Ophthalmology

Question 0

White pupil in newborn – suspected diagnosis? Alternative diagnosis?

Answer 0

Retinoblastoma

Congenital cataract

Question 1

Childhood ophthalmological problems? Ages?

Answer 1

#White pupil – newborn 
#Strabismus 
#Amblyopia – first 6-7 years of life

Question 2

Amblyopia? Mechanism? If not corrected?

Answer 2

Vision impairment resulting from interference with the processing of images by the brain

Faced with two overlapping images, brain suppresses one of them.

If not corrected early, permanent cortical blindness of the suppressed eye, even though eye was perfectly normal

Question 3

Strabismus - verified by? Surgery when? If not corrected?

If strabismus develops later in infancy – likely cause? Treatment?

Answer 3

Reflection from light comes from different areas of the two corneas; as soon as diagnosed; amblyopia

Exaggerated convergence caused by refractive difficulties; corrective lenses

Question 4

Patient presents with severe eye pain or frontal headache starting after watching movies for several hours – suspected diagnosis? Patient may also report seeing? Surgery when/how?

Answer 4

Acute angle closure glaucoma (Watching movies, dilates eyes for several hours)

Also see halos around lights;

Immediately – drill hole and Iris with laser to provide drainage route

Question 5

Patient with suspected acute closed angle glaucoma – physical exam findings?

Answer 5

#pupil mid dilated and does not react to light
#cornea cloudy with greenish hue
#eye firm

Question 6

While waiting for surgery for acute closed angle glaucoma, may give these medications?

Answer 6

#Carbonic anhydrase inhibitors (Diamox)
#Topical beta blockers
#Topical alpha-2 selective adrenergic agonists
#Mannitol
#Pilocarpine

Question 7

Patient presents with hot, tender, red, swollen eye and fever – suspected diagnosis? Physical exam finding that further suggests diagnosis? Surgery when?

Answer 7

Orbital cellulitis; 
#pupils dilated and fixed 
#eye has limited motion
#Hypopia

Drainage after Emergency CT scan

Question 8

Management of chemical burns of The eye?

Answer 8

#Irrigation for 30 minutes before transport to the ER
#In hospital, continued irrigation, and removal of corrosive particles
#PH testing before discharge

Question 9

Which type of chemical burns are worse?

Answer 9

Alkaline burns worse than acid burns

Question 10

Patient presents with seeing flashes of light and having “floaters” in eye – suspected diagnosis? Degree of severity correlated with? Surgery when?

Answer 10

Retinal detachment; the amount of floaters, flashes

Emergency intervention with laser spot welding to protect remaining retina

Question 11

Patient presents with sudden loss of vision eye – complication? Management?

Answer 11

Embolic occlusion of the retinal artery; permanent irreversible damage if clot does not move within 30 minutes

#Patient breathes into paper bag
#Someone repeatedly presses and releases eye in transit to ER (to shake clot away)

Question 12

Patients with newly diagnosed type two diabetes – number of years before retinopathy usually develops?

Answer 12

20