20 Must-Know Ophthalmology Flashcards NEET PG 2025

Flashcard 1

Hypermature or Morgagnian Cataract 

• MC complication- Phacolytic glaucoma is the leakage of lens protein blocking the trabecular meshwork due to the hypermature cataract.
• There is wrinkling of the capsule and leakage of the lens.
• During surgery, if the capsule is not visible properly trypan blue dye can be used to delineate the anterior capsule.

Flashcard 2

Diabetic Cataract

• It is a presenile and metabolic cataract.
• It is a snowflake or snowstorm cataract.
• It is more common in Type 1.
• A diabetic patient develops cataracts due to sorbitol accumulation in the lens.
• Sorbitol is very hyperosmotic and will imbibe water.
• The enzyme NADPH-dependent aldose reductase is responsible.
• Frequent change of glasses is not due to diabetic cataracts.
• Diabetes itself can be a cause of frequent changes of glasses.
• Fluctuating Refractive Errors occur in hyperglycemic patients because of myopic shifts. This is due to swelling that in turn increases the curvature. ·
• Vice versa, in case of hypoglycemia, we observe hypermetropic shift (towards lesser curvature).

Flashcard 3

Chalcosis

• It is the golden-brown copper deposition in the Descemet's membrane known as the Keyser Fischer (KF) ring.
• It starts superiorly and inferiorly and later becomes a circle.
• All patients with neurological complications of Wilson's disease will have a KF ring.
• Only 65-67% of patients with Hepatic involvement can have a KF ring.
• Sunflower cataract is a feature of Chalcosis.

Flashcard 4

ECCE (Extracapsular Cataract Extraction)

• The non-fundable IOLS are PMMA (Polymethyl methacrylate).
• Foldable IOLS are generally made up of silicone acrylic and hydrogel.
• Hydrophobic acrylic has the least chance of posterior capsule opacification.

Flashcard 5

Femtolaser Cataract Surgery

• Latest
• It involves:
  • Incision
  • Capsulotomy
  • Lens fragmentation.
• The pulse duration is 10^-15 sec.
• The wavelength is 1054 nm.

Flashcard 6

1. Congenital Glaucoma

• It can either be true congenital (the child is born with the problem).
  • It can be infantile (less than 3 years of age).
  • Juvenile (from 3 years to adolescence).
• Buphthalmos is the feature of true congenital and infantile disease because the sclera stretches only up to 3 years.

2. Acquired Glaucoma - they can be:

• Primary: can be open angle or angle closure.
• Secondary: can also be open angle or angle closure.

Flashcard 7

Pigmentary Glaucoma

• Pigment from the Iris disperses and flows through the aqueous and it blocks the trabecular meshwork.
• Transillumination defect
  • When the pigment moves more light flows.
  • If these pigments are deposited at the back of the cornea, it is known as Krukenberg Spindles.
  • There is a sudden rise of pressure after exercising due to rubbing the Iris with the suspensory ligament.
  • Reverse glaucoma is due to the shape of the Iris.

Flashcard 8

Congenital Glaucoma

• Buphthalmos: Big eye and large cornea.
• Corneal oedema
• Haab's striae: Horizontal
• Vogt's striae: Vertically parallel to the steep axis
• Seen in Keratoconus
• Treatment:
  • Goniotomy (TOC)
  • If there is no clear cornea, then Trabeculectomy with Trabeculectomy.

Flashcard 9

Bacterial Keratitis

• Fluorescence stained +ve ulcer
• The hypopyon is sterile.
• Most common bacteria:
  • Staphylococcus aureus
  • Staphylococcus epididymitis (in India)
• Hypopyon corneal ulcer- Pneumococcus
• Ulcus serpens
  • Ulcer presents in a serpentine manner.
• For all types of Keratitis, the patient presents with pain, redness, photophobia, and diminution of vision.
• Pseudocornea is a feature of sloughing ulcers.
• Pseudocornea is an important cause of anterior staphyloma.
• Perforating corneal ulcers can lead to leucoma adherens.
  • Management - Cyanoacrylate glue
• Nocardia resembles fungal keratitis.
• Pseudomonas can cause corneal perforation in 48 hours.
• Pseudomonas is the most common infection after contact lens use.

Flashcard 10

Trachoma (Sago-Grain Follicles) 

• It is caused by Chlamydia trachomatis strains A, B, Ba, and C.
• It is a disease of children.
• D-K causes adult inclusion conjunctivitis which is also called swimming pool conjunctivitis.
• Swimming pool conjunctivitis is also caused by adenovirus.
• It has both papillary and follicular reactions.
• Intracellular inclusion bodies are HP bodies.
• It has an inflammatory stage and a cicatrising stage.
• Follicles are on the upper palpebral conjunctiva and the upper limbus - these are called Herbert follicles.
• When there is scarring, there is a linear scar called the Arts line, and a scar at Herbert's follicles is called Herbert's pits.
• The only complication of Trachoma is a corneal ulcer.

Flashcard 11

Vernal Keratoconjunctivitis / Spring Catarrh

• It has a cobblestone appearance.
• It has an exogenous allergy (dust and pollen).
• It is seen in male children.
• It is a type 1 hypersensitivity reaction.
• It is presented as papillary hyperplasia either at the upper palpebral or at the upper limbus.
• When it is at the upper limbus, there are central dots known as Horner trantas spots which are Eosinophils.
• Treatment
  • All anti-allergic mast cell stabilizers.
  • It can also be associated with Keratoconus.

