Opthamology Flashcards
What is this condition, its causes, symptoms and treatments
Blepharitis
Non specific generalised inflammation of the eyelids
Causes = staph aureus, seborrheric dermatitis, rosacea, contact allery
Symptoms- itch, watery or dry, light sensitivity
Treatment - daily lid hygiene, lubrication, warn wet compress, treat cause (seb derm, rosacea)
What is this condition, its causes, symptoms and treatments
Ectropion
Lid turning outwards with exposure of the conjunctival sac
Causes- aging, scaring, facial nerve palsy - stroke or Bell’s palsy
Symptoms - irritation, gritty, burning, excess tear
Rx- topical lubrication, possible surgical intervention
What is this condition, its causes, symptoms and treatments
Entropion
Lid turning inwards with eyelashes abrading the cornea
Causes- trachoma, aging and scarring
Symptoms - redness and pain, light sensitivity, tearing, decreased vision when cornea scaring
Rx- check condition of cornea with fluorescein, lubricate, tape lid back from cornea, definitive mangement with surgery
What is this condition, its causes, symptoms and treatments
Pterygium
Raised, yellowish fleshy lesion at the limbus-collagen degeneration and fibrovascular proliferation
Causes - UV light, chronic irritation, genetics
Rx- Lubrication and sunglasses, surgery if over cornea
What is this condition, its causes, symptoms and treatments
Herpes Simplex Keratitis
Dendritic branching ulcer on the cornea - need a stain
Ask about history of previous red eye or cold sores
Rx- Topical or oral acyclovir, opthamologist referal
What is this condition, its causes, symptoms and treatments
Corneal Ulcer
associated with hx of contact lens wear
epithelial defect with opacified base
Bacterial or acanthamoeba
Rx- urgent opthalmologist referral for investigation and antibiotcs
What is this condition, its causes, symptoms and treatments
Subconjuctival Hemorrhage
Localised sharply circumscribed, no pain, no visual loss
Rx- Check BP, check INR if on warfrin, will resolve spontaneously
What is this condition, its causes, symptoms and treatments
Chalazion
Localised eyelif inflammation, minimal ocular involvement
Causes- cyst in tarsal plate, blocked eyelid
Symptoms - not painful but red
Rx- Topical antibiotics (minimal evidence), warm compress, occasionally surgery
What is this condition, its causes, symptoms and treatments
Herpes Zoster Ophthalmicus
Vesicular rash, may have dendritic corneal ulceration
Opthalmic branch of trigeminal nerve
ask about chicken pox history
Rx- oral antivirals, urgent referral if corneal ulceration
What is this condition, its causes, symptoms and treatments
Viral conjuctivitis
URTI history, gritty eye, watery discharge, begins with one eye spreads to another
no vision loss
Rx- strict hygiene, cool compress, lubricants
What is this condition, its causes, symptoms and treatments
Adenovirus
looks like ordinary viral conjuctivitis then progresses to chemosis, photo phobia, reduced vision
Be wary - can cause keratoconjuctivitis with pseudomembranes
Urgent ophthalmologist referal for steriods drops
What is this condition, its causes, symptoms and treatments
Allergic Conjuctivitis
Hx of atropy, asthma, eczema, hayfever
Rx- cool compresses, ocular lubricant, antihistamines
What is this condition, its causes, symptoms and treatments
Bacterial conjuctivitis
Red eye, purulent discharge, no visual loss, no corneal involvement
Rx- Strict hygiene, refular cleaning with warm water, topical antibiotics
What is this condition, its causes, symptoms and treatments
Acute angle-closure glaucoma
Red eye, hazy cornea, fixed semi dilated pupil, nausea, visionloss
Rx- urgent opthalmologist referral, IV acetazolamide, pilocarpaine, topical beta blocker
What is this condition, its causes, symptoms and treatments
Iritis
Pain, photophobia, red eye
smaller or irregular pupil
Rx- urgent opthalmologist referral, steriods
List some of the features you can see
- Haemorrhages
- Exudate
- Muculopathy
- New Vessels
- Can also get - cotton wool spots (soft exudate)
What causes Haemorrhages in the retina
Retinal infarct caused by partial arteriolar occlusion, or complete occlusion and then reperfusion
What causes Exudates in the eye
Localised infarcts in RNFL (retinal nerve fiber layer) –> obstructed axoplasmic flow in nerve axons –> swelling and atrophy of fibers
What causes maculopathy in the eye
Accumulation of intraretinal fluid due to capillary leak in the macular region
What causes Neovascularisation in the eye
Growth of abnormal vessels and fibrous tissue due to retinal ischemia
What is the mangement of a diabetic eye
- Urgent ophthalmology referal
- laser therapy for maculopathy and new vessels
- anti VEGF for maculopathy
- Blood Glu and pressure control
- No smoking or driving
Differentials for acute vision loss in non-inflammed eye
- Retinal Detachment
- Retinal artery or vein occlusion
- Migraine
- Hyperglycemia
- Amauroxis fugax
- Anterior ischemic optic neuropathy- temporal gaint cell arthritis
- Optic Neuritis - MS
Differentials for chronic vision loss in white eye
- Macular degeneration
- Refractive errors
- Cataracts
- Diabetic retinopathy
- Open angle glaucoma
Red flags in vision loss
- Sudden vision loss
- Vision loss with temporal arteritis symptoms - jaw claudication (pain with chewing), temporal tenderness
- Raised intraocular pressure – ie pain with tender globe and hazy cornea, nausea and fixed dilated pupil
- Pain on eye movement in younger patients 30-50 – optic neuritis
- History of new flashes and floaters
