Opthal

Question 1

50% of all blindness is due to

Answer 1

Cataracts

Question 2

Vit A function? Get from?

Answer 2

Immune system
Production of Rhodopsin

Animal produce and green leafy veg

Question 3

Vit A blindness is often very rapid and occurs when?

Answer 3

Sudden demand on Vit A stores - Eg during infection

*Should always give Vit A in malnourished kids with pyrexial illness [Especially Measles / diarrhoea]

Question 4

Vit A blindness is often very rapid and occurs when?

Answer 4

Sudden demand on Vit A stores - Eg during infection

*Should always give Vit A in malnourished kids with pyrexial illness [Especially Measles / diarrhoea]

Question 5

Vit A deficiency replacement

Answer 5

IM on days 1,2, 14
200k IU if >1yr

Question 6

Main infection-> blindness? Reservoir and spread?

Answer 6

Chlamydia Trachomatis
Reservoir is copious discharge from others with the disease
-Either then contact with hands / clothes
-Eye seeking flies - Musca domestica / Musca sorbens

Question 7

What happens in trachomata eye disease

Answer 7

Chronic repeated infection (as you don’t develop immunity)
-> keratoconjunctivitis
-> conjunctival Scar formation
-> turns eye lids inwards (entropion)
-> Eye lashes then abrade globe (trichiasis)
-> chronic keratitis and scaring + lots of secondary infections

Question 8

Seen on underside of upper eyelid in early trachomata disease?

Answer 8

Little white follicles
vascular proliferation

Question 9

Rx of trachomata eye disease?

Answer 9

SAFE strategy

Surgery for inturned lashes
Azithromycin (concentrated in tears)
Face washing - reduces reservoir and reduces fly attraction
Environmental improvement

Question 10

3 key ways leprosy affects eyes? which type of leprosy?

Answer 10

Direct invasion
-May get mass at the limbus (leproma)
-iris which produces white discrete particles

Type -1 reactions
-Inflammation of CN V / VII -> irreversible palsy.
-Paucibacilliary (PB) or Multibacilliary (MB) leprosy

Type 2 reactions (erythema nodosum leprosy)
-recurrent iritis / sceritis -> glaucoma / cataract
-MB leprosy only

Question 11

Bar invading eye directly how might face lepsoy cause blindness?

Answer 11

Facial palsy
-> incomplete closure of lids + anaesthetic cornea
-> chronic keratitis and scaring

Question 12

Chronic iritis in leprosy appearance?

Answer 12

Very small constricted pupil (unopposed action of constrictor)

Question 13

Answer 13

Cerebral malaria
white-centred haemorrhages, a superficial blot haemorrhage at the fovea, mild macular whitening (black arrow) and cotton wool spot (white arrow)

Question 14

Answer 14

ocular toxoplasmosis

Question 15

Answer 15

Ocular toxoplasmosis

Question 16

Answer 16

ocular CMV

Question 17

Answer 17

Ocular CMV

Question 18

Why high rates of cataracts in chronic leprosy

Answer 18

frequent steroid use

Question 19

What happened here in B? pt has leprosy

Answer 19

Lagophthalmos - the inability to close the eyelids normally
[due to facial nerve palsy from leprosy]