Flashcard 12

Bitot's Spots

• Xerophthalmia - Vitamin A deficiency
• WHO Grading
  • XN: Nyctalopia (Night blindness)
  • XIA: Conjunctival xerosis
  • XIB: Bitot spot (most common temporally)
  • XII: Corneal xerosis
  • XIIIA: Melting of the cornea (Keratomalacia involving 1/3rd of the cornea).
  • XIIIB: Keratomalacia involving more than 1/3rd of the cornea.
  • XS: Corneal scarring
  • XF: Xerophthalmic fundus (white spotted fundus).
• Treatment
  • If the patient is more than 1 year old - injective vitamin A 1 lakh IU is given on 0, 1, and 14th day.
  • If the patient is more than 1 year - half the dose is given.

Flashcard 13

• Pterygium is a connective tissue disorder.
• Pathology: Elastotic degeneration of conjunctival stroma.
• M/C- Nasally
• It is a subconjunctival fibrovascular triangular tissue encroaching the cornea with a head, cap (cellular infiltration) and body.
• Initially, it is a cosmetic problem, but in later stages of life, it may lead to astigmatism.
• If it covers the pupillary area, it may cause diminished vision.

Flashcard 14

Dacryoscintigraphy

It is a simple, non-invasive and physiological assessment of the nasolacrimal system. Dacryoscintigraphy uses the radioactive labelling of tears and following it with γ-counter.

Q. What is the treatment strategy to diagnose the lacrimal pump failure?

Ans. Dacryoscintigraphy

Q. What is the treatment strategy to diagnose the lacrimal drainage system?

Ans. John Titus

Flashcard 15

RAPD 

It can be diagnosed over and over again by swinging the torch between both eyes. When the doctor first shows light to the eye, it causes constriction again and again, but after so many attempts, suddenly, it causes dilatation instead of constriction in one of the eyes, which is abnormal. Marcus Gunn pupil- another name of RAPD. Diagnostic test- Swinging flashlight test.

Flashcard 16

Papilledema

• Blurring of disc margin and dilatation of the veins.
• Papilledema ® any edema around the disc
• Visual field defect: Enlargement of the blind spot or edema around the optic disc and constriction of the visual field because of the damage to the optic nerve.
• First sign of papilledema: Venous dilatation
• There is an imbalance of pressure; either the preliminary pressure is less or the retrolaminar pressure (intraocular area) is more.
• Disturbance in the gradient causing stasis of axoplasmic flow, ® Drainage stasis , in turn causes leakage and causes papilledema.

Flashcard 17

Normal Pupillary Action and Abnormal Pupillary Action

• Normal action is the light reflex which can be direct and consensual, the same eye is direct and another eye is consensual.
• Normally light that is directed in one eye produces pupil constriction in both eyes. The direct response is the change in pupil size in the eye to which the light is directed (e.g., if the light is shown in the right eye, the right pupil constricts).
• A consensual light reflex occurs because even when the light is shined in only one eye, a consensual response occurs in the other eye. The Afferent is through the third nerve. If there is any lesion in the afferent pathway (in the pretectal area), it results in Argyll Robertson Pupils.
• Argyll Robertson pupils (ARP) are characterised by small and irregular pupils that have little to no constriction to light but constrict briskly to near targets (light-near dissociation).
• In other words, light reflexes are absent and near reflexes are present, and the accommodation reflex is present in light-near dissociation.
• This term (ARP) is mainly used for neurosyphilis otherwise it is called light near dissociation.
• When the lesion is found in the efferent pathway, the ciliary ganglion is affected.
• Sluggish light reflex or little light reflex is present and sluggish accommodation.
• Holmes adie pupil is a unilateral condition with mid dilated pupil, it is a tonic pupil because it takes time to come back to normal. Generally present in middle aged females.
• If one eye is mid-dilated, then there is a chance of photophobia.
• If pupil size is different, it is called anisocoria.
• If anisocoria is more prominent in light, then the abnormal eye is the dilated one because light has constriction.
• Once we know the abnormal eye, a slit lamp examination is done to find any sphincter damage or the cause of why it is dilated.
• If it appears normal, then pilocarpine is administered at a dose of 0.125%.
• If the pupil reacts at such a small dose and the pupil constricts, then it indicates Holmes adie. If a pupil is not constricted, then the dose of pilocarpine is increased to 1% and the pupil is constricted at this dose, it is considered normal. If not constricted at this dose, it indicates that the patient has pharmacological mydriasis.

Flashcard 18

Lesions of the Visual Pathway 

• A indicates a lesion in the optic nerve: Left Hemianopia.
• B indicates a lesion in the chiasma: Bitemporal Hemianopia.
• C indicates a lesion at the junction of chiasma.
• D indicates a lesion at the optic tract: Right-sided homonymous hemianopia.
• E indicates a lesion at the temporal radiation fibre: Pie in the sky.
• F indicates a lesion at the parietal radiation fibre: Pie in floor.
• G indicates a lesion at the visual cortex: Congruous homonymous hemianopia (shows Macula sparing Key-hole vision).

Flashcard 19

Thyroid Eye Disease

• Superior limbic keratoconjunctivitis is a feature of thyroid eye disease (TED).
• The patient can be hypo/hyper/euthyroid.
• It is an autoimmune disease with a lot of inflammatory cells, multiplication of adipose cells, enlargement of muscles, and secretion of glycosaminoglycan. All these factors contribute to increased intraorbital pressure, pushing the eye outward and leading to proptosis.
• More common in females.

Flashcard 20

Blepharophimosis Syndrome 

• It occurs due to the FOXL-2 gene.
• Features
  • Shortening of horizontal lids
  • A fold of skin from the lower lid is called epicanthus inversus.
  • Ptosis
  • Increase in the distance between 2 medial canthus
  • Congenital ectropion of lower lid.

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