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General Medicine > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

Symptoms of acute angle closure glaucoma

A 
Pain 
Headache
Blurred vision
Halo around light
Nausea
Red eye
Unreactive pupil
Increased intraocular pressure
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2
Q

Symptoms of a blowout fracture

A

Fractured orbital floor
Upward gaze palsy
Diplopia on upward gaze

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3
Q

Causes of sudden loss of vision

A 
Retinal artery occlusion 
Retinal vein occlusion
Amaurosis fugax
Migraine
Episcleritis
Optic neuritis
Retinal detachment
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4
Q

Normal intra-ocular pressure

A

10-21mm/Hg

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5
Q

Diabetes is a risk factor for which eye diseases

A 
Cataracts
glaucoma
Retinal vein occlusion
Diabetic retinopathy
Pre-proliferative retinopathy 
Maculopathy
3rd N palsy
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6
Q

What is aniscoria

A

Unequal pupil size

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7
Q

What is presbyopia

A

Refractive error due to failure of accommodation with age

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8
Q

What is myopia

A

Short sightedness (long eyeball)

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9
Q

What is hypermetropia

A

Long sightedness (short eyeball)

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10
Q

What is astigmatism

A

Variation in corneal curvature

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11
Q

What are mydriatics

A

Act to dilate the pupils
Tropicamide = short acting
Cyclopentolate = long acting

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12
Q

What are miotic agents

A

Contstrict pupils

- pilocarpine

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13
Q

What is schirmer’s test

A

Rate at which strip of paper suspended from lower eyelid is wetted by tears

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14
Q

What is Sjögren’s syndrome

A

Systemic autoimmune disease

Immune cells attack exocrine glands that produce tears and saliva

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15
Q

Do pupils change time with age

A

Yes - become smaller

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16
Q

Signs + symptoms of Horner’s syndrome

A 
Miosis
Ptosis
Absence of sweating
Enopthalmos
Bloodshot conjunctiva
(Distinguish peripheral and central lesions by instilling1% cocaine)
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17
Q

What is retinoblastoma

A 
Mutation in Rb-1 on long arm of c.13
Autosomal dominant
Rapidly developing cancer
Increased risk of extra-retinal cancer
95% cure by surgery
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18
Q

What eye condition is a common complication of child birth

A

Subconjunctival haemorrhage
High pressure –> burst vessels in conjunctiva
No tx needed

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19
Q

Symptoms of viral conjunctivitis

A

Watery eye
Itch
Pink eye
Often associated with URTI or cold

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20
Q

What is ophthalmia neonatorum

A

Bacterial conjunctivitis contracted by newborns during vaginal delivery.
Caused by N. gonorrhoea or chlamydia
Can cause blindness

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21
Q

What is hypopion

A

Pus In anterior chamber of eye

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22
Q

Symptoms of keratitis

A 
Infection and inflammation of cornea
Pain
Redness
Discharge
Photophobia
Foreign body sensation
Tearing
Burred vision
Decreased visual acuity
Corneal erosion
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23
Q

What is dacryoadenitis

A

Inflammation of lacrimal glands
Swelling eyelid
Pain
Excess tears

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24
Q

What is trichiasis

A

Abnormally positioned eyelashes that grow backward into the eye
–> irritation, red, watery eye

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25
Q

Reiters syndrome triad

A

Reactive arthritis
Urethritis
Conjunctivitis

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26
Q

What is ulcerative keratitis

A

A corneal ulcer

Infection involving disruption of the epithelium

27
Q

What is episcleritis

A

Irritation + inflammation of the episclera

May be associated with RA, SLE, IBD, HSV, gout

28
Q

Characteristics of diabetic retinopathy

A

Hard exudates
Microaneurysms
New vessel formation

29
Q

Causes of cataracts

A 
Diabetes
Hypoparathyroidism
Blunt injury 
Steroids
Eczema 
myotonic dystrophy
Galactosaemia 
Congenital toxoplasmosis 
Wilson's disease
30
Q

What is scleritis

A

Serious inflammatory disease affecting the sclera

Occurs in SLE, RA, wergeners granulomatosis

31
Q

Symptoms of retinal detachment

A 
Photopsia (flashes of light)
Sudden dramatic increase in floaters
Dense shadow progressing from periphery
Straight lines appear curved 
Central loss of vision
32
Q

Symptoms of acute angle closure glaucoma

A 
Sudden onset eye pain
Red eye
Decreased visual acuity 
Halo around lights
Like looking through frosted glass
Vomiting
33
Q

Features of primary open angle glaucoma

A

Asymptomatic
Peripheral visual field loss
Cupped optic disc

34
Q

Chronic angle closure glaucoma symptoms and signs

A

Un-noticed visual loss
Increased or normal IOP
Cupped optic disc

35
Q

Risk factors for retinal vein occlusion

A 
Glaucoma
Hypertension
Diabetes
Haematological disorders
Systemic inflammatory conditions
36
Q

