Neuro > Ophthalmology > Flashcards

Ophthalmology Flashcards

(87 cards)

Study These Flashcards
1
Q

What is the choroid and where is it located?

A

It’s the vascular layer of the eye, located between the retina and the sclera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs of retinal detachment

A

-Flashes
-Floaters
-Shadow/curtain vision loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Central retinal artery occlusion (CRAO)

A

Acute blockage of the central retinal artery (main blood supply to the inner layers of the retina) due to a thrombus/embolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Findings indicative of a central retinal artery occlusion (CRAO)

A

-Sudden, painless vision loss
-Fundoscopy - pale central retina with a “cherry red” spot in the macula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Branch retinal arterial occlusion (BRAO)

A

Occlusion of one of the smaller branches of the central retinal artery.
Findings on fundoscopy are limited to one quadrant of the retina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Central retinal vein occlusion (CRVO)

A

Blockage of the central retinal vein, leading to backlog of blood, retinal hemorrhages, edema, and ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Findings indicative of a central retinal vein occlusion (CRVO)

A

-Sudden, painless vision loss
-Fundoscopy - “blood and thunder” appearance (hemorrhages in all quadrants, optic disc swelling, cotton wool spots)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Branch retinal vein occlusion (BRVO)

A

Occlusion of a branch of the central retinal vein.
Findings on fundoscopy are limited to one quadrant of the retina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What signalling molecule does the ischemic retina release?

A

Vascular endothelial growth factors (VEGFs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Effects of VEGFs

A

-Macular edema
-Neovascularization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment for CRVO / BRVO

A

-Laser the ischemic retina (photocoagulation) to suppress release of VEGFs
-VEGF inhibitor injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diabetic vitreous hemorrhage

A

Bleeding into the vitreous cavity of the eye (behind the lens) due to rupture of fragile new blood vessels that are formed by neovascularization in severe diabetic retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Amaurosis fugax

A

Transient, painless monocular vision loss (lasts minutes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ischemic optic neuropathy

A

Damage to the optic nerve due to insufficient blood supply
*Disease of the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mechanisms of ischemic optic neuropathy (2)

A

-GCA
-Non-arteritic ischemic optic neuropathy (thromboembolic mechanism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lab findings in GCA

A

-ESR: highly elevated (~100)
-CRP: usually elevated
-Platelet count: elevated (>400)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of GCA

A

Oral prednisone - start ASAP to prevent permanent vision loss and/or spread to other eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Visual effects of pituitary tumours

A

Compression of the optic chiasm –> bitemporal hemianopsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Optic neuritis is common in what neurologic disease?

A

MS - usually presents as the first episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Symptoms of optic neuritis

A

-Acute monocular vision + colour loss
-Pain with eye movements
-RAPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pupillary light reflex

A

-Afferent: CN II
-Efferent: CN III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Management of optic neuritis (3)

A

-MRI of brain + orbit to rule out mass and identify other areas potentially involved
-IV prednisone
-IFN (reduces risk / delays onset of MS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Myopia vs hyperopia

A

Myopia: short-sightedness - the eye is too long so light is focused in front of the retina
Hyperopia: far-sightedness - the eye is too short so light is focused behind the retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Severe hyperopia is a risk factor for?

