Ophthalmology - Definitions and useful passmed facts

Question 1

Exotropia

Answer 1

When one or both the eyes turn outwards

Question 2

Amblyopia

Answer 2

‘Lazy eye’

Can develop if squint not corrected in childhood

Question 3

Esotropia

Answer 3

Esotropia is where an eye deviates inward compared to the other

Question 4

Hypermetropia

Answer 4

Hypermetropia is also known as ‘long-sightedness’ where the eyes struggle to focus on things close-up

Question 5

Cycloplegics

Answer 5

Cycloplegics dilate the pupil which helps to relieve pain and photophobia

e.g. Atropine, cyclopentolate

Question 6

Keratitis

Answer 6

Keratitis describes inflammation of the cornea

Question 7

What is the type of visual problems that you get with cataracts, OAG, and macular degeneration?

Answer 7

Cataracts cause a generalised reduction in visual acuity with starbursts around lights

Glaucoma causes a peripheral loss of vision with halos around lights

Macular degeneration causes a central loss of vision with a crooked or wavy appearance to straight lines

Question 8

Key Features of Orbital Cellulitis

Answer 8

Orbital cellulitis is the result of an infection affecting the fat and muscles posterior to the orbital septum, within the orbit but not involving the globe

Cause - spreading upper respiratory tract infection from the sinuses

Differentiating orbital from preseptal cellulitis:
reduced visual acuity, proptosis, ophthalmoplegia/pain with eye movements are NOT consistent with preseptal cellulitis

Question 9

What is Periorbital cellulitis?

Answer 9

Periorbital (preseptal) cellulitis is a less serious superficial infection anterior to the orbital septum, resulting from a superficial tissue injury (chalazion, insect bite etc…)

Periorbital cellulitis can progress to orbital cellulitis

Question 10

What class of drugs can worsen acute angle closure glaucoma?

Answer 10

Drugs with anticholinergic effects like amitriptyline and oxybutynin

Question 11

AACG and OAG - which is associated with hypermetropia and which is associated with myopia?

Answer 11

Acute angle closure glaucoma is associated with hypermetropia, where as primary open-angle glaucoma is associated with myopia

Question 12

New classification for Non- proliferative Diabetic Retinopathy

Answer 12

A BCDE A4B2

Mild
A- Aneurysm (micro) 1+

Moderate
B- Beading/looping
C- Cotton wool spots
D- Dot/Blot haemorrhages
E- Exudate

Severe
A4- Aneurysms in all 4 quadrants
B2- Beading in 2 quadrants

(Then Proliferative is +neovascularisation)

Question 13

Treatment for OAG and AACG

Answer 13

• Open-angle glaucoma: latanoprost or timolol drops, then both together; then add dorzolamide drops then brimonidine drops as needed
• Closed-angle glaucoma: lie patient flat, then give pilocarpine drops plus oral acetazolamide together

Question 14

When is relative afferent pupillary defect NOT seen in optic neuritis?

Answer 14

RAPD will not be seen if there is bilateral optic neuritis, only seen in unilateral

Question 15

What class of drug is pilocarpine, what happens when used, and what condition is it used for?

Answer 15

Parasympathomimetic eyedrops
Causes pupillary constriction
AACG

Question 16

Argyll Robertson Pupil accommodation and pupillary reflex, which is present, which is not

Answer 16

ARP = Argyll Robertson Pupil

Therefore ARP-PRA
Accommodation Reflex Present-Pupillary Reflex Absent

Question 17

What does papilloedema look like on fundoscopy?

Answer 17

Blurring of optic disc margin

venous engorgement: usually the first sign

elevation of optic disc

loss of the optic cup

Paton’s lines: concentric/radial retinal lines cascading from the optic disc

Question 18

How do you determine what the cause of Horner’s syndrome is?

Answer 18

Horner’s syndrome - anhydrosis determines site of lesion:

head, arm, trunk = central lesion: stroke, syringomyelia
just face = pre-ganglionic lesion: Pancoast’s, cervical rib
absent = post-ganglionic lesion: carotid artery

Question 19

For which glaucoma is hypermetropia and myopia associated with?

Answer 19

Acute angle closure glaucoma is associated with hypermetropia

Primary open-angle glaucoma is associated with myopia