Ophthalmology

Question 1

A pt presents with bilateral red eye, watery discharge, itchiness and preauricular adenopathy with normal pupillary response most likely suffers from ….

Answer 1

Viral Conjunctivitis (easily transmissible)
(tx: topical antihistamines/ decongestants)

Question 2

A pt presents with unilateral red eye, purulent/thick discharge, significant crust formation overnight and normal pupillary response most likely suffers from …

Answer 2

Bacterial Conjunctivitis
(poorly transmissible)
(tx: topical antibiotics)

Question 3

A pt presents with red eye, photophobia, hx of autoimmune disease and pain when light is shined in unaffected eye most likely suffers from ….

Answer 3

Uveitis (iris, ciliary body, choroid inflammation)

Question 4

What diagnostic test is used to detect uveitis?

Answer 4

slit lamp

Question 5

What is the treatment for uveitis?

Answer 5

topical steroids

Question 6

What disease is keratic precipitates (inflammatory cells that accumulate on inside of cornea) associated with?

Answer 6

uveitis

Question 7

A pt presents with sudden onset red, severely painful eye that is hard to palpation and associated with fixed midpoint pupil (due to stuck pupil), walking into dark room invokes pain (b/c wants to react but can’t), hazy/cloudiness of cornea , cup to disc ratio > 0.3 and decreased visual acuity most likely suffers from ….

Answer 7

Acute Angle Closure Glaucoma

Question 8

What is the diagnostic test for Glaucoma?

Answer 8

Tonometry (elevation in intraocular pressure)

Question 9

What are the treatments for aucte angle closure glaucoma? (5)

Answer 9

1. Acetazolamide (decreased aqueous humor production)
2. Mannitol (osmotic diuretic)
3. Pilocarpine (increases aqueous humor outflow via constricting pupil)
4. beta blockers (decrease production)
5. Laser trabeculoplasty (last resort)

Question 10

A pt presents with red eye after trauma such as use of contact lenses and it feels like there is sand in the pt’s eye most likely suffers from …

Answer 10

Corneal abrasion

Question 11

What is the diagnostic test used for corneal abrasions?

Answer 11

fluorescein stain

Question 12

What medications increase the drainage of aqueous humor and used in the treatment of glaucome?

Answer 12

1. Prostaglandin analogues (latanaprost, travoprost, bimatoprost)
2. Pilocarpine

Question 13

What medications decrease the production of the aqueous humor and used in glaucoma?

Answer 13

1. carbonic anhydrase inhibitors (dorzolamide, brinzolamide)
2. topical beta blockers
   (timolol, carteolol, betaxolol, metipranolol, levobunolol)
3. alpha adrenergic (apraclonidine, brimonidine)

Question 14

A pt presents with red, swollen and painful eye and the sensation that something is caught under the eyelid most likely suffers from ….

Answer 14

Herpes Keratitis

Question 15

What should be avoided in herpes keratitis?

Answer 15

steroids (worsen growth of virus leading to blindness)

Question 16

What is the diagnostic test used to detect herpes keratitis?

Answer 16

Fluorescein staining (dendritic pattern under blue light)

Question 17

What is the treatment for herpes keratitis?

Answer 17

1. oral acyclovir ( or derivatives)

2. topical trifluridine or idoxuridine

Question 18

A pt presents with slowly progressive blurry vision, decreased color perception and difficulty with night driving (due to glare of headlights) most likely suffers from …

Answer 18

Cataracts (opacification of lens)

Question 19

What is the treatment for cataracts?

Answer 19

surgical removal of lens and replace with new intraocular lens

Question 20

What is the diagnosis of early cataracts?

Answer 20

slit lamp

Question 21

What patients should always have an ophthalmology consult immediately once diagnosed?

Answer 21

Diabetics

Question 22

A diabetic pt complaining of floaters in their eye is suggestive of …. formation

Answer 22

vitreal hemorrhages

Question 23

What are the findings in nonproliferative (background) retinopathy in diabetics? (4)

Answer 23

1. dilation of veins
2. microaneurysms
3. retinal edema
4. retinal hemorrhages

Question 24

What are the findings in proliferative retinopathy in diabetics?

Answer 24

1. intravitreal hemorrhages

2. neovascularization

Question 25

What is the most accurate diagnostic test for diabetic retinopathy?

Answer 25

fluorescein angiography (detects vessels that should undergo laser coagulation)

Question 26

What is the treatment for proliferative diabetic retinopathy other than tight glycemic control? (3)

Answer 26

1. laser photocoagulation 2. VEGF inhibitors (vascular endothelial growth factors inhibitors) 3. vitrectomy (to remove vitreal hemorrhage obstructing hemorrhage)

Question 27

What is the treatment for nonproliferative diabetic retinopathy?

Answer 27

tight glycemic control

Question 28

A pt presents with sudden, painless unilateral vision loss and ophthalmoscopic findings include pale retina, diminshed perfusion, cherry red spot on fovea and box-car segmentation of veins most likely suffers from ...

Answer 28

Central retinal artery occlusion (pale b/c blood cant get in)

Question 29

What are attempted treatments for central retinal artery occlusion? (5)

Answer 29

1. oxygen 2. ocular massage (to unobstruct vessel) 3. acetazolamide (decrease intraocular pressure) 4. thrombolytics 5. anterior chamber paracentesis

Question 30

A pt presents with sudden painless unilateral vision loss and ophthalmoscopic findings include disk swelling, venous dilation, toruosity, and retinal hemorrhages most likely suffers from ...

Answer 30

Central retinal vein occlusion (blood gets in but can't come out)

Question 31

A pt presents with sudden unilateral blurry vision without pain or redness, that is characterized as curtain coming down and have floaters and flashes at periphery of vision most likely suffers from ...

Answer 31

Retinal detachment | associated with myopia and diabetic retinopathy

Question 32

What is the treatment for retinal detachment? (3)

Answer 32

1. mechanical attachment (sugery, laser, cryotherapy) 2. inject expansible gas (to push retina back in globe of eye) 3. surgical removal of vitreous and surgical attachement to sclera

Question 33

A elderly pt presents with slow progressive bilateral central visual loss with drusen (yellowish deposits) most likely suffers from ...

Answer 33

Dry (atropic) type of macular degeneration

Question 34

A pt presents with rapid bilateral central visual loss with drusen (yellowish deposits) and neovascularization most likely suffers from ...

Answer 34

Wet (exudative) type of macular degeneration | more cause of blindness

Question 35

What is the most accurate diagnostic test for macular degeneration?

Answer 35

Fluorescein angiography

Question 36

What is the treatment for wet type of macular degeneration?

Answer 36

VEGF inhibitors (ranibizumab and bevacizumab)