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2010-06-27 16:18:07

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  1. Flashing lights, floating spots (black or red), field loss like curtain coming in from periphery. diagnosis?
    acute retinal detachment
  2. what happens to the affected pupil in acute retinal detachment in response to light?
    dilates due to RAPD
  3. sudden loss of vision in part of the visual field, retinal haemorrhages, dilated retinal veins, CWS. diagnosis?
    branch retinal vein occlusion
  4. sudden painless loss of vision with pale retina?
    retinal artery occlusion
  5. in retinal artery occlusion, what is the feature in the centre of macular?
    cherry red spot (sign of ischaemia)
  6. what is amaurosis fugax?
    severe temporary visual los due to a transient lack of blood supply to retina or visual cortex
  7. give 2 causes of amaurosis fugal?
    • TIA
    • temporal arteritis
  8. what is the commonest cause of visual loss in elderly?
  9. give 2 causes of acute optic neuropathy?
    • MS
    • atherosclerosis - ischaemia
  10. in acute optic neuropathy, describe the visual loss
    • rapidly progressive
    • decreased colour visa
  11. spontaneous appearance of blood between sclera and conjunctiva. diagnosis? and causes
    • subconjunctival haemorrhage
    • trauma, rubbing, severe coughing
    • HTN, clotting disorder
  12. mild eye irritation and redness, SUPERFICIAL. diagnosis? what is this assoc. with?
    • episcleritis
    • collagen vascular disorders - RA
  13. what is blepharitis? symptoms
    • chronic inflammation of eyelid margin
    • loss of lashes, different sizes
    • crusting at eyelid margins and gritty sensation in eye
    • caused by staph and acne rosacea
  14. history of pain, FB sensation, blurred vision, photophobia. diagnosis? and where would redness be?
    • corneal ulcer
    • max red around cornea
  15. pain, rainbow like haloes around lights, nausea, vomiting, dull deep periocular headache. diagnosis? what would pupils be like?
    • acute angle closure glaucoma
    • pupils semi dilated, not reactive to light
  16. what are the 3 features of acute angle closure glaucoma OE?
    • ciliary hyperaemia
    • corneal oedema
    • dilated pupil
  17. mild to severe eye pain, radiates to ear, forehead. DEEP DULL pain, wakes patient at night. diagnosis? Rx?
    • scleritis
    • happens in vasculitis
    • Rx: oral nsaid or steroids if severe
  18. blurred vision, photophobia, watery eye, pain if severe, redness in limbus. diagnosis? cause? pupil shape and reason?
    • anterior uveitis (iritis)
    • autoimmune disease e.g. sarcoid, behcets, seroneg spondylarthropathies
    • pupils: small and fixed due to adhesions between anterior lens and pupil margin
  19. if you see keratin precipitates and hypopyon what are these a feature of? how do you treat this?
    • anterior uveitis
    • Rx: topical steroids BUT rule out corneal ulcer by fluorescein dye test first
  20. infection of eyeball after eye surgery, blurred vision painful eye, photophobia, floaters. diagnosis? Rx
    • endophthalmitis
    • Rx: inject abx, surgical vitrectomy
  21. what are the features of grade I hypertensive retinopathy?
    tortuous arteries, thick shiny walls (silver wiring)
  22. what are the features of grade II hypertensive retinopathy?
    AV nipping where artery crosses vein as artery becomes thick
  23. what are the features of grade III hypertensive retinopathy?
    flame haemorrhages and CWS
  24. what are the features of grade IV hypertensive retinopathy?
    papilloedema (bilateral disc swelling due to increased ICP, veins congested)
  25. if there is redness most marked around cornea, what is this diagnosis?
    anterior uveitis
  26. if there is a red eye and dilated pupil, diagnosis?
    acute glaucoma
  27. if there is a red eye and small pupil, diagnosis?
    anterior uveitis
  28. what are the features of background DR?
    • HEM
    • haemorrhages - blots
    • exudates (hard) - lipid deposits
    • microaneurysm - dots
  29. what are features of pre-proliferative DR?
    • microaneurysm
    • haemorrhages
    • exudates
    • cotton wool spots
    • venous beading
    • (all signs of retinal ischaemia)
  30. what are features of proliferative DR?
    • new vessels - disc or elsewhere
    • haemorrahges
    • URGENT referral
  31. in DR, when is it necessary to refer to ophthalmologist? (4)
    • background with macular changes
    • background with decreased vision
    • pre-prolif
    • proliferative
  32. what happens to the lens in cataract?
    loss of transparency of crystalline lens
  33. what are the causes of cataract?
    • age
    • diabetes
    • htn
    • trauma
    • SE of steroids
    • uveitis
  34. what is the Rx of cataract?
    • remove when interfere with ADL
    • put intraocular lens in
  35. what are the fundoscopy features of glaucoma?
    cup:disc ratio increases
  36. what are the 2 main categories of AION (anterior ischaemic optic neuropathy)?
    • arteritis: related to GCA, PMR, older pts
    • non arteritis: younger, high BP, DM, hypermetropia
  37. what are the fundoscopy features and visual acuity of AION?
    • pale disc
    • swelling around edges
    • vision: only perception of light so need to Rx fast
  38. what happens to vision in retinal vein occlusion?
    sudden painless loss of vision
  39. what are the fundoscopy features of retinal vein occlusion?
    • stormy sunset look
    • engorged veins with haemorrhages
  40. what are the visual features of ARMD?
    • untreatable visual loss in elderly
    • CENTRAL visual loss
    • distorted and blurred vision
  41. what are the fundoscopy features of dry ARMD?
    drusen: nodules in choroid
  42. what are the fundoscopy features of wet ARMD?
    • damage in macular, haemorrage
    • unusual pigmentation at macula
  43. what is the Rx of wet ARMD?
    anti-VEGF injection Ranibizumab