AMC MCQ - You Can Do It!!!!!❤️❤️ > Ophthalmology > Flashcards

Ophthalmology Flashcards

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1
Q

Cataracts: risk factors

A
  • Ageing / Senility
  • Corticosteroid therapy
  • Diabetes
  • Hypoparathyroidism
  • Dystrophia myotonia
  • Trauma (may be delayed)
  • Ocular disease (e.g. glaucoma)
  • Smoking
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2
Q

Cataracts features

A

– Reading Difficulty
– Difficulty in recognising faces
– Problem with driving especially at night
– Difficulty with television viewing
– Reduce ability to see in bright light (glaring)
– May see haloes around light

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3
Q

Traumatic cataract features

A
  • under 45 years of age
  • injury to the lens by foreign body or direct impact
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4
Q

Cataracts management

A
  • Intraocular lens
    -phaecoemulsification to replace intraocular lens
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5
Q

Hyphaema causes

A

Trauma (squash ball, rugby)
- Blood clotting disturbances
- Medications (anticoagulants)
- Neovascularisation (diabetic retinopathy, previous eye surgery0
- melanoma or retinoblastoma
- abnormal vasculature

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6
Q

Hyphaemia features

A
  • presence of blood in the anterior chamber
  • ## impaired visual acuity
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7
Q

Hyphaemia management

A
  • Urgent referral to the ophthalmologist
  • bed rest with the head elevated 30 to 45° with eye shield
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8
Q

Unilateral cataract features

A

– A progressive blurring of vision.
– Glare, especially in bright light or when driving at night
– Monocular double vision

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9
Q

Nasolacrimal duct obstruction features

A
  • Clear eye discharge & crusting of the eyelashes
  • No redness or irritation
  • 6 to 20% of newborns
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10
Q

Nasolacrimal duct obstruction management

A
  • resolves spontaneously
  • requires antibiotics only when
    complicated conjunctivitis or dacryocystitis
  • Ophthalmologic consultation if persists past 12 months of age or earlier if complicated by recurrent infection
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11
Q

Diabetic retinopathy screening

A

2 yearly by either optometrist or ophthalmologist unless:

  • Aboriginal and Torrens Islanders
  • Non-English-speaking backgrounds
  • Visual loss
  • Poor diabetic control
  • hypertension
    -hyperlipidaemia
  • anaemia
  • renal disease
    -long duration of diabetes
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12
Q

Diabetic retinopathy predictors

A
  1. Non-English-speaking backgrounds
  2. Duration of diabetes
  3. Control of diabetes
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13
Q

Diabetic retinopathy screening in diabetic pregnant women

A

1st trimester

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14
Q

Diabetic retinopathy screening in children

A

Puberty

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15
Q

Diabetic retinopathy screening in gestational diabetes

A

diabetes persists after pregnancy

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16
Q

Diabetic retinopathy screening in Non proliferative diabetic retinopathy

Diabetic retinopathy screening in the context of non-proliferative diabetic retinopathy (NPDR) refers to the process of examining the eyes of individuals with diabetes to detect early signs of diabetic retinopathy before it progresses to a more severe form, such as proliferative diabetic retinopathy (PDR).

A

Screen every 3–6 months

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17
Q

Diabetic retinopathy risk factors

A

-Poor glycemic control.
-Longer duration diabetes.
-Poor lipid or blood pressure control.
-Aboriginal and Torrens Islanders

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18
Q

Diabetic retinopathy management

A

Prophylactic photocoagulation

Prophylactic photocoagulation refers to the preventive use of laser therapy to treat the retina in patients with diabetic retinopathy, with the goal of preventing the progression to more severe stages, such as proliferative diabetic retinopathy (PDR), and thus reducing the risk of significant vision loss.

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19
Q

Base orbital fracture features

A
  • Damage to infraorbital nerve failing to “push” the eyeball up
    1. Diplopia when gazing upwards
    2. enophthalmos (eye receding into the orbit)
    3. Numbness (cheek, upper lip, or upper gingiva)
  • Blurry vision
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20
Q

Superior orbital fracture features

A
  • vertical diplopia when gazing downwards
  • no numbness
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21
Q

Zygomatic fracture features

A
  • horizontal diplopia
  • Mallar flattening
    -difficulty in opening mouth
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22
Q

Hyphaemia complications

A
  • recurrent bleeding
  • glaucoma
  • blood staining of the cornea
  • all leading to permanent vision loss
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23
Q

Nasal bone fracture features

A
  • horizontal diplopia
  • cerebrospinal fluid leakage
  • epistaxis
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24
Q

Glaucoma risk factors

A

-The family history of glaucoma.
-Myopia.
-Diabetes Mellitus.
– Migraine.
– History of trauma to the eyes
– Abnormal blood pressure

