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PM3A > (PM3A) Ocular Conditions > Flashcards

(PM3A) Ocular Conditions Flashcards

1
Q

What is uveitis?

A

Inflammation or swelling of the middle layer of the eye

Of uvea/ uveal tract

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2
Q

Where is the uvea?

A

Middle layer of the eye

(1) Anterior: Ciliary body + iris
(2) Posterior: Choroid

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3
Q

What are some of the symptoms of uveitis?

A

(1) Ache/ pain
(2) Red eye
(3) Small pupil, irregular outline
(4) Blurred vision
(5) Cloudiness
(6) Headaches/ light sensitivity

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4
Q

What are some of the causes of uveitis?

A

Unclear

(1) Inflammation of the uvea/ iris
(2) Mainly affects children + young adults
(3) Association with trauma or autoimmune

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5
Q

What is the treatment for uveitis?

A

Depends on which areas of the eye are affected

(1) Corticosteroid eye drops
dexamethasone
(2) Corticosteroid injections
(3) Mydriatic eye drops, e.g. atropine sulfate

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6
Q

What is blepharitis?

A

Chronic inflammation of the eye lid

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7
Q

What are some of the symptoms of blepharitis?

A

(1) Itchy/ red + sore eye lids
(2) Eye lids stick together
(3) Problems opening eyes upon waking
(4) Crusty eyelashes
(5) Burning/ gritty sensation
(6) Photophobia
(7) Abnormal eyelashe growth + loss

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8
Q

What are the potential causes of blepharitis?

A

Sebaceous gland dysfunction

Can be caused by:
(1) Staphylococci infection
(2) Infestation of lice/ demodex lice
(3) Allergic reactions
(4) Fungal infection
(5) Viral infection

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9
Q

What is the typical treatment for blepharitis?

A

(1) Daily eye lid cleaning

(2) ABx for more severe cases - topical/ oral

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10
Q

Describe the usual onset of blepharitis symptoms.

A

Repeated episodes

Separated by periods without symptoms

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11
Q

What is a stye?

A

External hordeolum

Small + painful lump on inside/ outside of eyelid

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12
Q

What is an external hordeolum?

A

Stye

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13
Q

What are some of the common symptoms of a stye?

A

(1) Swollen/ lumpy
(2) Redness
(3) Swelling/ tenderness lasting several days
(4) Often a white head in the centre of the swelling

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14
Q

What are some of the potential causes of a stye?

A

(1) Acute staphylococcal infection of the sebaceous glands

(2) In-growing eyelash

(3) Can be associated with blepharitis

(4) Recurrent in diabetics

(5) Positive correlation with stress

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15
Q

What is the typical treatment for a stye?

A

Usually self-limiting (days-weeks)

Topical ABx if severe

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16
Q

What is conjunctivitis?

A

Inflammation of the conjunctiva

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17
Q

What are some of the different types of conjunctivitis?

A

(1) Bacterial conjunctivitis

(2) Allergic conjunctivitis

(3) Chlamydial conjunctivitis

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18
Q

What are some of the common symptoms of conjunctivitis?

A

(1) Uni/bilateral

(2) Sudden onset - seasonal

(3) Reddening of eyes

(4) Itchy + sore

(5) Watery eyes

(6) Swollen eyelids

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19
Q

What are some of the potential causes of conjunctivitis?

A

(1) Pollen - hay fever

(2) Dust mites

(3) Makeup

(4) Animal fur

(5) Eye drops

(6) Unclean contact lens

(7) Bacterial/ viral

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20
Q

What is the typical treatment for conjunctivitis?

A

Usually self-limiting within 2 weeks

(1) Allergic conjunctivitis: azelastine hydrochloride eye drops

(2) Infective conjunctivitis: chloramphenicol 1% tds-qds/ fusidic acid

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21
Q

What is keratitis?

A

Inflammation of the cornea

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22
Q

What are some of the symptoms of keratitis?

A

(1) Eyelid oedema

(2) Conjunctival inflammation

(3) Dicharge

(4) Corneal ulceration

(5) Pink eye

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23
Q

What are some of the potential causes of keratitis?

A

(1) Bacterial - contact lenses/ trauma

(2) Viral - herpes simplex

(3) Fungal - Candida

(4) Parasitic - pools/ hot tubs/ contact lens solution

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24
Q

What is the most common cause of blindness?

