Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP - Passmed > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

Where is the leison in RAPD?

A

Ipsilateral Optic nerve / severe retinal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the afferent and efferent pathways for pupillary light reflex

A

afferent: retina → optic nerve → lateral geniculate body → midbrain

efferent: Edinger-Westphal nucleus (midbrain) → oculomotor nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do prostaglandin analogues and miotics work in glaucoma mx? examples?

A

Prostaglandin analogue - Latanoprost

Miotic - Pilocarpine (muscarinic receptor agonist)

They increase uveoscleral outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are flashes and floaters in vision suggestive of?

A

Vitreous / retinal detachment - requires urgent referral to opthalmologist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the issue in open angle glaucoma?

A

imbalance between aqueous production and drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does latanoprost work?

A

prostaglandin analog used in glaucoma. - These are 1st line

It works by increasing uveoscleral outflow

(can lead to brown pigmentation of iris and increased eyelash length)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do BB work in open angle glaucoma?

A

Reduces aqueous production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do sympathomimetics work in open angle glaucoma? example and when to avoid?

A

Sympathomimetics (e.g. brimonidine, an alpha2-adrenoceptor agonist) - Reduces aqueous production and increases outflow

Avoid if taking MAOI or tricyclic antidepressants

Adverse effects include hyperaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do carbonic anhydrase inhibitors work in open angle glaucoma and examples?

A

Carbonic anhydrase inhibitors (e.g. Dorzolamide) -> Reduces aqueous production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do mitotics work in open angle glaucoma and examples? adverse effects?

A

Miotics (e.g. pilocarpine, a muscarinic receptor agonist) -> Increases uveoscleral outflow

Adverse effects included a constricted pupil, headache and blurred vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should 360 SLT be used in open angle glaucoma?

A

offer 360° selective laser trabeculoplasty (SLT) first-line to people with an IOP of ≥ 24 mmHg

360° SLT can delay the need for eye drops and can reduce but does not remove the chance they will be needed at all

a second 360° SLT procedure may be needed at a later date

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When is trabeculectomy used in open angle glaucoma? what does this do?

A

surgery in the form of a trabeculectomy may be considered in refractory cases - this opens up drainage pores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is cause of sudden painless loss of vision, that is characterised by a dense shadow starting peripherally and progressing centrally?

A

Retinal detachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common causes of sudden painless loss of vision?

A

ischaemic/vascular (e.g. thrombosis, embolism, temporal arteritis etc). This includes recognised syndromes e.g. occlusion of central retinal vein and occlusion of central retinal artery

vitreous haemorrhage

retinal detachment

retinal migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a RF for retinal detachment?

A

Myopia - short sightedness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features and causes of central retinal vein occlusion?

A

A cause of sudden paniless vision loss, incidence increases with age, more common than arterial occlusion

causes: glaucoma, polycythaemia, hypertension

severe retinal haemorrhages are usually seen on fundoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features and causes of Central retinal artery occlusion?

A

A cause of sudden paniless vision loss due to thromboembolism (from atherosclerosis) or arteritis (e.g. temporal arteritis)

features include afferent pupillary defect, ‘cherry red’ spot on a pale retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Flashes of light (photopsia) - in the peripheral field of vision

Floaters, often on the temporal side of the central vision

These are features of which sudden onset painless cause of vision loss?

A

Posterior vitreous detachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the features + causes of vitreous haemorrhage?

A

causes: diabetes, bleeding disorders, anticoagulants

Large bleeds cause sudden visual loss

Moderate bleeds may be described as numerous dark spots

Small bleeds may cause floaters

20
Q

night blindness + tunnel vision is suggestive of what? Fundoscopy findings?

A

Retinitis pigmentosa - inherited retinal disorder leading to progressive degeneration of retina

fundoscopy: black bone spicule-shaped pigmentation in the peripheral retina, mottling of the retinal pigment epithelium

21
Q

Herpes zoster ophthalmicus sign suggestive of ocular involvement?

A

Hutchinson’s sign: rash on the tip or side of the nose. Indicates nasociliary involvement and is a strong risk factor for ocular involvement

22
Q

Mx of Herpes zoster ophthalmicus?

A

oral antiviral treatment for 7-10 days (within 72h) - IV if severe / immunocompromised

Topical corticosteroids for any secondary inflammation

Ocular involvement - urgent ophthal review

23
Q

How can you distinguish between location of leison causing Horners syndrome?

A

Horner’s syndrome - anhydrosis determines site of lesion:
> head, arm, trunk = central lesion: stroke, syringomyelia, MS, Tumour and encephalitis

> just face = pre-ganglionic lesion: Pancoast’s, cervical rib, trauma + thyroidectomy

> absent = post-ganglionic lesion: carotid dissection / aneurysm, cavernous sinus thrombosis, cluster headache

24
Q

presentation of severe ocular pain, redness, nausea, vomiting and decreased visual acuity

is suggestive of?

