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Medicine > Opthamology > Flashcards

Opthamology Flashcards

0
Q

What is the management of bacterial conjunctivitis?

A

Topical Abx. (Chloramphenicol)

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1
Q

Give 3 common bacteria associated with bacterial conjunctivitis?

A

Staph. Epidermidis
Staph. Aureus
Strep. Pneumoniae
Haem. Influenzae

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2
Q

Give 3 pieces of advice you would give a patient with bacterial conjunctivitis?

A 
Follow up if condition worsens/persists
Frequent hand washing
Min. touching of eyes
Don't share towels
Avoid shaking hands
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3
Q

What is the management of allergic conjunctivitis?

A

1) Artificial tears
2) Mast cell stabiliser (sodium cromoglicate)
3) Mild topical steroid

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4
Q

What are the layers of the cornea?

A 
Epithelium
Basement membrane 
Bowmans layer
Stroma
Dua layer
Descemet membrane
Endothelium
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5
Q

Give 5 possible presentations of cataract?

A 
Reduced visual acuity
Glare in bright light
Distortion of lines
Altered colours
Monocular diplopia
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6
Q

State 2 ways you can manage cataracts?

A

Glasses prescription

Surgery (phacoemulsification)

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7
Q

Describe the path of aqueous humor in the eyeball?

A

Cilliary body -> Pupil -> Trabecular meshwork -> Canal of schlemm

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8
Q

State 4 types of drugs that can be used in glaucoma and say what their mechanism of action is?

A

Prostaglandin analogues - increase uveoscleral drainage of aqueos humor
Beta blockers - decrease humor production
Alpha adrenergic agonists - reduce production and increase outflow
Carbonic anhydrase inhibitors - decrease production

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10
Q

Which 4 parameters/symptoms are used in the screening of open angle glaucoma?

A

Increased Intraocular pressure (IOP)
Visual field loss
Optic disc appearance (disc cupping)
Open anterior chamber

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10
Q

Name 3 sight threatening causes of red eye?

A

Acute angle closure glaucoma
Corneal ulcer/abscess
Penetrating eye injury

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11
Q

Name 4 high risk factors for open angle glaucoma?

A

> 35yrs with +ve family history
African-Caribbean
Myopia
Diabetic/Thyroid eye disease

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12
Q

What are the pathological changes seen in diabetic retinopathy? 5 things

A 
Microaneurysms
Exudates
Haemorrhages
Ischaemia (cotton wool spots)
New vessel growth (proliferative)
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13
Q

What 3 systemic conditions can scleritis be associated with?

A

Wegener’s granulomatosis
Rheumatoid arthritis
SLE

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14
Q

Describe the diff. types of diabetic retinopathy severities?

A

Background - microaneurysms and exudates
Pre-proliferative - ischaemic changes (cotton wool)
Maculopathy - damage to the macula (oedema at macula, haemorrhages)
Proliferative - new fragile vessel growth

Advanced proliferative - retinal detachment/glaucoma

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15
Q

Name 3 methods of treatment for diabetic retinopathy and describe them?

A

Medical - Glycaemic control, BP control, Control associated conditions

Laser - Photocoagulation

Surgery - Vitrectomy (removal of vitreous)

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16
Q

Give 4 possible presentations of retinal detachment?

A

Fall in visual acuity
Flashes (flashing lights = photpsia)
Floaters (small haemorrhages)
Field loss

17
Q

Give 3 risk factors for developing age related macula degeneration?

A

Genetic predisposition
Cigarette smoking
Associated with vascular disease, hypertension and light exposure

18
Q

In fundoscopy, what is dry ARMD characterised by? 3 things

A

Soft drusen (small yellow deposits)
Pigment clumping
Macular atrophy

19
Q

How might you clinically differentiate between wet and dry ARMD?

A 
Wet = Sudden loss/distortion of vision
Dry = Gradual loss of vision over years
20
Q

Describe 2 surgical options for managing open angle glaucoma?

A

Laser surgery - target trabecular network hence lowering IOP

Trabeculectomy - creates opening in anterior angle for drainage

21
Q

Give 6 clinical features suggestive of acute angle closure glaucoma?

A

Ocular pain
Nausea/vomiting
Intermittent blurring of vision

IOP greater than 30 mm Hg
Mid-dilated non-reactive pupil
Loss of red reflex

22
Q

Which group of patients are likely to suffer from acute angle closure glaucoma?

A

Hypermetropic patients

23
Q

Suggest 4 visual problems that diabetes can cause?

A

Diabetic retinopathy
Cataract
Retinal vascular occlusions
Extraocular muscle palsy

24
Q

Name 2 conditions that might cause retinopathy?

A

Hypertension

Diabetes

25
Q

What is a dendtritic ulcer and how is it treated?

A

Ulcer caused by herpes simplex virus

Treat with topical acyclovir ointment

26
Q

Aside from trauma identify 3 other types of retinal detachment and explain pathology for each?

A

Tractional - retina pulled off by membranes growing across its surface

Exudative - break down of blood retinal barrier allowing fluid to accumulate in subretinal space

Rhegmatogenous - degenerative changes in neurosensory retina creating a hole allowing vitreous fluid to pass in subretinal space

27
Q

What is the clinical difference between episcleritis and scleritis?

A

Scleritis is associated with pain

28
Q

Give 4 main symptoms of retinitis pigmentosa?

A

Night blindness (nyctalopia)
Decreased peripheral vision
Decreased central vision
Glare (from cataract)

29
Q

Give 4 ways of managing ARMD?

A

High dose antioxidant vitamins
Possible registration of visually impaired
Laser therapy for wet ARMD
Anti VEGF drugs for wet ARMD

30
Q

What two tests can you perfom to diagnose squints?

A

Corneal reflection

Cover test

31
Q

How can you tell the difference between manifest squint and latent squint?

A

Latent squint: Remove covered eye and it will move to fixate

Manifest: Cover normal eye and squint eye will move to take up fixation

32
Q

What 3 ways can you manage a squint?

A

Optical: Assess refractive state and provide glasses
Orthoptic: Patching good eye
Operation: Resection of rectus muscles

33
Q

Give 3 ways you can manage acute closed angle glaucoma?

A

Pilocarpine + Acetazolamide
Analgesia
Antiemetic
Peripheral iridectomy

34
Q

State 4 clinical features seen in anterior uveitis?

A 
Pain
Photophobia
Low acuity
Lacrimation
Small pupil
35
Q

What 2 tests/investigations can you perform to diagnose anterior uveitis?

A 
Talbot test (pain increases on convergence of eyes)
Slit lamp (pus in anterior chamber)
36
Q

How might you treat anterior uveitis?

A

Prednisolone drops

Keep pupil dilated with cyclopentolate

37
Q

State 3 causes of sudden painless loss of vision?

A 
Vitreous haemorrhage 
Optic neuritis
Central retinal artery occlusion
Retinal vein occlusion
Anterior ischaemic optic neuropathy
38
Q

Give 3 ways retinal artery occlusion can be treated?

A

Ocular massage
Surgical removal of aqueous
Antihypertensives

39
Q

How does the appearance of the retina differ in arterial and venous occlusions?

A

Artery: Pale with cherry red (macula) spot
Vein: Hyperaemia and haemorrhages (stormy sunset appearance)

Medicine (17 decks)

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