Ophthalmology

Question 1

What are the types of age related macular degeneration?

Answer 1

Dry

Wet

Question 2

Which is the most common type of AMD?

Answer 2

Dry

Question 3

What are the stages of diabetic Retinopathy?

Answer 3

Background
Pre-proliferative
Proliferative

Question 4

What would you see in a congenital Horner’s?

Answer 4

Ptosis
Miosis
Heterochromia -eyes are different colours

Question 5

What are the types of conjunctivitis?

Answer 5

Bacterial
Viral
Allergic

Question 6

What are the 2 refractive parts of the eye?

Answer 6

Cornea

Lens

Question 7

Describe short sightedness

Answer 7

Myopia

When the refraction is such that the light does not focus on the retina itself but in front of it

Question 8

Describe long sightedness

Answer 8

The angle of refraction is such that the light focuses behind the retina

Question 9

What is strabismus?

Answer 9

A squint

Where the eyes point in different directions

Question 10

What is the management of a squint?

Answer 10

Eye patch
Glasses
Eye exercises
Corrective surgery

Question 11

What is inter nuclear opthalmoplegia?

Answer 11

Disorder of conjugate lateral gaze. The affected eye shows impairment of adduction.

Question 12

Internuclear opthalmoplegia tells us there is injury of the…

Answer 12

Medial longitudinal fasciculus

Question 13

Give 2 causes of INO

Answer 13

MS

Stroke

Question 14

What is giant cell arteritis

Answer 14

A systemic, immune mediated vasculitis affecting the medium and large arteries

Question 15

What are the risk factors for GCA?

Answer 15

PMR
European
60-80 years old
Genetics

Question 16

Describe the symptoms of GCA

Answer 16

Recent onset temporal headache
Myalgia, malaise, fever
Scalp tenderness
Transient visual sx 
Jaw and tongue claudication

Question 17

What investigations are done for suspected GCA?

Answer 17

ESR, CRP, Platelets

Temporal artery biopsy

Question 18

Describe an Argyll Robertson pupil

Answer 18

Bilateral, small, irregular pupils
Absence of light reflex
Prompt accommodation
Pupils dilate slowly with drops

Question 19

What are the causes of Argyll Robertson pupil?

Answer 19

Diabetic retinopathy

Syphilis

Question 20

Give sx of conjunctivitis

Answer 20

Red eye
Watery 
Discharge
Crushing of lid margins
Flu like sx

Question 21

What is the mx of conjunctivitis?

Answer 21

Eye bathing
Avoid towel sharing
Topical abx if needed
Topical lubricants

Question 22

How do you treat suspected chlamydia conjunctivitis?

Answer 22

Swab

Oral tetracycline or azithromycin

Question 23

What are the symptoms of allergic conjunctivitis?

Answer 23

Bilateral red eyes
Itch 
Watering 
Eyelid oedema 
Conjunctival swelling - chemosis

Question 24

What is the management of corneal abrasions?

Answer 24

Usually self resolve in 48 hours

Topical chloramphenicol if needed

Question 25

What are the 3 main layers of the globe?

Answer 25

Conjunctiva Episclera Sclera

Question 26

How does episcleritis present?

Answer 26

Unilateral redness | Uncomfortable not painful

Question 27

How does scleritis present?

Answer 27

Painful Intense redness of sclera and episcleral vessels Scleral necrosis

Question 28

What conditions is scleritis associated with?

Answer 28

``` RA vasculitis Wegener‘s granulomatosos SLE Spondyloarthopathies ```

Question 29

What is the management of scleritis?

Answer 29

NSAID | local steroid

Question 30

Anterior uveitis is inflammation of ...

Answer 30

Iris and ciliary body

Question 31

Describe the presentation of anterior uveitis

Answer 31

Acute onset pain, photophobia, watering | Red eye

Question 32

Intermediate uveitis is inflammation in the...

Answer 32

Vitreous

Question 33

What symptoms are associated with intermediate uveitis?

Answer 33

Floaters | Blurred vision

Question 34

Posterior uveitis is inflammation of the ...

Answer 34

Choroid | Retina

Question 35

What are the symptoms of posterior uveitis?

Answer 35

Painless blurring of vision Floaters Photopsia - flashing lights

Question 36

What is the management of uveitis?

Answer 36

Anti microbial +/- steroid

Question 37

What is presbyopia?

Answer 37

The diminished ability of the lens to accommodate with age

Question 38

What are the drugs given for glaucoma?

Answer 38

Prostaglandin analogues Beta blockers Alpha agonists Carbonic anhydrase inhibitors

Question 39

What might you find on examination of the eyes in a patient with thyroid eye disease?

Answer 39

``` Proptosis Decreased colour vision Restrictive strabismus Eyelid retraction Exposure keratitis Chemosis Periorbital swelling ```

Question 40

What is the mean age of diagnosis of retinoblastoma?

Answer 40

18 months

Question 41

What is the most common signs of retinoblastoma?

Answer 41

White pupillary reflex | Leukocoria

Question 42

Describe dry AMD

Answer 42

Oxidative stress and inflammation cause Retinal waste products accumulate in the retinal pigmented epithelium impairing it’s function and causing photoreceptor damage

Question 43

Describe wet AMD

Answer 43

Vascular endothelial growth factor plays a role and vessels grow through choroid and into the retina Can give anti-VEGF

Question 44

What signs might be seen in pre-proliferative diabetic retinopathy?

Answer 44

``` Microaneurysms Haemorrhages Hard exudates Cotton wool spots Venous beading ```

Question 45

What distinguishes proliferative retinopathy?

Answer 45

Neovsascularisation

Question 46

What are the treatments for diabetic retinopathy?

Answer 46

Anti VEGF injections Panretinal photocoagulation laser Macular laser Vitrectomy

Question 47

Describe a relative afferent pupillary defect

Answer 47

When the light is moved quickly form eye to eye, both pupils constrict initially. Paradoxical dilation is seen in the eye with the effect on moving the light back to that eye.

Question 48

What are the causes of RAPD?

Answer 48

``` Optic nerve disorders eg. Neuritis GCA glaucoma Orbital disease Ischaemic retina Retinal detachment Severe macular degeneration ```