Ophthalmology CCT Flashcards
30yo man presented with bilateral red eye and tearing for three days. There was no associated photophobia or pain. He has 20/20 vision in both eyes. Upon examination, there is diffuse conjunctival injection, sparing the limbal vessels. What is the most likely diagnosis?
A. Acute iritis
B. Microbial keratitis
C. Acute angle closure episode
D. Acute conjunctivitis
Ans: D
25yo woman presented with right eye redness with associated photophobia. Upon slit lamp examination, there were anterior chamber cells and flare. Vitreous clear, no cell. What is the most likely diagnosis?
A. Acute iritis
B. Microbial keratitis
C. Acute angle closure episode
D. Acute conjunctivitis
A. Acute iritis
80 yo man with a history of AF presented with acute loss of vision in his left eye. RAPD negative. Upon fundus examination, he has retinal pallor with a cherry red spot. What is the most likely diagnosis?
A. Central retinal vein occlusion
B. Central retinal artery occlusion
C. Anterior ischaemic optic neuropathy
D. Exudative age-related macular degeneration
Ans: B
30yo man was hit by a football in his right eye, and presented with periorbital oedema. Visual acuity 12/20. Upon fundus examination, multiple blood clots were observed in the vitreous humor, obscuring the view of the retina. What is the most likely condition?
A. Central retinal vein occlusion
B. Vitreous haemorrhage
C. Anterior ischaemic optic neuropathy
D. Exudative age-related macular degeneration
Ans: B
85yo man complained of progressive worsening of vision for a few months. He had bilateral cataract surgery 5 years ago with uneventful recovery. Fundus examination showed drusens and retinal pigmentary mottling around the macula. What is the most likely diagnosis?
A. CRAO
B. CRVO
C. Anterior ischaemic optic neuropathy
D. Dry age-related macular degeneration
Ans: D
40yo woman had a traffic accident recently. She complained of vertical diplopia and presented with a head tilt to the left. What is the most likely diagnosis?
A. Abducens nerve palsy
B. Oculomotor nerve palsy
C. Trochlear nerve palsy
D. Myasthenia gravis
Ans: C
30year old man suffered from a slip and fall injury. On examination of his eye, there is uveal prolapse and a distorted pupil, what is the most likely diagnosis?
A. Eyelid laceration
B. Open globe injury
C. Orbital fracture
D. Chemical injury
Ans: B
4 year old girl with left congenital ptosis presented with decreased visual acuity in the left eye. She has normal visual acuity in the right eye. Which of the following is the most likely cause of the decreased visual acuity in the left eye?
A. Anisometropia
B. Congenital cataract
C. Intermittent exotropia
D. Amblyopia
Ans: D
21 year old woman presented with a decrease in vision over the past three days. There is present of RAPD. She also complained of decreased red-green saturation. What is the most likely diagnosis?
A. CRVO
B.
C. Optic neuritis
Ans: C
20 year old man presented with eye redness and photophobia. On slit-lamp examination, anterior chamber cells and flare, keratic precipitate and posterior synechiae were detected. What is the most likely diagnosis?
A. Acute iritis
B. Epidermal keratoconjunctivitis
C. Acute keratitis
D. Acute conjunctivitis
A. Acute iritis (anterior uveitis)
A 22-year-old woman with a history of soft contact lens wear presented with a painful red eye. Examination of the cornea shows a confluent epithelial defect measuring 3mm by 2mm in size. Infectious keratitis is therefore suspected. What is the most likely causative organism?
A. Bartonella henselae
B. xx
C. Pseudomonas aeruginosa
D. xx
Ans: C
And staph aureus
M/80, OS pain & blur x 5 d, N/V. P/E: OS corneal haziness, mid-dilated fixed pupil. Dx?
A. Acute iritis
B. Acute microbial keratitis
C. Acute angle closure episode
D. Acute conjunctivitis
C. Acute angle closure episode
F/80, old age home. OS red & discharge x 1 w. P/E: OS copious discharge, conjunctiva injected, sparing limbic (?) vessels. Dx?
A. Acute iritis
B. Acute microbial keratitis
C. AACG
D. Acute conjunctivitis
D. Acute conjunctivitis
A 30-year-old lady with a history of systemic lupus erythematosus presents with right visual loss for 3 days. Examination reveals right relative afferent pupillary defect. Fundi examination reveals diffuse flame-shaped haemorrhages and cotton-wool spots. Which is the MOST LIKELY diagnosis?
A. Central retinal vein occlusion
B. Central retinal artery occlusion
C. Anterior ischaemic optic neuropathy
D. Exudative age-related macular degeneration
A. Central retinal vein occlusion
A 65-year-old man presents with progressive blurring of vision over the past 2-3 years, affecting both of his eyes. Examination revealed bilateral nuclear sclerosis cataracts. Fundi examination revealed no other abnormalities. Which is the MOST LIKELY cause of this patient’s blurring of vision?
A. Cataract
B. Primary open angle glaucoma
C. Diabetic macular oedema
D. Dry age-related macular degeneration
A. Cataract
M/60, poorly controlled HTN and hyperlipidaemia, lateral diplopia, failed Rt abduction. Dx?
A. Oculomotor nerve palsy
B. Trochlear nerve palsy
C. Abducens nerve palsy
D. Optic nerve atrophy
C. Abducens nerve palsy
Which of the following is an intraocular mass that is potential familial malignancy?
A. Retinoblastoma
B. Persistent hyperplastic primary vitreous
C. Toxocariasis
D. Congenital cataract
A. Retinoblastoma
Blurring of vision, photophobia, eye redness. Diagnosed to be panuveitis. Also erythema nodosum in lower limbs and history of aphthous and genital ulcers. What is the most likely systemic disease associated?
