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Opthamology > Week 2- Clinical > Flashcards

Week 2- Clinical Flashcards

1
Q

Define sympathetic ophthalmia

A

Rare, bilateral, granulomatous uveitis as a result of trauma or surgery to one eye

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2
Q

Give an example of an eye condition that is an example of Type I hypersensitivity

A

Acute Allergic conjunctivitis

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3
Q

Ocular cicatricial pemphigoid is an example of what type of immune response?

A

Type II hypersensitivity

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4
Q

Define visual acuity

A

Ability to distinguish between two objects at a distance

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5
Q

Name the charts used to measure visual acuity. How do you record data from this?

A

Snellen charts
distance(m)/line of letters e.g. 6/24
if only read some on that line then add negative e.g. 6/24-2

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6
Q

What is the average visual acuity in the population?

A

6/6

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7
Q

Why do they use mirrors to look at Snellen charts?

A

To achieve a 6metre distance even if the patient is only 3m from the mirror

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8
Q

What is the WHO definition of blindness?

A

Visual acuity of 3/60 or worse

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9
Q

What test might you use to measure visual acuity in children?

A

Preferential vision test

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10
Q

What charts are used to test colour vision?

A

Ishihara plates

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11
Q

How do the average ocular trauma causes differ between males and females?

A

Males- mainly 20s/30s, from assault/machinery

Females- mainly 60s+, from falls

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12
Q

Identify four steps which are important in ocular trauma assessment

A

History
Visual acuity tests
Eye examination
Fluorescein drops and slit lamp

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13
Q

What is hyphaema?

A

Blood within the anterior chamber of the eye

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14
Q

Consider how one would remove foreign bodies from the cornea

A

Use slit lamp
Use local anaesthetic
Use edge of a needle to scoop out
Give chloramphenicol to prevent infection

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15
Q

Name an investigation that is essential for IOFBs

A

X-ray for intraocular foreign bodies

Because often shards of metal from hammering

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16
Q

Which penetrates the eye more deeply? alkali or acid? Give three possible presentations of this

A

Alkali

Eye ischaemia, Scarring, vascularisation

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17
Q

How do you treat chemical eye trauma?

A

IRRIGATION until pH normal

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18
Q

Identify some of the signs and symptoms of conjunctivitis

A 
Red eye
discharge
Swollen
Discomfort
suppuration
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19
Q

Give three viral causes of conjunctivitis

A

Herpes zoster
Herpes simplex
adenovirus

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20
Q

What is keratitis?

A

Inflammation of the cornea

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21
Q

Name the most common cause of disciform keratitis and its treatment

A

Herpes viruses

Ganciclovir

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22
Q

What parasite is associated with contact lens use?

A

Acanthamoeba

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23
Q

What is orbital cellulitis?

A

Infection of the deep layer of the skin and the subcutaneous tissue in the orbit of the eye

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24
Q

Define sympathetic ophthalmia

A

Rare bilateral granulomatous uveitis that is secondary to trauma or surgery to one eye

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25
Q

What is cataracts?

A

Opacifications of the ends of the eye leading to blurred vision

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26
Q

Give two causes of swollen optic discs

A

Papilloedema

malignant hypertension

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27
Q

What is optic disc drusen?

A

Globules of mucoproteins and mucopolysaccharides that accumulate in the optic disc

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28
Q

What is the difference between homonymous/incongruous?

A

Homonymous- same part of field in each eye

Incongruous- different parts of visual field

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29
Q

What is the difference between hemianopic and quadratonopic?

A

Hemianopic- half of visual fields

Quadratonopic- Quadrant of visual fields

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30
Q

What are the Three Cs which should be investigated when it comes to optic disc examination

A

Contours- borders of the optic disc should be clear and well defined
Colour- should look orange/pink with a pale centre (orange/pink is healthy, well-perfused neuroretinal tissue.
Cup- pale cup should be a third of size of disc (0.3 cup ratio)

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31
Q

Ill-defined optic disc contours are a sign of what two conditions?