Common syx and signs of retinal vein occlusion

A

Sudden painless loss of vision
Flame haemorrhage
Cotton wool spots
Swollen optic disc

37
Q

Risk factors for retinal artery occlusion

A

Emboli from carotid or heart valve
Thrombosis
Arteritis

38
Q

Symptoms and signs of retinal artery occlusion

A 
Sudden painless loss of vision
Curtain coming down
Pale oedematous retina
Cherry red spots on macula 
Narrowed arteries
White emboli
39
Q

Symptoms of anterior uveitis

A 
Photophobia 
Red eye 
Watery eye
Lacrimation
Miosis
Blurred vision
40
Q

Causes of anterior uveitis

A 
Herpes simplex
Herpes zoster
RA
ankylosing spondylitis 
Sarcoidosis 
Behçet's disease
41
Q

Commonest cause of blindness in <65yo

A

Diabetic eye disease

42
Q

What is thrombotic ischaemia

A

A severe form of secondary glaucoma.

= Neovascular glaucoma due to new vessel formation in angle of anterior chamber.
Occurs in DM - proliferative retinopathy

43
Q

Treatment of an acute attack of angle closed glaucoma

A

Acetazolomide

44
Q

Features of background diabetic retinopathy

A

Capillary Microaneurysm (dot)
blot haemorrhage
hard exudate

45
Q

Features of pre-proliferative diabetic retinopathy

A 
Capillary Microaneurysm (dot)
blot haemorrhage 
hard exudate
AND
Venous haemorrhages 
Cotton wool spots (soft exudates)
46
Q

Features of proliferative diabetic retinopathy

A 
New vessels (neovascularisation) - thin walls, prone to rupturing 
Fibrosis

Plus all other features - dot and blot haemorrhages, hard and soft exudates

47
Q

Features of diabetic maculopathy

A

Hard exudates involving the macula

48
Q

Presentation of retinal detachment

A

Visual floaters
Reduced visual acuity
Visual loss like a curtain coming across

49
Q

What is an oculogyric crisis

A 
Dystonic reaction
Often associated with drugs
Presents with restlessness, agitation, confusion
Fixed upward deviation Of the eyes
\+/- fixed flexion deformity of the neck
\+/- open mouth and protruding tongue
50
Q

When do flame shaped retinal haemorrhages occur

A

Hypertensive retinopathy

51
Q

microvascular abnormalities associated with Hypertension on Funduscopy

A

arterial narrowing (copper or silver wiring),
arteriovenous nipping
Flame shaped haemorrhage

Malignant hypertension:
hard exudates appear as a 'macular star' (thin white streaks radiating around the macula), 
disc swelling, 
cotton wool spots, 
flame haemorrhages
arterial or venous occlusions
52
Q

What is a Scotcoma

A

Visual field defect surrounded by normal vision

53
Q

A lesion atthe optic nerve produces what visual field defect

A

Monocular visual field loss

54
Q

Lesion at the optic chiasm produces what visual field defect

A

Bitemporal hemianopia

55
Q

A lesion of the right optic tract produces what visual field defect

A

Left homonymous hemianopia

56
Q

Confusion at the temporal radiation produces what visual field defect

A

Homonymous upper quadrantinopia

57
Q

Lesion at the parietal radiation produces what visual field defect

A

Lower homonymous quadrantinopia

58
Q

A lesion at the occipital pole produces what visual field defect

A

Homonymous hemianopia with central sparing

59
Q

Signs of optic neuropathy

A 
Optic disc pallor 
Reduced visual acuity
Loss of red colour vision 
Central scotoma
RAPD
60
Q

Causes of optic atrophy

A 
Chronic glaucoma
Demyelination - e.g. MS
Trauma
Compression - e.g. Tumour
Diabetes 
Methanol / ethambutol 
Retinal artery occlusion 
Retinal vein occlusion
61
Q

What are miosis and mydriasis

A 
Miosis = pupil constriction
Mydriasis = pupil dilation
63
Q

Management of acute angle closure glaucoma

A 
Refer immediately - day or night. 
Lie the patient down
Topical agents include:
- Beta blockers, eg timolol 0.5%, one dose 
- Steroids, eg prednisolone 1%, 
- Apraclonidine 0.5-1% 
- pilocarpine 1-2%, 
**Acetazolamide IVI ** 
Offer analgesia ± antiemetics

Surgical - peripheral iridotomy / iridectomy

64
Q

Investigation and management of acute angle closure glaucoma

A

Examination - red eye + non-reactive mid-dilated pupil.
Palpation of the globe - hard
Measure the IOP >21 mmHg
slit lamp

General Medicine (25 decks)

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