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Optho Flashcards

1
Q

risk factors for cataracts

A 
DRATS-MUD
Dm
Rtx
Atopy
Trauma
Steroids
Myotonic dystrophy
Uveitis
Downs
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2
Q

MCC reversible blindness

A

cataracts

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3
Q

PC cataracts

A 
painless gradual decrease VA
glare
halos around lights at night
dimness
decrease colour intensity- 
CLOUD/ BLURRY VISION
monocular diplopia
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4
Q

3 types of cataracts

A
  1. cortical
  2. nuclear sclerosis
  3. posterior subcapsular
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5
Q

cortical cataracts associated with

A

DM and aging

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6
Q

nuclear sclerosis a/w

A

aging

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7
Q

NB extra facts for nuclear sclerosis

A

brunescent-yellowish

SECOND SIGHT PHENOMENA

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8
Q

posterior subcapsular=

A

FROSTED GLASs; posterior adjacent to the capsule

a/w DRATS-intraocular inflammation

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9
Q

diagnostic tests for cataracts

A
  • VA
  • Opthalmoscope- red reflex
  • Slit lamp
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10
Q

name of surgery for cataracts

A

phacoemulsification: sutureless 3mm incision AND place intraocular lens

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11
Q

complications of cataracts surgery

A 
RARE
C-GERD
Cystoid macular edema
Glaucoma
Endopthalmitis
Retinal detachment
Dislocated IOL
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12
Q

decrease aqueous production drugs

A

AB-D-P
Alpha agonists- AD, brimonidine
Betablockers- timolol
Diuretics

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13
Q

increase aqueous outflow drugs

A

Cholinomimetics- pilocarpine, carbachol

PG’s- latanoprost

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14
Q

BOTH: decrease aqueous production

increase aqueous outflow

A

ALPHA AGONISTS

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15
Q

definition of glaucoma

A
  • optic nerve damage
  • visual field defect
  • +/- IOP
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16
Q

optic nerve head damage in glaucoma

A

loss of ganglion cells and axons, thus loss of neuroretinal rim–> ENLARGEMENT of optic disc= cupping

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17
Q

EXTRA: spectrum of optic nerve damage

A
  1. pallor and cupping of optic disc: small paracentral scotoma
  2. concentric enlargement: arcuate defect
  3. superior expandion: arcuate defect
  4. advanced total cupping: temporal central island
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18
Q

different types of glaucoma

A
  1. POAG
  2. Low tension glaucoma
  3. Ocular HTN
  4. Chronic closed angle glaucoma
  5. secondary glaucoma- rubeotic
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19
Q

rubeotic glaucoma

A

neovascularisation secondary to DM

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20
Q

low tension glaucoma

A

glaucomatous disc with normal IOP

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21
Q

who is at risk for low tension glaucoma

A
  • women>60

- secondary vasc insuff

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22
Q

ocular HTN

A

normal disc with increase IOP

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23
Q

chronic closed angle glaucoma diagnosis based off of….

A

appearance of drainage angle
trabecular meshwork covered by lens
similar glaucomatous disc with increased IOP

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24
Q

risk factors for POAG

A
  • increase IOP
  • increase age
    FEMD
    family hx
    ethnicity- afrocarribean
    myopia
    DM
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25
Q

diagnosis of glaucoma

A
  1. VA– advanced
  2. Pupil rxn- RAPD with asym optic n damage
  3. gonioscopy- angle- open or closed
  4. Goldmann tonometry– applanation
  5. fundosocpy– cupping
  6. Humphrey visual fields
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26
Q

monitoring disease progression in glaucoma

A
  • Fundoscopy

- Humphrey vf

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27
Q

treatment of glaucoma

A

PG or Betablocker– individually then together, then CA inhibitor, then
Trabeculectomy

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28
Q

risk factors to becoming blind with glaucoma

A

severity at presentation
LE
rate of progression

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29
Q

dry ARMD

A

RPE atrophy– coalescence of depigmented RPE= clump of focal hypo/hyperpigmentation