A

Papilloedema

Optic disc drusen

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32
Q

Summarise the causes of optic neuropathy which cause neuroretinal discolouration

A 
Neuritis
Ischaemia
Granulomatous
Hereditary
Traumatic
Toxic
Irradiation
Compression
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33
Q

How many layers are there in the retina?

A

10 layers

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34
Q

What is the most common cause of quadrantinopia? What about inferior quadrant and superior quadrant defects?

A

Occipital lobe stroke
Inferior- parietal lobe
Superior- temporal lobe

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35
Q

What is hyperopia and what is mypoia?

A

Hyperopia- long sightedness

Myopia- short sightedness

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36
Q

What lens would you give a 1. Myopic and 2. hyperopic patient?

A
  1. Diverging lens (concave)

2. converging lens (convex)

37
Q

What is the difference between ametropia and Emmetropia?

A

Emmetropia- where no refractive error is present and so light is focused on the retina
Ametropia- where refractive error is present and so light is focused before/behind the retina

38
Q

What is anisometropia?

A

Where there is a significant difference between right and left eye ametropia

39
Q

What lens would you give a 1. Myopia and 2. hypermetropia patients?

A
  1. Diverging lens (concave/negative)

2. converging lens (convex/positive)

40
Q

What is astigmatism?

A

Where the image of an object is distorted because not all the light rays come to focus on the retina. Due to irregular curvature of the cornea/lens. Some light hits appropriately but other rays not.

41
Q

What is presbyopia?

A

The reduction of the ability of the eye to accommodate near vision with increasing age. Need reading glasses (convex/positive lens)

42
Q

What is a lazy eye (amblyopia)?

A

Reduced vision due to abnormal visual development in early life.

43
Q

What is the significance of pinhole acuity?

A

Is an indication of the best visual acuity the patient shall have after correction

44
Q

What is nystagmus?

A

Rapid involuntary movement of the eyes

45
Q

What are the four main aetiologies of visual field damage

A

vascular disease
space occupying lesions
demyelination (MS)
trauma/surgery

46
Q

Name the angle that is opened/closed in glaucoma

A

iridocorneal angle

47
Q

How come the fovea appears more red than the rest of the fundus?

A

Only possesses a single layer of ganglion cells.

48
Q

Give three possible fundoscopy findings of diabetic retinopathy.

A

Haemorrhages (dot/blot/flame)
hard exudates
microaneurysms

49
Q

Name the four areas of the retina

A

Superotemporal arcade
superonasal arcade
inferotemporal arcade
inferonasal arcade

50
Q

What is diplopia?

A

double vision

51
Q

How does sudden onset diplopia present?

A

manifest squint and diplopia (double vision)

52
Q

Name the test used to identify a manifest squint. Corneal reflections are a great indicator of asymmetry

A

Cover test

53
Q

Define the following: Esotropia, exotropia, hypertropia, hypotropia

A

Esotropia- outward movement of eye
Exotropia- inward movement of eye
hypertropia- downward movement of eye
hypotropia- upward movement of eye

54
Q

What is chemosis?

A

oedema of the conjunctiva that gives the eye a boggy appearance

55
Q

What is an epiretinal membrane

A

A thin membrane that can form over the macula of the retina that causes metamorphopsia

56
Q

What is central serous chorioretinopathy? In what population is it common?

A

Retinal detachment in the area of the macula due to localized leakage through the RPE into the subretinal space. Common in young adult males

57
Q

What group of diseases is indicated by metamorphopsia?

A

Macular diseases

58
Q

What is metamorphopsia and what is scotoma?

A

m- distorted vision of objects

s- where areas of vision are absent

59
Q

What is coloboma?

A

Absence of part of the iris leaving an irregular shaped pupil.

60
Q

Identify a symptom that is common in bacterial conjunctivitis but not in viral conjunctivitis

A

Yellow purulent discharge rather than watery discharge

61
Q

What imaging is used to aid the diagnosis of orbital cellulitis?

