Ophthalmology

Question 1

What is periorbital cellulitis?

Answer 1

Infection & inflammation of the skin & eyelid anterior to the orbital septum

Question 2

What are the causes of periorbital cellulitis?

Answer 2

Staph Aureus
H. influenza type B (if not vaccinated)
Secondary to sinus/paranasal/dental
Minor scratch
Insect bite

Question 3

How is periorbital cellulitis treated?

Answer 3

IV Abx for 5-7days

Question 4

What is a squint?

Answer 4

Misalignment of the eyes

Question 5

What are the causes of a squint?

Answer 5

Idiopathic
Tumour: Retinoblastoma 
Refractive error
Visual loss
Paralytic: CN palsy

Question 6

What are the signs & symptoms of a squint?

Answer 6

Diplopia
Amblyopia
Eye misalignment
Visual acuity loss (Retinoblastoma)

Question 7

How is a squint investigated?

Answer 7

Visual acuity test
Eye movements
Look for red reflex, pupillary reflex 
Close up & long distance sight 
Cover test
Cranial nerve exam
Simultaneous/alternative prism & cover test

Question 8

How is a squint managed?

Answer 8

Glasses: Correct refractive error
Eye patches
Exercises
Surgery: Extraocular muscles
Chemodenervation: Botulism toxin type A

Question 9

What are the causes of blindness?

Answer 9

Vit A deficiency
Measles
Opthalmia Neonatorium (Conjunctivitis)
Retinal dystrophies
CNS Disorder
Rubella
Retinopathy of prematurity
Trauma/ birth injury
Infected corneal ulcers

Question 10

What are the causes of childhood cataracts?

Answer 10

10-30%
Genetic
Immunise against rubella

Question 11

What are the different levels of blindness?

Answer 11

Partial: 3/60-6/60

Registered blind/ Severe<3/60 in better eye

Question 12

What are the signs & symptoms of periorbital cellulitis?

Answer 12

Systemically unwell
Fever
Erythema & tenderness over affected area

Question 13

What are the complications of untreated periorbital cellulitis?

Answer 13

Orbital cellulitis with evolving ocular proptosis
Limited ocular movement
Dec visual acuity
RARE: Meningitis, cranial abscess, CST

Question 14

What are the causes of conjunctivitis?

Answer 14

Neonates: Mostly non-bacterial, Staph Aureus, Pseudmonas, Strep
Childhood: Gram +ve cocci, H. influenzae, Adenovirus
Other: Gonococcal, Chlamydia

Question 15

How is conjunctivitis treated?

Answer 15

Neonate: Simple cleaning, topical Abx- Neomycin
Gonococcal: IV Ceftriaxone 25mg/kg
Chlamydial: Erythromycin PO 14days/ Topical Azithromycin 3days
Childhood: 5days Fusidic Acid/Gentamicin, Chloramphenicol drops 5days

Question 16

What things can cause blindness?

Answer 16

Retinal issues

Lens: Cataracts (congenital, LT steroid use)

Question 17

What are the complications of a squint?

Answer 17

Lazy eye

Question 18

What is a pseudo squint?

Answer 18

No problem with the eye leading to the squint e.g large epicanthic folds
Assess: Child looks into the distance, look into child’s eye does the light in the child’s eye land in the same place?
Yes= fine No= squint

Question 19

What is retinopathy of prematurity?

Answer 19

Caused by high O2 in neonates
Results in nevascularisation of the retina
Tx: Specialists
RF: Premature!!