Opthalmology Flashcards
What is angle recession glaucoma?
Trauma or perforation of corneal ulcer causing pressure in anterior chamber to drop and the lens and iris to collapse forwards, obstructing the trabecular meshwork
What is pseudoexfoliation syndrome?
Type of glaucoma
White amyloid type protein deposits in the anterior chamber can block the trabecular meshwork
An 81 year old female presents with longstanding slowly deteriorating visual loss. She states that her central vision is often blocked and distorted. What is the likely diagnosis?
Age related macular degeneration
What is an amsler grid?
Grid on which the patient is asked to draw what they see
Used to detect distortions or scotomas in visual fields
What are different signs seen on a dilated eye exam in dry and wet age related macular degeneration?
Dry - drusen, small yellow deposits around the macula
Wet - retinal bleeding
What are ocular involvements of juvenile idiopathic arthritis?
Anterior uveitis which can lead to glaucoma, cataracts and permanent visual damage if untreated
What does a cherry red spot seen on ophthalmoscopy show?
Central retinal artery occlusion
What signs might be seen in central retinal artery occlusion?
Pale retina
Cherry red spot
What can be causes of central retinal artery occlusion?
Thromboembolism
Arteritis
How can giant cell arteritis lead to amaurosis fugax?
Occlusion of temporal artery will reduce blood flow in the retinal, ciliary and ophthalmic arteries leading to temporary monocular blindness
Granulomatous inflammation can also affect the central retinal artery and ciliary arteries themselves
How do you diagnose giant cell arteritis?
Temporal artery biopsy
What are symptoms of retinal detachment?
Like a curtain falling down over part of the visual field
Flashing lights
Floaters
How are different types of conjunctivitis treated?
Viral: no treatment
Bacterial: chloramphenicol drops
Allergic: sodium cromoglycate drops
What is used to treat dry eyes?
Hydroxyethylcellulose drops
What drugs can be used in the management of acute angle closure glaucoma?
Timolol: non selective beta blocker
Latanoprost: prostaglandin analogue, reduce intraoccular pressure by increasing outflow of aqueous fluid
Acetazolamide: carbonic anhydrase inhibitor
Pilocarpine: parasympathomimetic
Brimonidine: alpha adrenergic agonist, lower eye pressure
What is usher syndrome?
Autosomal recessive disorder
Presents with retinitis pigmentosa (night blindness and tunnel vision) and sensorineural hearing loss
What is retinitis pigmentosa?
Night blindness and tunnel vision
What eye signs and symptoms will a patient who is vitamin a deficient have?
Night blindness
Thin cornea
Corneal ulcers and perforations
What are the symptoms of acute angle closure glaucoma?
Acute onset of pain
Vomiting
Reduced vision
Halos around lights
What is cogans syndrome?
Keratitis that occurs in patients with takayasus arteritis
Decreased visual acuity and glare due to opacification of the cornea
What types of infection can cause a red eye? And what characteristics would you expect?
Bacterial: sticky discharge with pus, lids stuck together in morning
Viral: watery discharge with pain
Chlamydia: watery, sticky, pain
What could be causes of bacterial conjunctivitis?
Staph
Strep
Haemophilus
What can cause viral conjunctivitis?
Adenovirus
Para influenza
What symptoms would you expect with a viral conjunctivitis?
Runny nose Cough Cold Sore eyes Haemorrhages on tarsal conjunctiva Pre auricula node
How do you treat a baby with chlamydia causing conjunctivitis?
Erythromycin
What symptoms would you expect with allergic conjunctivitis?
Itchy eye
Watery discharge
Clear sticky strings of mucus
Atopic patient
What is the treatment for allergic conjunctivitis?
Remove cause
Anti histamines
Mast cell stabilisers: sodium cromoglycate drops
Topical steroids: only if child with sight threatening disease
What signs and symptoms would you expect in a case of corneal abrasion?
Extreme pain
Photophobia
Mechanism of injury
History of foreign body in eye
What is the best way to inspect an eye with a corneal abrasion?
Local anaesthetic: benoxinate 1% to help patient open eye
Visual acuity test
2% fluorescein, shine blue light
Fluorescence seen where epithelium lost
How do you treat corneal abrasion?
If less than 1/3 cornea should heal overnight
Analgesic
Chloramphenicol eye drops
Pad if patient wants one
Council that it will be very painful, light and wind sensitive for a few days
Refer to ophthalmologist if caused by dirty object
What symptoms will a patient with corneal abrasion have?
Extreme pain
Photophobia
Watering
Reluctance to open eye
What often causes corneal foreign bodies?
Metal from power tools
What is required in a corneal foreign body to exclude perforation into eye?
X-ray
What symptoms will a patient with a corneal foreign body have?
Scratching sensation
Photophobia
Watering
How do you treat a sub tarsal foreign body?
anaesthetise the eye with benoxinate
Wipe tarsal plate with cotton bud
What is acanthamoeba?
Corneal opacity seen in contact lens wearers that have been worn overnight or washed in tap water
What is blepharitis?
Staph overgrowth at base of eyelashes - dandruff, tear dysfunction