Opthal 1

Question 1

Function of tear film (3)
Components of tear film (3)

Answer 1

1. Provides Smooth ocular surface so light rays can be refracted uniformly
2. lubrication so no friction between eyeball and lids
3. antibacterial
4. surface lipid layer via meibomian glands
5. middle aq layer via lacrimal glands
6. inner mucus layer via goblet cells

Question 2

Stye:

• Definition
• Risk factors
• Causative organism
• Symptoms
• Management

Answer 2

Stye:

• Definition: hordeolum externum, infection of glands zeis/moll/eyelash follicle
• Causative organism: aures
• Symptoms: painful red lump on eyelid, pus
• Management: warm compresses, analgesia, if assoc conjunctivitis then chloramphenicol

Question 3

Chalazion:

• Definition
• Symptoms
• Management
• Complications

Answer 3

Chalazion:

• Definition: hordeolum internum, meibomian cyst. Meibomian gland blocked with lipids + swells
• Symptoms: swelling eyelid, firm, more painful
• Management: warm compresses, massage to encourage drainage, surgical drainage
• Complications: infection, cellulitis, rupture, scarrring

Question 4

Blepharitis

• Definition
• Causes
• Symptoms
• Signs
• Investigations
• Management
• Complications

Answer 4

Blepharitis

• Definition: inflamm of eyelid margins due meibomian glands/s aures/seborrhoeic dysfunction
• Risk factors: rosacea
• Symptoms: gritty, itchy, dry, sore eyelids, sticky in morning
• Signs: inflammed lid margins, blocked glands, margin crusting, inflammed conjunctiva
• Investigations: punctate corneal staining with fluorescein
• Management: warm compresses, cleaning eyelids, abx, artificial tears
• Complications: styes, chalazions, conjunctivitis

Question 5

Entropion:

• Definition
• Causes
• Complications
• Management

Ectropion:

• Definition
• Complications
• Management

Answer 5

Entropion:

• Definition: eyelid turns inwards
• Causes: age, facial nerve palsy
• Complications: corneal damage + ulcers
• Management: tape, same day review, lubricating eyedrops

Ectropion:

• Definition: turns outwards
• Complications: exposure keratitis
• Management: lubricating, same day review

Question 6

Trichiasis:

• Definition
• Symptoms
• Management

Answer 6

Trichiasis:

• Definition: inward growth eyelashes
• Symptoms: corneal damage
• Management: electrolysis/laser

Question 7

Periorbital cellulitis:

• Definition
• Causative organisms
• Why more common in children
• Risk factors
• Pre vs post septal
• Symptoms and signs of preseptal
• Symptoms and signs of postseptal
• Investigations
• Management
• Complicationse

Answer 7

Periorbital cellulitis:

• Definition: periorbital soft tissue infection
• Causative organisms: s aures, epidermidis, strep pneumonia, haem influ
• Why more common in children: thinner bone sa and inc venous supply
• Risk factors: child, previous sinus infection, lack hib vaccine, recent eye bite, ear infection
• Pre vs post septal: pre is ant to orbital septum
• Symptoms and signs of preseptal: swelling painful red eye + oedema
• Symptoms and signs of postseptal: pain throbbing, ptosis, pupil involvement, palsy (restriction to extraoc muscles), fever
• Investigations: swabs mc+s, ct contrast orbital contents + sinuses, fbc/crp
• Management: refer all to secondary care, if child admit, oral coamox if preg, admit iv abx if post and drain if optic nerve compromise
• Complications: cs thrombosis, loss vision, intracerebral abscess, meningitis

Question 8

Cataracts:

• Definition
• Types of cataracts (3)
• Risk factors
• Symptoms
• Signs
• Investigations
• Management + complications of surgery
• Complications
• What is congenital cataracts + causes

Answer 8

Cataracts:

• Definition: inc opacity of lens
• Types of cataracts (3): cortical, subscapular (steroids), nuclear (age)
• Risk factors: trauma, steroids, age, smoking, alcohol, diabetes
• Symptoms: gradual dec vision, glare, starbursts around lights
• Signs: loss red reflex
• Investigations: slit lamp/fundoscopy
• Management + complications of surgery: inc prescription, brighter lights. Phacoemulsification if reduced qol/patient choice/ 6/9 but can mask diabetic/macular and cause endophthalmitis
• Complications
• What is congenital cataracts + causes: normally due to congen rubella syndrome. need urgent referral otherwise amblyopia

Question 9

Papilloedema:
- definition
- fundoscopy signs
- causes

Answer 9

Papilloedema:
- definition: optic disc swelling due to inc ICP
- fundoscopy signs: venous engorgement, blurring optic disc margins, loss of optic cup
- causes: SOL neoplastic/vascular, malig htn, iih, hydrocephalus