Optha

Question 1

Central Retinal Artery occlusion (CRAO)

causes n mx

Answer 1

atherosclerosis
GCA

emergency -> refer
if GCA get ESR n temp art bx to tx w steriods bc reversible

Question 2

Keratitis path and organisms

Presentation

Answer 2

Inflammation of the cornea bc infection

HSV , VZV, bacterial (abrasion->ulcer)

Sudden onset unilateral painful red eye (ciliary flush)
Photophobia
Gritty sensation
Esp contact lense wearers

Keratin precipitates (white spots on cornea =inflamm cells)

If VZV ie shingles = vesicles on erythematous base in cn5 distribution

Question 3

Iritis (anterior uveitis) path and presentation

Answer 3

Autoimmune HLA B27, males w ank spondylitis

Sudden onset unilateral painful
Bright red eye all over (ciliary flush)
Tender
Constricted pupil (miosis) and
Severe photophobia
Hypopeon

• threat to vision*

Question 4

Iritis diagnosis and tx

Answer 4

Clx = slit lamp, autoimmune HLAB27 Prednisone drops every one hour and cylopentate Only systemic if refractory

Question 5

Keratitis diagnosis and tx

Answer 5

Slit lamp
Fluresceine dye : HSV/VZV = dendritic pattern , abrasion, ulcer

Viral = self limiting
Antibacterial drops if bacteria

Question 6

Acanthamoebic keratitis

Answer 6

Pain out of proportion
Contact lens wearer
Recent freshwater swimming

Question 7

Scleritis path and associations

Answer 7

Autoimmune
Association RA and `SLE
More common in females

Question 8

Scleritis presentation and dx

Answer 8

Gradual onset unilateral painful red eye (ciliary flush)
Tender on palpation
Violacoeus hue in ambient light

Slit lamp
And RF and anticcp

Question 9

Scleritis management

Answer 9

Drops and systemic corticosteroids
NSAIDs
Methotrexate for RA

If not RA or methotrexate not tolerated
6mercapto
Azathioprine
Cyclophosphamide

Question 10

Root cause of both style and chalazion and 1st line tx for both

Answer 10

Tarsal gland obstruction

1st line
Warm compress
Eye massage
Eye hygiene

Question 11

Style path

Presentation

When to I&D

Answer 11

Tarsal gland obstruction-> mini abscess

More painful than chalazion

> 2weeks = I&D

Question 12

Chalazion path

Pt

I&D

Answer 12

Granulomatous rxn

Slower and bigger but less painful

> 4weeks = I&D

Question 13

Why do you cyclopentoate in iritis

Answer 13

Ciliary muscle spasm and contraction (=pupil constriction) painful

= give muscranic agonist

Question 14

What is ciliary flush

Answer 14

Ring of red or violet spreading out from around the cornea

Question 15

Organism causes of viral conjunctivitis

N present

Answer 15

Adenovirus
Coxsackie
Enterovirus

Uni->bi eyes
Watery discharge
May have preauricular LN
URI

Question 16

Causes of bacterial conjunctivitis

Presentation

Tx

Answer 16

Staph in adults

Strep Pneumoniae in kids

Unilateral purulent discharge
Stuck eyes in morning
Maybe preceding illness

Chloramohenicol
Hygiene towels pillows etc

Question 17

Conjunctivitis to watch out for

Answer 17

N. Gonorrhea in neonatal = can be vision threatening

C. Trachomatour world wide = leads to blindness bc recurrent conjunctivitis = scarring

Question 18

Epislceritis presentation

Answer 18

Sudden onset unilateral painful eye
Red eye all over (injection) - NOt ciliary flush
Lasts 7-10days

NSAIDs and time

Question 19

Risk of not properly caring for corneal abrasion

Answer 19

Ulcer

Question 20

Risk with corneal abrasion and contact lens wearer with poor hygiene

Answer 20

Ie sleeps w lenses
Not frequently changing

= pseudomonas

Proph w and drops

Question 21

Diagnosis of corneal abrasion

Answer 21

Flourosceine = yellow stained abrasion (de-epithilised surface)

Visualised better w cobalt blue filter on woods lamp or opthalmoscope

Question 22

primary open angle glaucoma risk factors

Answer 22

myopia (shortsighted)
increasing age
afro carib
htn
sm
corticosteroids

Question 23

primary open angle glaucoma long sighted or short

Answer 23

myopia

Question 24

hypermetropia which glaucoma

Answer 24

acute angle closure glaucoma

Question 25

causes of tunnel vision

Answer 25

papilloedema
glaucoma
retinitis pigmentosa
choroidoretinitis
optic atrophy secondary to tabes dorsalis
hysteria

Question 26

horners triad

Answer 26

miosis
ptosis
enopthalmos

Question 27

horners anyhdrosis head arm and trunk

Answer 27

= central lesion ie stroke syringomyelia

Question 28

horners anhyrdosis face only where is the lesion

Answer 28

pre gang lesion = pancoast , cervical rib

Question 29

anhydrosis absent in horners where is lesion

Answer 29

lesion is post ganglionic = carotid artery

Question 30

SE prostaglandin analogues

Answer 30

inc eyelash lenght
iris pigmentation
periocular pigmentation

Question 31

what eye drops may have caused corneal ulcer

Answer 31

steroid eye drops –> lead to fungal infections, which in turn cause corneal ulcer

Question 32

causes of red eye

Answer 32

conjuctinvitis
acute angle closure glaucoma
anterior uvetitis
scleritis
episcleritis
subconjuctival haemorhage

Question 33

bilateral red itchy with sticky exudate in neonate

Answer 33

chlamydia trachomatis

Question 34

diabetec retinopathy retinal findings

Answer 34

microanuerysms
blot/flamed shaped haemorrhages
hard exudates
cotton wool spots

neovasculrisation (proliferative)

Question 35

diabetic retinopathy tx

Answer 35

good sugar control

non prolif = watch and wait

maculopathy and change in visual acuity = intravitrial VEGF inhib

prolif
panretinal coagulation
intravit VEGF inhib

Question 36

diabetic retinopathy - maculopathy

Answer 36

hard exudates and other ‘background’ changes on macula
check visual acuity
more common in Type II DM

Question 37

diabetic pts inc risk of which eye conditions other than diabetic retinopathy

Answer 37

cataracts
glaucoma
vit haemorhage
retinal detachment
infection