OPTHALMOLOGY Flashcards
from what part of the eye does the vitreous membrane detach from in posterior vitreous detachment?
retina
what gender is more likely to develop posterior vitreous detachment?
females
what biological process causes the vitreous humour to naturally shrink and peel?
ageing
what is photospia? (it is a symptom of posterior vitreous detachment)
flashes of light
what visual abnormalities are present in greater number in posterior vitreous detachment?
floaters
what is the main complication of posterior vitreous detachment?
retinal detachment/tears
what is treatment for posterior vitreous detachment?
watch and wait
what is a vitreous haemorrhage?
leakage of blood into spaces around vitreous body
give 3 traumatic causes of vitreous haemorrhage
retinal tears
blood vessel tears around retina
SAH
give 3 pathological causes of vitreous haemorrhage
choroidal melanoma
age related macular degeneration
neovascularisation of retina
retinal ischaemia
what procedure is used to treat vitreous haemorrhage?
vitrectomy
what causes inflammation of the optic nerve in optic neuritis?
demyelination
what ophthalmological condition is associated with MS and neuromyelitis optica?
optic neuritis
where would you expect pain in optic neuritis?
retro-ocular/retro-orbital pain
what type of illness often precedes optic neuritis?
viral
what 2 visual impairments might you expect with optic neuritis?
rapid impairment
dyschromatopsia (loss of colour vision)
what medical imaging might you use to diagnose optic neuritis?
MRI
what drug type might you give to treat optic neuritis and why?
corticosteroids
anti-inflammatory
in retinal detachment, where does the retina detach from?
pigment epithelium
give a traumatic cause of retinal detachment
fluid leakage (vitreous detachment, injury etc)
give 2 retinal abnormalities that might cause detachment
traction
exudative
give an iatrogenic cause of retinal detachment
cataract surgery complication
what two symptoms does retinal detachment share with posterior vitreous detachment?
photospia
new floaters
how is the loss of vision characteristic of retinal detachment described?
‘curtains’ - outer to central visual loss
what diagnostic technique might you use to visualise the eye in a patient with suspected retinal detachment?
opthalmoscopy
name 2 procedures that you might use to treat retinal detachment?
vitrectomy
seal retinal breaks
relieve vitreoretinal traction
what 3 things does prognosis of retinal detachment depend on?
duration of detachment
is macula detached too?
underlying vascular health
what are the two main types of vascular occlusion that can happen in the eye?
retinal artery
retinal vein
give 5 causes of vascular occlusions
atherosclerosis thrombi glaucoma macular oedema diabetes hypertension smoking hypercholesterolaemia
what is ranibuzimab and why might you give it in the case of vascular occlusions?
inhibits vascular endothelial growth factor
reduces swelling & neovascularisation in vascular occlusions
what other drug type might you give for vascular occlusions?
steroids - swelling
give 3 complications of vascular occlusions
macular oedema
neovascularisation
neovascular glaucoma
retinal detachment
age related macular degeneration is a __a)__, __b)__ disorder
a) regenerative, degenerative
b) reversible, irreversible
a) degenerative
b) irreversible
what is the leading cause of blindness in developed countries?
age related macular degeneration
what causes dry ARMD?
accumulation of pigment epithelial waste - drusen
what causes wet ARMD?
accumulation of fluid after neovascularisation of pigment epithelium
what happens to pigment epithelium in dry ARMD?
atrophy
what happens to pigment epithelium in wet ARMD?
haemorrhage, scarring, swelling
what is the difference in progression between wet and dry ARMD?
dry = slow wet = fast
give 4 risk factors for ARMD
age smoking alcohol poor diet sun exposure
what part of the vision tends to be disorder in ARMD?
central (scotoma)
name 2 visual actions that are restricted in ARMD
fine print reading
facial recognition
close vision
what is ambler grid testing and what would it show in ARMD?
grid - tests distortion
ARMD lines would be wavy
why is ranuzimab given in wet ARMD?
stop further angiogenesis
what ophthalmological condition is described as opacification of the lens?
cataract
give 4 causes of cataracts
age trauma post-inflammatory diabetes congenital
are cataracts fast or gradual onset?
gradual
what is the most common cause of blindness worldwide?
cataracts
what ophthalmological condition is characterised by monocular diplopia with glares and haloes?
cataracts
how would the red reflex differ from a normal eye in cataracts?
reduced
how do you treat cataracts?
