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Y2 Ophthalmology > Week 2 > Flashcards

Week 2 Flashcards

1
Q

Mechanisms of ocular trauma

A

Blunt trauma
Penetrating trauma
Burns (chemical / physical)

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2
Q

What can blunt trauma lead to

A

Blowout fractures
Subconjunctival haemorrhage
Globe rupture
Hyphaemia
Traumatic uveitis

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3
Q

What injury mechanism can cause blowout fracture

A

Direct blow to the central orbit by fist/ ball

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4
Q

What can happen as a result of blowout fracture

A

Herniation
Trapdoor fracture

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5
Q

Which structure is likely to herniate in a blowout fracture

A

Inferior rectus muscle
Orbital fat

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6
Q

Where does the herniates go into

A

Maxillary sinus

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7
Q

Inferior rectus muscle herniation can cause

A

Diplopia
when ask the patient to look up, one eye cannot move up

But when ask the patient to look down, both eyes can

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8
Q

What is subconjunctival haemorrhage

A

Rupture of blood vessels in conjunctiva, releasing the blood into the space between conjunctiva and sclera

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9
Q

Besides from trauma, what else can cause subconjunctival haemorrhage

A

Heavy coughing
Strenuous exercise
Straining when constipated

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10
Q

What is hyphaemia

A

Blood in anterior chamber

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11
Q

What is traumatic uveitis

A

Inflammation of iris due to eye trauma

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12
Q

What is the urea

A

Layer behind the conjunctiva and sclera, containing iris, choroid and ciliary body

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13
Q

Why are corneal abrasions very sore

A

Due to dense sensory innervation of the cornea

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14
Q

What can be used to check for corneal lacerations

A

Fluorescein stain drops

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15
Q

Management of corneal laceration

A

Remove the foreign body causing it
Ocular lubricants
Analgesia
chloramphenicol if risk of infection

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16
Q

What is myotonic dystrophy

A

Group of inherited conditions that show muscle weakness and myotonia

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17
Q

What is myotonia

A

inability to relax after muscle contraction

18
Q

types of myotonic dystrophy

A

Classic dystrophia myotonica 1 (DM1)
Type 2 myotonic dystophy (DM2)

19
Q

Which type of myotonic dystrophy is more common

A

Classic dystrophia myotonica 1 (DM1)

20
Q

Myotonic dystrophia most commonly present at

A

20 years old

21
Q

Cause of classic dystrophia myotonic 1

A

Mutation in DMPK gene

22
Q

Presentation of myotonic dystrophia

A

Frontal balding in males
Long and thin face
Bilateral ptosis
Cataracts
Slurred speech
Loose jaw (mournful facial expression)
Muscle wasting and weakness

23
Q

What causes slurred speech in myotonic dystrophia

A

Myotonic tongue and pharyngeal muscles

24
Q

What cataracts are seen in myotonic dystrophia

A

Stellate posterior cortical cataract
Polychromatic cataract (Christmas tree)

25
Q

What physical test can be done to identify myotonic dystrophia

A

Shake the patient’s hand - the patient will be unable to release their hand due to myotonia

26
Q

What is neurofibromatosis type 1

A

Genetic condition that causes tumours along the nervous system

27
Q

Cause of neurofibromatosis type 1

A

NF1 gene mutation

28
Q

Presentation of neurofibromatosis type 1

A

> 6 cafe au last spots that are >5mm (pre puberty) or >15mm (post puberty)
Axillary or inguinal freckling
2 neurofibromas of any type on skin
Optic glioma
2 Lisch nodules

29
Q

What is optic glioma

A

slow-growing brain tumor that arises in or around the optic nerve

30
Q

What are Lisch nodules

A

Iris hamartomas (benign) that are seen as brown patches on the iris

31
Q

What can optic glioma result in

A

Afferent pupillary defect
Globe proptosis (the tumour is pushing the eyeball out)

32
Q

What is afferent pupillary defect

A

pupils respond differently to light stimuli

33
Q

Which thyroid disease causes eye disease

A

Grave’s - hyperthyroidism

34
Q

How does thyroid eye disease occur

A

Autoimmune disease caused by the activation of orbital fibroblasts by autoantibodies directed against thyroid receptors

35
Q

Presentation of thyroid eye disease

A

Proptosis (unilateral / bilateral)
Lid retraction
Red, watery eyes
Optic neuropathy (as the swelling worsens and compresses the optic nerve)

36
Q

How does proptosis occur in thyroid eye disease

A

The autoantibodies target the extra ocular muscles and orbital fat which causes swelling behind the eye hence pushes the eyeball out

37
Q

What habit can worsen thyroid eye disease

A

Smoking

38
Q

Complications of thyroid eye disease

A

Optic neuropathy
Exposure keratopathy
Double vision

39
Q

What is exposure keratopathy

A

corneal damage and infection occurs as the patient is unable to close their eyes

40
Q

What causes double vision in thyroid eye disease

A

Fibrosis of the extra-ocular muscles limiting the gaze in certain directions

Y2 Ophthalmology (8 decks)

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