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42 Cards in this Set

  • Front
  • Back
Topical cycloplegics
Homatropine 5%
Cyclopentolate 1%
Complications of topical steroids for the eye
Facilitate corneal penetration of HSV (permanent scarring/perforation)
Elevate IOP
Increase risk of fungal ulcers
Long-term: cataracts; glaucoma; precipitate HSV activation; perforation in some CT disorders
Name the two types of age-related macular degeneration.
Atrophic type/drusen (gradual)
Exudative type (acute)
Early and late symptoms of age-related macular degeneration.
Early: straight lines look crooked.
Late: central scotoma. Note that peripheral vision is spared.
Conservative treatment measures for age-related macular degeneration.
Monitor vision w/ Amsler grid for distortion
Smoking cessation
CVD control
Diet – fruits/veggies +/- dietary antioxidants
Top 4 causes of vision loss in elderly.
1. age-related macular degeneration
2. glaucoma
3. cataracts
4. diabetic retinopathy
What is considered normal intraocular pressure?
10-21 mmHg
What are signs/symptoms specific to angle-closure glaucoma, as opposed to primary open angle glaucoma?
Sx specific to ACG:
Ocular pain
Blurred vision
Halos/coronas around lights
Headache, N/V

Signs specific to ACG:
Conjunctival injection/red eye
Hazy/cloudy cornea
Pupil fixed, mid-dilated
High IOP on affected side
What is considered a normal cup:disk ratio?
cup:disc ratio = <0.5 has LOW level of glaucoma risk;
0.6-0.8 = moderate risk;
0.9+ high risk
Drug classes used to treat glaucoma.
Beta blockers
Alpha agonists
Cholinergic agonists
Carbonic anhydrase inhibitors
Osmotic agents
How to screen for primary open angle glaucoma?
IOP + optic disc eval + visual fields
Periodic, comprehensive eye exams for pts @ risk
Causes of secondary glaucoma.
Chronic steroid use
DM retinopathy
Vascular occlusions
What is the danger of acetazolamide + rebreathing CO2 in a patient with central retinal artery occlusion?
Could precipitate sickle cell crisis in a patient with sickle cell disease.
Why does large cell lymphoma cause eye problems?
Tumor affects eye and nervous system, causes chronic vitreous inflammation.
What is lost with compression of CN III first - PNS or somatic fibres?

How about ischemia of CN III?
Compression: PNS first, therefore blown pupil seen first.

Ischemia: somatic first, therefore movements lost before pupil blown.
What is hyphema, and what is the treatment?
Blood in anterior chamber.

Restrict activity, metal eye shield.
Topical cycloplegic
Topical steroid +/- systemic steroid or aminocaproic acid
Treatment of corneal abrasions.
Topical anesthetic, vison assessment, remove foreign bodies, florescein + cobalt blue light to assess.

Topical cycloplegic to decrease ciliary body spasm
Topical antibiotic
Pressure patch x 24 hours
F/u in 24 hours to re-check (should heal in 24-48 hours)

If contact lens wearer, then refer.
- also include gram -ve coverage in antibiotic.
Do not patch the eye, since there is increased risk of corneal ulceration.
Causes of red eye (non-traumatic)
Corneal inflammation/infection
Acute angle closure glaucoma
What is the treatment for bacterial conjunctivitis?
Topical antibiotics:
- adult: sulfacetamide 10% qid x 4 days
- children: erythromycin ointment qid x 4 days
Conditions associated with iritis.
Reiter's urethritis/bowel disease
Blunt trauma
What is the difference between preseptal cellulitis and orbital cellulitis?
Preseptal cellulitis does not affect the globe - vision ok, movements ok, no proptosis. Not as urgent - can refer to ophtho on a non-urgent basis. Manage with warm compress, systemic antibiotics.
Common causes of sudden loss of vision.
Central retinal artery or vein occlusion.
Retinal detachment.
Vitreous hemorrhage.
Optic neuropathy (temporal arteritis or other causes).
What is an obstructed eyelash follicular sebaceious gland called?
obstructed Meibomian gland?
What are some conditions associated with blepharitis?
Seborrheic dermatitis
What is a complication of nasolacrimal duct cyst?
Dacryocystitis (inflammation of the lacrimal sac). Requires systemic abx.
What is the name of the condition where there is a yellow-white deposit on the sclera adjacent to the limbus?

What if it extends into the cornea?
Causes of corneal opacity.
Bacterial keratitis.
Symptoms of iritis.
Decreased vision
What does distortion of an image indicate?
Macular pathology, eg AMD
Causes of floaters.
Vitreous detachment
Retinal detachment
Which drugs can cause toxic retinopathy?

Toxic optic neuropathy?
CHTT - chloroquine, hydroxychloroquine, tamoxifen, thioridazine

FINE - fluoroquinolones, isoniazid, ethambutol
What is amblyopia?
Amblyopia is a functional reduction in the visual acuity of an eye caused by disuse or misuse during the critical period of visual development.

Strabismus, refractive error, cataracts.
What are some consequences of long term steroid eye drops?
Fungal corneal ulcers
Risk factors for angle-closure glaucoma.
a. Asian race
b. hyperopic refractive error
c. positive family history of angle-closure glaucoma
What can cause corneal opacification?
Corneal edema (secondary to increased IOP).
Corneal inflammation/infection (e.g. HSV keratitis).
Symptoms of retinal detachment.
Flashing lights.
Shade over the vision in one eye.
Risk factors for open-angle glaucoma.
• Age - older
• Race - blacks 3 x higher than whites
• Family history
• Elevated IOP
Symptoms of cataracts.
• Blurred vision
• Monocular diplopia
• Starburst glare around lights (can't drive at night)
• Objects may appear more brown/yellow, and color discrimination may become difficult
Secondary causes of cataracts
• Trauma
• Inflammation
• Chronic steroid use
• Metabolic and nutritional defects
What is metamorphopsia?
Central visual distortion (indicates macular disease).
What is photopsia?
Flashing lights (indicates possible retinal detachment).
If acute angle closure glaucoma suspected, which drugs should be prescribed stat, if an urgent consult cannot be obtained?
Pilocarpine 2% gtt q15min x 2
Acetazolamide 500 mg PO or IV
glycerine or isosorbide 1mL/kg PO (over ice)
+/- Mannitol 20% 300-500mL IV