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Finals > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

accomodation

A

ability of the lens to change shape and vary the amount it refracts light

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2
Q

presbyopia

A

diminishing ability of the lens to accommodate - usually occurs with increasing age

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3
Q

Cataract

A

any opacity of the lens

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4
Q

Phacoemulsification

A

Surgery for cataracts where the lens is removed and replaced via a small self-sealing incision in the cornea

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5
Q

myadrisis

A

pupil dilation to allow more light to enter the eye - sympathetic innervation of dilator pupillae (arranged radially)

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6
Q

miosis

A

pupil contraction to allow less light to enter the eye - parasympathetic innervation (carried by oculomotor) of sphincter pupillae (encircles the pupillary margin)

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7
Q

anterior uveitis

A

inflammation of the iris +/- the ciliary body

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8
Q

intermediate uveitis

A

inflammation of the posterior ciliary body and nearby peripheral retina and choroid

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9
Q

posterior uveitis

A

inflammation of the retina and choroid

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10
Q

panuveitis

A

inflammation of the entire uveal tract (iris, ciliary body and choroid,

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11
Q

cycoplegia

A

paralysis of the ciliary muscle

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12
Q

rod cells

A

cells in the neural retina which detect contrast and movement

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13
Q

cone cells

A

cells in the neural retina which detect colour and detail

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14
Q

heterophoria

A

misalignment of the eyes

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15
Q

heterotropia

A

constant misalignment of the eyes

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16
Q

latent strabismus

A

misalignment of the eyes when vision is dissociated - cover/uncover test

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17
Q

ambylopia

A

‘lazy eye’ - inability to achieve full visual acuity despite corrected refractive error. Due to eye and brain failing to communicate

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18
Q

diplopia

A

double vision

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19
Q

incomitant strabismus

A

angle of deviation changes with direction of gaze

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20
Q

concomitant strabismus

A

angle of deviation remains the same with all directions of gaze

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21
Q

agnosia

A

inability to recognise common objects despite an intact visual apparatus

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22
Q

amaurosis fugax

A

transient, painless loss of vision

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23
Q

amblyopia

A

reduced visual acuity with no demonstrable organ defect

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24
Q

anopthalmos

A

congenital absence of the eyeball

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25
Q

blepharitis

A

inflammation of the eyelid

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26
Q

chemosis

A

conjunctival swelling

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27
Q

colobloma

A

congenital cleft due to failure of some portion of the eye or eyelid to complete growth

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28
Q

cycloplegic

A

a drug which paralyses accommodation and dilates the pupil

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29
Q

dacrocystitis

A

infection of the lacrimal sac

30
Q

ectropion

A

turning out of the eyelid

31
Q

entropion

A

turning inwards of the eyelid

32
Q

enucleation

A

complete surgical removal of the eyeball

33
Q

hypermetropia

A

long-sightedness (close objects are blurred)

34
Q

myopia

A

short-sightedness (commonly due to elongated eyeball ) distant objects are blurred.

35
Q

astigmatism

A

refractive error which due to cornea having greater curvature in one plane compared to another i.e. rugby ball shaped rather than football shaped.

36
Q

nystagmus

A

rapid, involuntary movements of the eye ball in any direction

37
Q

ptosis

A

drooping of the eyelid

38
Q

exophthalmos

A

abnormal protrusion of the eyeball

39
Q

RAPD causes

A

extensive retinal detachment

optic neuritis

40
Q

Cover/uncover test, which eye is the fixating eye?

A

movement will only be seen when covering the fixating eye

41
Q

Differentiating episcleritis and scleritis

A

In episcleritis, the injected vessels are mobile when gentle pressure is applied on the sclera. In scleritis, vessels are deeper, hence do not move

42
Q

Features of herpes zoster opthalmicus

A

vesicular rash around the eye, which may or may not involve the actual eye itself
Hutchinson’s sign: rash on the tip or side of the nose. Indicates nasociliary involvement and is a strong risk factor for ocular involvement

43
Q

Manegement of herpes zoster opthalmicus

A

oral antiviral treatment for 7-10 days
ideally started within 72 hours
intravenous antivirals may be given for very severe infection or if the patient is immunocompromised
ocular involvement requires urgent ophthalmology review

44
Q

Retinal Changes in diabetic retinopathy

A

Mild - 1 or more microaneurysm
Moderate - microaneurysms, blot haemorrhages, hard exudates, cotton wool spot
Severe - blot haemorrhages and microaneurysms in 4 quadrants, venous beading in at least 2 quadrants, intraretinal microvascular abnormalities
Proliferative - retinal neovascularisation - may lead to vitreous haemorrhage, fibrous tissue forming anterior to retinal disc

