Ophthalmology

Question 1

contact lense wearer + red eye, photophobia and gritty sensation (1)
causes (2)

Answer 1

Keratitis (inflammation of cornea)

• typically Staphylococcus aureus
• Pseudomonas aeruginosa is seen in contact lens wearers
• Other: Herpes

Question 2

Bacterial conjunctivitis in pregnancy

Answer 2

fusidic eye drops (can’t have chloramphenicol)

Question 3

recurrent watery or sticky eye in neonates - doesn’t respond to Abx

Answer 3

Congenital tear (lacrimal) duct obstruction, resolves by 1 year

REASSURANCE until 1 year

Question 4

cotton wool spots represent areas of…

Answer 4

RETINAL INFARCTION

Question 5

Corneal abrasion: treatment

Answer 5

cholcamphenicol to prevent infection

Question 6

Orbital compartment: what to do ((blood in the anterior chamber, proptosis, stiff eyelid, and a relative afferent pupillary defect)

Answer 6

URGENT decompression PRE imaging
immediate canthotomy

Question 7

mydriatic

Answer 7

large pupil

Question 8

Argyll-Robertson pupil

Answer 8

Argyll-Robertson pupil is one of the classic pupillary syndromes. It is sometimes seen in neurosyphilis. Typically the pupil accommodates but doesn’t react. A mnemonic used for the Argyll-Robertson Pupil (ARP) is Accommodation Reflex Present (ARP) but Pupillary Reflex Absent (PRA)

Features
small, irregular pupils
no response to light but there is a response to accommodate

Causes
diabetes mellitus
syphilis

Question 9

Punctate fluorescein staining of the cornea

Answer 9

dry eyes

Question 10

Ptosis + dilated pupil =;
ptos§is + constricted pupil =

Answer 10

Ptosis + dilated pupil = third nerve palsy; ptosis + constricted pupil = Horner’s

Question 11

Phenylephrine drops can be used to distinguish between

Answer 11

episcleritis and scleritis

. It blanches the redness in episcleritis but doesn’t in scleritis.

Question 12

positive Chvostek and Trousseau signs.

Answer 12

hypocalcaemia

Question 13

what metabolic disorder causes cataract

Answer 13

hypocalceamia

Question 14

Lens dislocation

Answer 14

Causes
Marfan’s syndrome: upwards
homocystinuria: downwards
Ehlers-Danlos syndrome
trauma
uveal tumours
autosomal recessive ectopia lentis

Question 15

A 32-year-old man with known Marfan’s syndrome presents to the emergency department with sudden, painless loss of vision in the left eye. There were no preceding symptoms and no trauma.

Answer 15

lens dislocation

Question 16

cheese and tomato pizza fundoscopy

Answer 16

central retinal vein occlusion

Question 17

chronic unilateral conjunctivitis resistant to treatment

Answer 17

Orbital lymphoma

Question 18

Argyll-Robertson causes

Answer 18

diabetes
syphilis

Question 19

what type of vision loss do you get in optic neuritis

Answer 19

Central scotoma is a classic finding in optic neuritis where patients experience a central visual field defect. This occurs because the papillomacular bundle, which serves central vision, is preferentially affected by the inflammatory process. The central scotoma may be absolute or relative and is typically demonstrated on visual field testing.

SUBACUTE visual loss

Question 20

black bone-spicule pigmentation on fundoscopy

Answer 20

Retinitis pigmentosa

Question 21

opaque retina with a cherry-red spot seen in CRAO.

Answer 21

Central retinal vein occlusion

Question 22

most common eye manifestation of RA

Answer 22

Keratoconjunctivitis sicca

Question 23

What is blepharitis?

Answer 23

Blepharitis is a common eye condition that makes your eyelids red, swollen, irritated, and itchy. It can cause crusty dandruff-like flakes on your eyelashes. Blepharitis can be uncomfortable. But it isn’t contagious, and it usually doesn’t cause any lasting damage to your eyes.

Question 24

stye (hordeolum external) VS chalazion

Answer 24

Question 24

Chorioretinitis

Answer 24

Chorioretinitis is an inflammatory condition affecting the choroid and retina of the eye. This dual inflammation can be precipitated by infectious or autoimmune aetiologies, leading to the potential for significant visual impairment if not promptly and effectively managed.

Causes
infectious
toxoplasmosis: most prevalent cause worldwide
cytomegalovirus: particularly in immunocompromised individuals such as HIV patients
syphilis
tuberculosis
autoimmune
sarcoidosis
Behçet’s disease
systemic lupus erythematosus