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Ophthalmology -FA > Refractive errors - Cataract - Glaucoma > Flashcards

Refractive errors - Cataract - Glaucoma Flashcards

1
Q

Refractive errors - correctable or not?

A

correctable with glasses

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2
Q

Refractive errors - types

A
  1. Hyperopia
  2. Myopia
  3. Astigmatism
  4. Presbyopia
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3
Q

hyperopia - mechanism

A

Eye too short for refractive power of cornea and lens

–> light focused behind retina

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4
Q

Myopia - mechanism

A

eye too long for refractive power of cornea and lens –> light focused in front of retina

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5
Q

Astigmatism - mechanism

A

abnormal curvature of cornea –> different refractive power at different axis

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6
Q

Presbyopia - mechanism

A

Age - related impaired accommodation (focusing on near objects), 1ry due to decreased lens elasticity

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7
Q

Cataract - definition

A

opacification of lens

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8
Q

Cataract - unilateral or bilateral / type of pain

A
  • often bilateral

- painless

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9
Q

Cataract often results in

A

decreased vision

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10
Q

Cataract - risk factors (10)

A
  1. increased age 2. ethanol 3. prolonged corticosteroid use 4. Diabetes mellitus (sorbitol) 5. trauma 6.smoking 6. excessive sunlight 7. infection
  2. congenital risk factors (a. classic galactosemia, b. galaktokinase deficiency, c. trisomies (13, 18, 21),
    d. Torches infection, e. Marfan f. Alport g. Mytonic dystrophy h. Neurofibromatosis 2)
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11
Q

Uveitis - definition

A

inflammation of uvea

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12
Q

uveitis is divided to (according the place) (AKA)

A
  1. anterior uveitis (iritis)
  2. intermediate uveitis: pars planitis
  3. posterior uveitis (choroiditis and/or retinitis)
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13
Q

Uveitis may have - symptoms/findings

A
  1. hypopyon (accumulation of pus in anterior chamber)

2. conjuctival redness

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14
Q

Uveitis is associated with

A

systemic inflammatory disorders:

  1. Sarcoidosis 2. Rheumatoid arthritis 3. juvenile arthritis
  2. Bechet disease 5 . HLA-B27
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15
Q

HLA associated with Uveitis

A

HLA-B27

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16
Q

optic disc is AKA

A

optic nerve head

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17
Q

optic disc is

A

the point of exit for ganglion cell axons leaving the eye.

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18
Q

The optic disc is shaped like a (and why)

A

doughnut with a pink neuroretinal rim and a central white depression called the physiologic cup.

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19
Q

Glaucoma - definition

A

optic atrophy with characteristic cupping, usually elevated intraocular pressure and progressive peripheral visual field loss

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20
Q

Glaucoma - characteristic cupping

A

thinning of outer rim of the optic nerve head versus normal

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21
Q

Glaucoma - intraocular pressure

A

usually elevated

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22
Q

glaucoma is divided to

A
  1. open angle

2. closed angle

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23
Q

open angle glaucoma is associated with

A
  1. increased age
  2. African american race
  3. family history
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24
Q

open angle glaucoma is divided to

A
  1. primary

2. secondary

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25
Q

causes of primary open glaucoma

A

unclear

26
Q

causes of secondary open glaucoma

A

blocked trabecular meshwork from

a. WBC (eg uveitis)
b. RBCs (eg vitreous hemorrhage)
c. retinal elements (eg retinal detachment)

27
Q

open angle glaucoma special characteristic

A

PAINLESS

28
Q

closed/narrow angle - divided to

A
  1. primary 2. secondary
    or
  2. chronic closure 2. acute closure
29
Q

primary closed/closed narrow angle - mechanism

A

enlargement or forward movement of lens against central iris (pupil margin) –> obstruction of normal aqueous flow through pupil –> fluid builds up behind iris, pushing peripheral iris against cornea and impeding flow through trabecular meshwork

30
Q

secondary closed/narrow angle - mechanism

A

hypoxia from retina disease (diabetes mellitus, vein occlusion) –> vasoproliferation in iris that contracts the angle

31
Q

disease associated with secondary closed/closed narrow angle

A
  1. diabetes mellitus

2. vein occlusion

32
Q

chronic closed/narrow angle - symptoms and findings

A
  1. often asymptomatic
  2. damage to optic nerve
  3. damage to peripheral vision
33
Q

acute closed/narrow angle is a ….

