Ophthalmologie

Question 1

Causes of peripheral vision loss

and additional symptoms

Answer 1

open angle glaucoma 
Painful red eye. 
Headache 
Nausea vomiting 
systemic symptoms

Question 2

1) Causes of sudden painless vision loss

2) Fundoscopy sign for both

Answer 2

1) Retinal artery thrombosis and retinal artery occlusion

2) Vein - blot haemorrhages artery - pallor

Question 3

Causes of central retinal artery arterial thrombosis

Answer 3

Atherosclerosis most common, GCA

Question 4

Causes of blurred vision

Answer 4

Cataracts

Vitreous humour detachment

Question 5

Other symptoms associated with cataracts

Answer 5

starbursts around lights

Brown yellow colours

Question 6

Causes of central vision loss

Answer 6

age related macular degeneration

Question 7

Causes of painful red eye

Answer 7

Acute angle glaucoma
Ant uveititis
Scleritis
Herpes keratitis

Question 8

Causes of painless red eye

Answer 8

Sub conductive haemorrhage
Episcleritis
Conjunctivitis

Question 9

Fundoscopy signs of diabetic retinopathy

Answer 9

Cotton wool spots 
blot haemorrhages 
neovascularisation 
micro aneurysms 
hard exudates

Question 10

Fundoscopy signs of hypertensive retinopathy

Answer 10

Cotton wool spots 
arteriole haemorrhages 
Artery-venous nipping 
Papilloedema  
hard exudates

Question 11

Fundoscopy signs of glaucoma

Answer 11

optic disc cupping

Question 12

fundoscopy signs of macular degeneration

Answer 12

drusens deposits

oedema

Question 13

fundoscopy signs of retinal vein occlusion

Answer 13

blot haemorrhages

Question 14

fundoscopy signs of retinal artery thrombosis

Answer 14

Pallor + cherry red spot

Question 15

1) Pathology of open angle glaucoma
2) What is classed as raised intra-ocular pressure
3) RF for open angle
4) Management

Answer 15

1) Poor drainage of aqueous humour through trabecular network
2) pressure > 23.9mmHg
3) African, Myopia, old, Fhx
4) Prostoglandin analogue - latanoprost
Beta blocker - timolol
Carbonic anhydrase inhibitors - dorzolamide

Question 16

1) Initial management of patient with acute painful red eye
2) Management of acute angle glaucoma
3) Definitive management
4) RF for acute angle

Answer 16

1) Urgent/same day referral to ophthalmologist
2) Lie on back, PO/IV acetazolamide, pilocarpine eyedrops (2% for blue, 4% for red). Analgesic and anti-emetic
3) Laser iridotomy
4) Female, age, Chinese, hyperopia

Question 17

1) Type of vision loss in cataracts
2) RF for cataracts
3) Sign on examination
4) Management and complication

Answer 17

1) General loss in acuity, Starbursts around lights
2) Old age, steroids, alcohol, smoking, diabetes, hypoclacaemia
3) Loss of red reflex
4) Replacement of sense.
Endophthalmitis. Inflammation of vitreous humour. Mx with intra-vitreous abx

Question 18

1) Symptoms of anterior uveitis
2) Associated conditions
3) Management

Answer 18

1) Dull, aching, painful red eye
Ciliary flush 
Reduced visual acuity
Floaters and flashes
miosis (constricted pupil)
Photophobia 
Pain on movement
Hypopyon 
2) HLA-B27 conditions 
3) Steroids + cyclopentilate eyedrops

Question 19

additional symptoms of scleritis

Answer 19

pain on eye movement
decreased visual acuity
photophobia

Question 20

Investigation of herpes keratitis

Answer 20

fluorescein eye drops -> denditic ulcer seen

Question 21

risk factors for retinal vein occlusion

Answer 21

leukemia
SLE
hypertension
diabetes

Question 22

What could cause the following
painless blurred vision over 2 days
spots of vision loss
floaters and flashing lights

What would be the management

What does this put the pt at risk of

Answer 22

Vitreous detachment

No management, brain will adjust

Retinal detachment

Question 23

What would cause the following

Peripheral vision loss over 2 days and flashing lights/floaters

Answer 23

Retinal detachment

Question 24

What would result in the following

Central scotoma
unilateral pain on eye movement
loss of colour vision
Afferent pupil light reflex defect

Answer 24

Optic neuritis

Question 25

Fundoscopy signs for raised ICP -

Answer 25

papilloedema

Blurring of optic disc

Question 26

management of orbital cellulitis

Answer 26

IV abx