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30
Q

bruch membrane

A

area separating inner choroidal vessels from RPE

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31
Q

drusen

A

white deposits/lipofuscin between RPE and photoreceptors

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32
Q

wet ARMD secondary to

A
  • inflammation
  • submacular haemorrhage
  • macular edema/exudate
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33
Q

END STAGE ARMD

A

GEOgraphical atrophy
SCARRING
IRREVERSIBLE loss of central vision

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34
Q

risk factors for ARMD

A
  • female
  • increasing age
  • smoker
  • caucasian
  • blue eyes
  • family history
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35
Q

PC ARMD

A
  • metamorphopsia
  • central scotoma
  • reading difficulties
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36
Q

2 types of wet

A

occult

classic

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37
Q

classic wet ARMD

A

well defined leakage

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38
Q

occult wet ARMD

A

mottled or ill-defined leakage

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39
Q

dx ARMD

A
  1. VA/VF
  2. Amsler grid
  3. OCT
  4. Fluorescin angio
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40
Q

dry ARMD tx

A

low vision magnifying aids

social services

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41
Q

wet ARMD

A

intravitreal VEG-F– 3 months, then maintenance

  • 2/3= stabilize
  • 1/3= improve
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42
Q

exogenous antioxidant vitamins

A
  • vits C, E
  • Beta-carotene
  • Zn
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43
Q

macular pigments

A
  • lutein

- zeaxathin

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44
Q

risk factors for DM retinopathy

A
  • CV risk factors
  • duration
  • ethnicity– black
  • anaemia
  • puberty
  • prego
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45
Q

microvascular pathophysiology for DM

A

capillary leakage–> ischaemia–> vascular occlusion
parasite loss
endothelial damage

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46
Q

neuroretinal pathophysiology for DM

A

impaired neurotransmission–> apoptosis

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47
Q

late PC of DM

A

DECREASE VA= LATE

  • macular edema= mcc vision loss
  • VH
  • retinal tractional detachment
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48
Q

clinical findings for DM retinopathy

A
  1. VA
  2. anterior segment (3)
  3. dilated fundal exam (3)
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49
Q

anterior segment findings DM retinopathy

A
  • IRIS NEOVASC
  • glaucoma- rubeotic- increase IOP
  • cataracts- lens
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50
Q

dilated fundal exam DM retinopathy

A
  • DM retinopathy
  • vascular occlusions
  • AION
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51
Q

dx of DM retinopathy

A

EXACT SAME AS ARMD (still do amsler in case of metamophopsia)

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52
Q

tx of DM retinopathy

A
  1. systemic- cv rf’s
  2. screening- annual, vital
  3. laser tx
  4. surgery= vitrectomy
  5. intravitreal Veg-F
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53
Q

laser tx indicated for…

A
  1. maculopathy

2. proliferative

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54
Q

maculopathy benefit from laser tx

A
  • closes leaky vessels
  • stimulates RPE pump
  • decreases edema
  • stabilizes vision
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55
Q

proliferative benefit from laser tx

A
  • destroys ischaemic retina

- decreases angiogenic GFs

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56
Q

focal/ grid laser tx….

A

MACULOPATHY
x central field
x burn spread–> foveal burn/blind spot

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57
Q

panretinal photocoagulation

A

x cannot drive
x peripheral field
x night vision
x painfull

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58
Q

sx in DM indications

A

VITRECTOMY

  • persistent VH
  • tractional RD
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59
Q

intravitreal veg-f for maculopathy

A
  • decrease edema

- increase vision

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60
Q

intravitreal veg-f for retinopathy

A
  • regress new vessels

- clear VH

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61
Q

combined laser and intravitreal tx DM

A
  • DIABETIC MACULAR EDEMA– diffuse OR focal

- PROLIF.D.R.– with VH or DME

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62
Q

background DR

A

microaneurysms
dot and blot haemorrhages
retinal edema
hard exudates

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63
Q

micro aneurysms are secondary to….

