Random Flashcards
What is Argyll Robertson pupil?
Small irregular pupils with no response to light but there is a response to accommodation
Can be caused by DM or syphilis
(Sometimes referred to as prostitutes pupil)
When would you see a dendritic ulcer on fluorescein eye stain?
In herpes simplex keratitis
What are the features of herpes simplex keratitis?
Red painful eye Photophobia Excessive watering of eyes May have decreased visual acuity Fluorescein stain may show an epithelial ulcer (dendritic ulcer)
What is the treatment for herpes simplex keratitis?
Immediate ophthalmology referral
Topical aciclovir
How are squints classified?
Classified as to where the eye deviates towards: Nose- esotropia Temporally- exotropia Superiorly- hypertropia Inferiorly- hypotropia
True or false
When you are testing for a squint you do the cover test and when you cover the unaffected eye the affected eye will move in the opposite direction to the classified squint
i.e. if it’s an Esotropic squint that would usually move towards the nose, it would move laterally when the other eye is covered
True
And well done for reading all that waffle!
What’s another word for squint?
Strabismus
What are the two types of squint?
Concomitant (common)
Paralytic (rare)
What causes a concomitant squint?
Imbalance in extraocular muscles
Convergent is more common than divergent
What causes paralytic squint?
Paralysis of the extraocular muscles
How can you treat squints?
Eye patches to prevent amblyopia (lazy eye that fails to reach full acuity)
Referral to secondary care
What condition do you think of when you hear grittiness in the eyes?
Blepharitis
What is blepharitis?
Inflammation of the eyelid margins
It may be due to meibomian gland dysfunction or seborrhoeic dermatitis/ staph infection
It is also more common in patients with rosacea
How may blepharitis present?
Bilateral Grittiness and discomfort Sticky eyes in the morning Eyelid margins may be red Styes and chalazions Secondary conjunctivitis May occur
How do you treat blepharitis?
Softening of the lid margin using hot compresses 2x a day
Mechanical removal of debris from lid margins using cotton wool buds dipped in cooled boiling water and baby shampoo
Artificial tears for symptom relief
What are the features of anterior uveitis?
Acute onset ocular discomfort and pain Pupil may be irregular and small Photophobia Blurred vision Red eye Lacrimation Ciliary flush Hypopyon- pus and inflammatory cells in the anterior chamber often resulting in visible fluid level
What conditions are associated with anterior uveitis?
Ankylosing spondylitis Reactive arthritis UC, Crohn Behçet’s disease Sarcoidosis
True or false
Anterior uveitis is associated with HLA-B27
True
How do you manage anterior uveitis?
Urgent review by ophthalmology
Cycloplegics (dilates the pupil which helps to relieve pain and photophobia) e.g. atropine, cyclopentolate
Steroid eye drops
How would you differentiate between peri orbital and orbital cellulitis?
Absence of painful movements, Diplopoda and visual impairments indicate periorbital
What is the other name for periorbital cellulitis?
Preseptal cellulitis
How would you manage periorbital cellulitis?
Refer to secondary care
Oral abz usually coamoxiclav
Children may require admission
NB bacterial infection can spread into the orbit and evolve into orbital cellulitis
Name some differentials for sudden loss of vision
Retinal detachment Vitreous haemorrhage Retinal migraine Amaurosis fugax (ischaemic event) Central retinal vein occlusion Central retinal artery occlusion
What are some causes of central retinal vein occlusion?
Glaucoma
Polycythaemia
HTN
