ICO Clinical Ophthalmology (Advanced) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Vogt striae

Fine vertical folds in Descemet membrane seen in keratoconus; they disappear transiently with digital pressure on the globe, distinguishing them from scarring.

Fleischer ring

Epithelial iron deposition at the base of the keratoconic cone, best seen with cobalt blue light; it is a supportive slit-lamp sign rather than a primary diagnostic test.

Munson sign

A V-shaped tenting of the lower eyelid on downward gaze in advanced keratoconus, caused by the protruding cone displacing the lid margin.

Acute angle-closure

Sudden IOP rise from blocked aqueous outflow with a shallow chamber and mid-dilated pupil; treated with IOP-lowering agents and laser peripheral iridotomy.

Laser peripheral iridotomy

Definitive treatment for pupillary block angle closure; it creates an alternate aqueous pathway and is indicated in acute attacks and high-risk fellow eyes.

4-2-1 rule

Severe nonproliferative diabetic retinopathy criterion: hemorrhages in four quadrants, venous beading in two, or intraretinal microvascular abnormalities in one.

Cherry-red spot

Foveal appearance in central retinal artery occlusion; the fovea stays red while surrounding retina whitens, and vision loss is sudden and painless.

Afferent pupillary defect

Relative pupillary escape when light swings from the normal to the affected eye, indicating asymmetric optic nerve or severe retinal dysfunction.

Giant cell arteritis

Large-vessel vasculitis in older adults with headache and jaw claudication; high-dose corticosteroid is started immediately to prevent bilateral blindness.

Papilledema

Bilateral optic disc swelling from raised intracranial pressure; acuity is preserved early, and the enlarged blind spot is an early field change.

Optic neuritis

Unilateral optic nerve inflammation with pain on eye movement, color desaturation, and an afferent pupillary defect; it is often associated with demyelinating disease.

Amblyopia

Reduced best-corrected acuity from abnormal visual experience during development, without structural cause; treated by correcting refractive error and occluding the better eye.

Hypopyon

Layering of white blood cells in the anterior chamber, indicating severe anterior uveitis or endophthalmitis; it requires urgent evaluation for infection.

Rhegmatogenous detachment

Retinal separation caused by a full-thickness break allowing fluid into the subretinal space; it presents with photopsia, floaters, and a visible flap.

Exudative detachment

Subretinal fluid without a retinal break, often from tumor, inflammation, or vascular leakage; it shifts with head position and requires medical workup.

Endophthalmitis

Severe intraocular infection, usually after surgery or trauma, with pain, hypopyon, and vitritis; treated with intravitreal antibiotics and vitrectomy if severe.

Corneal scrape

Sampling of a corneal ulcer for Gram stain and culture before antibiotics in sight-threatening cases, guiding organism-specific therapy.

Ocular surface squamous neoplasia

Malignant conjunctival or corneal epithelial proliferation that can mimic chronic unilateral conjunctivitis; any non-healing lesion warrants biopsy.

Thyroid eye disease phases

Active inflammatory phase is managed medically; rehabilitative surgery for proptosis, strabismus, and eyelid changes is deferred until the disease is stable.

ROP screening criteria

Screening is based on gestational age and birth weight thresholds; treatment urgency depends on zone I involvement and the presence of plus disease.

Disc cupping

Enlargement of the optic cup relative to the disc; it is not specific for glaucoma and must be interpreted with disc size, rim pattern, and progression.

Keratoconus topography

Inferior steepening with asymmetric bow-tie and scissoring retinoscopy; diagnosis rests on corneal topography or tomography rather than refraction alone.

POAG target pressure

A common initial goal is 20 to 30 percent reduction from untreated baseline IOP, adjusted for severity, rate of progression, and life expectancy.

Diabetic macular edema

Retinal thickening from leakage in diabetic retinopathy; anti-VEGF injections are first-line for center-involving edema, with laser for non-center cases.

Neovascular glaucoma

Angle closure from iris and angle neovascularization, often after retinal ischemia; treatment targets the underlying ischemia plus IOP control.

Retinoblastoma leukocoria

A white pupillary reflex in a child is retinoblastoma until proven otherwise; urgent examination under anesthesia and imaging are required.

Congenital glaucoma triad

Epiphora, photophobia, and blepharospasm in an infant with enlarged cornea and Haab striae indicate congenital glaucoma needing urgent surgery.

Anterior ischemic optic neuropathy

Sudden painless altitudinal field loss with sector disc edema in older adults; there is no proven acute treatment, and the fellow eye is at risk.

Traumatic hyphema

Blood in the anterior chamber after blunt trauma; management addresses IOP, rebleeding risk, and sickle cell status, which worsens prognosis.

Chalazion

Chronic lipogranulomatous inflammation of a meibomian gland presenting as a painless lid nodule; initial management is warm compresses and lid hygiene.

Bacterial keratitis

Corneal infection with infiltrate and epithelial defect, often contact lens related; urgent topical antibiotics and lens discontinuation are required.

Optic atrophy

Pallor of the optic disc from loss of axons; it is a sign of prior or ongoing optic nerve damage rather than a diagnosis in itself.