A

proliferation of pericytes

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64
Q

preproliferative DR

A 
cotton wool spots
intra-retinal microvascular abnormalities
venous changes
extensive RHs
arterial changes
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65
Q

cotton wool spots

A

secondary to impaired axonal transport–> ischaemia

TEMPORARY

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66
Q

intra-retinal microvascular abnormalities

A

arteriolar-venular shunts

capillary occlusion adjacent

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67
Q

venous changes

A

sausaging/beading

omega sign

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68
Q

arterial changes

A

attenuation of vessels

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69
Q

proliferative DR

A

ischemia–> VEGF–> neovasc- NVD/NVE–> RH–> traction vitreous= RD–> fibrosis

70
Q

advanced diabetic eye

A

rubeotic glaucoma
persistent VH
tractional RD– fibrotic bands

71
Q

maculopathy Diabetes

A

macular edema= variable visual impairment

macular ischaemia= SEVERE visual impairment

72
Q

maculopath in DM can be

A

mixed
diffuse
focal
ischaemic

73
Q

differential for leucocoria

A
  1. cataracts
  2. coloboma
  3. toxicariasis
  4. coloboma
    RETINA
  5. ROP
  6. retinal dysplasia
  7. retinal detachment
  8. COATS DISEASE
  9. primary persistent vitreous
  10. corneal opacity
74
Q

COATS DISEASE

A

exudative retinal telangiectasias

75
Q

3 parts of uvea

A
  1. iris
  2. ciliary body
  3. choroid
76
Q

anterior uveitis

77
Q

posterior uveitis

A

choroiditis

78
Q

uveitis

A
  • RA
  • JIA
  • sarcoidosis
  • HLA–B27
79
Q

keratoconus

A

abnormal conical shape of cornea–> astigmatism

80
Q

cause of keratoconus

A

MCC= SPORADIC
- downs
- contacts
atrophy

81
Q

keratoconus a/w

A

breaks in

  • bowmans membrane
  • descemet membrane
82
Q

munsons sign

A

bulging of lower eyelid when looking downwards with a keratoconus

83
Q

risk factors for retinal vein occlusion

A

atherosclerosis
HTN
DM
glaucoma

84
Q

fundoscopy retinal vein occlusion

A

blood and thunder; diffuse all 4 quads
venous engorgement
optic disc swollen
macular edema

85
Q

tx retinal vein occlusion

A

intra-lesional anti-veg-F

- laser

86
Q

risk factors for retinal artery occlusion

A

EMBOLI
THROMBUS
GCA

87
Q

timing for retinal artery occlusion

88
Q

fundoscopy for retinal artery occlusion

A 
cherry red macula
paleretina
boxcarring-- narrowing arterioles
cotton wool spots
hollenhorst plaques
89
Q

tx for retinal artery occlusion

A

globe massage

acute angle closure tx

90
Q

tx keratoconus

A

contact lens

CORNEAL TRANSPLANT

91
Q

most common site for tear for RD

A

SUPEROTEMPORAL RETINA

92
Q

risk factors for RD

A
  • age
  • myopia
  • DM
  • trauma
93
Q

photopsia—

A

tears in vessel–> blood drop into vitreous=

HAZY VISION

94
Q

3 types of retinal detachment

A
  1. rhegmatogenous
  2. tractional
  3. exudative
95
Q

rhegmatogenous RD

A

hole in the neurosensory retina= MC

96
Q

tractional RD

A

pull neurosensory away from RPE

97
Q

exudative

A

damage RPE–> subretinal fluid

98
Q

2 similar treatments for rhegmatogenous and tractional RD

A

SCLERAL BUCKLE sx

VITRECTOMY

99
Q

additional tx for rhegmat. RD

A
  • cryotx
  • laser tx
  • pneumatic retinopexy
100
Q

additional tx for tractional RD

A
  • membrane removal
  • intraocular gas
  • silicone oil
101
Q

inflammation difference between chalazion and hordoleum

A 
chalazion= granulomatous
hordoleum= acute inflammation
102
Q

other name for chalazion=

A

meibomian cyst

103
Q

other name for hordoleum=

104
Q

cysts of zeis and moll

A

zeis= modified sweat gland
moll= modified sebaceous gland of external eyelid
SMALL WHITISH OPAQUE CHRONIC PAINLESS NODULES

