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Opthalmology > Revision Tutorials (important) > Flashcards

Revision Tutorials (important) Flashcards

1
Q

what does a teardrop iris suggest

A

corneal injury- teardrop will point to it

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2
Q

how does corneal injury affect vision

A

changes corneal shape

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3
Q

what must you worry about in corneal penetrating injuries

A

retinal detachment symptoms- decrease in pressure in anterior chamber causes vitreous to move forwards

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4
Q

what must you always ask to check for retinal detachment

A

floaters that persist

flashes

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5
Q

what hypersensitivity reaction is sympathetic ophthamloplegia

A

type II

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6
Q

how can a head injury affect vision

A 
visual cortex (haemorrhage/ injury) = cortical blindness 
lens dislocation (vision reduced, increased red reflex)
retinal scarring
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7
Q

what should you assume in pupil deformities

A

perforating injuries until proven otherwise (may be normal)

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8
Q

what is the seidels test

A

flood eye with fluoroscene to look for penetrating injury, aqueous coming out of eye will dilute the fluoroscene

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9
Q

what is a perforating eye injury

A

will go in and out of eye

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10
Q

what eye condition results from infection under contact lenses

A

Acanthamoeba keratitis

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11
Q

what is the advice for people who wear contacts

A

dont sleep, swim or shower in them
dont wear for more than 5 days a week
dailys are safer than monthlys

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12
Q

when does it hurt to move your eye

A

inflammation at the back of the eye

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13
Q

what is affected to causes changes in colour

A

optic nerve

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14
Q

what is affected to causes changes to visual field

A

retina

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15
Q

what does corneal reflection show

A

position of eyes when looking at same point- squints

light high in eye then eye position low

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16
Q

what is a tropia

A

one eye looking straight, one eye squint

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17
Q

what is the cover test

A

covering eye alternately whilst looking at a fixed point, individual eye should not move when the other is covered, if it does then squint in that eye

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18
Q

what are the types of tropia

A

esotropia- outward movement of eye = eye turned in
exo-eye turned out (inward movement in cover test)
hyper- eye upward
hypo- eye downward

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19
Q

do you keep your glasses on for the cover test

A

yes

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20
Q

what is the fixing eye

A

eye that doesnt move in the cover test

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21
Q

can squints alternate between eyes

A

yes but will only be in one eye at a time

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22
Q

what will give you horizontal double vision

A

inward/outward position of eye

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23
Q

what will give you vertical double vision

A

eye upward/ downward position

24
Q

how do you asses occular motility

A

take glasses off, head still, follow torch with eyes, sclera should disappear where eye is looking (position of gaze)
visible sclera= weak muscles

25
Q

what is the primary position of the eye

A

looking forward

26
Q

how do you test each eye muscle

A 
up= SR/IO
up and in= IO
medial= medial rectus 
down and in= SO
down= SO/IR
down and out= IR
lateral= LR
up and out= SR
27
Q

where will double vision be the worst

A

where the muscle is the weakest

28
Q

what causes a horizontal diplopia

A

eso/exo tropia

29
Q

what causes a vertical diplopia

A

hyper/hypo tropia

30
Q

what diplopia will a 6th nerve palsy create

A

horizontal

31
Q

what is seen in a 3rd nerve palsy

A

MR, SR, IR, IO weakness
ptosis
pupil dilated

eye goes out and down in III nerve palsy as LR strongest muscle

32
Q

what is seen in a 4th nerve palsy

A

eye will elevate (as SO weak)

33
Q

why can nerves 3,4 and 6 all be affected at the same time

A

as all in cavernous sinus

34
Q

what are the most common causes of squint in the elderly

A

microvascular: diabetes, hypertension, hyperlipidaemia, age, hypercoagulability

35
Q

what nerve is at risk from whiplash injuries

A

4th (exits brain posteriorly)

36
Q

what causes a squint in children

A

raised ICP, shunt, viral, trauma

37
Q

what is visual acuity

A

the resolving power of the eye, ability to differentiate between two points

38
Q

how far away should a snellen chart be

A

6 meters

39
Q

how do you document a snellen chart result

A 
meters away/ line of letters  
- how many you got wrong
u/a unaided 
\+PH with pinholes 
\+ glasses

e.g. 6 (meters)/ 9 -1

40
Q

what can pinholes tell you

A

if vision blurring is down to needing glasses/ new prescription

41
Q

in your osce do you leave glasses on or off to do visual acuity

A

with glasses

can use pinholes use glasses to see if vision changes are just because they need glasses or a new prescription

42
Q

what happens if the patient can see the top letter at 3 meters

A

test if they can count fingers right infront of face (CF)
if not if they can see hand waving (HM)
if not if they can see light (POL)
if not= no perception of light (NPOL)

43
Q

what does close vision test

A

macula function
hold page at natural reading distance
smaller the number smaller the writing they can read

44
Q

how do you test the vision of babies/ children

A

babies differential vision - barcodes that get finer and finer

children shapes/ toys that they can point to

45
Q

why do you look into the distance to get pupils

A

so they dont accommodate to the light

46
Q

what does a swinging light test for

A

RAPD

47
Q

what does fluoroscein angiography test for

A

ocular circulation

48
Q

what happens to the macular is wet ARMD

A

is elevated by exudative fluid produced by a subretinal choroidal neovascular membrane

49
Q

what is the treatment for wet ARMD

A

intravitreal antiVEGF injections (only works in early cases)

50
Q

what can happen in neovascularisation of the optic disc

A

sight threatening
vitreous haemorrhage
sudden visual loss

51
Q

what is the treatment for optic disc neovascularisation

A

pan retinal laser photocoagulation (reduces hypoxic drive)

52
Q

what happens to the optic disc in glaucoma

A

enlargement of the optic cup as nerve fibres are lost in the neuroretinal rim
may be bayonetting of the vessels as the follow the deepened disc contour

53
Q

what is a normal cup to disc ratio

A

0.2-0.6

54
Q

what should a normal optic disc look like

A

neuroretinal rim (nerve fibre layer) is pink and even in thickness

55
Q

what is the cup to disc ratio in advanced glaucomatous cupping

A

0.9-1

56
Q

what is temporal cresent pigmentation found in

A

glaucoma

57
Q

what are the features of papilloedema

A

obscured disc margins, optic cup is lost, may be haemorrhages on the elevated optic disc surface or margin, dilated vessels at the disc

Opthalmology (16 decks)

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