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Year 4 - Ophthalmology > Pathology > Flashcards

Pathology Flashcards

1
Q

what are eye cataracts

A

opacification / clouding of the lens

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2
Q

causes of cataracts

A 
age 
diabetes 
sunlight - UVB 
steroids 
hypertension 
smoking
ocular trauma  
metabolic disorders 
genetic
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3
Q

symptoms of cataracts

A

gradual painless loss of vision
diplopia
difficulty reading / writing
halos around lights

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4
Q

signs of cataracts on examination

A

clouded lens

absent red reflex

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5
Q

management of cataracts

A

phaco-emulsification with intra ocular lens replacement surgery

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6
Q

what is a consequence of uncorrected cataracts in children

A

amblyopia (lazy eye) - eye fails to achieve visual acuity and vision does not develop properly

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7
Q

what is conjunctivitis

A

inflammation of the conjunctiva

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8
Q

what is scleritis

A

inflammation of the sclera

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9
Q

symptoms of scleritis

A

associated with pain on movement
red eye
impaired vision
associated with autoimmune conditions - SLE, RA

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10
Q

phenylephrine testing in scleritis is positive/negative

A

negative

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11
Q

what is episcleritis

A

inflammation of episclera

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12
Q

symptoms of episcleritis

A

no pain on movement
superficial
self limiting

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13
Q

phenylephrine testing in episcleritis is positive/negative

A

positive

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14
Q

How can you differentiate between scleritis and episcleritis

A

phenylephrine drops will cause blanching of vessels in episcleritis (positive) and no change in scleritis (negative)

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15
Q

what is glaucoma

A

progressive optic neuropathy usually due to an abnormal increase in intra-ocular pressure as a result of blockage to aqueous humour drainage (trabecular meshwork or canal of Schlemm)

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16
Q

what ultimately happens in glaucoma

A

pressure builds up and greatly impacts on optic nerve/disc resulting in a blindspot

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17
Q

what are the types of glaucoma

A

open and closed angle

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18
Q

which is more common, open or closed angle glaucoma

A

open angle

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19
Q

what is the pathology behind open angle glaucoma

A

blockage of drainage of aqueous humour

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20
Q

onset of open angle glaucoma

A

slow onset

asymptomatic

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21
Q

signs of open angle glaucoma on fundoscopy

A

cupping of the optic disc
characteristic field changes
raised IOP

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22
Q

what is the pathology behind closed angle glaucoma

A

the drainage system is fine but the iris BULGES FORWARD to block drainage angle meaning fluid can’t circulate and it accumulates behind the iris

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23
Q

acute closed angle glaucoma is an emergency, true or false

A

true!

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24
Q

symptoms of closed angle glaucoma

A 
acute red eye 
severe headache 
N+V
hazy cornea 
fixed mid dilated pupil 
reduced vision 
pain
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25
Q

management of closed angle glaucoma

A

laser a hole through the iris

26
Q

what is ARMD

A

ARMD is characterised by appearance of drusen in the macula

27
Q

what is drusen

A

fatty protein and lipid deposits

28
Q

what are the types of ARMD

A

dry and wet

29
Q

describe dry ARMD

A

no significant vascular proliferation
more common
less severe
essentially wear and tear of RPE layer

30
Q

describe wet ARMD

A 
significant vascular proliferation 
always begins as dry ARMD
neurovascularisation in choroid mediated by VEGF 
these new vessels are leaky and fragile 
more likely to lead to loss of vision
31
Q

management of dry ARMD

A

conservative

32
Q

management of wet ARMD

A

monoclonal Ab to VEGF

33
Q

commonest causes of retinopathy

A

hypertension and DM

34
Q

what is an Argyll Robertson Pupil

A

ocular sign
usually seen bilaterally
accommodates but does not react

35
Q

causes of an Argyll Robertson Pupil

A

late stage neurosyphilis
DM
MS
stroke

36
Q

what is rubeotic glaucoma

A

neovascularisation on surface of the iris

seen in severe DM or severe retinal vein occlusion

37
Q

features of diabetic retinopathy

A 
leaky vessels 
aneurysms 
oedema 
dot and blot haemorrhages 
flame haemorrhages
38
Q

what is papilloedema

A

swelling of the optic disc die to raised intracranial pressure

39
Q

what is CRAO (central retinal arterial occlusion)

A

blockage of the central retinal artery
eg amaurosis fugax ~ TIA of the eyes
usually from the carotids and thromboembolic disease

40
Q

describe vision loss in amaurosis fugax

A

vision loss like a curtain coming down

41
Q

what is CRVO (central retinal vein occlusion)

A

blockage of the central retinal vein
eg GCA vasculitis
eg atherosclerosis of neighbouring artery impinging on vein

42
Q

in which neurological condition can optic neuritis be seen

what is a sign of this

A

MS

RAPD

43
Q

what is a cause of ischaemic optic neuropathy

A

GCA

44
Q

what investigations are used to monitor signs in glaucoma

A

IOP - tonometry
visual fields - perimetry
optic disc - fundoscopy

45
Q

risk factors for open angle glaucoma

A

age
raised IOP
afro-carribean
FH

46
Q

what is the name of surgery for open angle glaucoma

A

trabeculectomy

47
Q

patient with which refractive error have an increased risk of closed angle glaucoma

A

hypermetropes

48
Q

management of closed angle glaucoma

A

reduce IOP medically

peripheral iridotomy

49
Q

what is the pathogenesis in wet ARMD

A

eye grows new blood vessels within the macula to ‘repair’ dry ARMD
new vessels are leaky and so bleed into retinal tissue

50
Q

CRAO treatment is only effective if presentation is within 12-24 hours, true or false

A

true

51
Q

management of CRAO

A

ocular massage
paper bag breathing
IV diamox
anterior chamber paracentesis

52
Q

management of CRVO

A

no signs of ischaemia - observe every 3 months
ischaemia but no neovascularisation - observe every 4-6 weeks
ischaemia + neovascularisation - urgent PRP

53
Q

what is Horner’s syndrome

A

paralysis of sympathetic supply to the eye

  • mild ptosis
  • constriction of pupil
  • anhydrosis
54
Q

risks of corneal transplant

A 
rejection 
astigmatism 
glaucoma 
uveitis 
retinal detachment
55
Q

risk factors for retinal detachment

A

myopia
previous eye trauma / surgery
FH

56
Q

complications of lens replacement surgery

A

endophthalmitis

unexpected refractive error

57
Q

pathophysiology of thyroid eye disease

A

inflammatory changes in the EOM and hypertrophy of orbital fat leading to ocular dysmotility, diplopia and proptosis

58
Q

indications for corneal transplant

A

keratoconus

corneal scarring following infection or trauma

59
Q

what is keratoconus

A

progressive thinning and bulging of the cornea into a conical shape

60
Q

how can you prevent corneal graft rejection

A

long term use of topical corticosteroids

61
Q

what is the surgical treatment for glaucoma

A

trabeculectomy

laser iridotomy

62
Q

what are sight threatening complications of BRVO

A

macular oedema

rubeotic glaucoma

Year 4 - Ophthalmology (12 decks)

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