Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Opthamology > Flashcards

Opthamology Flashcards

1
Q

4 Sx of AAGP

A

Decreased visual acuity with mydriasis
Headache
N+V
Haloes around lights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 Signs of AAGP

A

Hard, Red Eye
Semi dilated non-reacting pupil
Corneal oedema demonstrating dull or hazy cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

3 RF AAGP

A

Hypermetropia
Mydriasis
Lens growth with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

AAGP management

A

IV acetazolamide
Combination of eye drops (Pilocarpine, Timolol, Apraclonidine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

IV acetazolamide + components of eye drops function

A

IV acetazolamide - reduce aqueous secretions
Pilocarpine - increase outflow of aqueous humour
Timolol - reduce aqueous humour production
Apraclonidine - dual function, reduce aqueous humour production + increase uvoscleral outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AAGP definitive management

A

Laser peripheral iridotomy - creates tiny hole in peripheral iris to increase aqueous humour flowing to the angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

AAGP Investigations

A

Tonometry to measure increased IOP
Gonioscope to measure angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is ARMD

A

Degeneration of retinal photoreceptors that results in the formation of drusen on fundoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 RF ARMD

A

Age
Smoking
FHx
CVD RF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are Drusens

A

Yellow spots in the Bruch membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes rapid rapid LOV in W.ARMD

A

Choroidal neovascularisation - causes leakage of serous fluid and blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 Sx of ARMD

A

Reduction in visual acuity
Difficulties in dark adaptation/fluctuations during the day
Photopsia/ glare around objects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 investigations ARMD

A

Slit lamp microscopy - identifies any exudative/hemorrhagic changes
Fluorescein angiography - guides intervention with neovascular ARMD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

3 Management for ARMD

A

Dry - Zinc + ACE vitamins + Beta caroten
Wet - anti-vegf (ranibizumab)
Wet - laser photocoagulation (risk of acute visual loss)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 Allergic conjunctivitis Sx

A

Bilateral conjunctival erythema
Itch
Eyelids swollen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Allergic conjunctivitis management

A

Antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the uvea

A

Iris and ciliary body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

5 Features of Anterior Uveitis

A

Acutely painful red eye
Reduced visual acuity
Photophobia (Usually intense)
Small affected pupil
Pus in anterior chamber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How to differentiate Anterior uveitis vs AACG

A

Photophobia
Size of pupils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

5 Anterior Uveitis associated conditions

A

UC/Crohns
Ankylosing spondylitis
Sarcoidosis - bilateral disease may be seen
Bechets disease
Reactive arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

3 Anterior uveitis management

A

Refer ophthalmology
Cycloplegics - atropine
Steroid eye drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

2 Features Agryll-Roberston Pupil

A

Small, irregular pupils
Accommodation reflex present, pupillary reflex absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

2 ARP causes

A

DM
Syphillis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is blepharitis

A

Inflammation of the eyelid margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

2 Blepharitis causes

A

Meibomian gland dysfunction
Seborrhoeic dermatitis/staphylococcal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which condition is associated with blepharitis

A

Rosacea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Meibomian gland function

A

Secrete oil on to the eye surface to prevent rapid evaporation of the tear film.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

5 Blepharitis Features

A

Bilateral sticky eyes
Worse in the morning
Gritty and discomfort
Red eyelid margins
Styes more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Blepharitis management

A

1st line of treatment for blepharitis is hot compresses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Blurred vision - function of pinhole occluders

A

pinhole occluders are a useful way to check for whether the blurred vision is due to a refractive error or not
if the blurring improves with a pinhole occluder then likely cause is a refractive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is cataracts

A

condition where the lens of the eye gradually opacifies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is endopthalmitis

A

inflammation of aqueous and/or vitreous humour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

5 Causes of cataracts

A

Normal ageing process
Hypocalcemia
Smoking
Alcohol
Trauma
DM
Steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

