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opthalmology > teach > Flashcards

teach Flashcards

1
Q

which wall of the bony orbit is most commonly affected by blow-out fracture? - this on the eye

A

inferior wall

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2
Q

what extra ocular muscle elevates the eyeball

A

inferior oblique

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3
Q

which 2 structures form the outer fibrous coat of the eyeball

A

sclera and cornea

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4
Q

which 3 structures make up the uvea( 2nd layer of the eye)

A

iris, ciliary body , choroid

3 layers
outer fibrous coat - sclera and cornea
uvea next layer made up of iris, ciliary body and choroid
retina

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5
Q

cones ( distinguish between different colours) are mainly found in the fovea/macula

A

true

rods are for not vision and low light Vision

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6
Q

in which structure is aqueous humour produced

A

ciliary body

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7
Q

50yr old lady present with very painful red eye, cause and vomit, halos around Leith and blurry vision. she has hazy cornea and visual acuity

A

acute glaucoma

temporal arthritis - scalp tenderness and proximal muscle weakness

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8
Q

treatment for acute angle glaucoma

A

IV acetazolamid and timolol and apraclonidine and predinsiolve

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9
Q

buzz word

fixed mid-dilated pupil

A

acute angle glaucoma

also blurry vision
red painful eye
N+V and fixed mid-dilated pupil

diagnosed via a slit lamp

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10
Q

in acute angle closure glaucoma do you give treatment to both eyes or the affected

A

both due to the fact they are high risk

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11
Q

is hypermetropia(long sited) a rf for acute glaucoma

A

yes

myopia short sited - does not predispose them to it

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12
Q

a man present with 2 weeks of a painless rubbery eyelid lump what is it

stye
chalazion
pterygium
dacrocystitis

A

chalazion

more likely than a stye

painful Lump would have been a stye

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13
Q

a chalazion is granuloma due to blocked meibomian gland. RF include blepharitis and rosacea what are the symptoms and treatment

A

painless lump which is rubbery

hot compress, usually self resolves in 6 months , curettage is option

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14
Q

what is a stye

A

infection of lash follicle glands by staph

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15
Q

RF for stye include acne vulgarisms and DM

what are symptoms and treatment

A

painful lump in lid margin and swelling
maybe eyelash coming out

hot comrpee, topical antibiotics and eyelid hygiene and eyelash removal

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16
Q

68yr old man with several months of itchy sore eyes in the morning

trichiasis
corneal abrasion
blepharitis
entropion

A

blepharitis - inflamed lash line or lid margin

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17
Q

blepharitis is chronic inflammation of eyelid margin with infection or not - flakey

RF are atopic eczema dn seborrhaeic dermatitis

clinical features include

treatment

A

itchy sore eyes in the morning, crusty/scaly/oily lid margin

eyelid hygien and topical doxycycline if infection

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18
Q

is blepharitis is chronic condition

A

yes

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19
Q

35 woman with kitty eyes tremor on outstretched hands and pulse of 110bpm

parkinsons
thyroid eye diseas e
ectropion
bacterial endophthalmitis

A

thyroid eye disease

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20
Q

thyroid eye disease can result from people with graves disease with antibodies against TSH causing orbital inflammation

what are the sytmtposm and treatment

need to check TFTs

A

exophthalmos( immune response not the thyroid hormones causing this) ( kitty eyes) and lid lag accompanied
tremor and pusle
( symptoms same of hyperthryosidim )

antithyroid medications and surgery

TSH levels not raised in grave

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21
Q

6oyr odl man presents following seizure, left parietal mass what visual defect is he most likely to have?

A

right inferior quadrantopia

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22
Q

damage in cranial nerve get

A

monocular vision loss

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23
Q

damage to optic chaism

A

bitemporal hemianopia

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24
Q

damage to optic tract

A

homonymous hemianopia

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25
Q

optic tract meet maternal geniculate uncles. one goes through temporal and one through parietal lobe.

temporal lobe is inferior to parietal lobe it takes things form the superior optic radiation

and the partial lobe gets it from the inferior optic radiation

A

visual field defects

26
Q

pituitary tumour classically cause what visual field defect

A

bitemporal hemianopia

27
Q

60yr old patient with diabetes preens with gradual deterioration of vision and dazzling of view in well lit places

A

cataracts

28
Q

cataracts is lens opacity, risk facts are age and diabetes and stereo smoking and alto sue and genetics

diagnosis’s via slit lamp

treatment via phaecoemulfificaiton and lens implant

symtposm

A

bilateral painless blurring of vision over years, glare whilst driving at night

cataracts does not require urgent surgery

29
Q

RA severe eye pain and dominant blood vessels on either side of eyes

A

scleritis

30
Q

scleritis is inflammation of the sclera and RF include ocdntions such as RA, GP And polyarteritis ndoosa

symptoms are

diagnosis are ophthalmology examination and rheumatology review - could be flare

A

red eye, deep boring pain on the eyes, pain on movement , photophobia and decreased acuity

Treatment with high dose seteriods and DMARDS

31
Q

sudden loss of vision in right eye. hypertension , hyperlipidemain and diabetes and carotid bruit on examination

A

central retinal artery occlusions

pale retina with cherry red spot - stroke int eh artery

32
Q

central retinal artery occlusion is stroke of central retinal artery RF including CVD and stroke and carotid disease

symptoms are

A

sudden painless monocular severe visual loss and pale retina dn cherry red spot.

