Board Vitals Ophthalmology

Question 1

What happens if there is muscle entrapment after an orbital floor fracture?

Answer 1

Eye cannot look up because of inferior rectus muscle entrapment.

Question 2

What happens if there is muscle entrapment after a medial orbital wall fracture?

Answer 2

Eye cannot look laterally

Question 3

What is the difference between a chalazion and a hordeolum?

Answer 3

Chalazion - chronically blocked meibomian gland
Hordeolum - acute infection of meibomian gland or glands of Ziess

Question 4

Is a chalazion infected?

Answer 4

No

Question 5

Is a hordeolum infected?

Answer 5

Yes

Question 6

What should you do if there is chronic chalazia with eyelash loss?

Answer 6

Biopsy

Question 7

Fundoscopy shows diffuse swelling of optic disc with engorged vascular arcades and hemorrhages.

Diagnosis?

Answer 7

Central vein occlusion

Question 8

Patient has an afferent pupillary defect and decrease in color vision.

Diagnosis?

Answer 8

Optic neuritis

Question 9

What is the treatment of optic neuritis related to multiple sclerosis?

Answer 9

High dose IV methylprednisolone

Question 10

What is the treatment of acute closed angle closure glaucoma?

Answer 10

Topical aqueous suppressants (acetazolamide)

Question 11

What does an enlarged cup:disc ratio raise concern for in a patient experiencing worsening vision loss?

Answer 11

Primary open-angle glaucoma

Question 12

Do pituitary adenomas cause cupping of the optic nerve?

Answer 12

No

Question 13

Patient presents with progressive blindness. Exam reveals waxy and pallid appearance of optic disc, narrowed retinal arteries and bony pigmented spicules.

Diagnosis?

Answer 13

Retinitis pigmentosa

Question 14

Patient presents with conjunctival injection, itching, watery discharge, and is worse around dust.

Diagnosis?

Answer 14

Allergic conjunctivitis

Question 15

Patient with rosacea presents with crusting of eyelashes, with eyes “stuck shut” in the morning.

Diagnosis?

Answer 15

Blepharitis

Question 16

What is the next step in management of central retinal artery occlusion (CRAO)?

Answer 16

Optimize cardiovascular risk factors

Question 17

What is a Argyll-Robertson pupil?

Answer 17

Failure of pupils to constrict with light

Question 18

What ophthalmology condition is associated with multiple sclerosis?

Answer 18

Internuclear ophthalmoplegia

Question 19

Progressive vision loss, decreased vibrancy of colors, halos around streetlights, difficulty with night vision.

Diagnosis?

Answer 19

Cataracts

Question 20

What do multiple yellow deposits on fundoscopic examination indicate; in a patient with central vision distortion?

Answer 20

Macular degeneration

Question 21

What do cotton wool spots and optic disc swelling on fundoscopic examination indicate?

Answer 21

Hypertension

Question 22

Can amiodarone cause vision changes (blurry vision and colored halos)?

Answer 22

Yes (causes corneal deposits)

Question 23

Does oculomotor palsy (3rd cranial nerve) need treatment?

Answer 23

No (resolves on its own after weeks to months)

Question 24

Is prednisone indicated in 3rd nerve palsy due to diabetic mononeuropathy?

Answer 24

No

Question 25

Patient presents with eye pain and decreased vision after sleeping in contacts; exam shows diffuse conjunctival infection and purulent material.

Diagnosis?

Answer 25

Corneal ulcer