Ophthalmology

Question 1

Failure to correct childhood squints may lead to

Answer 1

amblyopia - lazy eye

Question 2

thick yellowish mucoid discharge

Answer 2

purulent discharge –> bacterial conjunctivitis

Question 3

linear branching corneal ulcer

Answer 3

herpes simplex keratitis

Question 4

Flashes + floaters are most commonly caused by

Answer 4

posterior vitreous detachment

Question 5

episcleritis vs scleritis

Answer 5

In episcleritis, the injected vessels are mobile when gentle pressure is applied on the sclera.
In scleritis, vessels are deeper, hence do not move

Question 6

keratitis Sx

Answer 6

red eye, photophobia and gritty sensation

Question 7

Holmes ADIe

Answer 7

= DIlated pupil, females, absent leg reflexes

Question 8

Cx of steroid eye drops

Answer 8

Steroid eye drops can lead to fungal infections, which in turn can cause corneal ulcers

Question 9

vitreous haemorrhage risk factors

Answer 9

Diabetes
Trauma
Anticoagulants
Coagulation disorders
Severe short sightedness

Question 10

Pain out of proportion of clinical presentation, contact lens and recent freshwater swimming

Answer 10

acanthamoebic keratitis

Question 11

Marcus Gunn pupil

Answer 11

RAPD

Question 12

During the ‘swinging light test’ the right and left pupil dilate when shining light into the right eye- where is the lesion

Answer 12

This indicates a problem with the right-sided afferent pathway –> right sided retina or optic nerve

Question 13

First-line treatment in a patient with a history of heart block- chronic glaucoma Tx

Answer 13

latanoprost

Question 14

Causes pupillary constriction, blurred vision and headaches- chronic glaucoma Tx

Answer 14

Pilocarpine

Question 15

Primary open-angle glaucoma: first-line Tx if the IOP is ≥ 24 mmHg

Answer 15

360° selective laser trabeculoplasty

Question 16

Horners vs third nerve palsy

Answer 16

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

Question 17

Central retinal vein occlusion - fundoscopy

Answer 17

severe retinal haemorrhages - pizza pie

Question 18

cotton wool spots represent

Answer 18

areas of retinal infarction (pre-capillary arteriolar occlusion)

Question 19

The use of mydriatic drops in a predisposed individual can precipitate

Answer 19

acute angle closure glaucoma

Question 20

red eye and reduced vision following intraocular surgery

Answer 20

endophthalmitis

Question 21

painless red eye, history of constipation

Answer 21

sub-conjunctival haemorrhage

Question 22

Argyll-Robertson pupil

Answer 22

Bilaterally small pupils that accommodate but don’t react to bright light. Causes include neurosyphilis and diabetes mellitus

Question 23

Anisocoria worse in bright light indicates

Answer 23

problem with the dilated pupil and its inability to constrict

problem with parasympathetic innervation
–> location of defect = ciliary ganglion, oculomotor nerve, or iris

e.g. Adies tonic pupil- ciliary ganglion

Question 24

aim of treatment of acute glaucoma

Answer 24

Reducing aqueous secretion + inducing pupillary constriction.

Question 25

complication of panretinal photocoagulation

Answer 25

A decrease in night vision

Question 26

a reduction in visual acuity, particularly for near field objects, worse at night

Answer 26

Wet AMD

Question 27

definitive treatment for wet AMD

Answer 27

anti-VEGF

Question 28

ocular complications of herpes zoster opthalmicus

Answer 28

conjunctivitis, keratitis, episcleritis, anterior uveitis

Question 29

Contact lens wearers who present with a red painful eye

Answer 29

referred to eye casualty to exclude microbial keratitis

Question 30

Orbital compartment syndrome

Answer 30

blood in the anterior chamber, proptosis, stiff eyelid, and a relative afferent pupillary defect.

Question 31

Orbital compartment syndrome Tx

Answer 31

immediate canthotomy- decompression

Question 32

dark spots obscuring his vision in his left eye, with a red hue to his vision

Answer 32

vitreous haemorrhage

Question 33

retinal detachment risk factors

Answer 33

diabetes mellitus myopia age previous surgery for cataracts (accelerates posterior vitreous detachment) eye trauma e.g. boxing

Question 34

proliferative diabetic retinopathy Tx

Answer 34

panretinal laser photocoagulation and Intravitreal VEGF inhibitors

Question 35

Anterior uveitis treatment

Answer 35

steroid and cycloplegic (mydriatic) eye drops

Question 36

blunt trauma with hyphen (blood in anterior chamber)

Answer 36

high risk of raised intraocular pressure

Question 37

causes of cataracts

Answer 37

normal ageing process smoking, alcohol trauma DM long term steroids radiation exposure myotonic dystrophy hypocalcaemia

Question 38

Horners syndrome anhydrosis of head arm and trunk

Answer 38

central lesion-->stroke syringomyelia

Question 39

horners syndrome anhydrosis of face

Answer 39

pre-ganglionic lesion--> pancoast tumour, cervical rib

Question 40

Horner's syndrome no anhydrosis

Answer 40

post-ganglionic --> carotid artery

Question 41

contact lens associated keratitis

Answer 41

pseudomonas infection

Question 42

Peripheral curtain over vision + spider webs + flashing lights in vision

Answer 42

think retinal detachment

Question 43

small fixed oval pupil, ciliary flush

Answer 43

anterior uveitits

Question 44

semi-dilated pupil

Answer 44

acute glaucoma

Question 45

central scotoma and red patches on the retina on fundoscopy

Answer 45

wet ARMD

Question 46

optic disc cupping, pallor, and disc hemorrhages.

Answer 46

primary open angle glaucoma

Question 47

closed angle glaucoma immediate treatment

Answer 47

urgent referral IV acetazolamide combination of eye drops- pilocarpine, timolol, apraclonidine

Question 48

closed angle glaucoma definitive treatment

Answer 48

laser peripheral iridotomy