A. Behcet’s disease
B. Diabetes mellitus
C. Stevens Johnson syndrome
D. Grave’s disease
A. Behcet’s disease
Patient presented with right eye redness, tearing and discomfort. Physical examination revealed tender preauricular lymph nodes. Diagnosis?
A. Acute iritis
B. Microbial keratitis
C. Acute angle closure episode
D. Epidemic keratoconjunctivitis
D. Epidemic keratoconjunctivitis
Objects fly into eye. Worry of what?
A. ?
B. Corneal abrasion
C. Acute angle closure glaucoma
D. Intraocular foreign body
D. Intraocular foreign body
A 20 year-old female is presenting with right eye pain and redness for one day. She reported the use of cosmetic contact lenses the previous day. On examination, there is central corneal infiltrate measured 3mm x 2mm and haze. There is also a right eye hypopyon measured 1mm in diameter. What is the most likely diagnosis?
A. Acute iritis
B. Acute microbial keratitis
C. Acute conjunctivitis
D. Acute angle closure episode
B. Acute microbial keratitis
70 year-old female presenting with 2-day history of left eye metamorphosia and visual impairment. Found to have submacular edema and submacular haemorrhage. What is the diagnosis?
A. CRVO
B. CRAO
C. AION
D. Exudative type AMD
D. Exudative type AMD (metamorphopsia due to submacular edema)
78 year old male had a sudden loss of vision after he woke up. He admitted the use of viagra the night before. Examination reveals right RAPD. Fundus exam reveals right swollen optic disc + splinter hemorrhage. What is the most likely diagnosis
A. CRAO
B. CRVO
C. AION
D. Exudative AMD
C. AION
60-year-old man was found to be often bumping into his periphery for the last year. VA 20/25 in both eyes. IOP 30mmHg in both eyes. Fundus examination showed increased optic disc cupping. What is the MOST LIKELY diagnosis?
A. Cataract
B. Primary open angle glaucoma
C. Diabetic macular edema
D. Dry age-related macular degeneration
B. Primary open angle glaucoma (always suspect glaucoma when cup: disc ratio >0.5)
30 year old man with binocular diplopia with bilateral drooping eyelids. The condition exacerbate at the end of the workday.
What is the MOST LIKELY diagnosis?
A. Myasthenia gravis
B. Trochlear Nerve palsy
C. Muscular dystrophy
D. Oculomotor Nerve palsy
A. Myasthenia gravis
man blurring of vision for 1 yr, supratemporal retinal tear with subretinal fluid
A. Retinal detachment
B. SAH
C. Orbital fracture
D. CN4 palsy
A. Retinal detachment
2yo child with right esotropia. fully correctable with spectacles. diagnosis?
A. accommodative esotropia
B. CN6 palsy
C. Duane syndrome
D. intermittent exotropia
A. accommodative esotropia
Bitemporal hemianopia. What is the most likely type of neuropathy.
A. Compressive Neuropathy
B. Ischemic Neuropathy
C. Post-radiation Neuropathy
D. Neuropathy (?optic neuritis)
A. Compressive Neuropathy (optic chiasm: pituitary adenoma)
20 year old male. Slip and fall. Facial injury. VA 20/20. Binocular diplopia. Diagnosis?
A. Orbital fracture
B. Open Globe Injury
C. Trochlear Nerve Palsy
D. SJS/TEN
A. Orbital fracture
HT, Hyperlipidemia. Sudden visual loss, diagnosis?
Central retinal vein occlusion
DM patient, staging of disease?
Treatment modality
Proliferative diabetic retinopathy
Panretinal photocoagulation
Blurring of vision, dx?
Subretinal hemorrhage
Dresin
Dark spot (scotoma)
Wet age related macular degeneration
Asymptomatic, dx?
Glaucoma (increased cupt to risk ratio of at least 0.8)
Clinical sign?
Cotton wool spot
Smoker, swelling and proptosis, dx?
Thyroid eye disease
20/M with history of ankylosing spondylitis , redness, diagnosis?
Anterior uveitis
Rheumatoid arthritis patients, painful and red eye, diagnosis?
Scleritis
Poorly controlled DM, complication?
Neovascular glaucoma/rubeosis iridis
Non arteritic anterior ischemic otpic neuropathy (optic disc swelling and hyperemic (red))
Visual field loss, dx?
Retinal detachment
Clinical sign?
Drusen (due to absence of other signs of diabetic retinopathy: no dot and blot hemorrhages, no neovascularization)
Contact lens user, Pain, Photophobia, Diagnosis?
Infective keratitis
Pain, Headache, Nausea and vomiting, IOP 41 mmHg, Diagnosis?
Acute angle closure glaucoma
Clinical sign?
Leukocoria
Retinoblastoma, congenital cataracts
Hypertension, Hyperlipidemia, Painless visual loss, Diagnosis?
Right eye central retinal artery occlusion
Cherry red spot and pale retina
Abnormal blood vessel
dx?
Epiretinal membrane
This contracts and pulls on the vessels (hence the appearance of vessels reaching towards the white space)
Clinical sign?
Hollenhorst plaque/emboli
Doctor says the cataract is too hard to be removed by phacoemulsification. Give an alternative treatment.
Extracapsular cataract extraction
Hyphema (bleeding in anterior chamber of eye between iris and cornea)
Posterior synechiae
Picture of A: caustic soda; B: acidic cleaner)
Your patient accidentally splashes a large amount of A or B into his/her eyes. Does A or B cause more damage?