105
Q

TX cysts of zeis and moll

A

simple incision

106
Q

tx molluscum contagiosum

A

shave excision

107
Q

trichiasis secondary to

A

blepharitis
SJS
trauma/ burns

108
Q

tx trichiasis

A

lubricant
electrolysis
eyelash pluck cryotx

109
Q

blepharitis two types

A
  1. staph– ulcerative and dry scales

2. seborrheic– NO ulcers, greasy scales

110
Q

toothpaste sign

A

blepharitis– discharge with pressure

111
Q

tx blepharitis

A

warm compresses and baby shampoo
antibiotics
short course steroids

112
Q

entropion diagnosis

A

forced lid closure– lid rolls inwards

113
Q

causes of entropion

A
  1. involution=MC
  2. cictricial
  3. spastic
  4. congenital
114
Q

involution as cause of entropion

A

= MC, AGING–> laxity

115
Q

causes of cicatricial entropion

A 
SC-SHOTT
SJS
Chemical burns
Surgery
Herpes zoster
Ocular pemphigoid
Trauma
Trachoma
116
Q

ocular pemphigoid–>

A

cictricial entropion:

older patients with chronic ulcers and adhesions

117
Q

spastic entropion–>

A

orbicularis oculi irritation

118
Q

causes of ectropion

A
  1. involution
  2. cicatricial
  3. mechanical
  4. paralytic
  5. congenital
119
Q

mechanical cause of ectropion

A

WEIGHT of tumor/ edema/ fat on the eyelid

120
Q

paralytic cause of ectropion

121
Q

diagnosis of ectropion

A

SNAPBACK TEST– pull eye inferiorly– lid remains away from globe

122
Q

treatment of entropion and ectropion

A

LUBE

SURGERY

123
Q

causes of ptosis

A

MCC= age related dehiscence
congenital
acquired

124
Q

acquired causes of ptosis

A

neurogenic- CN3, Horners
aponeurotic- rupture LPS
myogenic- mg, myotonic dystrophy
mechanical- inflam/tumor/vascular

125
Q

lagopthalmos

A

incomplete closure of eyelids–> CN7 palsy

126
Q

bells phenomeon

A

tighten eyes shut–> globes don’t go up anymore

= LAGOPHTHALMOS positive

127
Q

treatment of lagopthalmos

A

lubricants
tape eyelids
lateral tarsorrhaphy

128
Q

causes of blepharospasm

A

PARKINSONS
idiopathic
PYOGENIC

129
Q

benign tumors of eyelid

A
  • papilloma
  • seborrheic keratosis
  • keratocanthoma
  • naevi
  • capillary haemangioma
  • xanthelasma
130
Q

malignant tumors of eyelid

A
  • BCC
  • SCC
  • melanoma
  • meibomian cell ca
131
Q

pre-auricular lad– eye lid tumor

132
Q

symptoms of thyroid eye disease

A
  • red/ irritated/ discomfort
  • wide eye staring
  • diplopia
  • decrased vision
133
Q

signs of thyroid eye disease

A 
FULLNESS
conjunctival hyperemia
conjunctival edema= chemosis
lid retraction
lid lag 
resisted eye movement
optic neuropathy
134
Q

