ophthal

Question 1

argyll-robertson pupil - describe it and causes

Answer 1

small irregular pupil caused by DM or syphilis

Question 2

superior oblique does what to eyeball

Answer 2

depress and abduct

Question 3

pathophysiology of acute closed angle glaucome

Answer 3

blocked drainage from anterior chamber via canal of Schlemm

Question 4

RFs for ACAG

Answer 4

hypermetropia
old age
female

Question 5

ACAG sx

Answer 5

pain

nausea/vomiting

reduced visual acuity

symptoms worse with mydriasis/dark room

dull/hazy cornea

haloes

Question 6

ix for ACAG

Answer 6

gold standard is gonioscopy
also tonometry

Question 7

mx of ACAG

Answer 7

refer ASAP

medical: combination eye drops (pilocarpine + timolol), IV acetazolamide

surgical: laser peripheral iridotomy DONE WHEN ACUTE ATTACK SETTLED

Question 8

uvea consists of

Answer 8

iris, ciliary body, choroid

Question 9

anterior uveitis sx

Answer 9

acute pain with acute onset
photophobia
blurred vision
hypopynon - pus in chamber

Question 10

anterior uveitis associations

Answer 10

IBD
sarcoid
Still’s
seronegative arthropathies

Question 11

mx anterior uveitis

Answer 11

urgent referral
meds: prednisolone + cyclopentolate drops

Question 12

episcleritis associations

Answer 12

IBD and rheumatoid

Question 13

episcleritis sx

Answer 13

commonly painless red eye
watering and photophobia may be present

Question 14

episcleritis vs scleritis clinically

Answer 14

scleritis more painful

episcleritis blanches vessels on pressure or use of phenylephrine drops

Question 15

scleritis mx

Answer 15

urgent same day referral
oral NSAIDs mainstay
glucocorticoids used for severe presentations

Question 16

when does someone with conjunctivitis need to be same-day reviewed by ophthalmologist?

Answer 16

if they are a contact lens wearer

Question 17

corneal ulcer/abrasion ix

Answer 17

fluorescein staining

Question 18

keratitis definition

Answer 18

inflammation of cornea

Question 19

keratitis bacteria

Answer 19

staph aureus
pseudomonas in contact lens wearers

Question 20

antibiotics for keratitis of assumed bacterial cause?

Answer 20

quinolones are first line

Question 21

how long aciclovir for HZO

Answer 21

7-10days (oral)

Question 22

complications of HZO

Answer 22

post-herpetic neuralgia
ptosis
keratitis, conjunctivitis, uveitis

Question 23

mechanism of sudden vision loss in GCA

Answer 23

anterior ischaemic optic neuropathy

Question 24

non-arteritic causes of AION

Answer 24

diabetes
HTN
smoking

Question 25

s/s of optic neuritis

Answer 25

central scotoma RAPD acuity loss (central and colour) pain on movement

Question 26

optic neuritis drug causes

Answer 26

ethambutol chloramphenicol

Question 27

optic neuritis tx

Answer 27

IV methylprednisolone

Question 28

vitreous haemorrhage s/s

Answer 28

symptoms: painless acute loss of vision with floaters and red hue small: small block dots in vision large bleeds: loss of red reflex, retina not visualised

Question 29

vitreous haemorrhage causes

Answer 29

DM trauma warfarin

Question 30

retinal detachment aetiology

Answer 30

holes in retina allow fluid to separate retina from epithelium

Question 31

causes of retinal detachment

Answer 31

DM cataract surgery trauma myopia

Question 32

s/s retinal detachment

Answer 32

painless fall in acuity (curtain falling down) and field loss floaters flashes

Question 33

describe fundoscopy in optic neuritis

Answer 33

optic disc swollen

Question 34

describe fundoscopy in AION

Answer 34

pale optic disc swelling

Question 35

describe fundoscopy in vitreous haemorrhage

Answer 35

haemorrhage obscures fundus

Question 36

CRAO sx

Answer 36

sudden painless total loss of vision + RAPD

Question 37

CRAO fundoscopy

Answer 37

globally pale retina cherry red spot on retina

Question 38

CRVO fundoscopy

Answer 38

widespread hyperaemia severe retinal haemorrhages - 'stormy sunset'

Question 39

ARMD s/s

Answer 39

CENTRAL visual loss blurring of small words straight lines appearing curvy

Question 40

dry ARMD - signs

Answer 40

drusen - yellow fat deposits

Question 41

wet ARMD signs

Answer 41

choroidal neovascularisation

Question 42

ARMD ix

Answer 42

amsler grid - distortion of line seeing

Question 43

ARMD tx

Answer 43

wet: anti-VEGF e.g. bevacizumab

Question 44

POAG RF

Answer 44

age myopia DM afrocaribbean

Question 45

POAG sx

Answer 45

peripheral visual fields loss

Question 46

POAG fundoscopy signs

Answer 46

optic disc cupping

Question 47

POAG tx

Answer 47

IOP>24 ---> selective laser trabeculoplasty first line: prostaglandin anaologue e.g. latanoprost second line: beta blocker eye drops or CAi eye drops

Question 48

prostaglandin analogue example

Answer 48

latanoprost

Question 49

latanoprost MOA

Answer 49

increases uveoscleral outflow

Question 50

latanoprost SE

Answer 50

brown iris increased eyelash length

Question 51

which eye drops decrease aqueous production

Answer 51

Beta-blockers alpha-2 agonists CAi

Question 52

proliferative retinopathy tx

Answer 52

pan-retinal photocoagulation

Question 53

maculopathy tx

Answer 53

focal photocoagulation

Question 54

pan-retinal photocoagulation SE

Answer 54

decreased night vision acuity

Question 55

difference between non-proliferative and proliferative

Answer 55

proliferative - has neovascularization/angiogenesis

Question 56

cotton wool spots represent ....

Answer 56

areas of infarction

Question 57

maculopathy fundoscopy

Answer 57

hard exudates NEAR MACULA

Question 58

causes of cataracts

Answer 58

Age Steroids DM Smoking HYPOcalcaemia congenital

Question 59

cataracts s/sx

Answer 59

increasing myopia blurred vision haloes sign: decreased red reflex

Question 60

cataract surgery complications

Answer 60

posterior capsule opacification - thickening of lens - causing decreased acuity retinal detachment ENDOPTHLMITIS - inflammation of aqueous/vitreous humour

Question 61

retinitis pigmentosa sx

Answer 61

night blindness tunnel vision

Question 62

stye vs chalazion

Answer 62

stye usually more acute and painful

Question 63

entropion

Answer 63

eyelid inversion

Question 64

floaters especially seen in

Answer 64

retinal detachment vitreous haemorrhage

Question 65

divergent squint

Answer 65

eye deviates temporally

Question 66

carotid cavernous fistula

Answer 66

carotid aneurysm rupture leading to reflux of blood into cavernous sinus