OPTHAL 2

Question 1

hypertensive retinopathy in who

symptoms/signs

Answer 1

young people

attenuated blood vessels - copper/silver
cotton wool spots. hard exudates. retinal haemorrhage. optic disc oedema. dramatic fundal appearance. can have decreased vision

Question 2

diabetic retinopathy macuopathy is what
risk factors
what worse with new vessel growth

Answer 2

commonest treatable cause of blindeness is DM

duration of DM, type 2 DM, htn, pregnancy

new vessels in disc worse than new vessels elsewhere. vessels growing in iris rubeosis iriditis - can get secondary glaucoma

Question 3

diabetic retinopathy stages

management

Answer 3

none.
non proliferative mild, mod, severe
proliferation
R0 prescreen in 12 months
R1 1 dot haem/microaneurysm. 12 months
R2 4 or over blot haem in one half only. 6 months
R3 4 or over blot haem in bot inferior and superior hemifieleds or venous beading or IRMA refer
R4 new vessels or nitrous haem refer urgently

laser - damage retina - reduce metabolic load - can cause night blindeness

Question 4

diabetic maculopathy stages

Answer 4

none

observable exudates between 1 and 2 disc dm circle of the centre fovea 6 months

referable - any blot haem or hard exudates within 1 disc dm. refer

Question 5

SJS

Answer 5

occlusion of lacrimal glands, corneal ulcers

Question 6

horners syndrome is what

cause

Answer 6

paralysis of sympathetic supply to eye, mild mitosis, contracted pupil which does not dilate, ipsilateral reduced sweating

pan coast tumour, carotic/aortic aneurysms, lesions of neck, congenital, idiopathic

Question 7

third nerve cranial palsy

Answer 7

ptosis. down and out.

MR, SR, IR, IO, sphincter papillae, levator palpabele superioris

microvascular - pupil sparing, trauma, tumours, congenital, aneurysms - painful

Question 8

4th nerve palsy

Answer 8

congenital, tumours, trauma, microvascular

supériorité oblique. intorsion, depressed in adduction, weak abduction
head tilt - in cycle torsion weak
trauma
torsion, chin depressed

Question 9

6th nerve palsy

Answer 9

LR weakness
weakness of abduction. horizontal double vision when looking into the distance. papilloedema

vascular. acoustic neuroma. increased ICP. congenital

Question 10

internuclear opthalmeplegia

Answer 10

MI, vascular

loss of small print

Question 11

ptosis
anisocona
oscillopsia

Answer 11

droopy eyelid
different sized pupils
looks like things are moving

Question 12

new born VA
1m
6m
2-3y
4y

Answer 12

6/240
2/90
6/18
6/6
6/9.5

Question 13

ametropic
strabismic
anisometropic
stimulus deprevation

Answer 13

bilateral uncorrected refractive error
squinting eye is suppressed
unequal refrective error
congenital cataracts/ptosis

Question 14

brown’s

Answer 14

superior oblique is being pulled down so can’t pull eye up

Question 15

ESO
EXO
hyper
hypo

Answer 15

outward movement
inward
eye higher
eye lower

Question 16

latent phonia

Answer 16

sym corneal reflections
binocular vision
underlying deviation in both eyes

Question 17

manifest trophia

Answer 17

assym reflections
no/poor binocular vision
squint in 1 eye at a time

Question 18

occlusion therapy

Answer 18

total - patching

partial - 1% atropine dilates pupil - can’t accommodate

Question 19

management of adult squint

Answer 19

prism glasses
orthoptic exercises
botox if can’t have surgery
EOM surgery - function, cosmetic

Question 20

children visual system develops by when

convergent squints

Answer 20

by 6yo

corrected w glasses

Question 21

amblyopia cause

management

Answer 21

squint, refractive error, obstruction to visual axis - cataracts, ptsosi

occlusion treatment to good eye

Question 22

squint cause

management

Answer 22

congenital. long sighted. CNP. muscle pathology. blow out fracture

correct refractive error. treat amblyopia
squint surgery recession: reattach muscle posterior to insertion weakens muscle
resection: excise segment - strengthens

Question 23

baby with red reflex
retinoblastoma, coloboma
cataract
retinoblastoma/retinal detachment or dysplasia

Answer 23

alteration in colour - pale yellow

opacity

no/black reflex

Question 24

sticky eyes in infants cause
symptoms
ix
management

Answer 24

congenital nasolacrimal duct
sticky and watery
delayed flueoresene dye dissapearecne

bathe and massage. most revolve by 1y. if not - string and probing 12-18m