surgery - lens implant
what eye pathology is glaucoma linked to?
raised intra-ocular pressure
what part of vision in lost in glaucoma?
peripheral
what is the second greatest cause of visual loss worldwide?
glaucoma
is glaucoma familial or does it have no inheritance pattern?
familial
at what point in the progression of glaucoma does visual acuity start to be affected?
end stage
name 3 optic disc changes that you might observe in glaucoma
cupping
palor
splinter haemorrhages
RAPD is a clinical sign of glaucoma - what is it?
relative afferent pupillary defect
pupils will constrict less when a light is shone in the affected eye compared to a healthy eye
what simple test might you recommend for a patient with suspected glaucoma?
visual fields
what drug might you give to slow progression of glaucoma?
ocular hypotensive agent
why might you give prostaglandins to treat glaucoma? give an example of a drug
latanoprost
improve uveoscleral outflow
why might you give beta blockers to treat glaucoma?
reduce production of aqueous fluids
name 2 other types of drug that you might give to reduce aqueous production of fluids in glaucoma
alpha agonists
carbonic anhydrase inhibitors
what is myopia?
short sightedness
where does the light focus in myopia?
just in front of retina
would distant or close objects be out of focus in myopia?
distant
place the following words in the sentence
in myopia, the retina is ____, with lattice ____ and choroidal ________
thin/thick
degeneration/hypertrophy
atherosclerosis/neovascularisation
thin retina
lattice degeneration
choroidal neovascularisation
what shape lens would you use to correct myopia?
concave
what is hypermetropia?
long sightedness
what eyeball/lens abnormalities cause hypermetropia?
eyeball too short
lens not round enough
where does the light focus in hypermetropia?
behind retina
what shape are corrective lenses for hypermetropia?
convex
what type of condition is retinitis pigmentosa? does it have an inheritance pattern?
degenerative
is inherited
what 2 types of cells are broken down in retinitis pigmentosa?
rod cells first
then cone cells
fill in the blanks: retinitis pigmentosa results in reduced \_\_\_ vision, loss of \_\_\_\_ vision and loss of \_\_\_\_ vision, leading to \_\_\_\_\_\_\_\_ vision and \_\_\_\_\_phobia photo colour ultraviolet long-distance peripheral latticework night
reduced night vision loss of colour vision loss of peripheral vision leading to latticework vision photophobia
what does syndromic retinitis pigmentosa mean?
occurs with other neurosensory disorders
what is treatment for retinitis pigmentosa?
no cure
does optic nerve compression lead to permanent or temporary visual loss?
permanent
what would visual loss in optic nerve compression look like if the damage was anterior/distal to the optic chasm?
monocular
what visual loss might you expect if the optic chiasm was damaged?
bitemporal heteronymous hemianopia
what visual loss might you expect if the optic tract was damaged?
homonymous hemianopia
what can cause damage to the optic chiasm?
pituitary tumour
give a vascular cause for optic nerve compression
aneurysm
chronic use of what drug group can cause cataracts?
steroids
what antibiotic group can increase the risk of retinal detachment?
fluoroquinolones
what drug can cause the tears to appear orange/red?
rifampin
give 2 examples of medical emergencies that cause headaches
papilloedema
GCA
what is aniscoria?
difference in pupil sizes
hornet’s syndrome arises from a defect in what nervous system?
sympathetic
describe the pathway of the sympathetic chain from the chest into the eyes
lung apex
carotids
cavernous sinuses
into eye
what are the 3 main features of horner’s?
mitosis
ptosis
anhydrosis
acute horner’s presents with pain in the jaw or neck. what pathological abnormality is this assumed to be until proven otherwise?
carotid dissection
how is acute horner’s treated?
anticoagulation
what is the main cause of a third nerve palsy with pupillary involvement?
intracranial aneurysm
what is the pain cause of vascular third nerve palsy where the pupil is spared?
diabetes
where does the eye rest in third nerve palsy? why?
down and out
only LR and SO muscles working
what occurs to the eyelid in third nerve palsy? why?
ptosis
levator palpabrae superiors is paralysed
what occurs to the pupil in third nerve palsy? why
dilates
sphincter pupillae paralysed
what movement will the patient use to compensate in bilateral fourth nerve palsy?
chin depression
what movement will the patient use to compensate in unilateral fourth nerve palsy?
face tilt to contralateral side
where does the eye deviate in 6th nerve palsy?
inwards
