Eye Treatments

Question 1

How do you treat corneal abrasion?

Answer 1

• Stop contact lens wear

- Chloramphenicol - topical abx qds 1 week

Question 2

What investigations do you do for orbital blowout fracture or metal intraocular FB?

Answer 2

X ray (CT if high index of suspicion)

Question 3

What is the leading cause of blindness in the Western World?

Answer 3

Age related macular degeneration

Question 4

How does dry ARMD present?

Answer 4

Gradual loss of central vision

Question 5

How does wet ARMD present?

Answer 5

Acute loss of central vision

Question 6

What is the key sign in dry AMD?

Answer 6

Drusen

Question 7

What is the key sign in wet AMD?

Answer 7

Macular oedema and scarring

Question 8

What is non-arteritic anterior ischaemic optic neuropathy?

Answer 8

Infarction of optic nerve head due to occlusion of short posterior ciliary arteries

Question 9

How do you treat acute angle closure glaucoma to lower the IOP acutely?

Answer 9

• Acetazolamide IV 500mg (systemic)

- Eye drops = timolol (beta blocker) and apraclonidine (cholinergic), pilocarpine

Question 10

How do you definitively treat acute angle closure glaucoma?

Answer 10

Peripheral iridotomy - to create an alternative aqueous outflow passage

Question 11

How do you treat conjunctivitis?

Answer 11

• Viral = artificial tears, hygiene and limit contact
• Allergic = antihistamine eye drops
• Bacterial = chloramphenicol

Question 12

What is the biggest risk factor for a corneal ulcer (keratitis) and how do you diagnose it?

Answer 12

Contact lens wear

Fluorescein stain

Question 13

What bacteria can cause a corneal ulcer?

Answer 13

Pseudomonas, staph aureus

Question 14

What virus causes corneal ulcer?

Answer 14

Herpes (simplex and zoster)

Question 15

How do you treat a corneal ulcer?

Answer 15

• Remove contact lenses
• Empirical abx drops - chloramphenicol and orofloxacin (alternating)
• Steroid drops
• Depends on cause e.g. RA

Question 16

How do you diagnose anterior uveitis?

Answer 16

Slit lamp - ‘cell and flare’ in anterior chamber

Question 17

How do you treat anterior uveitis?

Answer 17

• Treat underlying aetiology
• Prednisolone drops
• Tropicamide/cyclopentolate (mydriatic/cycloplegic)

Question 18

What conditions is anterior uveitis associated with?

Answer 18

• Ankylosing spondylitis
• IBD
• Herpes
• Sarcoid
• Arthritis

Question 19

What are risk factors for ARMD?

Answer 19

• Age
• Smoking
• FH

Question 20

How do you diagnose ARMD?

Answer 20

Fluorescein angiography ± OTC scan

Question 21

How do you treat dry ARMD?

Answer 21

Nothing - lifestyle, monitoring

Question 22

How do you treat wet ARMD?

Answer 22

Regular intravitreal anti-VEGF injections (lifestyle, monitoring)

Question 23

What is the progressive of diabetic eye disease?

Answer 23

1) Non-proliferative diabetic retinopathy
2) Proliferative diabetic retinopathy
3) Maculopathy

Question 24

What are the sides of retinopathy on fundoscopy?

Answer 24

• Microaneurysms (dots)
• Haemorrhages (blots)
• Cotton wool spots (infarcts)
• Neovascularisation

Question 25

What are the signs of maculopathy?

Answer 25

- Progressive central vision loss | - Macular oedema

Question 26

How do you diagnose diabetic retinopathy/maculopathy?

Answer 26

Fundus photo ± OTC scan, fluorescein angiography

Question 27

How often is diabetic eye disease screened for in diabetic patients?

Answer 27

Yearly (fundus photo)

Question 28

How is diabetic eye disease managed?

Answer 28

- Lifestyle - RF modification | - Referral

Question 29

How do you treat maculopathy?

Answer 29

Laser photocoagulation

Question 30

How do you treat proliferative diabetic retinopathy?

Answer 30

Panretinal laser photocoagulation

Question 31

What can be used to treat macular oedema in maculopathy?

Answer 31

Intravitreal anti-VEGF injections

Question 32

What is the difference between episcleritis and scleritis?

Answer 32

Scleritis - v painful red, association with autoimmune disease (RA/SLE/IBD) Episcleritis - not as bad, less red, less pain

Question 33

How does subconjunctival haemorrhage present and how do you treat it?

Answer 33

- Diffusely red eye (between conjunctiva and sclera) - Painless - History of illness e.g. cough, vomit - Self resolves

Question 34

What is a key feature present in anterior uveitis?

Answer 34

Hypopyon, photophobia

Question 35

What are the key features of acute closed angle glaucoma?

Answer 35

- Cloudy cornea - Peripheral vision loss - arcuate - Optic disc cupping

Question 36

What is an eye sign that is a contraindication for LP?

Answer 36

Bilateral papilloedema