Printed Notes Flashcards
What is a marcus gunn pupil?
relative afferent pupillary defect
what are some causes of RAPD?
optic neuritis
optic atrophy
retinal disease
orbital cellulitis
What is Holmes Adie pupil?
dilated pupil has no response to light and slow response to accommodation (tonic pupil)
who is most affected by Holmes Adie pupil?
young women with sudden blurring of near vision
what is the cause of Holmes Adie pupil?
damage of post ganglionic parasympathetic fibres
what three things make up Holmes Adie syndrome ?
tonic pupil, absent lower limb reflexes, low BP
What are the four features of Horners syndrome ?
PEAS
ptosis
enophthalmos (posterior displacement)
anhydrosis
small pupil
What nerve root is affected by pan coast tumours?
T1
state some causes of horners syndrome ?
MS Wallenbergs lateral medullary syndrome pan coast tumour trauma cavernous sinus thrombosis
What is Argyll robertsons pupil?
small irregular pupils that accommodate but don’t react to light caused by DM or syphilius
what colour vision is affected by optic atrophy?
decreased red colour vision
what are the commonest causes of optic atrophy?
MS
glaucoma
what are the features of optic atrophy?
decreased acuity decreased colour vision central scotoma pale optic disc RAPD
state the causes of optic atrophy?
Charcot marie tooth disease Friedrichs ataxia alcohol, lead, B12 deficiency optic glioma pituitary adenoma glaucoma pagets DM, GCA MS, Devics HZV, TB lymphoma, leukaemia
what medications can increase risk of acute closed angle glaucoma?
anti cholinergics
sympathomimetics
TCAs
anti histamines
what are the symptoms of ACAG?
coloured halos around lights
severe pain
headache, vomiting, nausea, decreased acuity
what condition is the talbots test used for?
anterior uveitis
what is talbots test
increased pain on convergence
what is the treatment for episcleritis?
topical NSAIDs
state some causes of scleritis ?
wegeners
RA, SLE, vasculitis
what is a complication of scleritis ?
scleromalacia
what is the treatment for bacterial conjunctivitis?
chloramphenicol 0.5%
what infection can contact lens users get from swimming?
acanthamoeba
what is hutchisons sign?
vesicles on tip of nose preceding the development of ophthalmic herpes zoster shingles
what 5 questions should be asked for sudden loss of vision ? HELLP
headache eye movements hurt lights like curtain descending poorly controlled DM
what is the optic condition caused by GCA?
anterior ischaemic optic neuropathy
what does the retina look like in central artery retinal occlusion ?
pale retina
cherry red fovea
what is seen on the macula with dry ARMD?
drusen deposits
what is used to measure distortion with wet ARMD?
amsler grid
where is vision lost first in the periphery with primary open angle glaucoma?
supero nasal
state some risk factors for open angle glaucoma?
FHx, steroids, DM
what investigations can be done for glaucoma ?
tonometry
fundoscopy
what deficiency causes keratomalacia ?
Vitamin A
what is glucose converted to in the lens during poorly controlled DM to form cataracts?
sorbitol by aldose reductase
what is the management for proliferative diabetic retinopathy ?
pan retinal (macula sparing) laser photocoagulation
what is the management for macular diabetic retinopathy ?
focal or grid laser photocoagulation
state some congenital causes of cataracts ?
idiopathic rubella wilsons myotonic dystrophy galactosaemia
what is the most common inherited degeneration of the macula?
retinitis pigmentosa
what is the presentation of retinitis pigmentosa?
night blindness
tunnel vision
what does the fundoscopy of retinitis pigmentosa look like ?
optic atrophy
peripheral retinal pigmentation
what is an another name for DIDMOAD?
Wolfram syndrome
what are the features of DIDMOAD?
diabetes insipidus, diabetes mellitus, optic atrophy, and deafness
what are some associated conditions of anterior uveitis ?
seronegative arthritis - AS, psoriatic, Reiters JIA IBD sarcoidosis Behcets infection - TB, syphilis, HSV, CMV
what are some causes of optic neuritis ?
