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Opthalmology > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

Treatment of a stye

A

fusidic acid

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2
Q

Associated conditions with dry eye

A

sjrogens
mumps
sarcoidosis
amyloidosis

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3
Q

Treatment of strabismus

A

3 Os
Optical - spectacles
Orthoptic - patches
Operations - resection and recession of the rectus muscles

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4
Q

Explain what you would see in a RAPD

A

loss of direct consensual reflex in good eye but not in bad eye as efferent still intact

light shone in the affected eye, unaffected eye also does not constrict
light shone in unaffected eye, affected eye also constricts
light shone in affected eye again, pupil goes back to same size (looks dilated)

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5
Q

Name 3 causes of RAPD

A 
retinal detatchment
central retinal artery occlusion
central retinal vein occlusion
optic nerve ischaemia
optic neuritis
glaucoma
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6
Q

What would you see if an eye had an efferent defect

A

ptosis
fixed dilated pupil
down and out eye

(CN3 mediated eye movement and lid retraction)

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7
Q

name 3 causes of an efferent defect

A

cavernous sinus lesions
superior orbital fissure syndrome
diabetes
posterior communicating artery aneurysm

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8
Q

How does horners syndrome present

A

small (miotic) pupil
partial ptosis
pupil does not dilate in the dark
reduced unilateral swearing

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9
Q

Damage to what causes horners syndrome

A

sympatheric nerves to the face

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10
Q

Name 3 causes of horners syndrome

A

posterior inferior cerebellar artery occlusion
MS
Cavernous sinus thrombosis
Pancoast tumour (tumour of the apex of lung - non-small cell)
Hypothalamic lesions
Cervical adenopathy
Mediastinal masses

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11
Q

A patient presents with an acutely painful red eye - name 3 differentials

A 
acute angle closure glaucoma
anterior uveitis
scleritis
iritis
corneal abrasion
corneal ulcer
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12
Q

What is the pathophysiology of acute angle closure glaucoma?

A

blocked flow of aqueous from the anterior chamber via the canal of Schlemm (dilation of the pupil ie in darkness worsens this)

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13
Q

Name 3 features of acute angle closure glaucoma

A 
red painful eye
headaches
nausea
blurred vision 
haloes around lights
raised IOP
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14
Q

Drug treatment of acute angle closure glaucoma

A

pilocarpaine (miosis opens a blocked drainage angle)
IV acetazolaminde
Mannitol
Topical steroids and antihypertensive drops

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15
Q

Surgical treatment of acute angle closure glaucoma

A

peripheral iridectomy

clear lens extraction

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16
Q

What structures make up the uvea?

A

iris
ciliary body
choroid

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17
Q

What 2 tests highlight anterior uveitis

A

talbots test - pain gets worse with convergence

slit lamp - white precipitates on the back of the cornea

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18
Q

Treatment of anterior uveitis

A

prednisolone drops
cyclopentolate
adalimumab

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19
Q

Treatment of corneal ulcer

A

chlormaphenicol

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20
Q

What is scleritis associated with

A

connective tissue disorders

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21
Q

Treatment of scleritis

A

oral steroids and ciprofloxacin

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22
Q

Name 3 symptoms of anterior ischaemic optic neuropathy

A 
malaise
jaw claudication
tender scalp
thickened temporal arteries
neck pain
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23
Q

Name 3 conditions that are associated with anterior ischaemic optic neuropathy

A 
temporal arteritis
hypertension
hyperlipidaemia
DM
smoking
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24
Q

What colour goes first in the loss of colour vision

A

red

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25
Q

Fundoscopy reveals a white retina with a cherry red spot on the macula what is the diagnosis

A

central retinal artery occlusion

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26
Q

Fundoscopy reveals cotton wool spots, swollen optic nerve, retinal haemorrhages, macular oedema

A

central retinal vein occlusion

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27
Q

Fundoscopy reveals cupping of the optic disc, vessels emerging from the sic have breaks as they disappear into the cup and are seen at the base again

A

chronic simple (open angle) glaucoma

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28
Q

Treatment of simple glaucoma

A 
Latanoprost (prostaglandin analogue)
beta blocker (timolol)
alpha-adrenergic agonias (brimonidine)
acetazolomide (carbonic anhydrase inhibitor)
miotic (pilocarpine)

Surgery - trabeculectomy

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29
Q

What are the four Fs of retinal detachment

A

Floaters
Flashes
Field loss
Fall in acuity

Painless - may be as a curtain falling over the vision

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30
Q

Signs of diabetic retinopathy

A

oedema
cotton wool spots (ischaemic nerve fibres)
microinfarcts
new blood vessels elsewhere

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31
Q

What part of the retina has the highest visual acuity?

