Ophthalmology

Question 1

Name 2 eyelid infections?

Answer 1

styes, blepharitis

Question 2

What glands are affected with styes?

Answer 2

Molls and Zeis

Question 3

How to Mx a lid infection?

Answer 3

eyelid hygeine, cotton bud, baby shampoo dilated

Question 4

What is an entropion? what symptom and why?

Answer 4

lid inturning, degeneration of the lower lid. Inturned eyelashes irritate the cornea

Question 5

What is an ectropion? what symptoms?

Answer 5

lower lid eversion. Causes a watering eye and exposure keratitis.

Question 6

What is the effect of sympathetic NS on the pupil? list a sympathomimetic drug?

Answer 6

pupils dilate. Phenylephrine

Question 7

What is the effect of parasympathetic NS on the pupil? list a drug which mimics this.

Answer 7

constricted pupils. Tropicamide.

Question 8

What is opthalmoscopy used for?

Answer 8

red reflex, renal vasculature, optic nerbe

Question 9

What is myopic eye sight?

Answer 9

short sighted

Question 10

what is hypermetropic eyesight?

Answer 10

long sighted

Question 11

Name some abnormalities you could see on the retina?

Answer 11

haemorrhage, exudate, drusens, scarring, retinitis pigmentosa

Question 12

What is a scotoma?

Answer 12

a blind spot

Question 13

2 causes of flame haemorrhages?

Answer 13

retinal vein occlusion, hypertensive retinopathy

Question 14

What are the rod and cone cells uses?

Answer 14

RODS - outer retina, night vision

CONES - central retina, colour vision and acuity

Question 15

Name some causes of gradual loss of vision?

Answer 15

cataract, glaucoma, ARMD, Retinitis pigmentosa

Question 16

What is a cataract?

Answer 16

A cataract is a common eye condition where the lens of the eye gradually opacifies

Question 17

Causes of cataracts?

Answer 17

Smoking
Increased alcohol consumption
Trauma
Diabetes mellitus
Long-term corticosteroids
Radiation exposure

Question 18

Presentation of a cataract?

Answer 18

Reduced vision
Faded colour vision: making it more difficult to distinguish different colours
Glare: lights appear brighter than usual
Halos around lights

Question 19

Different types of cataracts and who they affect?

Answer 19

Nucleur - the elderly
Polar - inherited
Subscapular - steroid induced

Question 20

Ix for cataracts?

Answer 20

Ophthalmoscopy, slit light exam

Question 21

Mx for cataract?

Answer 21

UV protective sunglasses, lens surgery - remove and replace.

Question 22

What is the commonest type of glaucoma?

Answer 22

Chronic open angle glaucoma

Question 23

Definition of raised IOP?

Answer 23

> 21mmHG

Question 24

RF for chronic open angle glaucoma?

Answer 24

genetics, black patients, myopia, HTN, diabetes

Question 25

What features might be seen on optometry?

Answer 25

1. Optic disc cupping - caused by loss of disc substance 2. Optic disc pallor - indicating atrophy 3. Bayonetting of vessels - vessels have breaks as they disappear into the deep cup and re-appear at the base

Question 26

How might a patient present with chronic open angle glaucoma?

Answer 26

peripheral visual field loss, decreased visual acuity, optic disc cupping

Question 27

How to investigate chronic open angle glaucoma?

Answer 27

assess visual field, slit lamp exam, applanation tonometry (measure IOP)

Question 28

Management pathway for chronic open angle glaucoma?

Answer 28

1st line = Prostaglandin analogue e.g. Latanoprost - increases uveoscleral outflow 2nd line = B blocker e.g Betaxolol - reduces aqueous production OR carbonic anhydrase inhibitor e.g. Dorzolamide - reduces aqueous production

Question 29

What is age related macular degeneration?

Answer 29

degeneration of the macula which is usually bilateral. WET - exudative and neovascular DRY - drusen formation

Question 30

RF for ARMD?

Answer 30

age, smoking, family history, HTN, dyslipidaemia

Question 31

Presentation of ARMD?

Answer 31

reduced visual acuity, difficulties with dark adaption, fluctuating visual disturbance

Question 32

Ix for ARMD?

Answer 32

slit lamp microscopy, fluroscein angiography

Question 33

Mx for wet ARMD?

Answer 33

anti-VEGF e.g. Lucentis

Question 34

Name some causes of sudden loss of vision?

Answer 34

Branch/central retinal artery occlusion, ocular TIA, branch RVO, central, RVO, AION, optic neuritis, retinal detachment

Question 35

Presentation of a retinal artery occlusion?

Answer 35

sudden total loss of vision (central/top or bottom)

Question 36

Ix and Mx of a RAO?

Answer 36

carotid artery doppler, fasting lipids, ECG, FBC, ESR, CT head, clotting screen Mx = Aspirin

Question 37

Signs of a RVO? on ophtalmoscope?

Answer 37

blurred vision and visual field defects | OPHTHALMOSCOPE - flame haemorrhage, leaking veins, arteries intact, swollen optic disk

Question 38

Presentation of a retinal detatchment?

Answer 38

flashes, floaters and field loss

Question 39

Signs on ophtalmoscopy of hypertensive retinopathy?

Answer 39

microinfarcts, superficial flame haemorrhage, exudate

Question 40

RF for diabetic retinopathy?

Answer 40

poor glycaemic control, HTN, carotid stenosis, pregnancy, renal disease, anaemia

Question 41

Signs on fundoscopy of diabetic retinopathy

Answer 41

microaneurysms, dots and blots, cotton wool spots, lipid exudate, neuvascularisation

Question 42

Symptoms of conjunctivitis?

Answer 42

red eye, normal vision discharge and swollen

Question 43

Common causes of conjunctivitis?

Answer 43

viral - adenovirus bacterial - strep/staph allergy

Question 44

What is the difference between presentation of episclerritis and scleritis?

Answer 44

Episcleritis - mild irritation, redness, no discharge or visual changrs Scleritis - very painful, reduced vision

Question 45

Presentation of acute angle closure glaucoma?

Answer 45

very high IOP, N&V, unliateral painful red eye, loss of vision, photophobia, dilated pupil

Question 46

Mx of acute closed angle glaucoma

Answer 46

Lower pressure - B blocker + IV mannitol | Constrict pupil - pilocarpine drops