Exam Q

Question 1

What is Holmes-Adie pupil?

Answer 1

Dilated pupil which shows a delayed and incomplete constriction to light
If deep tendon reflexes occur forms the syndrome
Positive pilocarpine test
Hypersensitivity to the solution due to a degeneration of post-ganglionic neurones

Question 2

How does episcleritis present?

Answer 2

Mild or no discomfort red eye
Palpating the red patch can cause tenderness
Sectoral redness
Vision is normally unaffected

Question 3

How does iritis present?

Answer 3

More acute onset of pain in the eye
Causes photophobia
Visual acuity will be worsened in the affected eye
Redness is typically circumcorneal

Question 4

How does keratitis present?

Answer 4

Acute onset of pain 
Redness is circumcorneal 
Visual acuity worsened 
Uptake of florescent under cobalt blue light 
Area of corneal epithelial defect

Question 5

How does scleritis present?

Answer 5

Severe boring or aching pain which disturbs sleep
Eyeball tender to palpation
Vision may be affected
No effect with phenylephrine

Question 6

What is used to diagnose vitreous haemorrhage?

Answer 6

Ultrasound B-scan of the eye

Retinal detachment until proven otherwise

Question 7

What is a chalazion?

Answer 7

Meibomian cyst
Painless and become infected
Apply heat and massage daily

Question 8

Which drugs can induce angle closure?

Answer 8

Nebulised ipratropium

Tricyclic antidepressants

Question 9

What is optic neuritis associated with?

Answer 9

MS
Colour blindness
Young women

Question 10

What is the most common cause of a vitreous haemorrhage?

Answer 10

Proliferative diabetic retinopathy
Blurred red on fundoscopy
Usually fixes itself or remove blood in surgery

Question 11

How is temporal arteritis treated?

Answer 11

Steroids, other eye at risk
Pale, swollen disc
ESR and CRP, temporal biopsy looking for giant cells

Question 12

What is the management for central retinal artery occlusion?

Answer 12

IV or oral to lower pressure
Take out fluid with a needle
Breathe through a brown paper bag to raise CO2
Check source of emboli and risk factors

Question 13

What is the treatment for central retinal vein occlusion?

Answer 13

Anti-vegF to stop vessels leaking
See in a month majority resolve on their own
Age biggest risk factor
Worse group where pressure backlogs

Question 14

What are the causes of disc swelling?

Answer 14

Papilloedema (both eyes raised ICP)

Anterior ischaemic neuritis

Question 15

What causes the common nerve palsies?

Answer 15

III- aneurysm (right eye turns downwards and outwards)
IV- congenital trauma (right eye turns upwards)
VI- cranial pressure (right eye turns inwards)

Question 16

How is uveitis managed?

Answer 16

Referral in 24hr
Topical corticosteroids
Cycloplegic-mydriatic drug (paralyse ciliary body, relieves pain and prevents adhesions)

Question 17

What are the causes of sudden painless loss of vision?

Answer 17

Occlusion of central retinal artery or vein 
Ischaemic optic neuropathy 
Retinal detachment 
Vitreous haemorrhage 
Temporal arteritis
Hysterical blindness 
Macular lesions

Question 18

What are the causes of sudden loss of vision in both eyes?

Answer 18

Bilateral occipital lobe infarct, ischaemia or trauma
Severe bilateral Papilloedema
Hysterical blindness

Question 19

How does uveitis present?

Answer 19

Inflammation of the uveal tract (iris, ciliary body and choroid)
Pain, red eye, blurred vision, epiphora, photophobia, flashers and floaters
Diagnosed by slit lamp- inflammatory cells
Associated with IBD, AS, RA, sarcoidosis

Question 20

What causes microbial keratitis ?

Answer 20

Swimming with contact lenses on

Question 21

How does optic neuropathy present?

Answer 21

Transient sudden visual loss, painful eye movements, fundoscopy normal
RAPD

Question 22

What is ptosis associated with?

Answer 22

Horner’s
Occulomotor nerve damage
Myasthenia gravis
Lambert Eaton

Question 23

How does Horner’s present?

Answer 23

Miosis, anhidrosis, enopthalmos, heterochromia irydum (different eye colours)
Confirmed by cocaine drop test, lack of NA causes a failure to dilate the pupil