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My Ophthalmology > Pathology > Flashcards

Pathology Flashcards

1
Q

What are the cells of the epithelial surface of the lens?

A

they are anucleate

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2
Q

What is cupping?

A

raised intraocular pressure which degenerated the optic disc and nerve

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3
Q

What does cupping look like?

A
  • rolled edges of the optic disc
  • depressed centre
  • therefore, the optic disc appears larger
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4
Q

What is the main test for diplopia?

A
  • cover test: tests the squint and gives more information

- corneal reflections

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5
Q

What are the names for a squint with outward or inward movement?

A
  • outward = esotropia/convergent

- inward = exotropia/divergent

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6
Q

What are the names for a squint with upward or downward movement?

A
  • downward = hypertropia

- upward = hypotropia

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7
Q

What are the features and causes of horizontal double vision?

A
  • Esotropia or exotropia on cover test

- LR or MR problem

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8
Q

What are the features and causes of vertical double vision?

A
  • Hypertropia or hypotropia on cover test

- SR, SR, IR, IO problem

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9
Q

What causes a global haemorrhage?

A

vein occlusion

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10
Q

What causes a pale retina with a cherry red spot?

A

artery occlusion

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11
Q

What is normal pressure in the eye?

A

16-21

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12
Q

What are the two sight-threatening conditions?

A

GCA

Closed-angle glaucoma

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13
Q

What is the most common cause and age group for eye trauma?

A
  • 25-34y (younger men and older women)
  • in men, machinery and assault
  • in women, home-related falls
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14
Q

What is used to identify epithelial loss in the eye?

A

fluorescein drops

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15
Q

What are the main forms of blunt trauma to the eye?

A
  • Blow out fracture
  • Subconjunctival haemorrhage
  • Traumatic uveitis
  • Hyphaema
  • Tearing of intra-ocular structures eg lens detachment
  • Retinal detachment
  • Choroidal tear
  • Commotio retinae/bruised retina
  • Optic nerve avulsion
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16
Q

What herniates down into the sinuses in a blowout fracture?

A

inferior rectus or fat

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17
Q

What is hyphaema?

A

blood in the anterior chamber of the eye which pools and forms a meniscus

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18
Q

What does a retinal detachment look like?

A

crinkly appearance of the retina

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19
Q

What are the most common forms of penetrating trauma from large objects?

A
  • Lid laceration
  • Corneal laceration
  • Scleral lacerations
  • Sympathetic ophthalmia
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20
Q

What does a corneal laceration present with?

A
  • beam-shaped pupil
  • flat anterior chamber
  • seen with Seidel test with fluorescein
  • iris can leak
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21
Q

What are the main types of trauma from small objects?

A
  • Sub-tarsal
  • Conjunctival
  • Corneal: metallic foreign bodies
  • Intra-ocular: beware of fast moving particles and ALWAYS XR
  • Intra-orbital
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22
Q

How do you remove small foreign objects?

A
  • slit lamp
  • LA
  • edge of needle
  • cover with chloramphenicol ointment
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23
Q

What can a foreign body cause?

A

a traumatic cataract

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24
Q

What does alkali do to the eye?

A
  • changes to the conjunctiva and cornea
  • penetrate intraocular structures
  • look for ischemia around the limbus (china-white eye with no veins)
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25
Q

What do acids do to the eye?

A

coagulate proteins but don’t penetrate

26
Q

What is the treatment for chemical burns in the eye?

A
  • irrigate thoroughly immediately
  • check toxbase for pH and half-life etc
  • assess with slit lamp
    (solution to pollution is dilution)
27
Q

What are the golden rules for ocular trauma?

A
  • history is key
  • always record visual acuity
  • don’t forget fluorescein
  • handle suspected globe rupture with care
  • XR obits if suspicion of intra-ocular foreign body
  • immediate irrigation of chemical injuries (solution to pollution is dilution)
28
Q

What does hypertension do to the eye?

A

the fundus reflects the severity

  • attenuated blood vessels
  • cotton wool spots
  • hard exudates
  • retinal haemorrhage
  • optic disc oedema
29
Q

What is a central retinal artery occlusion?

A

sudden painless loss of vision and the retinal nerve fibre layers becomes swollen except at fovea (cherry red spot)

30
Q

What happens in a central retinal vein occlusion?

A
  • sudden painless visual loss
  • degree of ischemia correlates to the degree of reduced vision and fundal appearances
  • way more common than the artery ones
31
Q

What is a branch vein occlusion?

A

painless disturbance in vision which can be asymptomatic

32
Q

What are the causes of uveitis in inflammatory disease?

