ENT and Ophthalmology

Question 1

Role of optometrists

Answer 1

Examine eyes for defect in visions and screening for diseases

Question 2

Role of opthalmologist

Answer 2

Operations on eye, work in eye hopsitals/departments

Question 3

Role of orthoptists

Answer 3

Work with ophthalmologist, concerned with eye movement and inability for eyes to work together

Question 4

3 conditions that affect the eyes ability to work together

Answer 4

strabismus, amblyopia, diplopia

Question 5

3 causes of squint

Answer 5

Lack of co-ordination usually idiopathic

Known causes: refractive errors (hypermetropia), congenital abnormalities

Question 6

Management of squint in primary care

Answer 6

Refer any suspected/ confirmed to paediatric eye service by routine referral, urgent if serious underlying condition suspected
Ensure compliance with treatment plan (greatest barrier to improvement)

Question 7

Management of squint in secondary care

Answer 7

Managed by orthoptist with ophthalmologist
Corrective glasses can often correct them
occlusion therapy for amblyopia
Penalization use atropine to blur good eye to force use of other eye
Surgery: insertion point of extraocular muscle into the sclera

Question 8

What age are people with diabetes offered screening

Answer 8

Everyone over 11 years

Question 9

When are diabetics offered eye screening

Answer 9

No retinopathy: Annual
Background: Annual
Pre-proliferative: Refer to hospital 
Proliferative: Fast track to HES (then annual)
Maculopathy: Refer to HES

Question 10

Glycaemic control of diabetic eye disease

Answer 10

48-58mmol/ml - insulin or diet/metformin

Question 11

BP control in diabetic eye disease

Answer 11

130 with established retinopathy/nephropathy

140 retinopathy with ACEi

Question 12

Cholesterol control in diabetic eye disease

Answer 12

Only offer statin in T1 if > 40 or diabetic for >10y or established nephropathy/ CV risk factors. In T2DM if >10% 10y risk via QRISK2 give 20mh atorvastatin.

Question 13

First sign of diabetic renal disease

Answer 13

Microalbuminaemia

Give ACEi

Question 14

Lifestyle advice in diabetic disease

Answer 14

Smoking cessation, weight control, exercise

Pregnancy: retinal assessment at 8-12w and repeat 28w if normal/ 16-20w if abnormal

Question 15

Leading cause of vision loss worldwide

Answer 15

1: Cataracts
2: Glaucoma

Question 16

Most common cause of vision loss in UK

Answer 16

Age related macular degeneration

Question 17

Most common cause of vision loss amongst working age populations

Answer 17

Diabetic retinopathy

Question 18

Most common inherited cause of vision loss

Answer 18

Retinitis pigmentosum

Question 19

Common causes of blindness in children

Answer 19

High income: lesions of optic nerve, higher visual pathways

Lower income: measles, vitamin A deficiency, rubella, corneal scarring

Question 20

Changing patterns of visual loss

Answer 20

infectious causes have declined, diabetic retinopathy is rising