Ophtho

Question 1

EMERGENCY >60yo Metamorphosia, “wavy” Prolonged loss

Answer 1

Macular Degeneration

Question 2

Vesicular eruption Ulcerative HSV1 Mild to moderate symptoms of blepharitis Prevent secondary herpetic keratitis or infection Prophylactic polysporin Trifluridine

Answer 2

HSV Dermatitis

Question 3

RARE CA goes from EYE to liver CA goes from breast and lung to EYE Asymptomatic Usually Stage IV before detection

Answer 3

Choroidal Melanoma

Question 4

EMERGENCY Unilateral blurring, halos, photophobia PAIN N/V, diaphoresis Poorly reactive pupil Conjunctival injection IOP >60 Females, 55-70 yo, farsighted & short

Answer 4

Acute Closed Angle Glaucoma

Question 5

Seb. Derm, rosacea, Meiboman dys., infectious Greasy, flaky, scales Thick, cloudy secretions w/ pressure Baby shampoo scrubs Polymyxin B Doxycycline for recurrent

Answer 5

Blepharitis

Question 6

>60yo Family Hx Drusen (hyaline nodules). (Carbonated) Retinal scar - late sign

Answer 6

Atrophic Macular Degeneration

Question 7

Sneeze, valsalva, BM Pool of blood Can last several months

Answer 7

Subconjunctival hemorrhage

Question 8

MS Cold latitudes Most common cause of vision loss in younger Periorbital pain but NOT eye pain Marcus-Gunn pupil

Answer 8

Optic Neuritis

Question 9

Painless, firm, well demarcated Grayish conjunctiva Asymptomatic Triamcinolone

Answer 9

Chalazion

Question 10

EMERGENCY Associated w/ systematic disease Sarcoidosis, TB, MS, syphilis, IBS Hypopyon Decreased vision Steroids, F/U

Answer 10

Posterior Uveitis

Question 11

Hx severe myopia Develops in adolescence Blurring even w/ lenses Halo’s Night vision difficulty

Answer 11

Keratoconus

Question 12

Dry eyes, UV light, wind Overgrowth from conjunctiva to cornea Surgery if persistent

Answer 12

Pterygium (Surfers Eye)

Question 13

Excessive tearing - epiphora Idiopathic or from surgery / disease Eye Dr - probing or irrigation of duct

Answer 13

Nasolacrimal duct obstruction

Question 14

Slight opacification of macula Microaneurysms Hard exudates: yellowish lesions w/ discreet borders Asymptomatic Refer

Answer 14

Diabetic Macular Edema

Question 15

Muculopurulent drainage When caused by Nisseria - EMERGENCY Oculoquinolone Neomycin Oral ABX for severe

Answer 15

Bacterial Conjunctivitis

Question 16

Yellowish deposits at medial eye lids Asymptomatic, idiopathic Surgery

Answer 16

Xanthelasma

Question 17

Can see individual blood vessels Refer, non-urgent

Answer 17

Episcleritis

Question 18

Image falls short of retina

Answer 18

Myopia

Question 19

Yellow to light brown mass on nasal side of cornea No risk, no treatment

Answer 19

Pinguecula

Question 20

<20/40 in < 6 yo <20/30 in >6 yo VA difference of 2 lines Abnormal alignment Abnormal red reflex Asymmetry of vision Unilateral ptosis

Answer 20

Refer to Ophthomology

Question 21

Image falls long of retina

Answer 21

Hyperopia

Question 22

EMERGENCY Secondary to trauma Flashes, floaters Unilateral Retinal ruggae Marcus-Gunn pupil Surgery or else vision loss

Answer 22

Retinal Detachment

Question 23

Does not follow dermatome Global H/A PAIN Rash along V1 of trigeminal Refer Acyclovir

Answer 23

Herpes Zoster Ophthalmicus

Question 24

Inversion of lid FB sensation Aging, scar from chem burn Surgery

Answer 24

Entropion

Question 25

CONDITIONAL EMERGENCY\* Most common eye problem seen FB sensation, tearing, photophobia PAIN REFER if high speed injury or retained FB\* Analgesics ABX are controversial

Answer 25

Corneal Abrasion

Question 26

EMERGENCY Dendrites on exam Unilateral Topical antivirals

Answer 26

Herpes Simplex Keratitis

Question 27

Strabismic, Refractive, Deprivational (severe) Correct as a child or eye will shut down Patch good eye

Answer 27

Ambylopia

Question 28

EMERGENCY Red, warm, fever, caused by Staph, Strep Proptosis, restricted motility URI precursor, lid infection, trauma, surgery Can lead to vision loss Drain if abscess, CBC, culture, CT IV PCN or clindamycin w/ allergy

Answer 28

Orbital Cellulitis

Question 29

EMERGENCY Associated w/ any type of infection Contacts Dense corneal infiltrates WBC layering (hypopyon) PAIN Emergent referral

Answer 29

Corneal Ulcer

Question 30

Chromosome 22 Traumatic Cats Eyes Test for other diseases

Answer 30

Coloboma

Question 31

Punctuate staining Schirmer Test Artificial tears Restasis

Answer 31

Keratoconjunctivitis Sicca

Question 32

Seasonal Bilateral Stringy discharge Antihistamines Mast stabilizers

Answer 32

Allergic Conjunctivitis

Question 33

EMERGENCY Hx carotid disease Amaurosis Fugax - monocular blindness / curtain Profound vision loss White appearing retina Cherry Spots High risk for stroke

Answer 33

Retinal Artery Occlusion

Question 34

Progressive farsightedness “Reading glasses”

Answer 34

Presbyopia

Question 35

EMERGENCY Anterior \> Posterior Dozens of causes, RA, IBD, Bechets, Infection Decreased VA Constricted pupil Mydriatic drops (rest the iris), steroid drops

Answer 35

Uveitis (Iritis)

Question 36

Inherited, adolescent onset Night blindness, photophobia Shimmering - photopsia Vitamin A

Answer 36

Retinitis Pigmentosa

Question 37

Due to ischemia Neovascularization Loss of red reflex Scotomata, floaters, Cotton Wool Spots Can lead to acute glaucoma, retinal detachment Tx is good DM control

Answer 37

Proliferative Diabetic Retinopathy

Question 38

Rare Discoloration over cornea or iris Refer

Answer 38

Melanoma

Question 39

HTN “Stormy Sunset”, tortuous vessels Vision loss over 12 - 18 hrs

Answer 39

Retinal Vein Occlusion

Question 40

\>60yo Temporal arteritis Sudden monocular vision loss Jaw pain, scalp pain, neck pain, wt. loss Marcus-Gunn pupil Also \>40yo w/ HTN or DM

Answer 40

Ischemic Optic Neuropathy

Question 41

Usually NOT infective Sjogrens Starts lateral NOT hot to touch PAIN Steroids for idiopathic Augmentin Biopsy for recurrent or failure

Answer 41

Dacryoadenitis

Question 42

Prod \> absorption Family Hx, African Americans, DM, steroids Asymptomatic, chronic Check chamber depth w/ tangential lighting Miotic agents, carbonic anhydride, alpha adrenergics, prostaglandins, beta blockers, timoptic Surgery

Answer 42

Open Angle Glaucoma

Question 43

Diffuse arteriolar narrowing Cotton Wool Spots, thick vessels AV nicking, Copper wiring (can be missed) Sudden vision decrease, scotomata, diplopia Tx the HTN, not many options

Answer 43

Hypertensive Retinopathy

Question 44

Tender, general erythema PAIN Treat to prevent cellulitis from Staph Topical ABX I&D after failure

Answer 44

Stye (Hordeolum)

Question 46

May be due to irritation of cornea or conjunctiva Stress, caffeine, MS When severe it is Benign Essential Blepharospasm

Answer 46

Blepharospasms

Question 47

Infection of lacrimal sac Purulent discharge w/ or w/o pressure to sac PAIN Topical ABX Augmentin I&D if abscess

Answer 47

Dacryocystitis

Question 48

Sagging of bottom lid Visible space Aging, scarring, CN VII palsy Surgery

Answer 48

Ectropion

Question 49

Drooping of eyelid Obstructed visual field Horners Syndrome - CN VIII palsy Surgery

Answer 49

Ptosis

Question 50

Infection Unilateral Decreased vision, blurry Caused by TB, syphilis

Answer 50

Choroiditis

Question 51

Preauricular adenopathy Highly contageous Adenovirus

Answer 51

Viral Conjutctivitis

Question 52

EMERGENCY Blood in anterior chamber settles to lowest point 8 Ball Sign Trauma, Von Willebrands, surgery Refer

Answer 52

Hyphema

Question 53

Elderly, decreased night vision Halos, cloudy Loss of red reflex Decreased VA Trauma, DM, smoking Surgery

Answer 53

Cataracts