optho Flashcards
What is the most common cause of uveitis?
Uveitis is most commonly idiopathic.
When it is recurrent or bilateral, it should raise suspicion for rheumatologic diseases.
What type of beta blocker is Timolol?
Timolol is a nonselective beta blocker used to treat glaucoma.
What are the main side effects of Timolol?
The main side effects are hypotension and bradycardia.
What should be suspected in a patient with subacute to chronic vision loss and a pale optic nerve?
Optic atrophy should be suspected
What are the symptoms of corneal ulcer?
Purulent discharge, pain, and decreased vision in a contact lens wearer.
What is the likely diagnosis for purulent discharge, pain, and decreased vision in a contact lens wearer?
Likely diagnosis: Corneal ulcer.
What is the infectious agent likely causing mild conjunctivitis and pain with urination?
Infectious agent is likely Chlamydia.
What are injected scleral vessels a sign of?
Injected scleral vessels are a sign of scleritis.
What is included in the treatment for acute angle closure glaucoma?
Beta blockers, acetazolamide, and steroids.
Is blurry vision an early complaint of glaucoma?
Blurry vision is not an early complaint of glaucoma; peripheral vision loss is.
What is the likely diagnosis for an old man with painless vision loss and a history of hypertension and uncontrolled diabetes?
Likely diagnosis: Central Retinal Vein Occlusion (CRVO).
What does an image of diffuse retinal hemorrhage with dilated tortuous veins indicate?
It indicates Central Retinal Vein Occlusion (CRVO).
What are flashes and floaters signs of?
Flashes and floaters are signs of posterior vitreous detachment.
What is the typical treatment for corneal abrasion?
Prednisolone eye drops are not typically used for corneal abrasion.
What should be done after diagnosing a corneal ulcer?
The ulcer should be cultured, and broad-spectrum antibiotic eye drops should be started.
What are the symptoms of a corneal ulcer?
Eye pain, decreased vision, white spot on cornea, and hypopyon.
What are the risk factors for corneal ulcer?
Risk factors include advanced age, incomplete lid closure, and excessive air exposure.
What type of vision shift do cataracts often cause?
Cataracts often cause a myopic shift in vision.
What class of drugs is the first line treatment for diabetic retinopathy?
Anti-VEGF inhibitors such as intravitreal ranibizumab and aflibercept.
What is the likely diagnosis for an older patient with difficulties in near vision tasks that do not resolve with bifocal lenses?
Likely diagnosis: Age-related macular degeneration.
What is the most likely diagnosis in a young woman with decreased visual acuity and a clear cornea?
Likely diagnosis: Uveitis.
What is the infectious agent most commonly associated with viral conjunctivitis?
Most common cause of viral conjunctivitis: adenovirus.
What is a classic sign of viral conjunctivitis?
Preauricular lymphadenopathy.
What is the typical first line therapy for open angle glaucoma?
Prostaglandin analog class of drugs such as latanoprost.
What is the most common origin of uveitis?
Idiopathic.
What should be suspected in a patient with sudden severe eye pain, vomiting, and a mid-dilated pupil?
Likely diagnosis: Acute angle closure glaucoma.
What is the treatment for acute angle closure glaucoma?
Beta blockers, acetazolamide, and steroids.
What is the management for corneal ulcers?
Typically managed with topical antimicrobials and cycloplegics for pain management.
What is the likely diagnosis for a subacute, non-tender eyelid mass from an obstructed meibomian gland?
Likely diagnosis: Chalazion.
What are the symptoms of retinal detachment?
New floaters, flashing lights, followed by a curtain or shadow over part of the vision.
What must be evaluated in a patient presenting with an orbital fracture?
Extraocular muscle function must be evaluated.
What is the likely diagnosis for unilateral vision loss, pain with EOM, and a relative afferent pupillary defect?
Likely diagnosis: Optic Neuritis.
What is the treatment for a corneal abrasion from a fingernail or contact lens?
Treatment includes antibiotics with pseudomonas coverage, such as fluoroquinolones.
What is the next step for a young patient with subacute to chronic vision loss and signs of optic atrophy?
Next step is MRI of brain and orbit to rule out compressive lesions.