A

Acute angle closure glaucoma

25
Q

Mx of acute angle closure glaucoma?

A

combination of eye drops, for example direct sympathomimetic (pilocarpine), BB (timolol), a2 agonist (apraclonidine)

IV acetazolamide - reduce aqueous secretions

can also give topical steroids for inflammation

Definitive mx - laser peripheral iridotomy

26
Q

Keith-Wagener classification of hypertensive retinopathy?

A

I Arteriolar narrowing and tortuosity, Increased light reflex - silver wiring

II Arteriovenous nipping

III Cotton-wool exudates, Flame and blot haemorrhages, These may collect around the fovea resulting in a ‘macular star’

IV Papilloedema

27
Q

Pilocarpine MoA?

A

Pilocarpine is a muscarinic receptor agonist - increases uvoscleral outflow via constriction of pupil

28
Q

Leison in RAPD?

A

Severe retinal disease / optic nerve in dilated eye when light shines into it

29
Q

What are the features of optic neuritis?

A

gradual loss of visual acuity, painful eye movements, a relative afferent pupillary defect and evidence of a central scotoma

impairment of colour vision and red desaturation of images

30
Q

Causes of optic neuritis?

A

multiple sclerosis: the commonest associated disease
diabetes
syphilis

31
Q

Why do pts with orbital cellulitis need urgent abx?

A

risk of cavernous sinus thrombosis and intracranial spread

32
Q

How to distinguish between orbital and preseptal cellulitis?

A

reduced visual acuity, proptosis, ophthalmoplegia/pain with eye movements are NOT consistent with preseptal cellulitis

33
Q

application of fluorescein demonstrates a dendritic pattern of staining in affected eye

What is this suggestive of? mx?

A

epithelial / dendritic corneal ulcer which is a common presentation of HS keratitis

Mx - topical aciclovir

34
Q

What can percipitate acute angle closure glaucoma?

A

use of mydriatic drops, dilating pupil -> the peripheral iris to bunch up and block the drainage angle of the anterior chamber

eg using atropine, tropicamide, cyclopentolate

35
Q

What is an argyll robertson pupil and when is this seen?

A

constricted pupil that does not respond to light but responds to accommodation

Usually bilateral and seen with neurosyphilis

36
Q

When is a ciliary flush seen in the eye?

A

Anterior uveitis

37
Q

What are the differences between acute glaucoma and uveitis?

A

Both present with red eyes

glaucoma: severe pain, haloes, ‘semi-dilated’ pupil

uveitis: small, fixed oval pupil, ciliary flush

38
Q

sudden painless loss of vision, severe retinal haemorrhages on fundoscopy is suggestive of?

A

central retinal vein occlusion

39
Q

Mx of blepheritis?

A

Hot compresses + mechanical removal of lid debris (lid hygiene)

40
Q

How can proliferative diabetic retinopathy be managed? issues with this?

A

panretinal laser photocoagulation - 50% have noticable reduction in visual acuity due to scarring of peripheral retinal tissue, decrease in night vision (rods responsible for night vision are peripheral)

Intravitreal VEGF inhibitors eg ranibizumab - used in combination with the above, slow progression + improve

41
Q

Ophthalmoscopy features of a Weiss ring is suggestive of what condition? What symptoms are often seen?

A

Posterior vitreous detachment which commonly causes flashes and floaters

42
Q

What are angioid retinal streaks and what can cause this?

A

These are irregular dark red streaks radiating from the optic nerve head seen on fundoscopy

Causes include:
SPACE

Sickle-cell anaemia
Paget’s disease, Pseudoxanthoma elasticum
Acromegaly
Calcification and breaks in Bruch’s membrane .
Ehler-Danlos syndrome

43
Q

Most common ocular manifestation of RA?

A

keratoconjunctivitis sicca

can also get episcleritis and scleritis

44
Q

How can you distinguish between episcleritis and scleritis?

A

episcleritis (erythema)

scleritis (erythema and pain)

45
Q

reduced visual acuity and blurred vision, along with the presence of drusen on fundoscopy

Suggestive of what condition?

A

Dry age-related macular degeneration (AMD)

Drusen = Dry macular degeneration

Drusen are yellow deposits that accumulate under the retina and can lead to gradual loss of central vision

46
Q

Wet v Dry age related macular degeneration

A

Dry is slower and better prognosis

47
Q

Ix of age related macular degeneration?

A

slit-lamp microscopy is the initial investigation of choice

fluorescein angiography is utilised if neovascular ARMD - feature of wet ARMD

optical coherence tomography

MRCP - Passmed (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions