Ophthalmology

Question 1

Red eye cause (6)

Answer 1

• Glaucoma: severe pain, haloes, ‘semi-dilated’ pupil
• Uveitis: small, fixed oval pupil, ciliary flush
• Scleritis: severe pain (may be worse on movement), may be underlying autoimmune disease e.g. rheumatoid arthritis
• Conjunctivitis: discharge - purulent if bacterial, clear if viral
• Subconjunctival haemorrhage - history of trauma or coughing
• Endophthalmitis - pain and visual loss following intraocular surgery

Question 2

Blepharitis (inflammation of eye lids) Mx (3)

Answer 2

Hot compress, lid hygiene, artificial tears

Question 3

Orbital cellulitis
association
Mx

Answer 3

cavernous sinus thrombosis

Mx - IV Abx

Question 4

Retinal detachment
Features
Mx

Answer 4

sudden painless loss of vision, a shadow starting peripherally and progressing centrally
Floaters/ flashes - in vitreous detachment
Mx - urgent surgery

Question 5

Sudden visual loss causes (4)

Answer 5

• ischaemic - “amaurosis fugax”, curtain coming down, treat with aspirin ?TIA
• vitreous haemorrhage - sudden, dark spots, diabetes,
  bleeding disorders
• retinal detachment - dense shadow peripherally moving centrally
• vitreous detachment - floaters
• retinal migraine

Question 6

Open angle glaucoma Mx (3)

Answer 6

1st - prostaglandin analogue (Latanoprost) eyedrop
2nd - beta-blocker (Timolol), carbonic anhydrase inhibitor (Acetazolamide), or sympathomimetic eyedrop
3rd - surgery