Disease summary

Question 1

Acute glaucoma

Answer 1

sudden increase in the intra-ocular pressure. Painful red eye and hard eyeball with hazy vision.

Question 2

Adie’s pupil

Answer 2

One pupil is dilated (more than unaffected side) and reacts poorly to light. Benign and mainly affects young women.

Question 3

Argyll Robertson Pupil

Answer 3

One pupil is small, it reacts poorly to light, but well to accommodation. May be a sign of tertiary syphilis or MS. VDRL (veneral disease research lab) will be positive.

Question 4

Blepharitis

Answer 4

inflammation of eyelids. (possibly staphylococcal infection, allergy or seborrhea). Swollen itching tender eyelids. refer to dermatologist.

Question 5

Cavernous sinus thrombosis

Answer 5

Clot formation in the cavernous sinus in the brain following spread of infection from the face. Presents with swollen eyelids, and there will be diplopia due to CN 3, 4 or 6 damage which pass through the cavernous sinus. Refer urgently to hospital for antibiotics.

Question 6

Chalazion

Answer 6

Benign granulomatous lesion in the tarsal gland of the eyelid. Presents with painless swelling on the inside of the eyelid. May become infected. Refer to opthalmologist.

Question 7

Conjunctivitis

Answer 7

Infection of the conjunctiva. MC viral origin.

Question 8

Diabetic retinopathy

Answer 8

Damage to the retina seen in poorly controlled diabetes mellitus. Characterized by microaneuryms and flame hemorrhages in the retina. Presents with blurred vision.

Question 9

Eustachian tube blockage

Answer 9

May occur after upper respiratory infections. Opening of tube in nasopharynx becomes swollen and may be occluded. Causing the air within the middle ear cavity to be absorebed creating a vacuum which pulls the tympanic membrane inwards resulting in partial deafness. Presents with decreased hearing and retracted tympanic membrane.

Question 10

Hordeolum

Answer 10

An infected hair follicle of an eyelash. MC staphylococcal. Red painful swelling margin of eyelid.

Question 11

Horner’s syndrome

Answer 11

Caused by damage to sympathetic chain or ganglia of neck. Presents with unilateral ptosis, miosis and anhydrosis. May be associated with pancoast tumor, carotid artery dissection, or brain stem ischemia.

Question 12

Iritis

Answer 12

Inflammation of the iris. Associated with SLE, ulcerative colitis, crohn’s disease, or sarcoidosis. Painful gritty feeling with redness around iris.

Question 13

Macular degeneration

Answer 13

Age-related degeneration of macula. MC in elderly and white people. Presents with central loss of vision; the macula appears blurred and may be pigmented.

Question 14

Meniere’s disease

Answer 14

Recurring attacks of vertigo, tinnitus and hearing loss of unknown etiology. The patient becomes progressively dead as the disease progresses.

Question 15

Myasthenia Gravis

Answer 15

Autoimmune disorder caused by antibodies to acetylcholine receptors at the neuromuscular junction. Likely Middle aged females with thymic disorder. Presents with bilateral ptosis and diplopia which worsens as day progresses. Tensilon test will be positive.

Question 16

Otitis externa

Answer 16

Inflammation of the external auditory canal. May be bacterial or fungal in origin or allergy. Presents with ear pain which worsens on traction. Ear canal is often swollen and there may be small discharge.

Question 17

Otitis media

Answer 17

Inflammation of the middle ear. Viral or bacterial. MC in children due to straight Eustachian tube. Presents with ear pain and mild hearing losss. May be fever, appetite loss, and tympanic membrane swollen/red. Weber’s lateralizes to the affected side, and Rinne test might show bone conduction greater than air conduction in the affected ear.

Question 18

Pinguecula

Answer 18

Yellow triangular thickening of the bulbar conjunctiva on the inner and outer margins of the cornea with the base pointing towards the corners of the eye. Not on cornea.

Question 19

pterygium

Answer 19

Triangular thickening of the bulbar conjunctiva extending from the medial corner of the eye towards the cornea with the apex pointing towards the pupil. Related to chronic irritation and hot dry climates. May encroach on cornea refer if so.

Question 20

Seborrheic dermatitis

Answer 20

Inflammation of skin with a high concentration of sebaceous glands. Presents with dandruff, scaly itching eyebrows and eyelids. Refer if selenium sulfide shampoo is not helpful.