Pass Med Flashcards
OA Glaucoma:
- Lantanaprost
Increases uveoscleral outflow
SE = brown pigmentation of iris
OA Glaucoma: beta blockers e.g. Timolol
Reduces aqueous productive
Avoid in asthma/heart block
OA Glaucoma: Brimodine
alpha2-adreno receptor agonist
reduce aqueous production and increase outflow
AVOID if taking tricyclics
OA Glaucoma: Dorzolamide
Carbonic
reduce aqueous production
Macular degeneration - Sx
Blurred/distorted vision
Straight lines appearing crooked/wavy
Central scotomas
Mac Degeneration - RF
Smoking, age, family history, female, sun exposure
Mac Degeneration - Fundoscopy Dry vs Wet
Dry = Drusen (yellow spots)
Wet = neovascularisation (worse prognosis)
Marcus Gunn Pupil
Associated condition?
Damage to afferent pathway (retina/optic nerve) = pupil of affected eye will abnormally dilate when light is shined into it
Assoc with Multiple sclerosis
Holmes-Aide’s pupil
Dilated, does not react to direct light
Argyll Robertson pupil
Which Eye?
Which Assoc Condition
Constricted pupil, does not respond to light
Usually bilateral
Neurosyphilis
RARELY: diabetic neuropathy, not in the developed world
Flashes and Floaters ? DDx and Management
Vitreous Detachment- refer urgently to opthalmology
CN III Palsy
Abnormal H Test
- Double vision
Ptosis
Dilated pupil
CN IV Palsy
Superior Oblique
Abnormal H Test with double vision§
No change to eyelid or dilation of the pupil
CN VI palsy
Lateral Rectus
Unable to move eye laterally on H test
- Gives double vision
Mydriatic (dilated pupil) Causes
Atropine drops
Argyll Robertson
Holmes Aidie
CN III palsy
Tunnel Vision: Causes
papilloedema glaucoma retinitis pigmentosa choroidoretinitis optic atrophy secondary to tabes dorsalis hysteria
Fundoscopy: Central Retinal Vein Occlusion
Cheese and tomato pizza
- Sudden painless loss of vision
- Severe retinal haemorrhages
Hypertensive Retinopathy
Grade I
Arteriolar narrowing and tortuosity
Increased light reflex - silver wiring
Hypertensive Retinopathy
Grade II
AV Nipping
Hypertensive Retinopathy
Grade III
Flame and Blot haemorrhages
Cotton Wool Haemorrhages
Hypertensive Retinopathy
Grade IV
Papilloedema
Chronic Glaucoma
- Criteria (3)
- Chronic high pressure in the eye
<21 is normal, chronic = <30 - Cupping of optic disc
- Visual field changes (peripheral field defect)
If not screened, may not realise they have it as may have normal visual acquity
Acute Glaucoma
Rapid rise in pressure
- Eye pain, halos, warning signs
- Pressures may be high 60s
Accurate measurement of pressures:
- Applination tenometry
- Fluorescene and local anaesthetic