A
  • HLA-B27
  • sarcoidosis
  • TB
  • syphilus
  • juvenile and psoriatic arthritis
  • herpes zoster
  • toxoplasmosis
  • candidiasis
33
Q

What are the main features of GCA?

A
  • can cause blindness
  • multinucleated giant cells
  • inflammation of middle sized arteries
  • associated with polymyalgia rheumatica
34
Q

What are the features of thyroid eye disease?

A
  • proptosis, lid retraction, lid lag, lig oedema, there can be glaucoma, injection, chemosis
  • smoking worsens this
  • control thyroid function, surgical decompress
35
Q

What are the connective tissue disorders that can cause eye diseases?

A 
SLE = ocular inflammation
RA = dry eyes, scleritis and corneal melt
Sjogren's = dry eyes + infiltration of lacrimal glands
Marfan's = lens can dislocate superiorly
36
Q

What is the dermatology disease associated with the eye?

A

Stevens-Johnson syndrome causes occlusion of the lacrimal glands, corneal ulcers and symblepharon

37
Q

What is the main blood supply to the eye?

A
  • internal carotid artery gives rise to the ophthalmic artery which is the major blood supply to the eye
  • the central retinal artery is a branch of this
38
Q

What are the layers of the retina supplied by?

A
  • inner 2/3rds retina = central retinal artery

- outer 1/3rd retina (mostly photoreceptors here) = choroid

39
Q

What causes a pale or a dark retina?

A
  • pale = artery occlusion

- dark = vein occlusion

40
Q

What is the normal pathway of aqueous humour?

A
  • made in ciliary body
  • travels between lens and iris
  • through pupil
  • into trabecular meshwork
41
Q

What does most of the refracting in the eye?

A

the cornea does the majority and the lens does the rest

42
Q

What is myopia?

A
  • short-sightedness
  • image focussed in front of the retina
  • needs a concave lens
43
Q

What is hypermetropia?

A
  • long-sightedness
  • image focussed behind the retina
  • needs a convex lens
44
Q

What is astigmatism?

A

irregular corneal curvature

45
Q

What is presbyopia?

A

loss of accommodation with ageing

46
Q

What are the main causes of sudden visual loss?

A
  • A RMD
  • B leed/Blocked vessel
  • C losed angle glaucoma
  • D etached retina
47
Q

What are the main causes of gradual visual loss?

A
  • A RMD
  • B lur (refractive error)
  • C ataract
  • D iabetes
  • G laucoma
48
Q

What is involved in the second cranial nerve exam?

A
  • visual acuity
  • optic discs
  • colour vision
  • pupils
  • visual field assessment
49
Q

What are the functions of CSF?

A
  • maintains stable extracellular environment
  • buoyancy
  • provides mechanical protection
  • waste removal
  • nutrition
50
Q

What is the production of CSF?

A
  • made in the lateral ventricles by the choroid plexuses
  • travels through the 3rd and 4th ventricles
  • into the subarachnoid space
51
Q

What are the CSF-related causes of increased ICP?

A
  • obstruction to CSF circulation
  • CSF overproduction
  • inadequate absorption
52
Q

What are the causes of an optic nerve problem resulting in a visual field defect?

A
  • Common cause is ischaemic optic neuropathy (GCA)
  • Optic neuritis (if you have MS this is common)- scan with MRI
  • Tumours are rare
53
Q

How do altitiudinal visual field defects arise?

A
  • vessel supplying the retina splits into upper and lower

- if one of these is taken out there there is a loss of top or bottom vision

54
Q

What is optic neuritis?

A
  • progressive visual loss
  • pain behind eye on movement
  • colour desaturation
  • central scotoma
  • recovery is over weeks to months
  • optic atrophy following this
55
Q

What can the optic chasm be affected by?

A

pituitary tumour, craniopharyngioma or meningioma

56
Q

What are the optic tracts and radiations affected by?

A

tumours, demyelination and vascular anomalies

57
Q

What does injury to the optic tracts and radiations cause?

A

homonymous defects, macula not spared, quadrantanopia

58
Q

What is the occipital cortex affected by?

A

vascular disease or demyelination

59
Q

Is the macula spared in occiptal cortex pathology?

A

macula is spared because it is such a huge area of the occipital cortex so a problem is unlikely to take out the whole of this area so the macular will be ok

60
Q

What are the features of optic neuritis?

A
  • loss of vision in one eye
  • 24-48 hours
  • demyelination
  • colours affected
  • central structure in field tests

My Ophthalmology (5 decks)

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