Opthalmology Flashcards

1
Q

red eye, semi-dilated non reactive pupil, and a hazy cornea, pain, haloes, after dilation, painful presentation.

rf?

RF for more chronic form of this disease?

what are mydriatic agents (dilating) that trigger this?

A

Acute angle glaucoma closed. TX - timolol, iv acetazolamide, pilocarpine, brimonidine
definitive tx: laster irdotomy
tonometr - pressure
af: headahce,

rf: long sighted (cant see near things, acute)(hypermetropia), pupil dilation, lens growth

primary angle - latanprost first to treat.
myopia - short sighted (cant see far in advance, chronic glaucoma)

dilating agents: phenylephrine, atropine, cyclopentolate,

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2
Q

acute painful red eye
blurred vision and photophobia other sx?
tx?

with sx of urethritis/ joint pain?

if gritty:

A

anterior uveitis/ irits - TX atropine, C/s drops, cycloplegic drops (mydriatic)
SX: small, fixed oval pupil, ciliary flush, hypopyon.

reiter’s syndrome

keratitis

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3
Q

miosis (small pupil)
ptosis
enophthalmos* (sunken eye)
anhidrosis (loss of sweating one side)

A

Horner’s syndrome

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4
Q

Horner’s syndrome with heterchromia

A

Congenital horner’s syndorme

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5
Q

sudden or gradual vision loss, widespread retinal haemorrhages (‘blood and thunder’ appearance) and cotton wool spots due

A

Central retial vein occlusion -CX HTN, polycythaemia, glaucoma,

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6
Q

sudden, painless, unilateral vision loss. (RAPD),
pale retina with a cherry-red spot at the fovea

A

Central retinal A occlusion - due to vTE RF, arteritis

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7
Q

Gradual central VL, loss of near objects, adaptation to night, flickering of lights, distortion of line perception

A

subacute - wet macular degen, Anti VEGF
Gradual - drusen and dry mac degen

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8
Q

6 month old, recurrent, sticky eye

A

congenital nasolacrimal duct obstruction - reassure, resolved by 1 YO

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9
Q

light sensitivity and difficulty focusing on close objects, single dilated pupil, abscent knee jerk reflex, women

A

Holme-Adie pupil (Huge add pupil), slow to react to light, can be benign

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10
Q

18 YO F, ataxia, eye pain on movement, cant see red, central scotoma

A

Optic neuritis. AF: MS, DM, syphillis. TX- 4-6 weeks steroids, MRI
central scotoma

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11
Q

bilateral dry, gritty and sore eyes. finds minimal relief with the frequent use of lubricating eye drops.

painless lump on lid with gradual swelling?

painful, red bump, pus?

A

Meibonium gland blepharitis (need oily and watery part of tears). differs from chalazion - painless lump

stye - external hordeolum

internal is infecton of meibomian cyst (can leave chalazion.

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12
Q

painless VL cx?

one with flashes of flight, perpheral VL and floaters?

dense shadow starting peripherally after flashes an dfloaters?

can cause varing amounts of VL/ dark spots/ floaters?

A

Posterior vitreous detachment - floaters

RD - dense shadow. straight lines appear curved

Large bleeds cause sudden visual loss
Moderate bleeds may be described as numerous dark spots
Small bleeds may cause floaters - vitreous haemorrhage

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13
Q

Blurring of vision again years after cataract surgery

pain immediately after op?

A

Posterior capusle opacification

endopthalmitis

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14
Q

Associated conditions of episcleritis

scleritis conditions?

A

IBD, RA

scleritis: RA (most common), SLe, sarcoid, granulomatosis with polyangitis

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15
Q

Causes of peripheral VL? Tunnel vision?

A

Glaucoma
Retinal detatchment - dark shadow starts - peripherally and central VL, flashes before
Chorioradioretinitis - do HIV
Bitemp haemianopia - pit tumour
Retinitis pigmentosa - night VL

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16
Q

Causes of papilledaema? (usually bilateral)

A

space-occupying lesion: neoplastic, vascular
malignant hypertension
idiopathic intracranial hypertension
hydrocephalus
hypercapnia
Rare causes include
hypoparathyroidism and hypocalcaemia
vitamin A toxicity

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17
Q

painless, gradual swelling caused by a blocked oil gland, typically on internal eye lid

18
Q

painful, red, and sudden bump caused by a bacterial infection in a hair follicle or oil gland.

when do you tx with antibiotics?