A

Keratitis

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25
Q

What is the typical treatment for keratitis?

A

(1) Depends on severity of infection
eye drops ABx
cefazolin, vancomycin
IF bacterial:Oral ABx
doxycycline

(2) Antiseptic drops - chlorhexidine/ brolene/ hexamidine
- Anti-amoebic effect

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26
Q

Why may antiseptic eye drops be given for treatment of keratitis?

A

Anti-amoebic effect
microbial keratitis

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27
Q

What is ectropion?

A

Condition where eyelids turn outwards

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28
Q

What are some of the common symptoms of ectropion?

A

(1) Permanently watery eye

(2) Eyelid sag

(3) Exposure of conjunctival surface

(4) Exposure of corneal surface

(5) Decreased vision

(6) Ocular surface pain

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29
Q

What are some of the potential causes of ectropion?

A

(1) Weak muscles around the eye - old age

(2) Injury to the skin around the eyes

(3) Bell’s (facial) palsy

(4) Congenital (genetic) defect

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30
Q

What is the typical treatment for ectropion?

A

(1) Mild cases may not require treatment

(2) Operation (surgery) to correct is recommended

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31
Q

What is exophthalmos? (Proptosis)

A

Abnormal protrusion of the eye ball

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32
Q

What is proptosis?

A

Exophthalmos

Abnormal protrusion of the eye ball

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33
Q

What are some of the common symptoms of exophthalmos?

A

(1) Forced eyelid widening

(2) Staring expression

(3) Impaired eye movement

(4) Double/ blurred vision

(5) Dry + itchy eyes

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34
Q

What are some of the potential causes of exophthalmos?

A

(1) Increase in volume of tissue behind the eyes

(2) Associated with hyperthyroidism

(3) Hereditary disease - Grave’s

(4) Infection of the sinuses - in children only

(5) Protrusion of one eye - cyst/ brain tumour/ blood clot

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35
Q

What is the treatment for exophthalmos?

A

When caused by thyroid eye disease:

(1) Medication to correct thyroid hormone levels
i.e. carbimazole/propylthiouracil

(2) IV corticosteroid therapy

(3) Corrective surgery - following reduction of inflammation

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36
Q

What are cataracts?

A

Clouding of the lens in the eye

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37
Q

What are some of the common symptoms of cataracts?

A

(1) Blurred/ cloudy/ misty vision

(2) Gradual visual deterioration

(3) Age/ environment related

(4) Discomfort in bright light

(5) Colour fading

(6) Reading/ watching TV more difficult

(7) Glasses becoming less effective

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38
Q

What are some of the potential causes for cataracts?

A

(1) Protein aggregation in lens

(2) Eye injury

(3) Diabetes

(4) Uveitis

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39
Q

What are some of the risk factors for cataracts?

A

(1) Smoking

(2) Overexposure to light

(3) Prolonged steroid use

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40
Q

What is the typical treatment for cataracts?

A

Cataract surgery

No other proven treatment

41
Q

What is keratoconjunctivitis sicca?

A

Dry eye syndrome

Decreased tear production/ increased tear film evaporation

42
Q

What are some of the common symptoms of keratoconjunctivitis sicca?

A

(1) Ocular irritation - dryness/ soreness

(2) Usually bilateral

(3) Worsens throughout the day

(4) Redness of eyes

43
Q

What are some of the potential complications of keratoconjunctivitis sicca?

A

(1) Scarring

(2) Conjunctivitis

(3) Photosensitivity

(4) Corneal thinning

44
Q

What are some of the potential causes of keratoconjunctivitis sicca?

A

(1) Environmental factors

(2) Concomitant illness

(3) Hormonal changes

(4) Ageing

(5) Loss of tear fluid
- Lacrimal gland defect
- Meibomian gland defect
- Eyelid defect
- Cornea defect
- Tear duct/s defect

45
Q

What biological factors can cause loss of tear fluid?

A

(1) Lacrimal gland defect

(2) Meibomian gland defect

(3) Eyelid defect

(4) Cornea defect

(5) Tear duct/s defect

46
Q

What is glaucoma?

A

Group of eye diseases

Result in damage to the optic nerve

Causes vision loss

47
Q

What are some of the common symptoms of glaucoma?

