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Phase3 Specialties - Imperial College London MBBS > UKMLA Ophthalmology > Flashcards

UKMLA Ophthalmology Flashcards

1
Q

Which ethnicity is more prone to developing primary open-angle glaucoma?

A

Black Africans

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2
Q

What is the characteristic visual defect associated with Primary Open Angle Glaucoma?

A

Halos and tunnel vision
PAINLESS visual loss of the peripheral field

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3
Q

What is the fundoscopy finding associated with Primary Open Angle Glaucoma?

A

Cupping of the optic disc with a thin neuroretinal rim

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4
Q

What is the gold-standard investigation indicated to diagnose Primary Open Angle Glaucoma?

A

Goldmann applanation tonometry - measures intraocular pressure

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5
Q

What is the first line topical drug for the management of Primary Open Angle Glaucoma?

A

Topical prostaglandin analogue e.g., latanoprost

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6
Q

What is the mechanism of action of prostaglandin analogues

A

Increases aqueous outflow

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7
Q

Hypertrichosis is an adverse effect associated with which drug implicated in the management of Primary Open Angle Glaucoma?

A

Prostaglandin analogues

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8
Q

What is the mechanism of action of beta-blockers in the management of Primary Open Angle Glaucoma?

A

Reduces aqueous production

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9
Q

What is the indication for selective laser trabeculoplasty or surgery for the management of Primary Open Angle Glaucoma?

A

if IOP >24

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10
Q

What is the clinical difference in visual loss presentation between closed-angle versus open-angle glaucoma?

A

Closed angle = painful

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11
Q

A fixed mid-dilated pupil is associated with which type of glaucoma?

A

Closed-angle glaucoma

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12
Q

What is the clinical presentation of closed-angle glaucoma?

A
  • Acute red, painful eye
  • Hazy cornea
  • Corneal oedema
  • Blurred vision
  • Decreased visual acuity
  • Worse with mydriasis (e.g., watching TV in a dark room)
  • Haloes around lights
  • Lacrimation
  • Firm eyeball
  • Fixed mid-dilated pupil
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13
Q

Which investigation is indicated in closed-angle glaucoma to visualise the angle?

A
  • Gonioscopy
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14
Q

What is the first line management of closed-angle glaucoma?

A
  • Emergency (same day) referral to ophthalmologist

+ miotic agent e..g, pilocarpine

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15
Q

How does pilocarpine work?

A

Causes contraction of the ciliary muscle to open the trabecular meshwork

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16
Q

Which drug reduces the production of aqueous humour and is indicated in the the management of closed-angle glaucoma?

A

o Oral or IV carbonic anhydrase inhibitor (e.g., acetazolamide)

17
Q

What is the definitive management of closed-angle glaucoma?

A

Laser peripheral iridotomy

18
Q

Which organism is implicated in the contact-lens keratitis?

A

Pseudomonas aeruginosa.

19
Q

What is the management of herpes simplex keratitis?

A

Topical acyclovir 5 times/day, for 2 weeks

20
Q

What is the management of contact-lens keratitis?

A

Urgent ophthalmologist referral for ulcer scraping and topical fluoroquinolone (e.g., ofloxacin, levofloxacin, or moxifloxacin). Discontinue contact lens until symptom resolution.

21
Q

Which stain is used to identify dendritic ulcers in HSV keratitis?

A
  • Fluorescence stain
22
Q

What is the presentation of keratitis?

A
  • Photophobia
  • Lacrimation
  • Painful, red-eye
  • Foreign body, gritty sensation
  • Diminished visual acuity
23
Q

A foreign body gritty sensation and painful red eye is associated with which eye condition?

A

Keratitis

24
Q

What is the management for keratitis?

A

Urgent referral

25
Q

Tractional retinal detachment is associated with which pathology?

A

Proliferative diabetic retinopathy

26
Q

What is the most common cause of retinal detachment?

A

Rhegmatogenous (commonest form) – as the vitreous shrinks and partly separates from the retinal surface, a retinal tear may arise, allowing fluid to enter the subretinal space precipitating retinal detachment

27
Q

Floaters and flashers + shadow curtain involvement of visual loss is associated with what diagnosis?

A

Retinal detachment

28
Q

What fundoscopic finding is observed in patients with retinal detachment?

A

Asymmetrical red reflex

29
Q

What is the definitive management for retinal detachment?

A

Laser therapy

Vitrectomy

Phase3 Specialties - Imperial College London MBBS (8 decks)

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