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25
Tripod fracture features
- vertical/horizontal/oblique diplopia - difficulty in mastication
26
Open angle glaucoma treatment
- STAMP -Supine Position - Timolol topical (carteolol) - Acetazolamide IV - Mannitol -Pilocarpine topical
27
Long term treatment of acute closed-angle glaucoma
Laser iridotomy
28
Long term treatment of chronic open-angle glaucoma
Laser trabeculectomy
29
Difference between hypermetropia & presbyopia
Age 40 and is completed at 60
30
Contraindication to timolol
– severe hypotension – chronic obstructive airways disease – Moderate to severe asthma – uncontrolled cardiac failure – bradycardia or second or third-degree atrioventricular block
31
Eye corticosteroid side- effects
– **Microbial keratitis** – Corneal thinning – Delayed corneal healing – Corneal perforation – Cataract formation – Raised intraocular pressure – Glaucomatous optic neuropathy Microbial keratitis is a serious infection of the cornea, the clear, dome-shaped surface that covers the front of the eye. This condition can lead to severe pain, vision loss, and even blindness if not promptly treated. It is often associated with contact lens use, eye trauma, or underlying eye diseases.
32
Acute closed angle glaucoma features
- rapidly increased IOP - pain - nausea - blurred vision - eye redness - hazy cornea -pupils partially or fully dilated and unresponsive to light (anisocoria) - NO photophobia
33
Indications for referral of Ophthalmologist
– Penetrating eye injury or intraocular foreign body – Incomplete removal or practitioner uncertainty – Persisting foreign body symptoms – Persisting rust ring – Persisting vision loss – Keratitis – Endophthalmitis – Paediatric or uncooperative patients that may require examination under anaesthesia
34
Features of retinal detachment
- Hx of trauma, diabetic retinopathy, myopia and cataract surgery - sudden onset of floaters, flashes and field defects - painless loss of vision - dark shadow (curtain closing) of affected eye
35
Features of Posterior Vitreous detachment
- Age >70 years (66%) -**Vision acuity preserved**
36
Unilateral exophthalmos features
- most common **Graves’s disease (Thyrotoxicosis)** - orbital pseudotumor - orbital cellulitis - cavernous sinus - thrombosis - retrobulbar - retro-orbital tumours - Congenital glaucoma Nasopharyngeal tumours
37
Retinal artery occlusion fundoscopic features
- Cherry red spot - Retinal whitening
38
Chronic simple glaucoma fundoscopic features
- increased ratio of the optic cup to the optic disc - retinal vessels seem to be cut/ broken upon entering optic disk
39
external hordeolum (stye) pathogen
Staphylococcus aureus
40
external hordeolum (stye)
Warm compresses
41
Strabismus cut-off point
- 5 to 6 months to align by itself - Correcting strabismus before 4-6 years
42
dacryocystitis management
- flucloxacillin - amoxicillin - clavulanate - cephalexin
43
Macular degeneration features
- blurry centre of her vision - distortion of objects (straight lines wavy)
44
Types of age related macular degeneration
Dry - **slow progression** - 90% of AMD cases - drusen, pigmentation and sometimes haemorrhages at macula Wet - **rapid deterioration** - abnormal vessels grow from the choroid into the neurosensory retina &leak macula - rapid deterioration
45
Hypertensive retinopathy features
- papilloedema - straightening of the vessels - thickened opacified vessel walls - arteriovenous nicking
46
Bacterial conjuctivitis treatment
Chloramphenicol
47
inflammation of meibomian glands
Internal hordeolum
48
Features of viral conjunctivitis
- adenovirus - **watery** eyes - uni or bilateral affection - contact lenses - usually painless - vision preserved
49
Features of allergic conjunctivitis
- can be watery - bilateral -history of contact hypersensitivity (changing contact lenses), hay fever - usually painless - vision preserved
50
Features of keratitis
- herpes simplex/zoster infection - **circumcorneal dendritic ulceration** - eye pain and redness - grittiness (foreign body) -photophobia - lacrimation - vision and pupillary reflex **normal**
51
Features of acute uveitis (iritis)
- eye pain and redness - **visual acuity may be decreased** - photophobia - hypopyon (white cells precipitating in anterior chamber) -irregular constricted pupil (reflex abnormal) -history of prior surgery (phacoemulsification) - also associated with seronegative arthropathies (ankylosing spondylitis, RA, IBD)
52
53
Traumatic cataract features
- under **45 years** of age - injury to the lens by foreign body or direct impact
54
Conditions that require urgent referral to Ophthalmologist
- Significant eye trauma, burns, embedded foreign body in cornea, intraocular foreign body - Hyphaemia (>3mm)/hypopyon - Corneal ulcer - Severe conjunctivitis - Uveitis/ acute iritis - Behcet syndrome - acute glaucoma - giant cell arteritis - acute dacryocystitis - endophthalmitis - herpes zoster ophthalmicus
55
features of retinal artery occlusion
unilateral + sudden onset of significant vision loss - preceded by transient monocular blindness
56
Types of retina artery occlusion
attach pics
57
Hypopyon
sign not diagnosis indicates uveitis
58
Management of subconjunctival haemorrhage
- red discolouration NOT crossing the limbus = warm compress - red discoloration CROSSING the limbus = find underlying cause (Orbit CT) - AVOID NSAID's
59
Management of episcleritis
- Hypromellose (artificial tears) 4-6 times/day - Topical NSAID's diclofenac NOTE: Topical steroids (prednisolone) if all above not helping
60
Difference between subconjunctival haemorrhage & episcleritis
Subconjunctival haemorrhage: - micro tears in the sclera that cause haemorrhages, eyes appears dark red due to the accumulation of blood, but could also turn blue/purple/yellow after - no discomfort with the exception of trauma Episcleritis: - Patchy pinkish/redness of the eye usually found in the corner - no discharge, itchiness - mild discomfort -
61
Difference between episcleritis & scleritis
- If a patient's eye redness improves after phenylephrine instillation = episcleritis - scleritis is painful
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