dx thyroid eye disease

A

thyroid– TFTS, TPO

CT ORBIT– enlarged extraocular muscles– XS soft tissue and normal tendon

135
Q

dx optic neuropathy secondary to thyroid eye disease

A
  • VA/VF
  • fundoscopy
  • pupils
  • colour vision
136
Q

tx optic neuropathy secondary to thyroid eye disease

A

orbital decompression
strabismus sx
lid retraction sx

137
Q

tx thyroid eye disease

A
  • lubricants
  • NSAIDs
  • prisms– diplopia
  • steroids
  • immunosup
  • radiotherapy
  • surgery
138
Q

lens for esotropia and exotropia

139
Q

different types of squints

A

esotropia
exotropia
hypertropia
hypotropia

140
Q

different types of ambylopia

A

strabismic
stimulus deprivation– patho. obstacle
anisometropic– unequal refractive errors
ametropic– bilateral high refractive errors

141
Q

window to correct lazy eye=

A

8 years old

142
Q

orbital tumors MCC=

A 
LYMPHOMA
rhabdomyosarcoma
capillary haemangioma
carcinoma of lacrimal duct
optic nerve glioma
optic nerve meningioma
mets
143
Q

amaurosis fugax is secondary to…

A

arterial embolism

GCA

144
Q

non-arteritic anterior ischaemic neuropathy

A

sudden painless monocular MILD-MOD vision loss
RAPD
altitudinal field loss

145
Q

risk factor for N-AION

A

HYPERTENSION

146
Q

ESR for NON-AION

A

NORMAL ESR

147
Q

signs of GCA

A
  • scalp tenderness
  • tender nodular NON-pulsatile temporal artery
  • RAPD
  • swollen optic disc and pale
148
Q

dx GCA

A

FBC
ESR, CRP
Biopsy

149
Q

vitrehous haemorrhage has no…

A

NO red reflex

NO view of retina

150
Q

vitreous haemorrhage causes

A

MCC= DM

  • retinal vein occlusion
  • trauma
151
Q

PC optic neuritis

A

sudden LOV
PAIN on movement
dull ache

152
Q

signs of optic neuritis

A

RAPD
pale swollen optic disc
early= colour desaturation
papillitis or retrobulbar

153
Q

3 big causes optic neuritis

A

MS
idio
viral

154
Q

syneresis

A

CHRONIC flashes and floaters

155
Q

MCC flashes and floaters=

A

posterior vitreous detachment= 70%
ASYMPT.
NO retinal tear
NO RD

156
Q

other causes for flashes and floaters

A
  • PVD
  • migraine
  • VH
  • posterior uveitis
157
Q

retrobulbar optic neuritis

A

NORMAL optic disc

158
Q

treatment of GCA

A

IV methylprednisolone
60-80mg prednisone
—-> 5-10mg prednisone; 1-2years

159
Q

neurologic causes of diplopia

A 
CN3,4,6
SHTT MD. 
Stroke
HTN
Tumor
Trauma
MS
DM
160
Q

mechanical causes of diplopia

A
  • thyroid eye disease
  • orbital cellulitis
  • blow out fracture
  • lymphoma
161
Q

distorted vision causes

A

ARMD
macular hole
retinal vein occlusion

162
Q

tx of conjuncitivitis

A

chloramphenicol– drops every day for 2-3wks

Sodium chromoglycate- qds +/- olapatadine

163
Q

episcleritis

A

localized or diffuse redness

SPARING** palpebral conjunctiva

164
Q

tx episcleritis

A

RESOLVE SPONTANEOUSLY

—> oral NSAIDs or topical steroids

165
Q

iritis PC

A

PAINFUL eye, increasing in severity
photophobia
circumcorneal redness
constricted pupil

166
Q

tx iritis

A

INTENSIVE steroids and mydriatic–> cyclophentolate

167
Q

marginal keratitis

A

= peripheral corneal ulcer

168
Q

tx marginal keratitis

A

steroid/ Abx combo

169
Q

tx herpes simplex keratitis

A

3% acyclovir 5x/day for 2-3wks

170
Q

infective keratitis– bacterial:

A

ofloxacin OR

vancomycin + ceftazidime

Optho-SC1 (1 decks)

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