4 Sx of cataracts

A

Reduced vision
Faded colour vision
Glare
Haloes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

sign of cataracts

A

Defective red reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

2 investigations cataracts

A

Ophthalmoscopy: done after pupil dilation. Findings: normal fundus and optic nerve
Slit-lamp examination. Findings: visible cataract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

2 management cataracts

A

Non-surgical: In the early stages, age-related cataracts can be managed conservatively by prescribing stronger glasses/contact lens, or by encouraging the use of brighter lighting.
Surgical: replacement of lens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

2 Cataracts surgery complication

A

Posterior capsule opacification: thickening of the lens capsule
Retinal detachment
Posterior capsule rupture
Endophthalmitis: inflammation of aqueous and/or vitreous humour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

2 CRA occlusion causes?

A

relatively rare cause of sudden unilateral visual loss. It is due to thromboembolism (from atherosclerosis) or arteritis (e.g. temporal arteritis)

39
Q

3 CRA occlusion features

A

sudden, painless unilateral visual loss
relative afferent pupillary defect
‘cherry red’ spot on a pale retina

40
Q

CRA occlusion management

A

any underlying conditions should be identified and treated (e.g. intravenous steroids for temporal arteritis)

41
Q

CRV occlusion RF

A

increasing age
hypertension
cardiovascular disease
glaucoma
polycythaemia

42
Q

3 CRV occlusion features

A

sudden, painless reduction or loss of visual acuity, usually unilaterally
fundoscopy
1) widespread hyperaemia
2) severe retinal haemorrhages - ‘stormy sunset’

43
Q

3 CRV occlusion management

A

the majority of patients are managed conservatively
indications for treatment in patients with CRVO include:
macular oedema - intravitreal anti-vascular endothelial growth factor (VEGF) agents
retinal neovascularization - laser photocoagulation

44
Q

Why is Abx given in corneal abrasion

A

topical antibiotics should be given to prevent secondary bacterial infection

45
Q

5 features corneal abrasion

A

eye pain
lacrimation
photophobia
foreign body sensation and conjunctival injection
decreased visual acuity in the affected eye

46
Q

Investigation for corneal abrasion

A

fluorescein staining
examination typically reveals a yellow-stained abrasion (representative of the de-epithelialized surface) which is usually visible to the naked eye
visualisation is enhanced by the use of a cobalt blue filter (available on an ophthalmoscope) or a Wood’s lamp

47
Q

Corneal abrasion management

A

Topical Abx

48
Q

3 Indications for referral to ophthalmology

A

A patient with an organic foreign body in their eye (eg grass seed) should be referred immediately to ophthalmology for assessment (due to infection risk)Suspected penetrating eye injury due to high-velocity injuries (e.g. drilling, lawn moving or hammering) or sharp objects (e.g. as glass, knives, pencils or thorns)
Significant orbital or peri-ocular trauma has occurred.
A chemical injury has occurred (irrigate for 20-30 mins before referring)
Foreign bodies composed of organic material (such as seeds, soil) should be referred to ophthalmology as these are associated with a higher risk of infection and complications
Foreign bodies in or near the centre of the cornea
Any red flags e.g. severe pain; irregular, dilated or non-reactive pupils; significant reduction in visual acuity.

49
Q

Corneal ulcer

A

A corneal ulcer describes a defect in the cornea, typically secondary to an infective cause.

50
Q

Corneal abrasion

A

Any defect of the corneal epithelium and most commonly come about from a recent history of local trauma

51
Q

2 RF Corneal abrasion

A

Vitamin A deficiency
Contact lens use

52
Q

4 Causes corneal abrasion

A

bacterial keratitis
fungal keratitis
viral keratitis: herpes simplex, herpes zoster - may lead to a dendritic ulcer
Acanthamoeba keratitis: associated with contact lens use

53
Q

Corneal abrasion features

A

Same as corneal ulcer (-) foreign body sensation

54
Q

Diabetic retinopathy pathophysiology

A

Hyperglycaemia is thought to cause increased retinal blood flow and abnormal metabolism in the retinal vessel walls. This precipitates damage to endothelial cells and pericytes

