Eyes

Question 1

Features of central retinal vein occlusion

Answer 1

1) Sudden painless vision loss
2) Unilateral
3) Widespread cotton wool spots
4) Macular oedema
5) Rubeosis iridis
6) Retinal haemorrhages in all quadrants
7) RFs: smoking, HTN, DM, hyperlipidaemia

Question 2

Features of central retinal artery occlusion

Answer 2

1) Sudden painless vision loss
2) Unilateral
3) Pale retina
4) “Cherry red spot”
5) RFs: atherosclerotic RFs–> HTN, DM, dyslipidaemia

Question 3

Common causes of CRAO

Answer 3

1) Atherosclerosis
2) Embolic sources
3) Inflammatory causes- GCA

Question 4

What is emergency Mx of CRAO

Answer 4

1) Rule out GCA (ESR, CRP)
2) Lie pt flat to help maintain circulation
3) Decrease IOP

Question 5

Features of GCA

Answer 5

1) Headache
2) Scalp tenderness
3) Jaw claudication
4) A/w PMR
5) Acute unilateral vision loss

Question 6

What is the Rx for GCA

Answer 6

Immediate oral pred (40-60mg/day) HIGH DOSE. Take a temporal artery biopsy.

Question 7

Features of optic neuritis

Answer 7

1) Reduced VA
2) RAPD
3) Painful eye movements
4) Reduced colour saturation
5) Swollen inflammed disc due to papillitis
6) Blurred optic disc margins
7) Usually unilateral

NB: normal IOP

Question 8

What are the 2 types of macular degeneration?

Answer 8

1) Wet

2) Dry

Question 9

Which type of macular degeneration has no real Rx?

Answer 9

Dry

Question 10

Features of dry macular degeneration

Answer 10

1) Gradual CENTRAL vision loss
2) Central scotoma
3) Painless
4) FHx of macular degen
5) Scarred fovea
RFs: age, smoking

Question 11

What is the Mx of dry macular degeneration?

Answer 11

1) Mainly supportive
2) Stop smoking
3) Vitamin C and E supplementation

Question 12

Which is more common, wet or dry AMD?

Answer 12

dry- 90%

Question 13

Features of wet AMD

Answer 13

1) Rapid decrease in central vision (weeks- months)
2) Metamorphopsia
3) Central scotoma
4) Drusen
5) Scarred fovea
6) Intra-retinal haemorrhage

Question 14

What is the Mx of wet AMD

Answer 14

Monthly intra-vitreal anti- VEGF injections

Question 15

What is a RF for AMD?

Answer 15

Smoking

Question 16

What is a complication of dry AMD?

Answer 16

Can become wet

Question 17

Features of retinal detachment

Answer 17

1) Sudden visual loss
2) Painless
3) Flashers and floaters
4) On fundoscopy, may not see anything because it can be peripheral
5) Otherwise you would see that part of the retina is out of focus

NEEDS URGENT OPHTHAL REVIEW

Question 18

What is RF for retinal detachment?

Answer 18

Myopes

Question 19

Features of acute angle closure glaucoma

Answer 19

1) Unilateral red eye- sight threatening emergency
2) Throbbing pain of the eyebrow +/- radiation to forehead
3) Worsening vision loss
4) Mid-dilated pupil
5) Cloudy cornea
6) Shallow anterior chamber
7) Oval shaped pupil or tear drop shaped
8) Intra-occular pressures would be raised (60mmHg)

Question 20

Mx of Acute angle closure glaucoma

Answer 20

1) IOP reduction
2) Acetazolamide STAT (IV and oral)
3) Topical BBs
4) Topical steroids

Question 21

Features of chronic open angel glaucoma

Answer 21

• Gradual visual loss
• Can cause peripheral vision loss
• “Old pt complaining of not seeing things from side”
• Enlarged central cup “cupping” of optic nerve head

Question 22

Features of cataracts

Answer 22

1) Gradual visual loss
2) Dullness of vision
3) VA that doesn’t improve with pinhole or glasses (old pt goes to get new prescription but this doesn’t help)
4) Absent or reduced red reflex indicates an opacity of the cornea (in this case lens)
5) Can be bilateral

Question 23

RFs for cataracts

Answer 23

o Age
o Steroids
o DM