Ophthalmology: Degenerative eye conditions

Question 1

Presentation of macular degeneration

What is characteristic?

Answer 1

• Progressive reduced vision, blurriness, worse in night time
• More rapid in ‘wet’ macular degeneration
• Central scotomas
• Seeing ‘wavy’ lines

Question 2

Which type of macular degeneration carries a worse prognosis?

Answer 2

Wet macular degeneration

Question 3

Amsler grid test indication

Answer 3

Suspected macular degeneration – metamorphopsia

Detects central visual field defects, metamorphopsia and any dark areas/blind spots (scotomas)

Question 4

Investigations for macular degeneration

List 4

Answer 4

• Visual acuity test
• Amsler grid test
• Slit lamp / fundoscopy to look at retina
• OCT to look at retinal layers

Question 5

Fundoscopic findings in dry macular degeneration

Answer 5

Drusen (‘d’ for drusen) around the macula.

geeky medics

Question 6

Fundoscopic findings in wet macular degeneration

Answer 6

Subretinal fluid/blood (Leakage)

Question 7

Management of ‘dry’ atrophic macular degeneration

Answer 7

No definitive treatment.

Antioxidants e.g. vit A/C/E and zinc and healthy lifestlye (no smoking.)

Question 8

Management of ‘wet’ neovascular macular degeneration

Answer 8

Anti-VEGF injections (e.g., ranibizumab, aflibercept)

Question 9

Presentation of cataracts

Answer 9

• Gradual, painless visual loss
• Loss of colour
• Halos/glares
• Reduced/absent red reflex
• Asymmetrical
• Often in older adults

Question 10

Diagnosis of cataracts

Answer 10

• Opacity on slit lamp
• Snellen chart - reduced visual acuity
• Possible reduced red reflex

Question 11

Treatment of cataracts

Answer 11

Phacoemulsification + lens replacement surgery

Lens being broken down by US