Endothelial dysfunction leads to increased vascular permeability which causes the characteristic exudates seen on fundoscopy. Pericyte dysfunction predisposes to the formation of microaneurysms. Neovasculization is thought to be caused by the production of growth factors in response to retinal ischaemia

55
Q

4 Features of NPDR

A

microaneurysms
blot haemorrhages
hard exudates
cotton wool spots

56
Q

What are cotton wool spots indicative of

A

Retinal infarction

57
Q

2 panretinal laser photocoagulation complications

A

following treatment around 50% of patients develop a noticeable reduction in their visual fields due to the scarring of peripheral retinal tissue
other complications include a decrease in night vision (rods are predominantly responsible for vision in low light conditions

58
Q

Management Diabetic Retinopathy All.NPDR,PDR

A

All patients -
optimise glycaemic control, blood pressure and hyperlipidemia
regular review by ophthalmology

Maculopathy
if there is a change in visual acuity then intravitreal vascular endothelial growth factor (VEGF) inhibitors

Non-proliferative retinopathy
regular observation
if severe/very severe consider panretinal laser photocoagulation

Proliferative retinopathy
Pan-retinal laser photocoagulation
intravitreal VEGF inhibitors

59
Q

Mechanism of sight loss in PDR

A

The mechanisms of sight loss in proliferative diabetic retinopathy are retinal detachment and vitreous haemorrhage

60
Q

Episcleritis

A

acute onset of inflammation in the episclera of one or both eyes.

61
Q

4 Features episcleritis

A

red eye
classically not painful (in comparison to scleritis), but mild pain/irritation is common
watering and mild photophobia may be present
in episcleritis, the injected vessels are mobile when gentle pressure is applied on the sclera
in scleritis, vessels are deeper, hence do not move

62
Q

2 Associated condition episcleritis

A

inflammatory bowel disease
rheumatoid arthritis

63
Q

Episcleritis management

A

Conservative, artificial tears sometimes used

64
Q

Herpes simplex keratitis management

A

Herpes simplex keratitis treatment is topical aciclovir + immediate referral to opthalmology

65
Q

Fluorescein staining on herpes simplex keratitis

A

branched ulcer is very classical of herpes keratitis

66
Q

Herpes Zoster Opthalmicus

A

Herpes zoster ophthalmicus (HZO) describes the reactivation of the varicella-zoster virus in the area supplied by the ophthalmic division of the trigeminal nerve.

67
Q

Features HZO

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

68
Q

HZO management 2

A

oral antiviral treatment for 7-10 days
ocular involvement requires urgent ophthalmology review

69
Q

HZO complications 3

A

ocular: conjunctivitis, keratitis, episcleritis, anterior uveitis
ptosis
post-herpetic neuralgia

70
Q

Holmes Adie pupil + syndrome features

A

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

Holmes-Adie syndrome
association of Holmes-Adie pupil with absent ankle/knee reflexes

71
Q

Horner’s syndrome features 4

A

miosis (small pupil)
ptosis
enophthalmos* (sunken eye)
anhidrosis (loss of sweating one side)

72
Q

Horner’s syndrome: Anhidrosis distribution central.pre-ganglionic.post ganglionic

A

Central: Anhidrosis of the face, arm and trunk
Pre-ganglionic: Anhidrosis of the face
Post-ganglionic: No anhidrosis

73
Q

Horner’s syndrome: Anhidrosis causes

A

Central: Stroke, Syringomyelia, Multiple sclerosis, Tumour, Encephalitis
Pre-ganglionic: Pancoast’s tumour, Thyroidectomy, Trauma, Cervical rib
Post-ganglionic: Carotid artery dissection, Carotid aneurysm, Cavernous sinus thrombosis, Cluster headache

74
Q

Hypertensive retinopathy grading

A

STAHP forgetting the grading for HTN retinopathy
1. Silver wiring and Tortuosity
2. AV nipping
3. Haemorrhages (flame and blots)
4. Papilloedema

