Ophthalmology

Question 1

How does acute angle glaucoma present?

Answer 1

PC: severely painful, red eye
Associated features: visual loss, pt visualises haloes around lights, nausea, vomiting, headache
O/E: fixed, mid dilated pupil, hazy cornea, affected eye feels harder

Question 2

What kind of patient typically presents with acute angle glaucoma?

Answer 2

• middle aged to elderly

- hypermetropic

Question 3

What is anterior uveitis?

Answer 3

inflammation of the interior pigmented structures of the eye e.g. iris, cililary body

Question 4

How does anterior uveitis present?

Answer 4

PC: painful, red eye
Associated features: photophobia, +/- visual changes, +/- hypopyon
O/E: small irregular pupil, circumcorneal injection

Question 5

How does scleritis present?

Answer 5

PC: severely painful, red eye (can keep them up at night)
Associated features: onset of boring or piercing eye pain over several days, +/- visual loss
O/E: if severe or long standing then sclera may thin and reveal choroid below as a blue tinge

Question 6

What are the risk factors for anterior uveitis?

Answer 6

• smoking
• autoimmune disease, especially ankylosing spondylosis and UC
• recent infection e.g. CMV, shingles, reactive arthritis

Question 7

What are the risk factors for scleritis?

Answer 7

systemic autoimmune diseases e.g. RA

Question 8

How does herpes simplex keratitis present?

Answer 8

PC: red eye with gritty pain
Associated features: photophobia, excessive lacrimation
O/E: branching linear ulcer (dendrite) is visible on the surface of the cornea with fluorescein under cobalt blue light

Question 9

How does subconjuctival haemorrhage present?

Answer 9

PC: dramatic appearance of extremely red eye

Potential associated features: raised intrathoracic pressure, signs of trauma, hypertension

Question 10

Is subconjunctival haemorrhage an emergency?

Answer 10

No, it is a harmless collection of blood beneath the conjunctiva

Question 11

Is acute angle glaucoma an emergency?

Answer 11

Yes