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JL Opthalmology > Week 2 > Flashcards

Week 2 Flashcards

1
Q

How can you identify areas of epithelila loss?

A

Fluorescein drops

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2
Q

What can traumatic uveitis present with?

A

Dilated pupil, sensitive to light

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3
Q

What is a hyphaema?

A

Blood (red blood cells) in the anterior chamber

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4
Q

What is a hypoium?

A

White blood cells in anterior chamber

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5
Q

What test can be done for a penetrating injury?

A

Siedels test

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6
Q

What condition results from penetrating injury to one eye, autoimmune reaction in BIOTH eyes, inflammation in BOTH eyes and may lead to bilateral blindness?

A

SympATHETIC OPHTHALMIA

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7
Q

What might a hammer and chisel injuries cause to eye?

A

Intra-ocular foreign bodies

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8
Q

What should you always do when suspecting an intra-ocular foreign body?

A

X-ray

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9
Q

What substance can give cicatrising changes to conjunctiva and cornea?

A

Alkali

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10
Q

What might limbal ischaemia present like?

A

China white sign

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11
Q

What must be done for chemical injuries to eyes?

A

Thorough irrigation

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12
Q

What substances should you be aware of in chemical injuries?

A

Lime and cement

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13
Q

What should be used for irrigation?

A

2l saline

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14
Q

What is the term for swollen spotic discs secondary to raised intracranial pressure?

A

Papilloedema

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15
Q

What should all patients with bilateral optic disc swelling be suspected of having?

A

Raised ICP due to space occupying lesion

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16
Q

What does interruption of axoplasmic flow and venous congestion cause?

A

Swollen discs

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17
Q

What three components make up intracranial pressure?

A

Brain - 80%
Blood - 10%
CSF - 10%

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18
Q

Whast should you always check with patients with raised intracranial pressure and disc swelling?

A

Blood pressure

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19
Q

Where is most CSF produced?

A

In lateral ventricles by choroid plexus

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20
Q

What exam is ophthalmoscopy a part of?

A

Cranial nerve 2 examination

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21
Q

What type of age related macular degeneration can cause sudden visual loss?

A

Wet type

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22
Q

What presents with sudden visual loss, painless, RAPD and pale oedematous retina with threat like retinal vessels?

A

Occlusion of retinal circulation - central retinal artery occlusion

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23
Q

How do you manage CRAO within 24 hours?

A

Ocular massage - try to convert CRAO to BRAO

cAROTID Doppler

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24
Q

Name two variants of retinal artery occlusion?

A

Branch retinal artery occlusion

Amaurosis fugax - transient CRAO

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25
Q

What presents with transient painless visual loss, like a curtain coming down and lasts 5 minutes with full recovery?

A

Transient CRAO - amaurosis fugax

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26
Q

How do you manage amaurosis fugax?

A

Immediate referral to TIA clinic

Aspitin

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27
Q

What presents with sudden visual loss, moderate to severe visual loss, retinal haemorrhages, dilated tortuous veins and disc swelling and macular swelling?

A

CRVO

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28
Q

Name a drug used to treat CRVO?

A

anti-VEGFs

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29
Q

What is the difference in colour between artery vs vein occlusion?

A

Artery goes pale

Vein goes dark

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30
Q

How does the optic nerve head circulation become occluded in ischaemic optic neuropathy?

A

Posterior ciliary arteries become occluded resulting in infarction of the optic nerve head

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31
Q

Name two types of ischaemic optic neuropathy that cause sudden, profound visual loss with swollen disc?

A

Arteritic - inflammation (GCA)

Non-arteritic

32
Q

What signs are seen in ION?

A

Pale, swollen disc

33
Q

What presents with loss of vision, floaters, loss of red reflex, haemorrhage on fundoscopy?

A

Vitreous haemorrhage

34
Q

How is vitreous haemorrhage treated?

A

Vitrectomy

35
Q

What presents with painless loss of vision, sudden onset of flashes/floaters, may have RAPD and the management is usually surgical?

A

Retinal detatchment

36
Q

What involves new blood vessel growth under retina - leakiage causing build up of fluid/blood and eventually scarring?

37
Q

What are the symptoms and signs of wet ARMD?

A

Rapid central visual loss
Distrortion
Haemorrhage/exudate

38
Q

How is wet ARMD treated?