MS DM ethambutol, chloamphenicol zoster virus lyme disease
does retinal vein occlusion have RAPD?
yes
what are two complications of retinal vein occlusion?
glaucoma
neovascularisation
what are some causes of transient visual loss?
TIA, migraine
MS
subacute glaucoma
papilloedema
what investigation is good for macular degeneration ?
OCT (optical coherence tomography)
state three management options for wet ARMD?
Photodynamic therapy Intravitreal VEGF inhibitors Bevacizumab (Avastin) Ranibizumab (Lucentis) Antioxidant vitamins (C,E) + zinc
what is the commonest cause of blindness in the world?
trachoma
cataracts
glaucoma
keratomalacia (Vit A deficiency)
what investigation should be done for diabetic retinopathy?
fluorescein angiography
in diabetic CN III palsy what function might be spared? and why?
pupil may be spared
- as the nerve fibres run peripherally and receive blood from pial vessels
what is the presentation of cataracts?
increasing myopia
blurry vision
glare from lights
monocular diplopia
state some complications of cataracts surgery ?
Anterior uveitis / iritis VH Retinal detachment Secondary glaucoma Endophthalmitis
what is retinitis pigmentosa associated with?
Friedrich’s ataxia
Refsum’s disease
Kearns-Sayre Syndrome Usher’s Syndrome
what does Leukocoria mean ?
white pupil - no red reflex
what is hordeolum externum treated with?
fusidic acid
what are the causes of blepharitis ?
seborrhoeic dermatitis
staph infection
what is Lagophthalmos?
difficulty in lid closure over eye lid
what is Pinguecula?
yellow lesions on either side of cornea
what is Pterygium
growth of conjunctiva which invades cornea
what is the treatment for orbital cellulitis ?
IV Abx: Cefuroxime (20mg/kg/8h IV)
what is the presentation of carotico cavernous fistula ?
Engorgement of eye vessels Lid and conjunctival oedema, Pulsatile exophthalmos
Eye bruit
state some causes of flashes (photopsia)
headache, migraine retinal detachment (flashes and floaters)
what conditions are halos seen?
cataract,
corneal oedema, acute glaucoma (with eye pain)
what condition is zig zag lines seen?
migraines
what sign can develop with seasonal allergic conjunctivitis ?
small papillae on tarsal conjunctivae
what is the treatment for allergic conjunctivitis ?
Antazoline: antihistamine drops:
Cromoglycate: inhibits mast cell degranulation
what is the treatment for trachoma?
Tetracycline 1% ointment ± PO
what is the cause of onchocerciasis ?
Caused by microfilariae of nematode Onchocerca volvulus
what is the treatment for onchocerciasis ?
Ivermectin
what is the classification called of hypertensive retinopathy ?
Keith wagener classification
what is the keith wagener classification ?
- Tortuosity and silver wiring
- AV nipping
- Flame haemorrhages and soft / cotton wool spots 4. Papilloedema
what condition is roth spots seen ?
infective endocarditis
what systemic inflammatory disease can cause retinopathy ?
dermatomyositis
what condition can cause corneal calcification?
hyper parathyroidism
what are Kayser-Fleischer Rings?
dark rings that appear to encircle the iris of the eye. They are due to copper deposition in part of the cornea (Descemet’s membrane)
what condition causes Kayser-Fleischer Rings?
wilsons disease
what are mydriatics (Anti-Muscarinics) used for in the eye?
pupil dilation and eye examination
state some names of mydriatics ?
Tropicamide
Cyclopentolate
what is the function of miotics?
constrict the pupil
what condition is miotics used for?
acute closed angle glaucoma
what topical antihistamines can be used?
Emedastine Antazoline
what medication is used for open angle glaucoma ?
b blockers prostaglandin analogues alpha agonists carbonic anhydrase inhibitors miotics
what is the treatment for chlamydial conjunctivitis ?
oral tetracycline
what is charles bonnet syndrome ?
a type of psychophysical visual disturbance and the experience of complex visual hallucinations in a person with partial or severe blindness.