A

CT scan

62
Q

What is endophthalmitis? What is the major cause of this and how is it treated?

A

Inflammation within the eye
Staph epidermidis
intravitreal antibiotics

63
Q

Toxoplasmosis gondii and toxocara are associated with what condition?

A

Chorioretinitis

64
Q

Nam the drug combination used to treat uveitis

A

Mydriatics and steroids

65
Q

Identify a possible cause of CNIII palsy that is unlikely for the other cranial nerve palsies.

A

Aneurysm

66
Q

What bilateral cranial nerve palsy may be caused by head trauma?

A

CNIV

67
Q

What does CRAO stand for?

A

Central retinal artery occulsion

68
Q

Describe some of the symptoms of CRAO

A

Sudden visual loss
painless
RAPD present
Pale retina

69
Q

How does CRVO present in fundoscopy?

A

Dilated tortuous veins
haemorrhages
disc and macular swelling
Deep red fundus

70
Q

Define glaucoma

A

A condition of the optic nerve where increased intravitreal pressure leads to a loss of retinal nerve fibres and results in a loss of vision.

71
Q

What is the difference between open angle and closed angle glaucoma?

A

OA- Increased pressure due to a blockage of the trabecular meshwork
AA- Increased pressure due to blockage of the canal of Schlemm and trabecular meshwork

72
Q

Give two signs of presentations of glaucoma on fundoscopy

A 
Enlarged cups (cupping)
Neuroretinal discolouration
73
Q

Describe the signs and symptoms of closed angle glaucoma

A 
Acute onset
Acute red eye
Nausea and vomiting 
headache
acute visual loss
glaukomflecken
cloudy cornea
74
Q

Identify three topical drug types used to reduce intraocular pressure in glaucoma

A

Beta blockers
Prostaglandins
carbonic anhydrase inhibitors

75
Q

How does Papilloedema present on a fundoscopy?

A

swollen optic discs with irregular contours and neuroretinal discolouration

76
Q

Describe the difference between the pathophysiology of wet and dry ARMD

A

WET- abnormal growth of new blood vessels beneath the retina lead to reduced macular function
DRY- chronic choroid ischaemia leads to degeneration of retinal pigment epithelium

77
Q

Name the three main types of retinal detatchment

A

Rhegmatogenous
tractional
Exudative

78
Q

Describe retinal detatchment.

A

Separation of inner nervous layer from outer Retinal Pigment Epithelium with fluid accumulating under the tear.

79
Q

Define ischaemic optic neuropathy

A

Occlusion of posterior ciliary arteries resulting in optic nerve head neuropathy

80
Q

Name a rheumatology condition that can cause ischaemic optic neuropathy

A

Temporal (giant cell) arteritis

81
Q

Congenital, nuclear, posterior subcapsular and christmas tree are all subtypes of what condition?

A

Cataracts

82
Q

What is cataracts?

A

Opacifications of the lens of the eye leading to blurred vision

83
Q

Identify some of the aetiologies of cataracts

A 
Cumulative UVB damage
trauma
surgery
hypertension
glaucoma
age-related
diabetes
genetic
84
Q

What is the most common cause of optic neuritis? How does optic neuritis present?

A

Multiple sclerosis

Unilateral eye pain that may improve over time

85
Q

How does Horner’s syndrome present?

A

Miosis, anhidrosis and ptosis

Due to disorder of the sympathetic innervation in the brainstem or cervical region

86
Q

What characterises Iron-containing foreign body injuries?

A

Orange halos

87
Q

What is the most common type of age related cataract?

A

Nuclear sclerotic cataract

88
Q

What is the most common bacterial cause of keratitis with contact lens users?

A

Pseudomonas aeringosa

89
Q

How does Chorioretinitis present on fundoscopy? Name a virus that causes this?

A

white lesions surrounded by areas of hemorrhagic necrotic areas.
Cytomegalovirus

Opthamology (2 decks)

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