Eyes Ophthalmology

Question 1

Blepharitis Mx

Answer 1

1st
- warm compress eyes for 5-10 minutes
- massage eyelids with cotton wool buds
- clean eye lids with water (+/- baby shampoo diluted)
- avoid contact lenses during infection

2nd (no improvement after 6 weeks)
- Top Abx
- eg Chloramphenicol
- eg Fucidin

3rd
- PO Abx
- eg Doxy

Question 2

Squint (AKA Strabismus) - misalignment of eyes Mx

Answer 2

Normal under 3 months
if Above 3 months - refer paeds orthoptist

Question 3

Acute angle closure glaucoma Fx

Answer 3

Symptoms/
headache, nausea, vomiting
blurred vision
haloes

Signs/
eyeball hard to touch
pupil fixed and dilated
reduced VA

Question 4

Acute angle closure glaucoma Mx

Answer 4

Medical emergency - refer Ophthalmology admission

If not possible:
- lie patient on back, face up (reduce pressure)
- analgesia and anti sickness
- Acetazolamide PO

Question 5

Cataracts Fx

Answer 5

Cloudiness of vision
especially at night
haloes

Question 6

Cataracts Mx

Answer 6

Refer Ophthalmology for surgery

Question 7

Age related macular degeneration (AMD) Fx

Answer 7

Central > peripheral visual loss
reading, facial recognition difficult

Question 8

AMD Mx

Answer 8

Urgent <1WW Ophthal refer - if rapid onset
if worsening before review - go to eye casualty

DVLA
if one eye effected - no need to tell
if both eyes - tell DVLA

Question 9

Retinal detachment Fx

Answer 9

Floaters
flashes of light
sudden onset loss of vision - peripheral to centre (like a curtain)
reduced visual acuity - blurred vision

Question 10

Retinal detachment Mx

Answer 10

Urgent (same day) Ophthalmology review

Often send to optician if not urgent

Question 11

Red eye DDx

Answer 11

Conjunctivitis
Subconjunctival haemorrhage
Episcleritis
Trauma/ Foreign body
Acute Glaucoma
Acute anterior uveitis
Corneal ulcer
Scleritis
Endophthalmitis