What are the symptoms of orbital cellulitis?
Pain with EOM, proptosis, diplopia, and constitutional signs.
What is the likely diagnosis for redness, crusting, itching, burning, and tearing of the eyelid margin?
Likely diagnosis: Blepharitis.
What is the classic sign of herpes zoster ophthalmicus on the cornea?
Pseudodendrites on the cornea.
What is the next step for a patient with pre-septal cellulitis and systemic symptoms?
Next step: Admit for IV antibiotics.
What are signs of the oculocardiac reflex?
Symptoms of nausea, vomiting, and bradycardia.
What is the diagnosis for a patient with red, painful, photophobic, and miotic eye 2-3 days post trauma?
Likely diagnosis: Post traumatic iritis.
Is the cornea typically clear without infiltrates in corneal abrasion?
Yes, the cornea is typically clear without infiltrates.
What may be seen in corneal ulceration?
Hypopyon and a white spot on the cornea.
What is the difference between internal hordeolum and chalazion?
Internal hordeolum is an acute, tender purulent inflammation, while chalazion is typically nontender and non-purulent.
What is the treatment for anterior uveitis?
Steroids and cycloplegics.
What condition describes clear vision for close objects but not for far ones?
Myopia.
What are the symptoms of scleritis?
Severe eye pain, deep injection, bluish hue to sclera, and no change in redness upon application of 2.5% phenylephrine.
What is the likely diagnosis for a young woman with decreased visual acuity and a clear cornea?
Likely diagnosis: Uveitis.
What is the significance of the presence of rash alongside the nose in herpes zoster?
It is called Hutchinson sign and is a predictor of ocular involvement.
What is the diagnosis for itching, burning, and foreign body sensation in the eye with repeated chalazion?
Likely diagnosis: Blepharitis.
Is optic neuritis commonly associated with a pale optic nerve upon examination?
No, optic atrophy will commonly have a pale optic nerve.
Is vitreous detachment a normal part of the aging process?
Yes, vitreous detachment is a normal part of the aging process.
What is acute angle-closure glaucoma associated with?
Severe pain or photophobia and a hazy cornea.
What are common symptoms of acute angle-closure glaucoma?
Severe pain, photophobia, hazy cornea, fixed mid-dilated pupil, and elevated intraocular pressure.
What is the likely diagnosis for a patient presenting with decreased visual acuity, eye pain, clear cornea, miotic pupil, and photophobia?
Uveitis
What makes conjunctivitis unlikely?
Conjunctivitis is unlikely if tearing or mucus discharge are not present.
What is the likely diagnosis for a patient with recurrent uveitis and lacrimal gland enlargement?
Sarcoidosis
What is the definitive diagnostic procedure for lacrimal gland enlargement?
Lacrimal gland biopsy. Chest CT or CXR is also indicated to detect hilar lymphadenopathy.
What is the likely diagnosis for a large spot on the sclera that developed after sneezing with no other symptoms?
Subconjunctival hemorrhage
What are the first-line treatments for diabetic retinopathy?
Intravitreal ranibizumab and aflibercept, both are anti-VEGF inhibitors.
What is commonly associated with blepharitis?
Staph aureus bacteria and demodex infestation when chronic.
What is the most appropriate initial step in any ocular chemical injury?
Irrigation of the eye with saline, even if the patient previously washed his eye with soap and water.
What is the goal of irrigation in ocular chemical injuries?
To irrigate until the pH normalizes, typically 1 to 10 liters.
What is the first step in the workup of unilateral optic neuritis?
MRI of the brain and orbits to rule out potential multiple sclerosis.
What is the likely diagnosis for an older patient with problems with glare and decreasing visual acuity?
Cataracts, which typically begin to develop around age 50 but become significant around age 60 to 70.
What are common characteristics of anterior uveitis?
Extreme photophobia, eye pain, injection, decreased vision, and may see cells floating in the anterior chamber on slit lamp.
How does blepharitis typically present?
Usually affects both eyes and is typically chronic.
What is the likely diagnosis for painless vision loss with retinal whitening and a cherry red spot?
Central retinal artery occlusion (CRAO), unlikely to see hemorrhage unlike in central retinal vein occlusion (CRVO).