A

macula lutea

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32
Q

What retinal changes do dry and wet AMD cause?

A

dry AMD - atrophy of the retina, central scotoma, good peripheral vision
wet AMD - new vessel growth under the retinal, localised retinal detachment, distorted central vision and a central scotoma

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33
Q

Eye changes with leukaemia

A

retinal haemorrhages

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34
Q

Eye changes with infective endocarditis

A

roth spots

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35
Q

Eye changes with atheroma in carotids

A

amaurosis fugax

36
Q

Eye changes with wilsons disease

A

kayser fleicher rings

37
Q

Eye changes with hypoparathyroidsm

A

lens opacities

38
Q

Eye changes with hyperparathyroidism

A

conjunctival and corneal calcification

39
Q

Eye changes with TN and sarcoid

A

choroidretinitis, uveitis

40
Q

Eye changes with SLE

A

conjunctivitis, scleritis

41
Q

Eye changes with reiters

A

uveitis (arthritis, urethritis)

42
Q

Eye changes with ankylosing spondylitis

A

uveitis

43
Q

Persistent watery eye in infant

A

nasolacrimal duct obstruction - give it a massage

44
Q

Treatment of blepharitis

A

mechanical removal of the debris from lid margins

Hot compress

45
Q

Causes of painless sudden loss of vision

A

amaurosis fugax
central retinal artery occlusion
retinal detachment (curtain coming down)
vitreous haemorrhage

46
Q

floaters in a patient with diabetes who has a painless sudden loss of vision

A

vitreous haemorrhage

47
Q

How does herpes simplex keratitis present

A

red painful eye
photophobia
dendritic corneal ulcer
decreased visual acuity

48
Q

name 3 features of optic neuritis

A 
unilateral decrease in visual acuity over hours or days
red desaturation
pain worse on eye movement
RAPD
central scotoma
49
Q

Pathways of the pupillary light reflex

A

afferent: retina → optic nerve → lateral geniculate body → midbrain
efferent: Edinger-Westphal nucleus (midbrain) → oculomotor nerve

50
Q

What is the argyll robertson pupil

A

the prostitutes pupil - neurosyphyllis

DM

Accomodation Reflex Present but no response to light - bilaterally small irregular pupils

51
Q

Drusens formation is indicative of what condition

A

dry age related macular degenerationt

52
Q

Treatment of anterior uveiltis

A

steroid and mydriatic drops

53
Q

Name 3 conditions associated with anterior uveitis

A 
ankylosing spondylitis
reactive arthritis
IBD
Behcets disease
sarcoidosis (bilateral)
54
Q

Glaucoma primarily effects what part of vision

A

peripheral vision

55
Q

What type of AMD carries the worse prognosis

A

Wet - Leakage of serous fluid and blood can subsequently result in a rapid loss of vision.

56
Q

What is more common a convergent or divergent squint?

A

convergent

57
Q

What would wet AMD look like on fundoscopy?

A

well demarcated red patches that represent intra-retinal or sub-retinal fluid leakage or haemorrhage

58
Q

What does dry AMD look like on fundoscopy?

A

drusen, yellow areas of pigment deposition in the macular area

59
Q

What is a central scotoma related to?