A

(1) Largely asymptomatic - slow onset

(2) Impairment of peripheral vision

(3) Hazy/ blurred vision

(4) Rainbow-coloured circles around bright lights

(5) Severe eye/ head pain

(6) Nausea/ vomiting - associated with eye pain

(7) Sudden sight loss

48
Q

What are some of the potential causes of glaucoma?

A

Triggers are unknown

Usually associated with excessive pressure within the eye damaging the optic nerve

Caused by misbalance of production and drainage in the aqueous humour

Trabecular meshwork progressively blocked/ impaired

49
Q

What is the trabecular meshwork?

A

the spongy tissue located near the cornea
Drainage point of the aqueous humour in the eye

50
Q

What are the main types of glaucoma?

A

(1) Open-angle glaucoma (~90%)

(2) Angle-closure glaucoma

51
Q

What is open-angle glaucoma?

A

Most common type of glaucoma (~90%)

Slow clogging of drainage canals

Slow development

Lifelong condition

52
Q

What is angle-closure glaucoma?

A

Least common main type of glaucoma (~10%)

Blocked drainage canals

Sudden rise in intraocular pressure

Develops very quickly

53
Q

What are some of the risk factors for glaucoma?

A

(1) Age - more common >40yrs old

(2) Blood pressure - low BP increased risk

(3) Race
- african/ afro-caribbean increased risk of chronic open-angle glaucoma
- asian increased risk of acute angle-closure glaucoma

(4) Family history - increased risk

(5) Short/ long sight

(6) Medical history - diabetes increases risk

54
Q

What is myopia?

A

Short-sightedness

55
Q

What effect does myopia have on glaucoma risk factor?

A

Increased risk of chronic open-angle glaucoma

56
Q

What effect does short-sight have on glaucoma risk factor?

A

Increased risk of chronic open-angle glaucoma

57
Q

What effect does diabetes have on glaucoma risk factor?

A

Increased risk of glaucoma

58
Q

What are some treatment options for glaucoma?

A

(1) Prostaglandin analogues

(2) Beta-blockers

(3) Carbonic anhydrase inhibitors

(4) Sympathomimetics

(5) Miotics

59
Q

Why are prostaglandin inhibitors used for treatment of glaucoma? I R

A

Increase the flow of aqueous humour fluid out of the eye

Reduces the intraocular pressure

e.g. latanoprost

60
Q

Why are beta-blockers used for treatment of glaucoma? R R

A

Reduce intraocular pressure

Reduce production of aqueous humour in the eye

e.g. timolol maleate

61
Q

Why are carbonic anhydrase inhibitors used for treatment of glaucoma? R R

A

Reduce production of aqueous humour

Reduces intraocular pressure

e.g. brinzolamide

62
Q

Why are sympathomimetics used for treatment of glaucoma? R I

A

Reduces production of aqueous humour

Increases flow of aqueous humour out of the eye

e.g. brimonidine tartrate

63
Q

Why are miotics used for the treatment of glaucoma?
O Imp

A

Open up blocked trabecular meshwork

Improves drainage of aqueous humour out of eye

e.g. pilocarpine hydrochloride

64
Q

What is acute injury of the eye?

A

(1) Foreign body in eye

(2) Corneal scratch

65
Q

What are some of the common symptoms of acute eye injury?

A

(1) Dry eye sensation

(2) Sensation of a foreign body

(3) Normal appearance with some redness

(4) Excessive tear production

66
Q

What are some of the potential causes of acute eye injury?

A

(1) Superficial eye injury/ trauma (scratch)

(2) Fingernails

(3) Working with power tools

(4) Dirt/ grit

67
Q

What is diabetic retinopathy?

A

Damage to the retina

Resulting from diabetes

68
Q

What are some of the common symptoms of diabetic retinopathy?

A

(1) Few early warning signs

(2) Black spots in the vision

(3) Early stages detectable by fundus photography

(4) Early stages: non-proliferative

(5) Late stages: proliferative

69
Q

What are some of the potential causes of diabetic retinopathy?

A

(1) Microvascular changes - due to poor glycaemic control degenerating vascular walls

(2) 80% of diabetic patients >10 years

70
Q

What percentage of diabetic retinopathy cases are preventable if monitored and treated correctly?