A

Anti-VEGF treatment - injected into vitreous cavity. stops new blood vessels growing by binding to VEGF

39
Q

How might gradual visual loss present with early and late?

A 
Early = redduced VA
Late = decreased visual field
40
Q

List the causes of gradual visual loss? cardigan

A
  1. Cataract
  2. Age related macular degeneration (dry)
  3. Refractive error
  4. Diabetic retinopathy
  5. Inherited diseases - retinitis pigmentosa
  6. Glaucoma
  7. Access to eye clinic - non-urgnet
41
Q

What drugs can cause cataracts?

42
Q

What are the symptoms and signs of dry ARMD?

A

Gradual decline in vision and central vision missing (scotoma)
Drusen - build up of waste products below RPE
Atrophic patches of retina

43
Q

What is myopia?

A

Short sighted

44
Q

What is hypermetropia?

A

Long sighted

45
Q

What is astigmatism?

A

Usually irregular corneal curvature

46
Q

What is the term for progressive optic neuropathy?

47
Q

What do patients with closed angle glaucoma present with?

A

Painful, red eye/visual loss, headache, nausea and vomiting

48
Q

Give some signs of open angle glaucoma?

A

Cupped disc
Visual field defect
May or may not have IOP

49
Q

Is the epithelium liphobic or hydrophobic?

A

Hydrophobic

50
Q

Is the stroma hydrophobic or hydrophilic?

A

Hydrophilic

51
Q

What type of drugs penetrate the epithelium and what ones penetrate the stroma?

A

Lipid soluble drugs - epithelium

Water soluble drugs - stroma

52
Q

Name a drug with both lipohpilic and hydrophilic properties?

A

Chloramphenicol

53
Q

Name two substances which make steroids more hydrophobic?

A

Alcohol or acetate

54
Q

Name a substance which makes steroids more hydrophilic?

55
Q

Which one - pred acetate or pred phosphate has better penetration in uninflamted cornea?

A

Prednisolone acetate

56
Q

Name a preservative which disrupts lipid layer of tear film and enhances corneal penetration?

A

Benzalkonium

57
Q

What two eye side effects can steroids cause?

A

Cataract and glaucoma

58
Q

Name the first line glaucoma medication?

A

Prostanoids - latanoprost

59
Q

Name four other glaucoma medications other than prostanoids?

A
  1. Betablockers
  2. Carbonic anhydrase inhibitors
  3. Alpha adrenergic agonist
  4. Parasympathomimetic - pilocarpine
60
Q

Give four uses for fluorescein?

A
  1. Shows corneal abrasion
  2. Tonometry
  3. Diagnosing nasolacrimal dut obstruction
  4. Angiographt
61
Q

What drugs cause pupil dilation by blocking parasympathetic supply to iris?

A

Mydriatics - trpicamide

Side effects: blurring, AACG

62
Q

What class of drugs cause pupils to dilate?

A

Sympathomimetics

63
Q

Name a TB drug which causes optic neuropathy?

A

Ethambutol - colour vision

64
Q

Name a drug which causes maculopathy?

A

Chloroquine

65
Q

What is the main cause of neuro-opthalmic disease?

66
Q

What way does lateral rectus move the eye?

67
Q

Give four causes of 6th nerve palsy?

A
  1. Microvascular
  2. Raised intracranial pressure
  3. Tumour
  4. Congenital
68
Q

Give three movements of superior oblique?

A

Intorsion
Depression in adduction
Abduction (weak)

69
Q

What does a head tilt suggest?

A

4th nerve palsy

70
Q

What can cause bilateral IV palsy?

A

Blunt head trauma

71
Q

Give four causes of 4th nerve palsy?

A
  1. Congenital decompensated
  2. Microvascular
  3. Tumour
  4. Bilateral - closed head trauma
72
Q

What does occular position of down and out suggest?

A

3rd nerve palsy

73
Q

Give five causes of third nerve palsy?

A
  1. Microvascular
  2. Tumour
  3. Aneurysm
  4. MS
  5. Congenital
74
Q

Whast would be the cause of a painful third nerve palsy?

75
Q

What causes progressive visual loss, pain behind eye especially on movement, colour desaturation, central scotoma and gradual recovery?

A

Optic neuritis

76
Q

Pathology where - causes quadrantanopia?

A

Optic tracts and radiation

77
Q

Pathology where - causes homonomous defect, macular sparing and congruous?

A

Occipital cortex

JL Opthalmology (6 decks)

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