OPHTHALMOLOGY -------------------------

. PAPILLAEDEMA: --------------- . Transient loss of vision lasting few seconds with change in head psition. . caused by ++ ICT manifested by morning headaches or change in headache intensity with head position.

. Optic neuritis: ----------------- . Associated with multiple sclerosis. . Unilateral eye pain & visual loss.

. Exrenal hordeolum = Syte : ---------------------------- . Staphylococclal abscess of the eyelid. . Tx: Warm compresses. . If not resolved within 48 hours ---> incision & drainage.

. Allergic conjunctivitis: -------------------------- . Intense itching - hyperemia - tearing - conjunctival oedema & eye lid edema.

. CATARACT: ----------- . Progressive thickening of the lens. . Blurred vision & glare. . Tx: Lens extraction.

. Acute angle closure glaucoma: ------------------------------- . Old pts 55 - 70 ys. . Acute severe eye pain. . Blurred vision , nausea & vomiting. . Fixed dilated pupil non reactive to light.

. Open angle closure glaucoma: ------------------------------ . Loss of peripheral vision. . preserved central tunnel vision. . More common in AFRICAN AMERICANs. . Macular degeneration: ----------------------- . Loss of central vision. . More common in OLD AGE.

. Post-operative ENDOPHTHALMITIS: --------------------------------- . H/O of recent ocular operation. . symptoms manifest within 6 weeks of surgery. . pain & -- visual acuity. . swollen eyelids, corneal edema & infection.

. Herpes Zoster Ophthalmicus: ----------------------------- . Dendriform ulcers. . Vesicular rash in the trigeminal distribution.

. CMV Retinitis: ---------------- . HIV pt with CD4 < 50. . Fundoscopy: Yellow - white patches of retinal opacification & hemorrhages are diagnostic.

. Optic neuritis: ----------------- . Central scotoma. . Afferent pupillary defect. . Change in colour perception. . -- visual acuity. . Ass. e' Multiple sclerosis.

. Vitreous hemorrhage : ----------------------- . Sudden loss of vision. . Floaters in the visual field. . Diabetic retinopathy is the most common cause. . Fundus is hard to be visualized with obscured details.

. HSV ---> dendriTIC ulcers.

. HZV ---> dendriFORM ulcers.

. Amaurosis Fugax: ------------------ . Curtain falling down. . Whitened edematous retina following the distribution of the retinal arterioles. . caused by retinal emboli from the ipsi-lateral carotid artery. . CRAO = CENTRAL RETINAL ARTERY OCCLUSION: ----------------------------------------- . Sudden unilateral painless loss of vision. . Pallor of the optic disc + CHERRY RED FOVEA + Boxcar segmentation.

. CRVO = CENTRAL RETINAL VEIN OCCLUSION: --------------------------------------- . Sudden painless unilateral loss of vision. . THUNDER & BLOOD appearance.

. Vitreous hemorrhage: --------------------- . Black curtain coming down infront of eyes = Retinal detachment. . Photopsia (Flashes of light). . Floaters (Spots in the visual field).

. Central retinal vein occlusion: --------------------------------- . Sudden monocular loss of vision. . Blood & thunder appearance. . Optic disc swelling. . Retinal hemorrhage. . Dilated veins. . Cotton wool spots.

. Central Retinal Artery Occlusion:----------------------------------- . Sudden painless loss of vision.

. Pallor of the optic disc. . Cherry red fovea. . Boxcar segmentation of blood in the retinal veins.

. Diabetic retinopathy: ----------------------- . H/O of D.M. . -- visual acuity in both eyes. . Micro-aneurysms. . Dot & blot hemorrhages. . Hard exudates. . Macular edema. . Tx ARGON laser photocoagulation to prevent complications.

. Presbyopia: ------------ . Difficulty in near vision. . Prespyobia is due to -- in lens elasticity not due to macular degeneration !! . A history of middle aged individual who has to hold books at an arms length to read is classic.

. On Tx of Acute glaucome , ATROPINE is contraindicated. . 1st line Tx: I.V. MANNITOL.

. Multiple Sclerosis : ---------------------- . FEMALE with multiple neurological presentations. . Associated optic neuritis can lead to blurring of vision & retro-bulbar pain.

. Sub-conjunctival hemorrhage ---> No ttt .. Just Observation.

. CRAO Tx: ocular massage + High flow Oxygen.

. Sympathetic Ophthalmia: ------------------------- . Damage of one eye (sympathetic eye) after a penetrating injury to the other eye. . Due to UN-COVERING OF HIDDEN ANTIGENS !

. In HIV pts: ------------- .. HSV & HZV : -------------- ... Pain-ful. ... Ass. with karatitis & conjunctivitis. ... Fundus: Peripheral pain lesions & central necrosis.

.. CMV : -------- ... Pain-less. ... Not ass. e'keratitis or. conjunctivitis. ... Fundus: Hemorrhages & fluffy or granular lesions around retinal vessels.

. Neuro-fibramatosis type 1 = Axillary freckling + Cafe' au lait patches + Optic glioma. ---------------------------

. Diabetic pt with blurry vision:--------------------------------- . Type 2 D.M. with HYPEROSMOLAR HYPERKETOTIC state without ketoacidosis.

. Glucose in urine with NO KETONES. . NKHS = Non Ketotic Hyperosmolar $ so, the cause of blurring of vision is HYPEROSMOLARITY !

. Macular degeneration: ----------------------- . Grid test: distortion of the straight lines that appear wavy !

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