A

Amblyopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Astigmatism
The cornea and/or lens has an irregular curvature - light focuses at multiple points on or near the retina instead of a single sharp focus
26
Presbyopia
Age-related loss of the eye’s ability to accommodate due to gradual stiffening of the lens and weakening of the ciliary muscles
27
Cataract
An opacity (clouding) of the lens of the eye
28
Common signs/symptoms of cataracts
-Reduced vision -Glare (esp at night) -Dulled red reflex -Fundus may be difficult to visualize
29
Management of cataracts
1. Optimizing eye glasses 2. Surgical removal of the cataract and replacement of an artificial lens when glasses no longer work and vision loss is severe
30
What ocular disease is characterized by loss of peripheral vision first?
Glaucoma - peripheral vision deteriorates first and later on central vision is affected (can go unnoticed for a while)
31
What ocular disease is characterized by loss of central vision first?
Macular degeneration - loss of central vision, peripheral vision remains intact
32
Normal flow of aqueous humour in the eye (6)
Ciliary body (posterior chamber) --> through the pupil --> anterior chamber --> trabecular meshwork --> schlemm's canal --> venous system
33
Normal intraocular pressure
21.5 mmHg or less
34
Pathophysiology of glaucoma
Aqueous humour outflow is blocked or reduced --> aqueous humor accumulates --> increased intraocular pressure --> optic nerve head gets compressed and blood flow to it is obstructed
35
Open-angle vs angle-closure glaucoma
**Open-angle:** blockage is in the trabecular meshwork - slow, chronic **Angle-closure:** blockage is at the entrance to the trabecular meshwork (iris blocks the drainage angle) - acute, emergency
36
Can glaucoma be diagnosed by increased intraocular pressure alone?
-IOP can be increased for other reasons (ocular htn) -Some people with glaucoma have normal IOP -Glaucoma is defined by the presence of optic nerve damage
37
Signs/symptoms of glaucoma (3)
-Optic nerve disc cupping (higher cup-to-disc ratio) -Intraocular pressure - usually increased -Decreased peripheral visual fields
38
Strategy for managing open-angle glaucoma
Medical first, then laser and/or surgery if that fails
39
Meds for glaucoma management (5)
-**Prostaglanding analogues:** enhance uveoscleral outflow - local side effects -**Beta blockers:** suppress aqueous production -**Carbonic anhydrase inhibitors:** suppress aqueous production - systemic side effects -**Adrenergic agents:** suppress aqueous production + might enhance uveoscleral outflow -**Cholinergic agents:** contract the ciliary body to constrict the pupil, which makes the drainage angle larger
40
Trabeculectomy
Surgical management of glaucoma - a flap is created in the sclera over the trabecular meshwork and a hole is made underneath, going into the anterior chamber - fluid drains into the conjunctival veins
41
Macular degeneration
Disease of progressive degeneration of the macula, leading to loss of central vision
42
Genetics and macular degeneration
Macular degeneration is genetically inherited
43
What are drusens?
White clumps that form due to macrophage accumulation in areas filled with breakdown products of photoreceptor cells
44
Dry vs wet macular degeneration
**Dry:** when large areas of cells degenerate, drusens accumulate under the retina, making it look hypopigmented **Wet:** when subretinal neovascularization occurs in these areas due to VEGF release
45
Management of macular degeneration
-Mild cases – optimal glasses -As visual acuity deteriorates – low vision aids (handheld magnifiers, enlarged font size, etc.) -Pharmacologic treatments: vitamin and antioxidant supplementation -Wet AMD: treatment of choice – repeated intravitreal injections of a VGEF inhibitor
46
Diabetic retinopathy
A complication of diabetes that causes progressive damage to the retinal vessels --> retinal ischemia + leaky capillaries --> vision loss
47
Features of diabetic retinopathy on fundoscopy (4)
-**Hard exudates** (yellow spots - deposits of lipids and proteins due to leaky capillaries) -**Flame hemorrhages** -**Dot and blot hemorrhages** -**Cotton wool spots**
48
Management of diabetic retinopathy
-Good blood sugar control -Injections of VGEFi -Focal laser treatment to areas of leaky blood vessels (reduce edema) -Pan-retinal photocoagulation (stop neovascularization) -Vitrectomy (for non-resolving vitreous hemorrhage)
49
Hypertensive retinopathy
Damage to the retinal blood vessels due to chronic high blood pressure
50
Signs of hypertensive retinopathy (mild to severe)
**Mild:** -Arteriolar constriction -Vessel wall thickening + opacification -Arteriovenous nicking **Moderate:** -Flame hemorrhages -Cotton wool spots -Hard exudates -Microaneurysms **Severe:** all of the above plus disc edema
51
Management of hypertensive retinopathy
BP control
52
Blepharitis
Inflammation of the eyelid margin (where the roots of eyelashes are)
53
Management of blepharitis
-Lid hygiene (warm compresses, washing debris off lashes, etc.) -Erythromycin ointment if inflammation is severe
54
What is the tear film?
A thing coating that covers the cornea and conjunctiva - keeps the eye moist and protected from debris
55
What causes dry eye?
Chronic inflammation of unknown origin - interferes with production of the tear film
56