A

90%

71
Q

What percentage of patients with diabetes for longer than 10 years will develop diabetic retinopathy?

A

80%

72
Q

What are the typical treatments for diabetic retinopathy?

A

(1) Laser treatmetn

(2) Management of diabetes

(3) Intravitreal injections/ implant with fluocinolone acetonide

(4) Operation to remove blood/ scar tissue

73
Q

What is fluocinolone acetonide?

A

Corticosteroid

74
Q

What is a sub conjunctival haemorrhage?

A

Bleeding underneath the conjunctiva

75
Q

What are some common symptoms of subconjunctival haemorrhage?

A

(1) Blood form burst blood vessel cover surface of eyeball - not in eyeball itself

(2) Initial pain disappears quickly

(3) No change in vision

76
Q

What is a potential cause of subconjunctival haemorrhage?

A

Mild physical trauma

77
Q

What is the typical treatment for subconjunctival haemorrage?

A

No treatment required if infection not present

Check for significant trauma

78
Q

What is age related macular degeneration (AMD)?

A

Painful eye condition

Causes loss of central vision

Usually bilateral

79
Q

What are some of the common symptoms of age related macular degeneration (AMD)?

A

(1) Difficulty reading

(2) Less vibrant colours/ dulling

(3) Difficult recognising faces

(4) Does not affect peripheral vision

80
Q

What are the types of age related macular degeneration (AMD)?

A

(1) Dry age related macular degeneration

(2) Wet age related macular degeneration

81
Q

What is dry age related macular degeneration (AMD)?

A

Cells of macula become damaged

Due to build up of deposits called drusen

Most common type of AMD

Least severe type of AMD

~90% of all AMD cases

82
Q

What is wet age related macular degeneration?

A

Also known as neovascular AMD

Develops when abnormal blood vessels form under macula

Damage macula cells

83
Q

Where is the macula?

A

At the back of the eye

84
Q

What does damage to the macula do?

A

Distorts the macula + bleeds

Affects central vision

85
Q

What are some of the risk factors for age related macular degeneration (AMD)?

A

(1) Smoking

(2) Obesity

(3) Cardiovascular disease

(4) Family history

86
Q

What is the treatment for age-related macular degeneration?

A

No cure for either type of AMD

Wet AMD: Treated monthly with intraocular injections with anti-vascular endothelial growth factor (anti-VEGF) medication
- e.g. ranibizumab

87
Q

What are some symptoms of myopia?

A

(1) Distant objects appear blurred

(2) Close objects are clear

(3) Manifests from childhood to 25 years old

88
Q

What percentage of the UK population have myopia?

A

30%

89
Q

What causes myopia?

A

(1) Rays of light are focused short of the retina in the eye

(2) Eye is too long from front to back

(3) Cornea too steeply curved

90
Q

What is hyperopia?

A

Long-sightedness

91
Q

How can myopia or hyperopia be corrected?

A

(1) Contact lenses

(2) Glasses

(3) Myopia - concave lens (minus)

(4) Hyperopia - convex lens (plus)

92
Q

How are contact lenses held in the eye?

A

Thin transparent discs

Sit on the cornea

Held in place by eyelid pressure + tear film surface tension

93
Q

What types of contact lenses are there?

A

(1) Rigid - hard/ gas permeable

(2) Soft - hydrogel/ silicone hydrogel

94
Q

What care advice must be given for contact lens wearers?

A

(1) Worn for a limited number of hours per day

(2) Require strict cleaning

(3) Daily disposables are best option

95
Q

What are some complications of wearing contact lenses?

A

(1) Papillary conjunctivitis

(2) Ulcerative keratitis

(3) Acanthamoeba keratitis - sight threatening parasite

96
Q

What is papillary conjunctivitis?

A

Allergic reaction of the eye

97
Q

What is ulcerative keratitis?

A

Inflammation + ulceration of the cornea

98
Q

What is acanthamoeba keratitis?

A

Sight threatening parasite

99
Q

Name some rarer conditions of the eye, besides those known in more detail.

A

(1) Cancer

(2) Keratoconus - corneal degeneration

(3) Limbal stem cell deficiency

(4) Corneal dystrophies

(5) Cicatrical pemphigoid - autoimmune blistering

PM3A (36 decks)

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