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Question 1

Define trichiasis

Answer 1

Eyelashes growing into the globe instead of away from it

Question 2

Management of adult NLDO?

Answer 2

Dacryocystorhinostomy

Question 3

Management of congenital NLDO?

Answer 3

1. Conservative management (90% resolve within their first year )
   • Sac compression and massage
   • Antibiotics if needed ( tobramycin / erythromycin )
   • warm compresses
2. Surgery :
   • Probing and dilatation
   • Stent insertion

Question 4

Finding in CNIII Palsy

Answer 4

• dilated pupil (ciliary muscles)
• ptosis (levator)
• abducted eye, looking slightly downwards (function of SO + LR)
• no diplopia since there is complete ptosis

Question 5

D.D. Eye pain on occular movement

Answer 5

Optic neuritis
Scleritis

Question 6

D.D RAPD

Answer 6

Optic neuritis
Angle closure glaucoma

Question 7

Symptoms of optic neuritis

Answer 7

Pain on occular motility
RAPD
decreased visual acuity
Colour vision loss

Question 8

Symptoms of optic neuritis

Answer 8

Pain on occular motility
RAPD
decreased visual acuity
Colour vision loss

Question 9

Symptoms of optic neuritis

Answer 9

Pain on occular motility
RAPD
decreased visual acuity
Colour vision loss

Question 10

Why do we give cycoplegics (atropine) in anterior uveitis?

Answer 10

Relieve pain
Relieve photophobia
Slight anti microbial effect
Prevent posterior synechia

Question 11

How do we exclude corneal ulcers?

Answer 11

Fluorescin staining under slit lamps.

Question 12

State two findings in cicatricial trachoma

Answer 12

Arlt’s line (band of fibrous tissue in tarsal Conjuctivita)
Herbert’s pits (superior limbal depressions post follicular healing)

Question 13

Management of trachoma

Answer 13

SAFE!
Surgery is aimed at relieving entropion and trichiasis and
maintaining complete lid closure.
• Antibiotics should be administered to those affected and to all
family members, A single dose of azithromycin (20 mg/kg up to 1
g) is the treatment of choice, Erythromycin 500 mg twice daily for
14 days, Topical 1% tetracycline ointment is less effective than oral
treatment.
• Facial cleanliness is a critical preventative measure.
• Environmental improvement, such as access to adequate water
and sanitation, and control of flies.

Question 14

Management of viral Conjuctivitis

Answer 14

pontaneous resolution of adenoviral infection usually occurs within 2–
3 weeks
• Viral conjunctivitis is highly contagious so reduction of transmission risk
should be done by proper hand hygiene, avoiding eye rubbing and
towel sharing
• For Molluscum contagiosum, Although lesions are self-limiting removal
is often necessary to address secondary conjunctivitis or for cosmetic
reasons.
• Discontinuation of contact lens wear until resolution of symptoms.
• Preservative-free artificial tears four times daily may be useful for
symptomatic relief

Question 15

Presentation and treatment of allergic Conjuctivitis?

Answer 15

Presented with acute itching and watering but
the hallmark is chemosis. Treatment is usually not required except for cold compresses

Mild Symptoms: Artificial tears.
• Moderate Symptoms: add Mast cell stabilizers or
Antihistamines
• Severe Cases: Topical steroids in addition to
preceding medications and oral antihistamines may
be indicated.

Question 16

Management of VKC/ AKC?

Answer 16

1. GENERAL (ABC)
   Avoid allergens
   Bandage contact lenses to heal epithelial defect
   Cool compress
   They both have the same treatment however AKC is unremitting
2. MEDICAL ( mast cell stabilizers / topical steroids if corneal ulcer/ topical antihistamines in acute exacerbation / topical NSAIDS/ oral antihistamine to help sleep and avoid eye rubbing)
3. SURGICAL ( uperficial keratectomy to debride ulcers and allowing reepithelization.
   • Surface restoration surgeries as amniotic membrane grafting or eyelid
   procedure as botulinum induced ptosis in severe cases of persistent epithelial
   defects)

Question 17

Findings in patient of AKC

Answer 17

• Other atopic conditions (AD)
• . Eyelid erythema and scaling.
  2. Conjunctival discharge (mucoid) , hyperemia and papillae with cicatrization
  in sever cases with symblepharon formation.
  3. Corneal keratopathy including vascularization, epithelial defect and
  keratoconus is common in 15%.
  4. Presenile subcapsular cataract and may be related to long term steroids use.
  5. Retinal detachment is more common than in general population.

Question 18

What must we exclude in a child w/ buphthalmous

Answer 18

Retinoblastoma

Question 19

How can we confirm the diagnosis of retinoblastoma?

Answer 19

Ocular US

Question 20

Treatment of central vs peripheral retinoblastoma?

Answer 20

Central: systemic chemo followed by laser
Peripheral: systemic chemo followed by cryotherapy/ brachytherapy

Question 21

Presentation, investigations and treatment of rhabdomyosarcoma?

Answer 21

Presentation: proptosis, but with no pain
Investigations: CT orbit + biopsy
Treatment: very good response to radiotherapy

Question 22

Management of ocular malignancies arising from adnexa?

Answer 22

Removal w/ safety margin + lid reconstruction

Question 23

What investigations are required for a secondary ocular malignancy?

Answer 23

CT orbit + incisional biopsy.

Question 24

Which 2ry ocular malignancy is associated with hyperviscosity + low platelets?

Answer 24

Leukemia

Question 25

Presentation of 2ry metastasis of eye?

Answer 25

Raccoon eyes
Squint
Proptosis