Ophthalmology

Question 1

Headache, red watery eye, onset in dark, mid-dilated pupil and corneal oedema?

Answer 1

Acute primary angle closure

Question 2

Mangement of cluster headaches

Answer 2

Nasal Sumatriptan - helps relief the cluster headaches
Verapamil - is for prevention

Question 3

White spots in mouth, maculopapular rash on body, coryzal symptoms and unvaccinated?

Answer 3

Test for measles

Question 4

Red eyes, dry mouth mucosa - which antibody test?

Answer 4

Anti-Ro/La for Sjogrens

Question 5

Antiphspholipid presents with miscarriage, rash and which visual symptom?

Answer 5

CRAO - sudden painless vision loss in one eye, pale retina, cherry red spot

Question 6

Bacterial keratitis presentation

Answer 6

Acute eye pain, photophobia, blurred vision, poor contact habits

Question 7

Investigation for orbital cellulitis

Answer 7

CT orbit and sinus

Question 8

Common pres of retinoblastoma

Answer 8

Loss of red reflex unilaterally
Eye moves out

Question 9

Enophthalmos presents assoc with fracture of which facial bone?

Answer 9

Ethmoid

Question 10

Stormy-sunset fundus suggests which pathology?

Answer 10

CRVO

Question 11

Small, pink nodules with a central umbilication that occur in clusters - on eyes and upper thighs?

Answer 11

Molluscum contagiosum (poxvirus can be transmitted sexually hence thighs)

Question 12

Define chalazion

Answer 12

A chalazion is a cyst created secondary to obstruction of the Meibomian glands.
A chalazion is not an infection and thus is non-tender and non-fluctuant on examination.

Question 13

Severe eye pain, corneal oedema, reduced vision 2 days post-op cataract surgery?

Answer 13

Bacterial endophthalmitis
Manage with intravitreal antibiotics ± steroids or surgery

Question 14

Red and severely painful eye, post-sinus infection?

Answer 14

Orbital cellulitis

Question 15

Presentation of cluster headaches

Answer 15

Severe ocular pain for 15mins - 1hr with periods of remission lasting months
Assoc with watery and red eyes, runny nose

Question 16

Dry eyes and dry mouth are assoc with which systemic disease?

Answer 16

Sjogren’s syndrome
- anti-Ro/La antibodies

Question 17

Sign of HT retinopathy on fundoscopy

Answer 17

Arteriovenous nipping

Question 18

Define leukocoria and what is it indicative of?

Answer 18

White pupil reflex
Retinoblastoma

Question 19

Firts line investigation of acute angle closure glaucoma

Answer 19

Goldman’s tonography

Question 20

Which glaucoma drug can change eyelash appearance?

Answer 20

Travoprost

Question 21

Severely injected, forward displaced eye with no pain and inability to abduct affected eye is suggestive of?

Answer 21

Carotid cavernous fistula

Question 22

Patient with myopic prescription, cataracts and sudden floaters/flashes is suggestive of?

Answer 22

Retinal detachment

Question 23

IV vs oral acetazolamide in patient with acute angle closure glaucoma?

Answer 23

IV - secondary care
Oral - community/GP

Question 24

Arteriovenous nipping is assoc with what disease of retina?

Answer 24

Hypertensive retinopathy

Question 25

When does prednisolone dose change in GCA?

Answer 25

prednisolone 40mg if no visual impairment 60mg if visual symptoms.

Question 26

Definitive treatment of acute angle-closure glaucoma

Answer 26

Peripheral laser iridectomy

Question 27

Myopia and hypermetropia are assoc with which type of glaucoma?

Answer 27

Myopia (-) - open angle Hypermetropia (+) - closed angle

Question 28

First line management of open angle glaucoma

Answer 28

Prostaglandin analogue e.g. latanoprost

Question 29

Most common EOM injury in orbital blowout fracture

Answer 29

Inferior rectus

Question 30

First line investigation in GCA

Answer 30

ESR

Question 31

Proptosis indicates what type of cellulitis?

Answer 31

Orbital - preseptal usually has preceding sinus infection

Question 32

Loss of vision in inner bottom part of vision would indicate what type of retinal detachment?

Answer 32

Superior temporal detachment (opposite)

Question 33

Pathology affecting the temporal lobe would result in what kind of visual pathway defect?

Answer 33

Contralateral homonymous superior quadrantinopia

Question 34

What happens to rod cells when exposed to light?

Answer 34

Rhodopsin is converted into opsin and trans-retinal. This causes sodium channels to CLOSE and the membrane is HYPERPOLARISED which results in NO neurotransmitter being released into the synapse

Question 35

Young female patient loss of vision and colour vision impairment, assoc with periorbital pain and swollen optic disc?

Answer 35

MS - suggests optic neuritis

Question 36

How can you differentiate between chlamydial and gonococcal neonatal conjunctivitis?

Answer 36

Chlamydial - most common, 4-28 days, painful lump in mother's groin (lymphogranuloma venerium) Gonococcal - 1-3 days of life

Question 37

Corneal abrasion form foreign object would present as ? on slit lamp exam

Answer 37

Vertical linear defects in the corneal epithelium

Question 38

What complication presenting with floaters can result from posterior uveitis?

Answer 38

Exudative posterior vitreous detachment

Question 39

Fundoscopy findings of ischaemic optic neuropathy

Answer 39

Optic disc swelling - acute phase Pale optic disc (suggests optic atrophy) - chronic phase

Question 40

Blunt force to eye assoc with pain, diplopia, limitation of eye movement and endophthalmos suggests?

Answer 40

Oribtal blow out fracture/fracture of ethmoid bone

Question 41

Which artery is damaged in anterior ischaemic optic neuropathy e.g. GCA?

Answer 41

Posterior ciliary artery

Question 42

What does a tear drop sign suggest on X-ray?

Answer 42

Orbital blow out fracture - appearance of herniated intraorbital fat (+/- inferior rectus muscle) which has protruded through a fracture of the inferior orbital wall.

Question 43

2 types of orbital blow out fractures

Answer 43

Open door - large, displaced and comminuted Trapdoor - linear, hinged, and minimally displaced

Question 44

Example of a medication causing acute closed angle glaucoma

Answer 44

Anti-muscarinics e.g. amitriptyline

Question 45

Flashes and floaters and loss of vision in one quadrant of the eye?

Answer 45

Retinal detachment

Question 46

Which nerve controls complete closing of eyelid?

Answer 46

Facial nerve

Question 47

Visual complication of NF1

Answer 47

Optic glioma

Question 48

What type of vessel beading is specific to diabetic retinopathy?

Answer 48

Venous

Question 49

Bit of bark in eye would cause what appearance on slit lamp?

Answer 49

Lots of vertical lines

Question 50

Hyperaemia and white corneal deposits suggests

Answer 50

Bacterial keratitis

Question 51

Management of dacrocystitis

Answer 51

Cephalexin oral

Question 52

Management of BRVO with no mac oedema

Answer 52

Obs and manage lifestyle