due to raised IOP
138
Q

A young patient presents with visual symptoms. Acute unilateral worsening of vision. Associated pain with eye movements. RAPD seen and reduced visual acuity in affected eye. Likely diagnosis and two other common symptoms seen in this condition

A

Optic neuritis
Reduced colour vision
Central scotoma

139
Q

How should any contact lens wearing patient present with a painful red eye be managed and why ?

A

Urgent referal to eye casualty to exclude microbial keratitis

140
Q

Serious complication of surgery to replace lens in cataracts

A

Endophthalmitis

141
Q

Cause of nuclear cataracts

A

Change in lens refractive index - old age

142
Q

Cause of polar cataracts

A

INherited

143
Q

Cause of subcapsular cataracts

A

S = steroids

144
Q

Cause of dot opacities cataracts

A

D = DM = mytonic Dystrophy

145
Q

explain which way the eye with deviate in different types of suint

A

the nose: esotropia
temporally: exotropia
superiorly: hypertropia
inferiorly: hypotropia

146
Q

presention of stye in SBA and management

A
  • Painful swelling of eye, yellow head pointing to the lid margin
  • Analgesia and warm compress
147
Q

how can drusen be described in SBA

A

Accumulations of extracellular material between Bruch’s membrane and the retinal pigment epithelium of the eye

148
Q
A

Finals (92 decks)

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