AMK day 14/10/23

Question 1

sclera

Answer 1

white part of eye - fibrous layer that protects and shapes the eye.
HWere EO msucles attach

Question 2

Choriod

Answer 2

is a vascualr layer that provides oxygen and nuritents to the retina

Question 3

fovea

Answer 3

where visual acuity is highest and is repsonsible for sharp vision

Question 4

features of Auveiits ( iritis)

Answer 4

pinful red eye
ciliary flush
hypopyon - whote cell collection in eye
pain on eye movement
miosis
abnromally shaped pupil
reduced visual acuity

usually due to autoimmune causes
infection
trauma
ischaemia
malignancy

Question 5

Mx of ant uveitis

Answer 5

ophthalmology referral
steroid eye drops
mydriatics for sx relief - cyclopentolate ( 6-8hrs of blurry vision) or atropine ( will have blurry vision for a white) most use tropacamide)
immunosuppressants

Question 6

eye pain and blurry. dendritic ulcer in cornea - most likely organ

Answer 6

herpes simplex 1( face lips and eyes)

Question 7

contact lenses in tap water - treatment for this

Answer 7

acanthamoeba - chlorine is treatment

Question 8

herpes simplex 2 affects

Answer 8

genitals

Question 9

keratitis sx

Answer 9

inflamamtion of cornea

painful red eye
photphobia - hence wearing sunglasses
dendritic ulcers
BF sensation
epiphora - watery eyes
reduced visual acuity

Question 10

keratitis mx

Answer 10

same day opthalmolog assessment
acyclovir

Question 11

blurred vision, cannot drive at night due to glare for cars. T2DM , COPD

Answer 11

catarcts

Question 12

difference bwteen viral and bacterial conjuctivits

Answer 12

bacterial - Purulent discharge(thick and pus like)
Eyes may be ‘stuck together’ in the morning)
viral - Serous discharge((clear and thin; may be present in a healthy,)
Recent URTI
Preauricular lymph nodes

Question 13

cataracts sx

Answer 13

slow redution in vision
blurring
halos
glare
abnromal red relfex

Question 14

RF cataracts

Answer 14

Increasing age - biggest RF
Smoking
DM
steriod use
alcohol
metabolic disorders - hypocalcaemia
women

need surgery

Question 15

4 days post cataract surgery - painful red eye, hypopyon, reduced vision, photophobia, floaters what is tx

Answer 15

intravitreal abx ( vancomycin)

Question 16

central vision worse. T2DM. vessels and haemorrhages around fovea. fatty deposits across the retina and around the macula what is the answer

Answer 16

wet ARMD

Question 17

how is hypothyroidism linked to blephairits

Answer 17

hypothyroidism has been linked to blepharitis due to its association with meibomian gland dysfunction.

Question 18

mx of chronic open angle glaucoma

Answer 18

NICE guidelines
offer 360° selective laser trabeculoplasty (SLT) first-line to people with an IOP of ≥ 24 mmHg NICE
360° SLT can delay the need for eye drops and can reduce but does not remove the chance they will be needed at all
a second 360° SLT procedure may be needed at a later date
prostaglandin analogue (PGA) eyedrops should be used next-line NICE
the next line of treatments includes:
beta-blocker eye drops
carbonic anhydrase inhibitor eye drops
sympathomimetic eye drops
surgery in the form of a trabeculectomy may be considered in refractory cases.

Question 19

acue angle closure glaucoma what is

Answer 19

angle between iris and cornea is clsoed off as the iris bulges forward and seals off(closure) the trabeuclar meshwork and then aqueosu humour cannot drain away therefore icnrease IOP and causing pain and then down teh line optic nerve damage

Question 20

sx of acute angle closure glaucoma

Answer 20

sudden onset
peripheral vision loss
severly painful red eye
blurred vision
cornea looks hazy to others
halos in vision/around lights
fixed dilated pupil
firm pupil on palpation
assoicated headache/ NandV
decreased visual acuity

Question 21

why does the cornea look hazy in glaucoma

Answer 21

build u aqueous humour getting pushed into the cornea causing the cloudiness

Question 22

rf for acute angle closure glauocma - from lorena teach will in

Answer 22

adreneregic medication
hypermetropia

Question 23

pathology of open angle glaucoma

Answer 23

graudual onset with increased reisitance due to decrease in aqueous humour outflow through trabecula mesh network leadign to increased IOP and more optic nerve damage - angle between the iris and cornea is normal

Question 24

presentation of open angle glaucoma

Answer 24

gradual
loss of perioherla vision
haloes
fluctuaitng pain headahce sand blurred v

Question 25

rf of open angle

Answer 25

icnreasing age
fmaily hisotry
myopia
black

Question 26

ix for open angle

Answer 26

fundoscop shows cupping of optic nerve - increased cup to disc ratio
goldmann applanation tonometry - measures IOP - note IOP can be normal - gold

Question 27

mx of open angle

Answer 27

AMK - treatment start over 24mmHg
prostaglandin first line
bb or alpha 2 antaognist - brimonidien
carbonic anhydrase i
trabeculectomy

Question 28

normal intraocular pressure

Answer 28

10-21mmHg

Question 29

what is a stye and tx

Answer 29

infected abscess within follicle - hordeolum

staph

painful

warm compress and analgesia

Question 30

chalazion

Answer 30

cyst due to obstruction of emibomian gland on inside of eye

non fluctuant and painless

Question 31

entropion

Answer 31

inwards turning of eyelid causing lashes to brush against eyeball

painful

corneal damaeg

need to tape eylid down and lubricating eye drops

Question 32

ectorpion

Question 33

bacterial keratitis most comkon ause in contac tlens

Answer 33

peseudomonas

acanothomeoba - unproportionate pain

Question 34

pus within the anterior chamber.

Answer 34

hypopyon

Question 35

As her anisocoria is worse in the light, her right pupil which is more dilated than her left, is most likely to be the abnormal pupil. This is because an anisocoria worse in the light suggests an inability of the eye to constrict in response to light, hence the pupillary asymmetry becoming more apparent as the normal eye constricts.

means different in pupil size

where is the problem

Answer 35

right ciliary gnaglion

Question 36

exotropia can lead to what

Answer 36

Amblyopia, also known as ‘lazy eye

Question 37

why is a CT scan with contrast should be done if orbital cellulitis is suspected

Answer 37

to assess the posterior spread of infection

Question 38

tx for corneal abrasion like accidently scratching your eye

Answer 38

Corneal abrasion: topical antibiotics should be given to prevent secondary bacterial infection

Question 39

complication of pan-retinal laser photocoagulation for diabetic retinopathy

Answer 39

decrease in night vision

Question 40

Which one of the following features is not present in diabetic pre-proliferative retinopathy?

Microaneurysms
Blot haemorrhages
Cotton wool spots
Venous beading

Neovascularisation

Answer 40

neovascularisation

Question 41

treat proliferative diabetic retinopathy

Answer 41

Intravitreal VEGF inhibitors + pan-retinal photocoagulation laser

. This patient has stage 3 proliferative diabetic retinopathy, and so will benefit from a combination of both an anti-vascular endothelial growth factor (VEGF) injection and pan-retinal photocoagulation laser.

Question 42

segmented areas of redness and dilated episcleral vessels

Answer 42

episcleritis

Question 43

A 26-year-old woman presents to her GP practice with a painful lump on the edge of her left eyelid. She is otherwise well and has no past medical history. On examination it appears that she has a small pus-filled abscess in the area. Her visual field is not affected. Given the likely diagnosis, which of the following treatments should be advised?

Answer 43

Advise regular warm steaming as first line treatment for stye