Ambulatory high yields: ophtho

Question 1

Old person w/ gradual loss of central vision + blurred vision, distortion, scotoma. Dx?

Answer 1

Age-related macular degeneration. Dry because it was gradual. Wet would have been sudden

Question 2

Tx of wet MD?

Answer 2

Injections of VEGF inhibitors

Question 3

Person walks into movie theater and develops red, painful eye w/ blurry vision and “halos”. Dilated, non-reactive pupil.

Answer 3

Acute angle-closure glaucoma

Question 4

Black person >50 w/ progressive visual field loss and increased cup:disc ratio

Answer 4

Chronic open-angle glaucoma

Question 5

Old person w/ gradual loss of visual acuity and complaints of glare and night driving

Answer 5

Cataracts

Question 6

MCC of red eye

Answer 6

Conjunctivitis

Question 7

Near-sighted patient magically starts getting better w/o tx. Sup?

Answer 7

“Second sight”- patient develops cataracts, which cause increased refractive power and correct for near-sightedness (at first)

Question 8

Focal unilateral blotchy redness of the conjunctiva. Otherwise asx

Answer 8

Subconjunctival hemorrhage

Question 9

Severe, deep pain in a red eyed RA patient

Answer 9

Scleritis

Question 10

Circumcorneal injection, blurred vision, pain, photophobia in a young guy

Answer 10

Anterior uveitis

Question 11

Dentritic ulcer on the cornea w/ ocular irritation and photophobia

Answer 11

HSV keratitis

Question 12

Red eye(s) w/ watery discharge and a palpable preauricular lymph node

Answer 12

Viral conunctivitis

Question 13

College girl comes back from ~sPrInG bReAk~ and has rapid onset of copious purulent exudate–> severe redness, swelling, and pain. Dx, next best step, and tx?

Answer 13

Hyperacute conjunctivitis from gonorrhea. Call ophtho and give IM ceftriaxone + topical therapy

Question 14

Rapid onset of ocular irritation, hyperemia and tearing + mucopurulent exudate w/ crusting. Dx?

Answer 14

Bacterial conjunctivitis

Question 15

MCC of bacterial conjunctivitis?

Answer 15

S. pneumo