treatment is excluded giant cell arteritis ( temporal arteritis - check CRP or ESR) , stroke work up and according to local protocols

easily treateded with steroids

33
Q

which is typical appearance of a retina with CRAO

A

pale retina with cherry red spot

34
Q

CMV retinitis

A

pizza-pie appearance

35
Q

retinitis pigmentosa

A

bone spicule pigmentation

36
Q

central retinal vein occlusion

A

stormy sunset appearance

exactly same symptoms as arteries

37
Q

60 yr old man if refereed to you by opticiity after fundoscopy

shown eye with big bright spot

A

(chronic) glaucoma

38
Q

chronic glaucoma is progressive characteristic of optic nerve damage and visual field losss. RF is age , raised intracoular pressure , black African and high myopia

symtposm are

diagnose is slit lamp exam ( CDR>1/3, gonioscopy , perimetry and tonometry

treatment is

A

none until late
acute scotoma
peripheral VL
spot needs to be bigger than 1/3

topical latanoprost and trabeculoplasty, trabeculectomy

advanced cases tunnel vision only can see through there macula

39
Q

myopia is a risk factor for chronic glaucoma

A

yes but not for acute angle closure glaucoma

40
Q

10 yr old male with right eye difficult to open after sleep, diffuse conjunctival injection and significant mucopuruletn discharge

A

bacterial conjunctivitis

red/pink eye and itchy if allergic , one purulent if bacterial

treatment for bacterial is chloramphenicol if docent resolve

allergic avoid allergen and antihistamines
viral self resolves

41
Q

what is visual acuity

A

Visual acuity (VA) is a measure of the ability of the eye to distinguish shapes and the details of objects at a given distance.

42
Q

on routine review of diabetic man has this eye

cataract
diabetic retinopathy
age related macular degneraton or glaucoma

A

diabetic retinopathy

43
Q

diabetic retinopathy one of the microvasuclar complications- include chronic hyperglycaemia causing cap damage
RF are DM fro over 20 years
clinicla features include painless bilateral VL

exudates and haemorrhage

treatment is

A

strict glycemic control

panretinal photocoagulation PRP

intravitreal anti-VEGF

44
Q

3 microvascular complications of diabetes

A

retinopathy
nephrotpathy
neuropahty

45
Q

previously healthy 63yr old man left eye pieced by intermitted flashes and curtain like loss of lateral vision that began when he woke up

A

retinal detachment

46
Q

retinal detahcenet is neural retina separation from RPE , high myopia, trauma and age and strong sneeze are RF - clinical features

treatment

A

flashes and floaters
curtain coming down

diagnosed on fundoscopy

time critical surgery - gas tamponade

47
Q

does myopia increase the risk of retinal detachment

A

yes

48
Q

24yr old man acutely with pain in left eye. Temp of 39 and redness and swelling of completely closed left eye

A

orbital cellulitis

if eyes shut means eyelids are shut

ifnalmmtion of the skin

49
Q

orbital cellulitis is infection orbital contents and often secondary to sinusitis or ethmoidist as comes in resent with eyelid inflation and pain of eye, proptosis fever and chills. diagnoses via septic screen and CT/MRI

treatment is

A

IV broad spectrum antibiotics

ENT and ophthalmology

50
Q

what infection precedes orbital cellulitis

A

sinusitis

51
Q

79 yr odl man noticed vision has worsteds over last year

treatment of this

A

age related macular degeneration

age main risk factors

druse in back of the eye causing loss of central vision ( opposite to glaucoma which is peripheral )

lifestyle changes and Anti-VEGF in wet

52
Q

drusen are pathogenic of macular degeneration

A

true - more specifically dry macular degeneration

53
Q

40yr old man with cilia injection , hypo-yon , photopbia and a small pupil and eye pain when reading

A

anteriro uveitis

3rd and 6h never palsy cause diplopia

54
Q

anterior uveitis/ iritis

ifnalmtion or the iris

major risk factors

symtposma re painful red eye with photophobia and hypopyon( pus in cornea) , blurring and perilimbial injection ( redness round the cornea) and cells and flares on slit lamp

treatment is what

A

ankylosing spondylitis and reactive arthritis and RA

topical corticosteroids and treat underlying cause of rheumatoid condition

55
Q

which gene is most associated with antihero uveitis

A

HLA - B27 - the one with ankylosing spondylitis

56
Q

30yr lady with acute blurring visionamdn eye pain fundoscopy revealed blurred disc marginal and an elevate disc

A

optic neuritis

57
Q

optic neuritis is idiopathic and ifnalmmtion of optic nerve - MS too

RF anre MS and NMO and MOG

acute unilateral VL , pain on eye movements, RAPD, central scotoma ,and papillitis

MRI scan

treatment is

A

steroids and joint ophthalmology and neuroblastoma

58
Q

50yr old women with painful red eye. Dendritic ulcer is diagnosed after flurosecin stain under blue light

A

keratitis

59
Q

infective keratitis is infection of the cornea - viral bacteria fungal or acanthamoeba

rf is people who wear contact lens , cold sores or immunosuppreison

symtpsom

what is the treatment

A

round ulcer - bacterial
dendritic ulcer if HSV

diagnose if corneal scraping to get organism

treatment is empriaicla topical antimicrobials and modify based on MCS

60
Q

pain out of proportion to clinic signs what type of keratitis would you suspect

A

acanthoamoeba

the eye looks normal but a lot of pain

opthalmology (2 decks)

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