OPHTHALMOLOGY REVISION - GP
Chloramphenicol eye drops:
- Hordeolum (stye) with conjunctivitis
- Dacryocystitis
- Bacterial conjunctivitis
- Corneal abrasion
Lid hygiene (warm compresses and mechanical removal of debris):
- Blepharitis - bilateral grittiness
- Hordeolum
- Viral non-herpes conjunctivitis
Artificial tears (hypromellose):
- Keratoconjunctivitis sicca (dry eye) - bilateral dryness and grittiness often in elderly,
worse at end of day
Gradual painless vision loss globally, faded colour vision, glare with halos around lights, defect
in red reflex, cloudy lens? Cataracts → phacoemulsification
Unilateral or bilateral gradual painless vision loss centrally, metamorphopsia (straight lines
appear wavy), scotoma, impaired adaptation to darkness? Macular degeneration → Amsler
grid, fundoscopy → dry - antioxidants (zinc + vitamins A, C and E), wet - anti-VEGF injections
Bilateral gradual painless vision loss peripherally to centrally, impaired adaptation to darkness,
halos around lights, headaches? Primary open-angle glaucoma → myopia (short-sighted,
African) → prostaglandin analogue eye drops to increase uveoscleral outflow (latanoprost)
Diabetic retinopathy
- Classification is non-proliferative (NPDR), proliferative (PDR) or maculopathy
- NPDR mild - ≥1 microaneurysm, moderate - cotton-wool exudates, flame and
blot haemorrhages, hard exudates, severe - involvement of all 4 quadrants
- Tx: NPDR mild - observation, NPDR moderate/severe - focal laser photocoagulation,
PDR pan-retinal photocoagulation + anti-VEGF injections
Hypertensive retinopathy
- Keith-Wagener classification is:
- I - AV narrowing and tortuosity (silver wiring)
- II - AV nipping
- III - cotton-wool exudates, flame and blot haemorrhages
Chloramphenicol eye drops:
- Hordeolum (stye) with conjunctivitis
- Dacryocystitis
- Bacterial conjunctivitis
- Corneal abrasion
Lid hygiene (warm compresses and mechanical removal of debris):
- Blepharitis - bilateral grittiness
- Hordeolum
- Viral non-herpes conjunctivitis
Artificial tears (hypromellose):
- Keratoconjunctivitis sicca (dry eye) - bilateral dryness and grittiness often in elderly,
worse at end of day
Gradual painless vision loss globally, faded colour vision, glare with halos around lights, defect
in red reflex, cloudy lens? Cataracts → phacoemulsification
Unilateral or bilateral gradual painless vision loss centrally, metamorphopsia (straight lines
appear wavy), scotoma, impaired adaptation to darkness? Macular degeneration → Amsler
grid, fundoscopy → dry - antioxidants (zinc + vitamins A, C and E), wet - anti-VEGF injections
Bilateral gradual painless vision loss peripherally to centrally, impaired adaptation to darkness,
halos around lights, headaches? Primary open-angle glaucoma → myopia (short-sighted,
African) → prostaglandin analogue eye drops to increase uveoscleral outflow (latanoprost)
Diabetic retinopathy
- Classification is non-proliferative (NPDR), proliferative (PDR) or maculopathy
- NPDR mild - ≥1 microaneurysm, moderate - cotton-wool exudates, flame and
blot haemorrhages, hard exudates, severe - involvement of all 4 quadrants
- Tx: NPDR mild - observation, NPDR moderate/severe - focal laser photocoagulation,
PDR pan-retinal photocoagulation + anti-VEGF injections
Hypertensive retinopathy
- Keith-Wagener classification is:
- I - AV narrowing and tortuosity (silver wiring)
- II - AV nipping
- III - cotton-wool exudates, flame and blot haemorrhages
