Common Conditions of the Eye

Question 1

How does conjunctivitis present?

Answer 1

• Red, watering eyes
• Discharge
• No loss of vision as long as it doesn’t spread to the corneaq

Question 2

How is conjunctivitis treated?

Answer 2

Antibiotic eye drops if likely to be bacterial

Question 3

Name the two types of stye or hordeolum

Answer 3

• External: affecting the sebaceous glands of the eyelash

- Internal: affecting the meibomian glands

Question 4

Name the common causes of a corneal ulcer

Answer 4

• Infectious: viral/bacterial/ fungal
• Trauma
• Corneal degenerations
• Corneal dystrophy

Question 5

Describe the presentation of corneal dystrophies and degenerations

Answer 5

• Bilateral and opacifying
• Non-inflammatory
• Sometimes due to accumulation of substances within the cornea
• 1st to 4th decade
• Decreased vision
• Starts in one layer of the cornea and spreads to the others

Question 6

Why is there less chance of graft rejection in a corneal transplant?

Answer 6

Because the cornea is avascular

Question 7

What is glaucoma?

Answer 7

Raised intraocular pressure

Question 8

What is the most common form of glaucoma?

Answer 8

Primary open angle glaucoma

Question 9

What are the consequences of raised IOP?

Answer 9

• Pressure on the nerve fibres leads to visual field defects
• Pressure on the optic nerve head leads to t he optic disc appearing unhealthy, pale and cupped
• Ultimately it results in blindness

Question 10

How can primary open angle glaucoma be managed?

Answer 10

• Eye drops to decrease IOP: prostaglandin analogues, beta-blockers or carbonic anhydrase inhibitors
• Laser trabeculoplasty
• Trabeculectomy

Question 11

How does angle closure glaucoma present?

Answer 11

• Sudden onset, painful blurry or lost vision
• Headaches
• O/e: red eye, cornea often opaque, shallow AC, pupils mid dilated and IOP severely raised

Question 12

How can an acute angle closure glaucoma episode be managed?

Answer 12

• IV infusion with or with out oral therapy of carbonic anhydrase inhibitors
• Analgesics and antiemetics
• Constrictor eye drops: pilocarpine
• Beta blocker drops
• Steroid eye drops: dexamethasone
• Iridotomy (laser) on noth eyes

Question 13

Name the types of uveitis

Answer 13

• Anterior uveitis: iris +/- ciliary body
• Intermediate: ciliary body
• Posterior: choroid

Question 14

What are the causes of uveitis?

Answer 14

• Isolated illness (e.g. infective)
• Autoimmune causes e.g. HLA-B27
• Chronic diseases e.g. TB
• Systemic diseases: ankylosing spondylosis

Question 15

How does anterior uveitis present?

Answer 15

• Red and painful eye
• Visual loss
• Hypopyon (cells in the AC settle inferiorly)

Question 16

How does intermediate uveitis present?

Answer 16

• Hazy vitreous

- Floaters or hazy vision

Question 17

How does posterior uveitis present?

Answer 17

Blurred vision

Question 18

Name the layers of the cornea

Answer 18

• Epithelium (stratified squamous non-keratinised)
• Bowman’s membrane (basement membrane)
• Stroma (regularly arranged collagen - no blood vessels)
• Descemet’s layer
• Endothelium (single layer)

Question 19

Why do cataracts develop?

Answer 19

• Older fibres are never shed but compacted in the middle
• No blood supply to the lens (entirely dependent on diffusion)
• Absorb harmful UV rays to protect the retina but are then damaged themselves
• Damaged lens fibres become opaque causing a cataract

Question 20

Name the triad of signs used for diagnosing glaucoma

Answer 20

• Raised IOP
• Visual field defects
• Optic disc changes