45
Q

ARMD

types and causes

A

degeneration of photoreceptors
dry - formation of drusen
wet - choroidal neovascularisation leads to blood and serous fluid leakage

46
Q

(4) ARMD risk factors

A

increasing age
smoking
family Hx
CVS risk factors

47
Q

Presentation of ARMD (5)

A 
subacute loss of vision
difficulty seeing in the dark
variable vision day to day
flashing/flickering lights
'glare' around objects.
48
Q

Mx of ARMD

A

dry - antioxidants

wet - anti-VEGF, laser photocoagulation

49
Q

Causes of cataracts (9)

A 
increasing age
smoking
alcohol
diabetes
corticosteroid use
trauma
radiation exposure
myotonic dystrophy
hypocalcemia
50
Q

Presentation of cataracts(5)

A 
gradual onset 
decrease in VA
faded colours
glare
halos around lights
51
Q

Mx of cataracts

A

optimise vision - glasses and increased lighting

surgery - replace the lens with an artificial one

52
Q

compliciations of phacoemulsification

A

posterior capsule opacification
posterior capsule rupture
retinal detachment
inflammation of the aqueous or vitreous humour

53
Q

Retinal detachment presentation

A

Dense shadow that starts peripherally progresses towards the central vision
A veil or curtain over the field of vision
Straight lines appear curved
Central visual loss

54
Q

Vitreous haemorrhage presentation

A

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

55
Q

Argyll-Robertson Pupil

A

a pupil that accommodates but does not react to light

seen in neurosyphilis and diabetes

56
Q

causes of mydriasis (4 plus 3 drug groups)

A 
third nerve palsy
Holmes-Adie pupil
traumatic iridoplegia
phaeochromocytoma
congenital

Drugs:
topical mydriatics: tropicamide, atropine
sympathomimetic drugs: amphetamines, cocaine
anticholinergic drugs: tricyclic antidepressants

57
Q

What is a Holmes-Adie pupil?

A

A benign condition most commonly seen in women.
usually a unilateral dilated pupil
once the pupil has constricted it remains small for an abnormally long time
slowly reactive to accommodation but very poorly (if at all) to light

58
Q

Causes of papilloedema (5)

A 
space-occupying lesion: neoplastic, vascular
malignant hypertension
idiopathic intracranial hypertension
hydrocephalus
hypercapnia
59
Q

What is acute closed-angle glaucoma?

A

physical obstruction of aqueous flow through the trabecular network resulting in a sudden onset raised intraocular pressure, causing optic neuropathy

60
Q

what is chronic open-angle glaucoma?

A

increased resistance in the trabecular network results in increased IOP which causes optic neuropathy

61
Q

presentation on acute closed-angle glaucoma (7)

A

acutely painful eye or headache
decreased visual acuity
pain exacerbated by mydriasis - dark room
red eye
seeing haloes around lights
corneal oedema
systemic upset e.g. nausea, vomiting, abdo pain

62
Q

risk factors for acute closed-angle glaucoma (3)

A

increasing age
pupillary dilatation
hypermetropia

63
Q

management of acute closed-angle glaucoma

A

urgent Opthalmology referral
reduce aqueous secretions - acetazolamide
constrict pupil - pilocarpine eye drops

64
Q

risk factors or chronic open-angle glaucoma (7)

A 
increasing age
family hx
being black
myopia
hypertension
diabetes
corticosteroids
65
Q

presentation of chronic open-angle glaucoma (3)

A

insidious - often detected at routine appointments
decreased peripheral vision, initially nasal scotoma
decreased VA

66
Q

fundoscopy findings in chronic open-angle glaucoma(5)

A 
optic disk cupping (cup:disk ration >0.7)
optic disk pallor
bayonetting of vessels 
cup notching 
disk haemorrhage
67
Q

management of chronic open-angle glaucoma

A

1st - prostaglandin analogue eyedrops
2nd - beta-blocker eye drops
3rd surgery or laser therapy

68
Q

What is Nasolacrimal duct obstruction? management?

A

imperforate membrane, usually at the lower end of the lacrimal duct causes eye-watering
Around 1 in 10 infants have symptoms at around one month of age
teach parent lacrimal duct massage

69
Q

risk factors for vitreal haemorrhage (5)

A 
Diabetes
Trauma
Anticoagulants
Coagulation disorders
Severe short sightedness
70
Q

staging 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
IV	Papilloedema

Finals (34 decks)

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