What is the conjunctiva?
A thin transparent mucous membrane that lines the inner surface of the eyelids and covers the sclera (but not the cornea)
57
Conjunctivitis
Inflammation of the conjunctiva - due to infection or allergy
58
Presentation of allergic, viral, and bacterial conjunctivitis
**Allergic:** watery discharge with mucous **Viral:** watery discharge, swollen pre-auricular nodes **Bacterial:** purulent discharge
59
Investigations for conjunctivitis
None - no labs or cultures unless unresponsive to topical antibiotics Clinical diagnosis
60
Management of allergic, viral, and bacterial conjunctivitis
**Allergic:** antihistamines or anti-inflammatory eye drops **Viral:** supportive **Bacterial:** topical antibiotics
61
Treatment for chlamydial/gonococcal conjunctivitis in newborns
Erythromycin or silver nitrate in the eyes in the delivery room
62
Subconjunctival hemorrhage
Collection of blood beneath the conjunctiva due to damage to the conjunctival vessels (trauma or surgery most common causes)
63
Scleritis vs episcleritis
**Scleritis:** inflammation of the sclera - severe and painful **Episcleritis:** inflammation of the soft tissue between the sclera and conjuctiva - benign and self-limited
64
Investigations to differentiate scleritis vs episcleritis
If someone has episcleritis, the redness will blanche with the application of topical phenylephrine (vasoconstrictor)
65
Management of scleritis vs episcleritis
**Scleritis:** high dose oral steroids or systemic immunosuppressives **Episcleritis:** oral NSAIDs or mild topical steroids
66
How to better visualize corneal abrasions
Fluorescein dye under cobalt blue light - areas of abrasion will glow bright green
67
Management of corneal abrasions
-Small abrasions - antibiotic drops can speed healing -Larger abrasions - patch to immobilize the eyelid *Don't give topical anesthetic drops to take home - interfere with healing and toxic to intact epithelium *Follow daily until resolved to monitor for infection
68
Uveitis
Inflammation of the uveal tract (any or all of - choroid, ciliary body, iris)
69
Key features of uveitis (5)
-**Ciliary flush** (redness localized around the cornea) -**Synechiae** (when inflammatory scarring causes part or all of the iris to become adherent to the lens capsule)e -Smaller pupil on affected side due to synechiae -**Hypophon** (layer of WBCs at the bottom of the anterior chamber) - severe cases -**Keratic precipitates** (WBC deposits on the surface of the cornea)
70
Management of uveitis (2)
-Hourly topical prednisolone drops and homatropine (dilator) -Laser iridotomy (when synechia form all around the pupil)
71
Management of acute angle-closure glaucoma (5)
-Pilocarpine drops (constricts the pupil) -Glaucoma drops -Diuretic -IV mannitol (helps draw fluid from the eye) -Laser to burn a hole in the iris - once IOP has gone down
72
Orbital cellulitis
Infection of the soft tissue behind the orbital septum - pushes the eye forward and restricts eye movements
73
Preseptal cellulitis
Infection of the soft tissues around the eye (like the eyelid) - does not cause bulging, no pain with eye movements
74
Management of orbital and preseptal cellulitis
**Orbital:** IV antibiotics, drain any abscess **Preseptal:** oral or IV antibiotics
75
Keratitis
Infection of the cornea
76
Bacterial vs viral keratitis - causes + presentation
**Bacterial:** usually due to wearing contact lens too long, white infiltrate in the cornea **Viral:** due to HSV reactivation, dendritic appearance with fluorescein stain
77
Management of bacterial vs viral keratitis
**Bacterial:** 4th gen fluoroquinolone drops **Viral:** trifluridine drops or oral acyclovir *Corneal transplant needed in rare cases where there's severe scarring
78
Endophthalmitis
Infection inside the eye - involves the acqueous and/or vitreous humour
79
Key feature of endophalmitis
Pus in the anterior chamber
80
General approach to ocular trauma (4)
1. Analgesics 2. Measure visual acuity 3. Inspection (outside --> inside, don't forget to evert the eyelid) 4. Next appropriate steps (call ophtho, take to OR, etc.)
81
Pathway of tear production to drainage (8)
Lacrimal gland --> eye surface __> medial canthus __> lacrimal puncta __> superior + inferior canaliculi __> common canaliculus --> lacrimal sac --> nasolacrimal duct
82
Key feature of corneal FB
Rust ring around where the FB was in the cornea
83
Key feature of corneal laceration
Distortion of the pupil because the iris is drawn toward the open corneal wound
84
Chemical burns - mild to severe presentation
**Mild:** clear to mildly cloudy cornea, diffuse conjunctival redness **Moderate:** mild to moderate cloudy cornea, some whitening around the cornea (ischemia) **Severe:** moderate to severe clouding of the cornea
85
Treatment for mild-severe chemical burns
**Mild:** irrigation to bring pH to normal, will recover on it's own **Moderate:** involve ophthalmology **Severe:** need to insert an artificial plastic cornea
86
Hyphema
Blood in the anterior chamber of the eye - caused by trauma to the root of the iris
87
Management for a hyphema
-Steroid drops -Monitor IOP -Severely restrict activities dor 1 week -Surgical evacuation of blood (only in rare cases where the IOP gets really high) -Check the drainage angle
Neuro
flashcards
Decks in class (28)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions