Ophthalmology

Question 1

Deep red eye that is very painful and may be associated with reduced visual acuity and blurred vision and systemic connective tissue disorders:

Answer 1

Scleritis

Question 2

Causes of relative afferent pupillary defect:

Answer 2

Retinal detachment
Optic neuritis (multiple sclerosis, might present with headaches and red desaturation too)

Question 3

What drops can be used to distinguish between episcleritis and scleritis

Answer 3

Phenylephrine

Question 4

Painful red eye with photophobia and epiphora, next step:

Answer 4

Fluorescein staining, if epithelial defect refer urgently, managed with topical aciclovir for herpes simplex keratitis

Question 5

Treatment for Herpes zoster ophthalmicus

Answer 5

Immediate referral/oral aciclovir

Question 6

Argyll-Robertson Pupil (ARP) is Accommodation Reflex Present (ARP) but Pupillary Reflex Absent (PRA), most common cause in the UK

Answer 6

Diabetes, used to be neurosyphilis

Question 7

Elder, deterioration in vision at night, fluctuation from day to day, drusen in Bruch’s membrane:

Answer 7

Dry age-related macular degeneration

Question 8

Bilateral recurrent uveitis with a history of pulmonary disease

Answer 8

Sarcoidosis

Question 9

Ptosis + dilated pupil = Ptosis + constricted pupil =

Answer 9

Third nerve palsy
Horner’s syndrome

Question 10

Type of visual defect found in a pituitary tumour:

Answer 10

Bitemporal hemianopia, upper quadrant defect

Question 11

Type of defect in primary closed angle glaucoma:

Answer 11

Unilateral peripheral visual field loss

Question 12

Large irregular pupil, reacts sluggishly to light, once constricted it remains like that for a long time:

Answer 12

Holmes Adie pupil

Question 13

Pupil doesn’t react to light, when exploring the other pupil, both dilate:

Answer 13

Marcus Gunn pupil