General

Question 1

Causes of poor fundal view for fundoscopy

Answer 1

Cataracts

Vitreous haemorrhage

Corneal scarring

Question 2

Define: Amblyopia

Answer 2

Poor vision in an eye due to obstruction of vision during childhood.
- No anatomical abnormality in the eye.
-

Question 3

Most common causes of amblyopia

Answer 3

Uncorrected hypermetropia

Constant squint

Question 4

Carotid-cavernous fistula

- Definition

Answer 4

Connection between the ICA or ECA and venous networks of the cavernous sinus

• Leads to high flow shunt from ICA/ECA to venous drainage in cavernous sinus
• Causes impaired drainage of blood from the orbit.

Question 5

Carotid-cavernous fistula

- Presentation

Answer 5

Proptosis
- pulsatile

Orbital bruit

Chemosis

Ptosis

Ocular misalignment,

Question 6

Carotid-cavernous fistula

- Causes

Answer 6

Trauma (most common)

Spontaneous

Question 7

Examples of IOP raising medications

Answer 7

Steroids

Tropicamide (pupil dilator, anticholinergic)

Ketamine

Question 8

Examples of IOP lowering medications

Answer 8

Prostaglandin analogues (increases aqueous drainage via uveoscleral flow)
- i.e. latanoprost

Beta-blockers (reduce aqueous production)
- i.e. timolol

Carbonic anhydrase inhibitor (reduce aqueous production)
- i.e. dorzolamide (topical), acetazolamide (systemic)

Alpha-2 agonist (reduces aqueous production, increases uveoscleral flow)
- i.e. apraclonidine

Mitotics (contracts ciliary muscles which increases trabecular meshwork drainage)
- i.e. pilocarpine

Osmotics (decreases aqueous volume)
- i.e. mannitol

Question 9

Define keratometry

Answer 9

Measures the anterior corneal surface curvature

Question 10

Corneal topography

• Definition
• Indications

Answer 10

Measures and quantifies the curvature of cornea
- Provides information about the whole corneal shape.

Indications

• Keratoconnus
• Astigmatism
• Laser eye surgery
• Contact lens fitting

Question 11

ULTRASONIC PACHYMETRY

- definition

Answer 11

Investigation that uses ultrasound to measure the central corneal thickness (CCT)

Question 12

Normal central corneal thickness ranges between…

Answer 12

530 and 545 micrometres

Question 13

Side effects of fluorescence angiography (4)

Answer 13

Urine discolouration

Nausea

Vasovagal syncope

Anaphylaxis

Question 14

Contraindication of fluorescence angiography

Answer 14

Shellfish allergy

Question 15

Idocyanine green angiography

• Definition
• Contraindication

Answer 15

Uses near-infrared light to detect indocyanine green bound to albumin in the blood
- Helps to visualise choroidal vasculature

Contraindications

• Pregnancy
• Seafood allergy
• Iodine allergy

Question 16

What does an electroretinogram (ERG) do?

Answer 16

Assess electrical activity of the retinal in response to a light stimulus

Question 17

What does an electro-oculogram do?

Answer 17

Reflects the activity of photoreceptors and retinal pigmental epithelium

Question 18

Indications of ERG and EOG

Answer 18

Best disease

Retinitis pigmentosa

Question 19

Factors that can lead to incorrect tonometry measurements

Answer 19

Excessive fluorescein (overestimates IOP)

Low/high CCT

Astigmatism

Calibration errors

Question 20

Gonioscopy

-Definition

Answer 20

Investigations that assess whether the iridocorneal angle is open or close
- Inability to visual all structures indicates a closed angle

Structures

• Schwalbe line
• Nonpigmented and pigmented trabecular network
• Scleral spur
• Ciliary body

Question 21

Perimetry

• Definition
• Examples

Answer 21

Investigations to assess visual field defects

Examples

• Humphrey visual field analysis
• Goldmann visual field testing

Question 22

Which cases have to be notified to the DVLA

Answer 22

Diplopia

Visual field defects
- i.e. retinitis pigmentosa, bilateral glaucoma

Nyctalopia (night blindess)

Blepharospasm (involuntary twitch/blinking)

Question 23

The first and second most common causes of infectious blindness are…

Answer 23

1- Trachoma

2- Onchocerciasis (Onchocerca volvulus parasitic worm)

Question 24

Deficiency of what vitamin is the most common cause of childhood nutritional blindess in Africa?

Answer 24

Vitamin A