Corrections 2

Question 1

What ethnicity is a risk factor for AACG?

Answer 1

Asian

Question 2

Typical IOP in AACG?

Answer 2

≥40mmHg

Question 3

What investigation provides a diagnosis of AACG?

Answer 3

Gonioscopy –> allows assessment of iridocorneal angle

Question 4

What combination of eye drops are used in AACG?

Answer 4

1) Beta blocker e.g. timolol

2) Alpha agonist e.g. apraclonidine

3) Direct parasympathomimetic e.g. pilocarpine

Question 5

Effect of pilocarpine on ciliary muscle?

Answer 5

Causes ciliary muscle contraction

Question 6

Can IOP be normal in 1ary open angle glaucoma?

Answer 6

Yes!

Question 7

What ethnicity are at risk of POAG?

Answer 7

Black patients

Question 8

What medication can increase the risk of POAG?

Answer 8

Steroids

Question 9

Describe visual loss in POAG?

Answer 9

Peripheral visual field loss

Question 10

Give 2 fundoscopy findings in POAG

Answer 10

1) Optic disc cupping
2) Optic disc pallor (indicating optic nerve atrophy)

Question 11

How can POAG (and AACG) cause optic nerve atrophy?

Answer 11

The increase in pressure damages the optic nerve by reducing the amount of blood that can get through the tiny blood vessels and by pressing on the nerve itself.

Question 12

Define endophthalmitis

Answer 12

inflammation of aqueous and/or vitreous humour

Question 13

What is the most common cause of blindness in the UK?

Answer 13

ARMD

Question 14

What is the most common cause of curable blindness worldwide?

Answer 14

Cataracts

Question 15

Describe vision loss in ARMD

Answer 15

Vision loss particularly for near field objects

Question 16

Features of ARMD?

Answer 16

• Straight lines appear wavy (Amsler grid)
• Reduction in visual acuity, particularly for near field objections
• Deterioration in night vision
• Visual hallucinations (Charles-Bonnet)

Question 17

Features of retinal detachment?

Answer 17

• Flashes & floaters
• Painless vision loss (like a curtain/shadow) from the periphery to the centre

Question 18

Mx of patients with new onset flashes and floaters?

Answer 18

Urgent referral (<24 hours) to an ophthalmologist for assessment with a slit lamp and indirect ophthalmoscopy for pigment cells and vitreous haemorrhage.

Question 19

What can posterior vitreous detachment lead to?

Answer 19

Retinal detachment

Question 20

1st line mx of HSV keratitis?

Answer 20

Topical antivirals e.g. ganciclovir or acyclovir

Question 21

Most common bacterial cause of microbial keratitis?

Answer 21

Staph. aureus

Question 22

Most common bacterial cause of microbial keratitis in contact lens wearers?

Answer 22

Pseudomonas aeruginosa

Question 23

Mx of contact lens wearers with a painful red eye?

Answer 23

Same day referral for assessment –> rule out microbial keratitis

Question 24

1st line abx in microbial keratitis?

Answer 24

Topical quinolones e.g. ciprofloxacin

Question 25

What is a ciliary flush? What condition is it seen in?

Answer 25

A red ring around the cornea that's caused by dilated blood vessels. It's also known as perilimbal redness. Seen in anterior uveitis.

Question 26

1st line mx of anterior uveitis?

Answer 26

Topical steroid & cycloplegic agent (e.g. atropine)

Question 27

Posterior synechiae are a potential complication of anterior uveitis. What are these?

Answer 27

Adhesions between the iris and lens can lead to pupil distortion, iris bombe, and angle-closure glaucoma.

Question 28

Cause of an irregular pupil in anterior uveitis?

Answer 28

Posterior synechiae

Question 29

What are corneal ulcers highly associated with?

Answer 29

Extended contact lens wearers (especially overnight)

Question 30

What are some ocular complications of herpes zoster ophthalmicus?

Answer 30

conjunctivitis, keratitis, episcleritis, anterior uveitis

Question 31

Mx of herpes zoster ophthalmicus?

Answer 31

oral antiviral treatment for 7-10 days

Question 32

Mx of Ramsay Hunt syndrome?

Answer 32

Oral aciclovir + steroids

Question 33

What is Adie's tonic pupil due to?

Answer 33

due to ciliary ganglion dysfunction (results in parasympathetic dysfunction --> pupil is dilated). Anisocoria is WORSE in bright light.

Question 34

How soon should oral aciclovir be started in herpes zoster ophthalmicus?

Answer 34

Within 72h of onset

Question 35

What can be seen on fundoscopy following pan-retinal photocoagulation in proliferative diabetic retinopathy?

Answer 35

dark circular scars at the periphery

Question 36

Describe stage I to IV of hypertensive retinopathy (Keith-Wagener classification)

Answer 36

I - arteriolar narrowing and tortuosity, silver wiring II - AV nipping III - cotton wool spots, flame & blot haemorrhages IV - papilloedema