A

macular degeneration

60
Q

Open angle glaucoma is associated with what kind of visual loss

A

peripheral

61
Q

macular degeneration affects what kind of visual loss

A

central field visual loss

62
Q

Treatment of dry and wet AMD

A

Dry - Antioxidant supplements

Wet - Ranibizumab

63
Q

Signs of acute angle closure glaucoma

A

severe pain
decrease acuity
semi-dilated pupil
hazy cornea

64
Q

signs of anterior uveitis

A

acute onset
pain
blurred vision and photophobia
small fixed oval pupil

65
Q

What medication for glaucoma causes brown pigmentation of the iris and increased eyelash length

A

latanoprost

66
Q

What glaucoma medication should be avoided in asthmatics and patients with heart block

A

beta blockers - timolol

67
Q

What side effects does the glaucoma medication pilocarpine have

A

Miotics - constricted pupil, headache, blurred vision

68
Q

What glaucoma medication do you have to avoid if taking antidepressants?

A

brimonidine - alpha 2 adrenoreceptor

69
Q

Signs on fundoscopy of background retinopathy

A

microaneurysms

blot haemorrhages

70
Q

Signs on fundoscopy of pre-proliferative retinopathy

A

cotton wool spots
venous bleeding
cluster haemorrhages

71
Q

Signs of proliferative retinopathy

A

retinal neovascularisation

fibrous tissue

72
Q

Name 3 risk factors that predispose to cataracts

A 
Smoking
Alcohol
Trauma
DM
Corticosteroids
Radiation exposure
Downs syndrome
Hypocalcaemia
73
Q

What is the test for a squint

A

corneal light reflection test

74
Q

A 64-year-old woman with type 2 diabetes mellitus presents as she has started to bump into things since the morning. Her medications include metformin, simvastatin and aspirin. Over the previous two days she had noticed numerous ‘dark spots’ over the vision in her right eye. Examination reveals she has no vision in her right eye. The red reflex on the right side is difficult to elicit and you are unable to visualise the retina on the right side during fundoscopy. Examination of the left fundus reveals changes consistent with pre-proliferative diabetic retinopathy. What is the most likely diagnosis?

A 
Vitreous haemorrhage
- DM
- aspirin
- inability to visualise the retina
 'dark spots'
75
Q

What is an Adie pupil?

A 
dilated pupil
slow reactive to light
caused by damage to parasympathetic innervation to the eye due to infection
Commonly seen in females
Accompanied by absent reflexes
76
Q

What is Hutchinsons pupil

A

unilaterally dilated pupil unresponsive to light

as a result of compression of the occulomotor nerve on the same side by an intracranial mass

77
Q

Name 3 causes of tunnel vision

A

papilloedema
glaucoma
retinitis pigmentosa

78
Q

Name 3 causes of papilloedema

A 
SOL
malignant HTN
idiopathic intracranial hypertension
hydrocephalus
hypercapnia
79
Q

Name 3 signs of papilloedema on fundoscopy

A

venous engorgement
loss of venous pulsation
loss of optic cup

80
Q

How do you differentiate between scleritis and episcleritis

A

scleritis is painful whereas episcleritis is not

both cause a watery eye with photophobia

81
Q

A patient presents with a sudden loss of vision with severe retinal haemorrhages on fundoscopy (cheese and tomato pizza)

A

central retinal vein occlusion

82
Q

Symptoms of vitreous/retinal detachment

A

flashes and floaters
sudden painless loss of vision
refer urgently

83
Q

Features of herpes zoster ophthalmicus

A

vesicular rash around the eye

hutchinson sign - rash on the tip or side of nose

84
Q

A 75-year-old lady, who has been a diabetic for over 25 years attend her regular follow-up sessions. During the consultation, the lady mentions to her GP that she has had difficulty with her vision over the past few months, especially in the left eye. She described it as a blurry vision and also reported seeing round figures around lights at night. The lady has never had problems with her vision in the past. She currently also takes medications to manage her blood pressure and cholesterol levels. Physical examination is otherwise unremarkable. What is the diagnosis?

A

Cataract

85
Q

Anterior uveitis is associated with what diseases?

A 
Autoimmune conditions:
Ankylosing Spondylitis
Behçet’s Disease
Juvenile Idiopathic Arthritis
Reactive Arthritis (also known as Reiter’s Syndrome)
Inflammatory bowel disease
Sarcoidosis

Opthalmology (1 decks)

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