Ophthalmology Flashcards
What is the most common cause of unilateral proptosis?
A ) Cavernous haemangioma of the orbit
B ) Intracranial space-occupying lesion
C ) Lymphoma
D ) Optic nerve sheath meningioma
E ) Orbital cellulitis
F ) Thyroid eye disease
Answer: Thyroid eye disease
Unilateral proptosis is most commonly due to thyroid eye disease. This is the commonest cause for unilateral or bilateral axial proptosis in adults (more common in females). It is further confirmed by the fact that intraocular pressure rises on up gaze due to the involvement of inferior rectus muscle.
A ) Central retinal artery occlusion
B ) Central retinal vein occlusion
C ) Glaucoma
D ) Macular degeneration
E ) Non-proliferative retinopathy
F ) Proliferative retinopathy
Answer: Central retinal artery occlusion
A ) Central retinal artery occlusion
B ) Central retinal vein occlusion
C ) Glaucoma
D ) Macular degeneration
E ) Non-proliferative retinopathy
F ) Proliferative retinopathy
Answer: Proliferative retinopathy
Explanation: Diabetic retinopathy represents microvascular end-organ damage as a result of diabetes. Vascular endothelial growth factor (VEGF) is secreted by the ischemic retina. VEGF leads to increased vascular permeability resulting in retinal swelling/edema and angiogenesis or new blood vessel formation.
Causes of a small pupil include which of the following?
A ) Carbon monoxide poisoning
B ) Ethylene glycol poisoning
C ) Holmes-Adie pupil
D ) Pontine haemorrhage
E ) Third nerve palsy
Answer: Pontine haemorrhage
A ) Central retinal vein occlusion
B ) Diabetic retinopathy
C ) Hypertensive retinopathy
D ) Raised intracranial pressure
E ) Retinal detachment
Answer: Hypertensive retinopathy
A ) Central facial nerve palsy
B ) Fourth nerve palsy
C ) Internuclear ophthalmoplegia (INO)
D ) Peripheral facial nerve palsy
E ) Sixth nerve palsy
F ) Third nerve palsy
= C) Internuclear ophthalmoplegia (INO)
Internuclear ophthalmoplegia is a disconnection syndrome characterised by impaired horizontal gaze. It occurs as a result of interruption to the medial longitudinal fasciculus (MLF), commonly due to multiple sclerosis or haemorrhage. Affected individuals have slowed or limited adduction in the eye ipsilateral to the lesion, with associated abducting nystagmus in the contralateral eye. In the diagram below, the right eye is not able to fully adduct (look toward the left side) while the left eye can fully adduct.
Which ocular pathology is NOT associated with type II diabetes?
A ) Anterior uveitis
B ) Cataracts
C ) Diabetic retinopathy
D ) Extraocular muscle palsy
E ) Glaucoma.
= A) Anterior uveitis
Explanation: Diabetes is associated with retinopathy, cataract (a rare ‘snowflake’ cataract in youth and a greater frequency and earlier onset of age related cataract), glaucoma (but the association of chronic open angle glaucoma is disputed), and extraocular muscle palsy due to microvascular disease of the third, fourth, or sixth cranial nerves
Answer: Maxilla bone
Answer: 10-21mmHg
Glaucoma is a group of eye diseases that cause intraocular pressure (IOP) to rise, in some cases as high as 70mmHg. In primary open-angle glaucoma (POAG), the most common form, there is a reduced outflow of aqueous humour through the trabecular meshwork.
Answer: Zygomatic bone
Which of the following is a cause of sudden visual loss?
A ) Cataracts
B ) Chronic glaucoma
C ) Optic atrophy
D ) Optic neuritis
E ) Tobacco amblyopia
Answer: Optic neuritis
What is the most common cause of orbital cellulitis?
A ) Adenovirus
B ) Chlamydia trachomatis
C ) Pseudomonas aeruginosa
D ) Staphylococcus and streptococcus species
E ) Varicella zoster virus
Answer: Staphylococcus and streptococcus species
Answer: Non-proliferative diabetic retinopathy
In non-proliferative diabetic retinopathy, chronic hyperglycaemia causes damage to retinal capillaries, weakening capillary walls. These microaneurysms can rupture in a dot-like appearance referred to as “dot-and-blot” haemorrhages. Fluid from the leaky vessels can recede, leaving behind lipid byproducts which appear as “hard exudates”.
Answer: Episcleritis
Answer: Separation of the iris (Iridodialysis)
You are performing fundoscopy on a patient with hypertensive retinopathy when you are asked to describe your
findings. What does “copper and silver wiring” refer to?
A ) Abnormal colouring of the arterioles
B ) An enlarged retinal arteriole that crosses a vein and can press down and cause swelling distal to the crossing
C ) Capillary occlusion ischaemia and degeneration of the vascular smooth muscle
D ) Degeneration of retinal blood vessels to the point where they leak plasma and bleed onto the retina
E ) Small areas of yellow-white discolouration on the retina
Answer: Abnormal colouring of the arterioles
Answer: Iritis (anterior uveitis)
How does acute iritis present?
Presentation of acute iritis
- Painful inflammation of the iris
- Uncommon in children – can be acute, chronic or relapsing
- May be associated with other conditions, such as rheumatoid arthritis, Behçet’s disease, malignancy, trauma to eye, infection.
How does viral conjunctivitis present?
Presentation of viral conjunctivitis
- Common condition (more common than bacterial form)
- Presents with pink conjunctiva and dilated blood vessels
- Not usually associated with pain, photophobia or visual disturbance
- Discharge unusual, although the eye may water excessively
- Often associated with a viral URTI
Which of the following ocular emergencies is also life threatening?
A ) Acute glaucoma
B ) Acute iritis
C ) Corneal ulcer
D ) Leukocoria (white reflex)
E ) Lid/globe lacerations
Answer: Leukocoria (white reflex)
A ) Infective endocarditis
B ) Myeloma
C ) Syphilis
D ) Systemic lupus erythematosus
E ) Tay-Sachs disease
Answer: Infective endocarditis
The presence of white-centred haemorrhages (Roth spots) should prompt the consideration of possible infective endocarditis. This patient’s diagnosis was confirmed with echocardiography and blood cultures.
Answer: Optic canal
Answer: Corneal foreign body
Answer: Retinal detachment
Answer: Subconjunctival haemorrhage
Answer: Acute angle-closure glaucoma
Answer: Infraorbital groove
Which of the following ophthalmic conditions can occur in HLA-B27 associated diseases (e.g. ankylosing spondylitis, inflammatory bowel disease, and reactive arthritis)?
A ) Acute anterior uveitis
B ) Conjunctivitis
C ) Herpes keratitis
D ) Open angle glaucoma
E ) Posterior vitreous detachment
Answer: Acute anterior uveitis
Answer: Frontal bone
Answer: Marginal keratitis
You have been referred a case of primary open-angle glaucoma. Which of the following findings would be important in diagnosing the case?
A ) Corneal ulcer
B ) Injected conjunctiva
C ) Narrow drainage angle between the cornea and iris
D ) Optic disc cupping
E ) Refractive error
Answer: Optic disc cupping
In opthalmological terms, backward displacement of the globe is known as __________.
A ) Enophthalmos
B ) Exophthalmos
C ) Midbrain pupil
D ) Preseptal cellulitis
E ) Proptosis
Answer: Enophthalmos
Explanation: Enophthalmos is backward displacement of the globe. This may be seen following an orbital fracture when orbital contents are displaced into an adjacent sinus. It is also said to occur in Horner’s syndrome but this is really a pseudo-enophthalmos due to narrowing of the palpebral fissure.
Answer: Herpes simplex keratitis
The hallmark of HSV keratitis is the presence of multiple small branching epithelial dendrites on the surface of the cornea, although often times it first presents as a coarse, punctuate epithelial keratitis, which may be mistaken for a viral keratitis.
Answer: Retinal detachment
Which of the following is a triangular, fleshy wing of conjunctiva that encroaches on the cornea?
A ) Chalazion
B ) Entropion
C ) Hyphaema
D ) Pterygium
E ) Strabismus
Answer: Pterygium
Answer: Herpes simplex keratitis
48 hours following cataract surgery, a patient complains of ocular pain and visual loss. On examination, their eye appears red with ciliary injection, corneal oedema, and an absent red reflex. The first suspicion must be:
A ) Acute conjunctivitis
B ) Anterior uveitis
C ) Bacterial endophthalmitis
D ) Corneal ulcer
E ) Secondary glaucoma
Answer: Bacterial endophthalmitis
Answer: Central retinal vein occlusion
Causes of mydriasis include which of the following?
A ) Argyll Robertson pupil
B ) Horner’s syndrome
C ) Old age
D ) Opiates
E ) Third nerve palsy
Answer: Third nerve palsy
Answer: Branch retinal artery occlusion
Answer: Amaurosis fugax
Answer: Cotton wool spots
Cotton wool spots are white spots on the retinal surface caused by microinfarction. They are mainly associated with hypertension and diabetes, but can be seen with HIV, lupus, thrombocytopaenia, hypercoagulable states, connective tissue disorders, and other conditions.
Answer: sympathetic : dilation
A patient blinks both eyes when the right cornea is touched and does not blink at all when the left cornea is touched. Where is the problem?
A ) Left facial nerve
B ) Left ophthalmic nerve (branch of trigeminal nerve)
C ) Right facial nerve
D ) Right ophthalmic nerve (branch of trigeminal nerve)
E ) Both facial and ophthalmic nerve
Answer: Left ophthalmic nerve (branch of trigeminal nerve)
Answer: Central retinal artery occlusion
Answer: Inferior orbital fissure
Answer: Marginal keratitis
With aging, the elasticity of the lens and the strength of the ciliary muscle decrease, resulting in the loss of accommodation. In this condition, light from nearby objects falls behind the retina, causing blurred vision.
What is the name of this condition?
A ) Emmetropia
B ) Hyperopia
C ) Myopia
D ) Neurotropia
E ) Presbyopia
Answer: Presbyopia
What structure produces aqueous humor?
A ) Ciliary processes
B ) Cornea
C ) Iris
D ) Lense
E ) Retina
= A) Ciliary processes
Answer: Pupillary constriction and an increase in the refractive power of the lens
Answer: parasympathetic : constriction
Posterior cerebral artery (PCA) infarction causes which of the following visual lesions?
A ) Bitemporal heteronymous hemianopsia
B ) Contralateral homonymous hemianopsia
C ) Contralateral homonymous hemianopsia with macular sparing
D ) Contralateral upper homonymous quadrantanopsia
E ) Ipsilateral blindness
= C ) Contralateral homonymous hemianopsia with macular sparing
Angiogenesis contributes to the cause of what visual defect in diabetes?
A ) Cataracts
B ) Glaucoma
C ) Hyperopia
D ) Myopia
E ) Rubeosis iridis
= E ) Rubeosis iridis
Which of the following most accurately describes the pupillary light reflex?
A ) Its afferent nerve is the optic (CN II) and its efferent nerve is the oculomotor (CN III)
B ) Its afferent nerve is the optic (CN III) and its efferent nerve is the oculomotor (CN II)
C ) Its afferent nerve is the trigeminal (CN V) and its efferent nerve is the facial (VII)
D ) Its efferent nerve is the optic (CN II) and its afferent nerve is the oculomotor (CN III)
E ) Its efferent nerve is the optic (CN III) and its afferent nerve is the oculomotor (CN II)
= A) Its afferent nerve is the optic (CN II) and its efferent nerve is the oculomotor (CN III)
Answer: Central retinal vein occlusion
Lesion of which part of the visual pathway is shown by the following visual defect?
= Answer: Meyer’s loop
Lesion of which part of the visual pathway is shown by the following visual defect?
Answer: Middle portion of the right calcarine sulcus
- The calcarine sulcus (or calcarine fissure) is an anatomical landmark located at the caudal end of the medial surface of the brain. The calcarine sulcus is where the primary visual cortex is concentrated.
A pituitary adenoma would cause which of the following visual pathways lesions?
A ) Bitemporal heteronymous hemianopsia
B ) Contralateral homonymous hemianopsia
C ) Contralateral homonymous hemianopsia with macular sparing
D ) Contralateral upper homonymous quadrantanopsia
E ) Ipsilateral blindness
Answer: Bitemporal heteronymous hemianopsia
A 42-year-old man with a history of myopia presents to his GP complaining of the sudden, painless deterioration in his vision in the right eye, flashing lights and the presence of floaters. He is a contact lens wearer. What is the most likely diagnosis?
A ) Acute angle glaucoma
B ) Amaurosis fugax
C ) Microbial keratitis
D ) Optic neuritis
E ) Retinal detachment
F ) Vitreous haemorrhage
Answer: Retinal detachment
Answer: Right optic nerve
= Answer: Dacrocystitis
Dacrocystitis is a bacterial infection of the lacrimal sac. It can arise in infants when the lacrimal passage fails to open, or in adults due to trauma, chronic sinusitis, or sinonasal neoplasma. It presents with a painful, tender mound overlying the lacrimal sac; there can also be muculopurulent discharge.
Answer: Trichiasis
Aqueous fluid is produced in which chamber?
A ) Anterior chamber
B ) Posterior chamber
C ) Trabecular chamber
D ) Vitreous chamber
E ) None of the above
= B ) Posterior chamber
Answer: Blepharitis
Blepharitis, an inflammatory condition of the eyelid margin, is a common cause of ocular discomfort and irritation in all age and ethnic groups. While generally not sight-threatening, it can lead to permanent alterations in the eyelid margin or vision loss from superficial keratopathy, corneal neovascularization, and ulceration.
Answer: Branch retinal artery occlusion
A middle cerebral artery (MCA) infarction causes which one of the following visual pathways lesions?
A ) Bitemporal heteronymous hemianopsia
B ) Contralateral inferior quadrantonopia
C ) Homonymous hemianopia without macular sparing
D ) Ipsilateral blindness
E ) Paracentral scotoma
Answer: Homonymous hemianopia without macular sparing
= Lacrimal bone
= Retinal drusen; age-related macular degeneration
Drusen are yellow-white flecks scattered around the macular region that are made up of dead retinal pigment epithelium. The cause is typically age-related macular degeneration. Hard exudates (associated with diabetes and hypertension) tend to be deep yellow and have sharper margins.
What condition presents with dendritic ulcers on the surface of the cornea?
Answer: Herpes simplex virus keratitis
= Non-proliferative diabetic retinopathy
There are areas of hard exudates with dot haemorrhages giving the diagnosis of non-proliferative diabetic retinopathy.
Answer: Non-proliferative diabetic retinopathy
There is an area of hard exudates, with a couple of dot haemorrhages giving the diagnosis of background diabetic retinopathy. The dot haemorrhages (microaneurysms) are indicative of diabetes.
The Amsler grid is useful in which of the following eye pathologies?
A ) Age-related macular degeneration
B ) Mild, non-proliferative diabetic retinopathy
C ) Moderate, non-proliferative diabetic retinopathy
D ) Proliferative diabetic retinopathy
E ) Retinal detachment
F ) Severe, non-proliferative diabetic retinopathy
G ) Vitreous haemorrhage
= A ) Age-related macular degeneration
Which of the following is the epithelial-lined tube which carries tears from the punctum to the lacrimal sac?
A ) Cilia
B ) Lacrimal gland
C ) Lacrimal sac
D ) Lateral canthus
E ) Lower canaliculus
What is a condition where light, originating from a distance, is focused in front of the retina?
A ) Emmetropia
B ) Hyperopia
C ) Myopia
D ) Neurotropia
E ) Presbyopia
C ) Myopia
Answer: Chalazion
Chalazion is a chronic sterile lipogranuloma residing within the eyelid that originates from an obstructed meibomian gland of the tarsal plates.
Answer: Proliferative diabetic retinopathy
= Sclera
Answer: produced by the epithelium of the ciliary body -> posterior chamber -> flows through the pupil -> anterior chamber -> drained into the canal of Schlemm
Aqueous humor is produced by the epithelium of the ciliary body. It is secreted into the posterior chamber, from which it flows through the pupil to enter the anterior chamber. The aqueous humor is drained into the canal of Schlemm, which is a venous sinus found near the limbus.
Answer: Fovea centralis
Answer: Open-angle glaucoma
Glaucoma describes a group of conditions in which there is characteristic cupping of the optic disc with corresponding visual field defects, due to retinal ganglion cell loss. It is a progressive condition and is the most common cause of irreversible blindness worldwide. Primary open angle glaucoma (POAG) is a subset of the glaucomas defined by an open, normal appearing anterior chamber angle and raised intraocular pressure (IOP), with no other underlying disease.
Answer: Chalazion
Chalazia commonly present as a nodule of an eyelid. It arises from obstruction of the sebaceous (oil glands) of the eyelid tarsal plate. It affects the upper eyelids more commonly than lower lids because there are more meibomian (sebaceous) glands in the upper lid.
A ) Augmentin
B ) Ceftriaxone
C ) Chloramphenicol
D ) Flucloxacillin
E ) Gentamicin
C ) Chloramphenicol
Answer: Macular degeneration
Macular degeneration is the leading cause of vision loss in Australians over 40. Ageing, smoking, hypertension, atherosclerosis, high cholesterol, and obesity are all risk factors. On fundoscopy, yellow-white lipid/protein deposits (drusen) are typical of age-related macular degeneration.
Answer: Third nerve palsy
Aqueous humor of the eye drains into ______.
A ) Schlemm’s canal
B ) the anterior chamber
C ) the iridocorneal angle
D ) the posterior chamber
E ) the uvea
Aqueous humor of the eye drains into A) Schlemm’s canal.
= Supraorbital notch
Answer: Posterior bundle of the right optic radiation
Answer: Sphenoid bone
A ) Blood culture and lumbar puncture
B ) Blood culture then intravenous antibiotics
C ) Prednisolone and antihistamines
D ) Topical chloromphenicol with mucosal MC&S
E ) Urgent computed tomography (CT) of orbital fossae.
Answer: Blood culture then intravenous antibiotics
Explanation: This child has moderate periorbital cellulitis, requiring inpatient admission, blood culture, and IV antibiotics (likely Flucloxicillin or Ceftriaxone). An important differential is an orbital cellulitis. This is an ocular emergency as it can lead to blindness, intracranial infection, and cavernous thrombosis.
When the ciliary muscles are relaxed, the lens is relatively ________, allowing the eye to focus on objects that are ________.
A ) flat : close
B ) flat : distant
C ) round : close
D ) round : distant
E ) transparent : anywhere within the field of view
When the ciliary muscles are relaxed, the lens is relatively flat, allowing the eye to focus on objects that are distant.
Answer: Ethmoid bone
Answer: Pterygium
Pterygiums are fibrovascular growths that extend from the conjunctiva toward or onto the corneal surface. They are caused by extended exposure to sunlight and/or wind.
When the ciliary muscles are contracted, the lens is relatively ________, allowing the eye to focus on objects that are ________.
A ) flat : close
B ) flat : distant
C ) round : close
D ) round : distant
E ) transparent : anywhere within the field of view
When the ciliary muscles are contracted, the lens is relatively round, allowing the eye to focus on objects that are close.
The junction between the sclera and the cornea is called:
A ) the bulbar conjunctiva
B ) the limbus
C ) the palpebral conjunctiva
D ) the uvea
E ) the zonular fibrils
B ) the limbus
Answer: Sixth nerve palsy
Answer: Fourth nerve palsy
The following features are seen in which eye pathology?
Answer: Severe, non-proliferative diabetic retinopathy
Answer: Proliferative diabetic retinopathy
A ) Branch retinal vein occlusion
B ) Central retinal artery occlusion
C ) Glaucoma
D ) Multiple sclerosis
E ) Panretinal photocoagulation scarring
F ) Retinitis pigmentosa
F) Retinitis pigmentosa
Loss of night vision and peripheral vision are classic features of retinitis pigmentosa. The fundi shows the characteristic ‘bone spicule’ areas of pigmentation in the periphery of the retina.
Answer: Primary open angle glaucoma
Answer: Moderate, non-proliferative diabetic retinopathy
Fundoscopic features of diabetic retinopathy include:
- Mild: Microaneurysms, intraretinal haemorrhages and hard exudates are present.
- Moderate NPDR: Microaneurysms, severe intraretinal haemorrhages, exudates, cotton wool spots, venous beading and intraretinal microvascular abnormalities (IRMA)
- Severe NPDF: Microaneurysms, cotton wool spots. Intraretinal haemorrhages in four quadrants. Venous beading. Severe IRMA
- PDR: New blood vessels on the optic disc, vitreous haemorrhages, tractional retinal detachment
Answer: Proliferative diabetic retinopathy
The key fundoscopic feature of proliferative diabetic retinopathy is neovascularisation, seen here around the optic disk.
Answer: Retina
What minimum visual acuity is necessary for driving private vehicles in WA?
A ) 6/12 in both eyes, without the use of visual aids
B ) 6/12 in one or both eyes, utilising visual aids (e.g. glasses) as needed
C ) 6/20 in one or both eyes, without the use of visual aids
D ) 6/6 in one or both eyes, utilising visual aids (e.g. glasses) as needed
E ) 6/9 in both eyes, without the use of visual aids
B ) 6/12 in one or both eyes, utilising visual aids (e.g. glasses) as needed
3 actions of the inferior oblique?
Answer: Elevation, extorsion, abduction.
Answer: Lesion shown by pin 1
- Central scotoma caused by inflammation of the optic disc (optic neuritis) and optic nerve (retrobulbar neuritis).
- Common causes of scotomata include demyelinating disease such as multiple sclerosis.
Answer: Fourth nerve palsy
Answer: Anterior uveitis, chlamydia
Answer: Cataract
A cataract is an opacification of the lens caused by degeneration of lens proteins associated with increased age. It presents with slowly progressing blurry vision.
Answer: Lesion shown by pin 9 = Left homonymous hemianopia with macular sparing
Answer: Iris
The action of the superior rectus muslce is:
A ) Depression, extorsion, adduction
B ) Depression, intorsion, adduction
C ) Elevation, extorsion, abduction.
D ) Elevation, extorsion, adduction
E ) Elevation, intorsion, abduction
F ) Elevation, intorsion, adduction
F) Elevation, intorsion, adduction
- NOTE: The action of the eye muscle and the movement of the eye during clinical testing are two distinct questions. This question often confuses students. Review the following diagrams for further explanation.
- In its primary position, the superior rectus elevates the eye and since it connects in a medically oblique plane (23° angle with visual axis), its secondary actions are adduction and intorsion.
Answer: Pupil
Answer: Blepharitis
Blepharitis is diffuse inflammation of the lash follicles of the eyelids. It presents with a chronic gritty sensation, tenderness and flaky debris on the lid margins. Typically skin organisms such as S. aurueus are the culprit.
Answer: Posterior communicating artery
Zygomaticofacial foramen
Homonymous hemianopia is due to the lesion at:
A ) Optic nerve
B ) Occipital cortex
C ) Optic chiasma
D ) Optic tract
E ) Retina
D ) Optic tract
Answer: Papilloedema
Papilloedema is swelling of the optic disc due to raised intracranial pressure. The optic disc margins appear indistinct; it is elevated above the retinal surface.
Bitemporal hemianopia (loss of the outer half of both visual fields) is often due to compression of the optic chiasm (e.g. by a pituitary adenoma).
Answer: Arteriovenous nicking
Hypertensive changes of AV nicking shown by cricles in the following image:
- Arteriovenous nicking, also known as AV nicking, is the phenomenon where, on examination of the eye, a small artery (arteriole) is seen crossing a small vein (venule), which results in the compression of the vein with bulging on either side of the crossing.
Answer: Hypertension
The signs of hypertensive retinopathy include constricted and tortuous arterioles, retinal hemorrhage, hard exudates, cotton wool spots, retinal edema, and papilledema.
A 78-year-old woman presents at the emergency unit with a constricted right visual field. As both eyes are affected, the attending physician assumes that the left optic tract might be damaged. Between which two structures does the optic tract run?
A ) Lateral geniculate and superior colliculus
B ) Lateral geniculate nucleus and optic chiasm
C ) Optic chiasm and retina
D ) Optic nerve and retina
E ) Visual cortex and optic radiation
Answer: Lateral geniculate nucleus and optic chiasm
Answer: Lesion shown by pin 4
Answer: Orbital cellulitis
Orbital cellulitis is a bacterial or fungal infection of the lids and orbital tissues. It may arise from an infected skin lid wound, or the spread of infection from a blocked and infected ethmoid sinus. Fungal infection may arise in immune-compromised patients. It can be restricted to tissues in front of the orbital septum (pre-septal) or extend into tissues behind the septum (post-septal). Untreated infection risks spread into the intracranial space.
Answer: Non-proliferative diabetic retinopathy
Answer: Supraorbital fissure
Answer: Trauma
A hyphaema is crescent-shaped layers of haemorrhage in the anterior chamber, typically caused by trauma which has torn blood vessels at the iris root.
Answer: Wet age-related macular degeneration
Bleeding under the retina in the macular region is most commonly found in the wet form of age-related macular degeneration, when new choroidal vessels grow into the retina. It can be partly prevented with intravitreal injections of anti-vascular endothelial growth factor.
Answer: Sixth nerve palsy
