Ophthalmology

Question 1

Causes of tunnel vision

Answer 1

papilloedema
glaucoma
retinitis pigmentosa
choroidoretinitis
optic atrophy secondary to tabes dorsalis
hysteria

Question 2

Primary open angle glaucoma Mx

Answer 2

Latanoprost - increases uveoscleral outflow. (also make iris brown, increase eye lash length)

Timolol - reduce aqueous production

Brimonidine - both (contraindicated in those using MAOI)

Question 3

Posterior vitreous detachment Fx

Answer 3

flashes of light
floaters in periphery

Question 4

Retinal detachment Fx

Answer 4

Dense shadow from periphery into centre
straight lines appear curved

Question 5

Vitreous haemorrhage Fx

Answer 5

Large bleed - sudden loss

moderate bleed - numerous dark spots

small bleeds - floaters

Question 6

Horners syndrome Fx

Answer 6

ptosis - drooping of eyelid
miosis - constricted pupil
anhidrosis - lack of sweating

Question 7

Third nerve palsy Fx

Answer 7

pstosis - drooping of eyelid
mydriasis - dilated pupil
“down and out” = appearance of eye

Question 8

Argyll Robertson pupil Fx

Answer 8

accommodating pupils - bilateral constricted pupils
Do not react to light

associated with neurosyphilis

Question 9

Holmes-Aidie pupil Fx

Answer 9

Unilateral dilated pupil
Poorly reacts to light
Slow constriction on accommodation
Absent reflexes in other parts of the body

Question 10

Central vein occlusion Fx

Answer 10

Sudden, painless, unilateral vision loss

Associated with
CVD, HTN, increase age

Question 11

Age related macular degeneration Ix and Mx

Answer 11

Amsler grid - distortion of line perception

Urgent Ophthalmology referral

Question 12

Optic neuritis Fx

Answer 12

unilateral gradual decrease in vision
pain on eye movement
poor discrimination of colours
RAPD
central scotoma

Question 13

Nasolacrimal duct obstruction Fx

Answer 13

Persistent watery eye <1yo

Mx
lacrimal duct massage
self resolve by 1yo

if >1yo - refer ophthalmology

Question 14

Red painful eye differential

Answer 14

Acute angle closure glaucoma: severe pain, haloes, ‘semi-dilated’ pupil

Uveitis: small fixed pupil, photophobia

Keratitis: photophobia, fluorescein stain shows ulcer

Question 15

Meibomian cyst Mx

Answer 15

1st- warm compress BD

If atypical - 2WW refer Ophthal
- bleeding, ulceration, loss of eye lashes, distortion of eyelid margin

Question 16

Contact lens associated keratitis cause

Answer 16

pseudomonas aeruginosa

Question 17

Retinitis pigmentosa Fx

Answer 17

night blindness + tunnel vision
inherited/ strong family history

Question 18

Acute angle closure glaucoma

Answer 18

can be precipitated by Mydriatic drops

Question 19

Eyelid issues examples (5)

Answer 19

blepharitis: inflammation of the eyelid margins typically leading to a red eye

stye (hordeolum externum): infection of the glands of the eyelids

chalazion (Meibomian cyst)

entropion: in-turning of the eyelids

ectropion: out-turning of the eyelids

Question 20

https://geekymedics.com/fundoscopic-appearances-of-retinal-pathologies/

Fundoscopy images revision

Answer 20

https://geekymedics.com/fundoscopic-appearances-of-retinal-pathologies/

Fundoscopy images revision

Question 21

blepharitis Mx

Answer 21

hot compress + lid hygiene

Question 22

herpes zoster ophthalmicus Mx

Answer 22

PO Aciclovir
(Top steroid can help with inflammation)

Question 23

herpes zoster ophthalmicus Fx

Answer 23

red, painful eye with discharge
decreased acuity
dendritic ulcer on staining

Question 24

Primary open-angle glaucoma Mx

Answer 24

Refer to Ophthalmology
1st - 360° selective laser trabeculoplasty (SLT)
2nd - prostaglandin analogue - eg latanoprost
3rd - Timolol, Brimonidine

Question 25

Older person, painless visual loss DDx

Answer 25

Macular degeneration = central field loss
Primary open-angle glaucoma = peripheral field loss

Question 26

Corneal abrasion Mx

Answer 26

Top Chloramphenicol

Question 27

Most common post surgical complication of cataract surgery

Answer 27

posterior capsule thickening

Question 28

Marcus Gunn/ Relative Afferent Pupil defect Fx

Answer 28

When light is shone into the affected eye - the affective eye dilates. (should constrict if normal)

Question 29

Allergic conjunctivitis Mx

Answer 29

Sodium Cromoglicate (Top mast cell stabiliser)

Question 30

Amiodarone eye side effect

Answer 30

corneal microdeposit - night glare