A

true ophthalmic emergency

34
Q

acute closed/narrow angle - mechanism

A

elevated intraocular pressure pushes iris forward –> angle closes abruptly

35
Q

acute closed/narrow angle - do not give (and why)

A

epinephrine because of its mydriatic effect

36
Q

acute closed/narrow angle - symptoms and signs

A
  1. very painful
  2. red eye
  3. sudden vision loss
  4. halos around halos
  5. rock hard eye
  6. frontal headache
37
Q

congenital risk factors for cataract a. classic galactosemia, b. galaktokinase deficiency, c. trisomies (13, 18, 21),
d. Torches infection, e. Marfan f. Alport g. Mytonic dystrophy h. Neurofibromatosis 2)

A

a. classic galactosemia, b. galaktokinase deficiency, c. trisomies (13, 18, 21), d. Torches infection e. Marfan f. Alport g. Mytonic dystrophy h. Neurofibromatosis 2

38
Q

Conjunctivitis - definition/presentation

A

inflammation of the conjuctiva –> red eye

39
Q

Conjunctivitis - types and presentation (and MC)

A
  1. Allergic –> itchy eyes
  2. Bacterial –> pus
  3. Viral (MC)–> sparse mucous discharge, swollen preauricular node
40
Q

Conjunctivitis - treatment

A

bacterial –> antibiotics

viral –> self resolving

41
Q

viral conjunctivitis is often due to

A

adenovirus

42
Q

allergic conjunctivitis - characteristic

A

bilateral

43
Q

Viral vs bacterial conjunctivitis - transmissible

A

Virus easy

Bacterial poorly

44
Q

Viral vs bacterial conjunctivitis - adenopathy

A

Only virus (preauricular)

45
Q

characteristics of Viral conjunctivitis

A

bilateral, Watery discharge, easily transmissible, normal vision. itchy, preauricular adenopathy, no specific therapy

46
Q

characteristics of Bacterial conjunctivitis

A

unilateral, purulent + thick discharge, poorly transmissible, normal vision, not itchy, no adenopathy, topical antibiotics

47
Q

red eye (opthalmologic emergencies) - types and presentation

A
  1. conjunctivitis: itchy eyes with discharge
  2. uveitis autoimmune disease
  3. glaucoma: pain
  4. abrasion: trauma
48
Q

red eye (opthalmologic emergencies) - types and eye findings

A
  1. conjunctivitis: normal pupil
  2. uveitis: photophobia
  3. glaucoma: fixed midpoint pupil
  4. abrasion: like sand in the eye
49
Q

red eye (opthalmologic emergencies) - types and most accurate test

A
  1. conjunctivitis: clinical diagnosis
  2. uveitis: slit lamp examination
  3. glaucoma: tonometry
  4. abrasion: fluorescein stain
50
Q

red eye (opthalmologic emergencies) - types and best initial therapy

A
  1. conjunctivitis: topical antibiotics
  2. uveitis: topical steroids
  3. glaucoma: acetazolamide, mannitol, pilocarpine, laser trabeculoplasty
  4. abrasion: no specific therapy, patch not clearly beneficial
51
Q

glaucoma treatment if medical treatment fails

A

laser trabeuloplasty

52
Q

it can precipitate closed angle glaucoma

A

walking into a dark rook can precipitate pain because of pupillary dialation (SOS)

53
Q

acute angle-closure glaucoma - the diagnosis is confirmed by

A

tonometry

54
Q

acute angle-closure glaucoma - treat with (and why)

A
  1. IV acetazolamide
  2. IV mannitol: osmotic driving of fluid out of the eye
  3. Pilocarpie, beta-blockers and apracloinidine to constrict the pupil and enchance and enchance drainage)
  4. laser iridotomy
55
Q

keratitis - definition / presentation

A

infection of cornea

the eye may be very red, swollen and painful, but do not use steroids

56
Q

hepres keratitis - never use …. (why)

A

steroids –> make it worse / increase the production of the virus

57
Q

hepres keratitis - diagnosis

A

Fluorecein staining of the eye helps confirm the dendritic pattern seen on examination

58
Q

hepres keratitis - treatment

A

oral acyclovir, famciclovir or valacyclovir

topical anthepretic treatment is trifluridine and idoxuridine

59
Q

Cataracts - diagnosis

A

early Cataracts: ophthalmoscope or slit lamp exam

advanced: visible on examination

60
Q
  1. Hypertropia is corrected by

2. myopia is corrected by

A
  1. convex lens

2. biconcave lens

61
Q
  1. astigmatism is corrected by

2. presbyopia is corrected by

A
  1. cylindric lens

2. convex lens

Ophthalmology -FA (9 decks)

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