75
Q

Infective conjunctivitis types and features

A

Bacterial conjunctivitis
Purulent discharge
Eyes may be ‘stuck together’ in the morning)

Viral conjunctivitis
Serous discharge
Recent URTI
Preauricular lymph nodes

76
Q

Infective conjunctivitis management

A

normally a self-limiting condition that usually settles without treatment within 1-2 weeks
topical antibiotic therapy is commonly offered to patients, e.g. Chloramphenicol. Chloramphenicol drops are given 2-3 hourly initially whereas chloramphenicol ointment is given qds initially
topical fusidic acid is an alternative and should be used for pregnant women. Treatment is twice daily

77
Q

Keratitis

A

inflammation of the cornea

78
Q

Keratitis causes 4

A

bacterial
-typically Staphylococcus aureus
-Pseudomonas aeruginosa is seen in contact lens wearers
fungal
amoebic
-acanthamoebic keratitis
increased incidence if eye exposure to soil or contaminated water
parasitic: onchocercal keratitis (‘river blindness’)

79
Q

Keratitis management

A

stop using contact lens until the symptoms have fully resolved
topical antibiotics
typically quinolones are used first-line
cycloplegic for pain relief
e.g. cyclopentolate

80
Q

Contact lens wearers and red painful eye

A

Contact lens wearers who present with a red painful eye should be referred to eye casualty to exclude microbial keratitis

81
Q

Anisocoria: How do differentiate where the problem is

A

Anisocoria worse in bright light implies a problem with the dilated pupil

This is because an anisocoria worse in the light suggests an inability of the eye to constrict in response to light, hence the pupillary asymmetry becoming more apparent as the normal eye constricts.

82
Q

Holmes Adie pupil

A

Tonically dilated pupil, slowly reactive to light with more definite accommodation response. Caused by damage to parasympathetic innervation of the eye due to viral or bacterial infection.

83
Q

most common cause of a persistent watery eye in an infant

A

Congenital nasolacrimal duct obstruction, resolves in 95% by one year of age

84
Q

Orbital compartment syndrome features 4 + management

A

eye pain/swelling
proptosis
‘rock hard’ eyelids
relevant afferent pupillary defect

urgent lateral canthotomy (before diagnostic imaging) to decompress the orbit

85
Q

Optic neuritis features 5

A

unilateral decrease in visual acuity over hours or days
poor discrimination of colours, ‘red desaturation’
pain worse on eye movement
relative afferent pupillary defect
central scotoma

86
Q

Optic neuritis management

A

high-dose steroids
recovery usually takes 4-6 weeks

87
Q

Optic neuritis causes

A

multiple sclerosis: the commonest associated disease
diabetes
syphilis

88
Q

How to differentiate orbital cellulitis vs preseptal cellulitis

A

Orbital cellulitis differentiated from preseptal cellulitis by presence of: reduced visual acuity, proptosis and pain with eye movements

89
Q

Orbital cellulitis features 5

A

Redness and swelling around the eye
Severe ocular pain
Visual disturbance
Proptosis
Ophthalmoplegia/pain with eye movements
Eyelid oedema and ptosis
Drowsiness +/- Nausea/vomiting in meningeal involvement (Rare)

90
Q

Orbital cellulitis management

A

Patients with orbital cellulitis require admission to hospital for IV antibiotics due to the risk of cavernous sinus thrombosis and intracranial spread

91
Q

Orbital cellulitis RF 3

A

Childhood -Mean age of hospitalisation 7-12 years
Previous sinus infection
Lack of Haemophilus influenzae type b (Hib) vaccination
Recent eyelid infection/ insect bite on eyelid (periorbital cellulitis)
Ear or facial infection

92
Q

What investigation for orbital cellulitis and why

A

CT scan with contrast should be done if orbital cellulitis is suspected to assess the posterior spread of infection

93
Q

Papilledema causes 3

A

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

94
Q
A

Finals (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions