Ophthamology

Question 1

What should a primary care provider do for a presumed retinal detachment?

Answer 1

Refer and position with head down

Question 2

In what age range do you expect to most commonly find amaurosis fugax?

Answer 2

Patients older than 50

Question 3

What is the #1 cause of retinal artery occlusion?

Answer 3

Atherosclerotic carotid disease

Question 4

When treating herpes keratitis should you use topical antivirals, topical steroids, or both?

Answer 4

Don’t use steroids. Topical antiviral and refer

Question 5

A patient describes his vision loss as a curtain coming down and then going back up. What might the diagnosis be?

Answer 5

Amaurosis fugax

Question 6

A patient presents with a painful, red nodule on the eye. What diagnosis should you be thinking of? What treatment should you begin with?

Answer 6

Hordeolum (stye). Warm compress and progress to topical antibiotics of necessary

Question 7

A fundal exam shows a cherry-red spot. What diagnosis should you be thinking of?

Answer 7

Central retinal artery occlusion

Question 8

A college student presents with a little purulent drainage from one eye and nontender preauricular lymphadenopathy. What diagnosis and pathogen should you be thinking of?

Answer 8

Chlamydia conjunctivitis

Question 9

What should a primary care provider do for presumed retinal artery occlusion?

Answer 9

Ophthalmic emergency!! Refer and intermittent pressure and release of the eye

Question 10

A patient presents with unilateral blurriness developing over a few days. Fundal exam shows a “blood and thunder” pattern. What is the most likely diagnosis?

Answer 10

Central vein occlusion

Question 11

What is appropriate treatment for central vein occlusion?

Answer 11

Typically self-limited. Treat underlying disease

Question 12

Is glaucoma more prevalent in males or females?

Answer 12

Females 3:1

Question 13

Give two risk factors for glaucoma

Answer 13

African American descent and diabetes

Question 14

What is the yellow, brown fleshy mass on the conjunctiva which usually does not interfere with vision?

Answer 14

Pinguecula

Question 15

A fundal exam shows a cup to disc ratio of >0.5. There are also vessels bending over the disc. What is the most likely diagnosis?

Answer 15

Glaucoma

Question 16

A patient presents saying that he doesn’t seem to need his glasses anymore after 30 years. What is the most likely diagnosis?

Answer 16

Cataract

Question 17

A patient has meta-morphopsia and central blind spot. What is the most likely diagnosis?

Answer 17

Macular degeneration

Question 18

What is the most likely quadrant for a retinal detachment?

Answer 18

Superior temporal

Question 19

A patient presents with pain in one eye. The cornea is hazy and pupils are fixed. What is the most likely diagnosis?

Answer 19

Glaucoma

Question 20

What is the most common way of testing for metamorphopsia?

Answer 20

Amsler grid

Question 21

You notice Drusen deposits on a fundal exam. What is the most likely diagnosis?

Answer 21

Macular degeneration

Question 22

A patient presents with irritated, burning and tearing eyes. You notice some scurf and scales. Where do you being treatment?

Answer 22

This is blepharitis. Treatment begins with good eye hygiene and moves on to topical abx if necessary

Question 23

A patient has a history of multiple styes. He now has a painless nodule on his eyelid and minor conjunctivitis. What is the most likely diagnosis?

Answer 23

Chalazion

Question 24

What are the most common colors lost in color blindness?

Answer 24

Red and green

Question 25

What is the term for eyelids that turn in?

Answer 25

Entropion

Question 26

What is the term for bilateral yellow plaques near the eyes?

Answer 26

Xanthelasma

Question 27

A fundal exam shows an opalescent retina and boxcarring of arterioles. What is the most likely diagnosis?

Answer 27

Central retinal artery occlusion

Question 28

What is the most common preceding event for orbital cellulitis?

Answer 28

Upper respiratory infection

Question 29

Vision loss described as a curtain coming down should make you think of what diagnosis?

Answer 29

Retinal detachment

Question 30

Cutting the optic nerve causes blindness where?

Answer 30

In the ipsilateral (same side) eye

ie. Cut the left optic nerve causes blindness in the left eye

Question 31

Cutting the optic chiasm causes deficits where?

Answer 31

It causes heteronymous bitemporal hemianopia

ie Both eyes, both temporal visual fields vision loss

Question 32

Cutting the optic tract causes deficits where?

Answer 32

It causes homonymous contralateral hemianopia
ie Cutting the left optic tract causes vision loss in nasal visual field of the left eye and temporal visual field in the right eye

Question 33

Does aqueous fluid fill the anterior chamber or the posterior chamber of the eye?

Answer 33

Anterior chamber

Question 34

Do rods have high-threshold or low-threshold for light?

Answer 34

Low threshold; sensitive to low-intensity light; and function well in darkness. Low acuity and do not participate in color vision

Question 35

Point of central vision in the eye?

Answer 35

Fovea centralis

Question 36

Which cranial nerve originates or terminates in the thalamus?

Answer 36

Optic nerve

Question 37

A blunt blow or trauma to the eyebrow can cause visual field loss. What has happened?

Answer 37

Retinal detachment

Question 38

Which cranial nerve innervates the superior oblique muscle for vertical eye movements?

Answer 38

CN 4 - Trochlear

Trauma affects inward, vertical gaze

Question 39

Which anti-tuberculosis drug can cause optic neuropathy with vision changes?

Answer 39

Ethambutol

Changes can be reversed if stopped early enough