Opthal

Question 1

What do you add to the eye to visualise corneal changes

Answer 1

flurorescein

Question 2

what changes will blepharitis show on fluroscein

Answer 2

punctate epithelial erosions

Question 3

what is the management of a corneal FB

Answer 3

remove FB
evert lid to check for subtarsal FB
Abx - choramphenical

Question 4

what is the management of a pre-septal cellulitis

Answer 4

PO co-amoxiclav

PO clindamycin if penicillin allergy

Question 5

what is the management of orbital cellulitis, if pt is septic or age <12m

Answer 5

admit pt 
septic screen 
CT head 
IV abx 
Urgent opthal/ENT review

Question 6

what will you see in orbital cellulitis on an MRI head

Answer 6

fluid in the ethmoidal sinus

Question 7

what are the risk factors for corneal ulcer/bacterial keratitis?

Answer 7

Contact lens use (poor hygiene)
Smoking
Ocular surface disease

Question 8

what is the management of corneal ulcer/bacterial keratitis?

Answer 8

Urgent ophth r/v
Corneal scrape MC&S
Intensive TOP abx

Question 9

what are the sx of acute anterior uveitis?

Answer 9

pain, photophobia, red eye, blurred

posterior synaechiae = iris sticking to lens

Question 10

how do you treat acute anterior uveitis

Answer 10

topical steroids and dilating drops

Question 11

what are the features of scleritis?

Answer 11

red eye pain, photophobia
severe boring pain
bluish hue to sclera
chemosis

Question 12

what is the management of sceritis

Answer 12

urgent referral to opthal

+ TOP/PO steroids

Question 13

what is the medical management of primary open angle glaucoma?

Answer 13

lower the intraocular pressure

• medical - prostaglandin analogues
• laser - trabeculoplasty
• surgical - trabeculectomy

Question 14

what drugs are used to lower intraocular pressure?

Answer 14

prostaglandin analogue e.g. bimatoprost
B-Blocker - timolol
alpha2 agonists - iopidine
carbonic anhydrase inhibitors - azetazolamide

Question 15

what are the sx of acute angle closure glaucoma

Answer 15

Sudden onset visual loss
Red eye
N&V
Abnormally shaped mid-dilated pupil
Corneal oedema

Question 16

what are the risk factors for AACG

Answer 16

hypermetropia, age, East-Asian ethnicity

Question 17

what is the management of acute angle closure glaucoma

Answer 17

Urgent ophth r/v
PO/IV acetazolamide
TOP Pilocarpine + IOP lowering drops
Anti-emetics / analgesia

After acute attack, consider peripheral iridotomy

Question 18

what are the risk factors for retinal detachment

Answer 18

myopia, age, previous cataract surgery, trauma

Question 19

what is the management of retinal detachment

Answer 19

urgent opthal review for surgical management

Question 20

what are the risk factors for cataracts

Answer 20

Age
Smoking
DM
UV exposure
(trauma)

Question 21

what is the tx of cataracts

Answer 21

Phacoemulsification = ultrasound destruction of old lens
Intraocular lens (IOL) = new artificial lens (pseudophakia)

Question 22

what are the risks of cataract surgery

Answer 22

Posterior capsular opacification
Cystoid macular oedema (uncommon)
Retinal detachment (rare)
Endophthalmitis (very rare

Question 23

what is the management of diabetic retinopathy

Answer 23

address DM control and HTN

If neovascularisation seen then refer for pan-retinal photocoagulation

Question 24

what investigation should you always get in age related macular degeneration

Answer 24

optical coherence tomography

Question 25

what is the management of age related macular degneration

Answer 25

Lifestyle modification for both - smoking cessation, BP control and lose weight

For wet = intravitreal anti-VEGF
Dry - supportive

Question 26

what is a key feature of wet macular degeneration

Answer 26

degeneration of the macula and neovascularisation + pre-retinal haemorrhages

Question 27

what can giant cell arteritis result in in the eye

Answer 27

anterior ischaemic optic neuropathy = profound unilateral visual loss

Question 28

what is the management of CRAO

Answer 28

refer to stroke centre for urgent assessment