Conditions

Question 1

Age related macular degeneration

Answer 1

degeneration retinal photoceptors, retinal pigment epithelium and bruch’s membrane

• shadowy areas in central vision, unusually fuzzy or distorted vision

Amler grid test, fundoscopy, fluorescein angiography, tonometry

DRY AMD = no treatment, visual aids to reduce effect on life

WET AMD = anti-VEGF injections i.e. raibizumab, photodynamic therapy

Question 2

What are anti-VEGF medications?

Answer 2

Anti-vascular endothelial growth factor

• prevent growth of blood vessels
• stop blood vessels leaking

Question 3

Cataracts

Answer 3

formation anomalous “bladder” cells, metamorphosis lens substance into eosinophilic balls, morgagnian globules, progressive granulation and liquefaction

ageing or injury, other eye conditions increase risk

• clouded/blurred/dim vision, inc difficulty seeing at night, photosensitivity, “halos”, faded/yellowing colour vision

dilated fundus exam, measure IOP, slit lamp anterior chamber, glare vision test

stronger visual aids/cataract surgery

Question 4

Open Angle Glaucoma

Answer 4

intraocular hypretension with angle between cornea and iris open, trabecular meshwork slowly becomes clogged

decreased peripheral vision, continuous loss leading to central vision loss

tonometry, visual field testing

meds to lower pressure

• dec production aqueous humor; beta adrenergic receptor antagonist, carbonic anhydrase inhibitors
• inc outflow; prostaglandin analogues, trabeculoplasty

Question 5

Diabetic macular oedema

Answer 5

accumulation fluid in macula due to leaking blood vessels

• blurry/wavy central vision, faded colours, range from slightly blurry to notable vision loss

fluorescein angiography, optical coherence tomography

anti-VEGF drugs, steroids, eye drops, laser eye treatment

Question 6

Keratoconus

Answer 6

cornea bulges into cone shape deflecting light as it enters the eye

mild blurry vision, distorted vision, photophobia, eye redness or swelling

corneal scans, refraction, vision testing

Glasses/contacts, eventual corneal transplant may be required

Question 7

Conjunctivitis

Answer 7

inflammation conjunctiva

Viral; usually adenovirus

Bacterial; staph aureus, haem influenzae, strep pneumoniae, pseudomonas auerginosa

• gritty feeling, itching/burning, excessive tearing, discharge, swollen eyelids, pinky discolouration, photophobia

rapid adenovirus immunoassay, cell culture, gram stain, PCR

Antibiotics; ointment or drops

Question 8

Amblyopia

Answer 8

aka lazy eye, eye fails to achieve normal visual acuity

• eyes wandering in/out, not appearing to work together, poor depth perception, squinting or shutting

visual acuity testing, stereopsis (depth perception), assess fixation, anterior segment examination

glasses, eye patches, atropine drops, surgery

Question 9

Nystagmus

Answer 9

involuntary movement eyes resulting in reduced/impaired vision

diseases, accidents, neurological problem

• photophobia, dizziness, difficulty seeing in dark, vision problems, holding head tilted, feeling world is shaking

slit lamp examination

No cure; surgery temp, drugs i.e. botox

Question 10

Uveitis

Answer 10

inflammation uvea

• gen vision problems, floaters, eye pain, redness, photophobia, headaches, small pupil

Identify cause; blood tests etc, ocular imaging to assess site and severity

infective or non-infective?

topical steroid drops work for anterior

Question 11

Closed angle glaucoma

Answer 11

drainage system blocked, rapid increase in IOP

• abrupt onset eye pain, redness, blurriness, headaches, nausea, “halos”

tonometry, visual field testing, imaging

iridotomy (hole in iris) to allow drainage, medication to avoid raised pressure

Question 12

Diabetic retinopathy

Answer 12

high blood glc levels damage retina (esp blood vessels)

• floaters, blurrinsss, fluctuating vision, impaired colour vision, dark/empty area of vision, vision loss

photography of fundus, optical coherence tomography screening, fluorescein angiography, B scan US

laser treatment, eye surgery, anti-VEGF injections

Question 13

Retinal detachment

Answer 13

retina pulls away from back of eye (and thus BVs)

• floaters, sudden flashing lights, dark curtain/shadow

visual acuity, slit lamp, indirect opthalmoscopy

surgery

Question 14

Normal tension glaucoma

Answer 14

normal pressure in eye, but optic nerve damage

some people experience migraines, cold hands/feet, low bp

imaging optic nerve to observe changes, eye pressure <21mmHg

lower IOP as much as possible

Question 15

Retinoblastoma

Answer 15

Rare form of cancer, rapidly develops from immature cells of retina

Inherited in some cases, RB1 gene autosomal dominant

Usually <5yo

• unusual white reflection of pupil
• squint
• change in iris colour
• red or inflamed
• poor vision

Small tumours; laser treatment, cryotherapy

Large tumours; brachytherapy, chemotherapy, removal of eye

*chemo may be required prior to some of the treatments