A

Stye - external hordeolum
Internal - could lead to a chalazion

tx if associated with conjunctivitis

19
Q

child with Red/green colour change, eye swelling, pain eye movements, mild proptosis

most common cx

no pain on eye movement?

RF?

A

Orbital cellulitis - common cause is ethmoidal sinusitis, lack of HiB influenzae vaccine, Recent eyelid infection/ insect bite on eyelid (periorbital cellulitis). do CT

no pain - preseptal cellulitis

no vaccine/ ear infection,

20
Q

TXof bacterial conjuctivitis? pregnant women?

A

Chloramphenicol normally
Fusidic acid for pregnant women

21
Q

cx of central scotoma?

A

MS, cotton wool spots (HTN), methyl acohol, ethambutol, quinine, vascular blockages,

22
Q

zerpes zoster opthalmicus - what is hutchinson’s sign?
TX?

A

rash on tip of nose indicates likihood of eye involvement (cornea)

antiviral P/O 7-10 days within 72 hrs

23
Q

Marfan’s syndrome, sudden VL - cx?

A

lens dislocation (upwards)
others: EDS, homocystinuria

24
Q

subacute unilateral VL with eye pain on movements, RAPD, colour desaturation?

A

optic neuritis AF: MS, cenral scotoma
do MI brain/ orbits

25
red eye, photophobia, gritty senation (hc of contact lens), foggy and washed out typical cx?
keratitis bacerial - staph A lens - pseudomonas aeruginosa
26
cx of cataracts
hypocalcaemia, radiation, myotonic dystrophy, smoking, trauma, DM, CS long term
27
definition of endophatlmitis?
inflammation of aqueous/ vitreous humour
28
worsening vision over months with metamorphopsia and central scotoma?
wet AMRD
29
dry AMRD characterised by?
drusen
30
episcleritis vs scleritis?
pain phenylephrine drops - vessels blanch in episcleritis IDB - episcleritis RA - AF scleritis
31
most common rheumatoid manifestation in eyes?
keratoconjunctivits sicca
32
younh woman, blurred vision, painful movement, loss of red vision. what ix? defect VL? other cx?
MRI - optic neuritis af MS central scotoma CLS, temp arteriti, infective (syphillis, tb, amiodarone, ethambutol,
33
dm2 went to GP had fundoscopy and then developed sudden painful eye with VL in the evening driving in dark?
AACG - mydriatic drops/ dilation at nigh can worsen sx
34
single dilated pupil, once light is shone, stays constricted for long time? but reacts to accommodation what is the syndrome?
Holmes-adie pupil syndrome: with abscent ankle/ knee reflex
35
Argyl Robertson syndrome?
ARP, PRA B/L dilated eyes that dont respond to light but do accommodate. Af - neurosyphillis/ dm - most common in UK
36
high intraocula pressure with Hx of T2dM and peripheral VL. dx? tx first line?
primary open angle glaucoma - tx first latanprost. SE borwn pigmentation, increases lash length
37
Primary open angle tx: pilocarpine - dilator or constrictor? brimonidine - when to avoid
pilocaripine is miotic (constrictor) avoid brimonidine if on TCA/ MAOi. SE. high K
38
dilated eye cx?
third nerve palsy Holmes-Adie pupil traumatic iridoplegia phaeochromocytoma congenital
39
Argyl robertson pupil :
ARP PRA. small irregular pupils that do not respond to light. Af: neurosyphillis/ dm
40
Horner's cx: central pre-ganglionic post ganglionic?
central - anhydrosis trunk, face, arm. STROKE SYRINGOMYLIA, MS/ tumour pregang- anhydrosis on face T tumour (pancoast), thyroidectomy, cervical rib post gang- no anhidrosis. Carotid artery dissection Carotid aneurysm Cavernous sinus thrombosis Cluster headache
41
hypertensive eye classes on fundoscopy? SAFE?
Silver lining 1 AV Nipping 2 Flame Shaped Hem 3 Edema 4 SAFE
42