Opthal

Question 1

What are the causes of Central Retinal artery occlusion

Answer 1

Thromboembolism

Arteritis

Question 2

What are the causes of central retinal vein occlusion

Answer 2

Glaucoma
Polycythemia
Hypertension

Question 3

What are the causes of papillodema

Answer 3

Hypertension (malignant)
Hypertension (intracranial)
Hypertension (in the CSF space - hydrocephalus)
SOL
Hypercapnia

Question 4

What is dacryocytis?

Answer 4

Inflammation of the lacrimal sac which presents as swelling and erythema at the inner canthus, with epiphora (watery eye)
treated with antibiotics

can sometimes be caused by congenital lacrimal duct obstruction of the structures but usually resolves by age 1

Question 5

What are the common side effects of lantaprost?

Answer 5

eye lash growth
iris pigmentation
perioccular pigmentation

Question 6

What is the mechanism of action of lantoprost?

Answer 6

prostaglandin which increased the uveoscleral outflow of aqueous humour

this works in the same way as muscarinic recepter agonists

Question 7

how do beta blockers work in glaucoma?

Answer 7

reduce the amout of aqeuous humur produced

wierdly so do alpha agonists - but they also let it out more too - increased uveoscleral outflow

Question 8

What are the causes of argyl robertson pupil?

Answer 8

pin point pupils which accomodate but do not contrict to light

prostitutes pupil
neurosyphylis
diabetic neuropathy - developing world

Question 9

how does macular degeneration present?

Answer 9

reduced acuity
blurring of vision
central loss before peripheral

Dry - drusen

Wet - retinal haemorrhage due to neovascularisation of the retina from choroid

Question 10

What is the treatment for dry mac deg?

Answer 10

none - conservative only

stop smoking - high dose vitamins - CE Zinc beta carotene (antioxidant dietary supps - shouldnt take beta arotene if you smoke - Lung ca)

Question 11

What is the treatment for wet mac deg?

Answer 11

photocoagulation

anti vegf therapy

Question 12

Risk factors for macular degeneration?

Answer 12

family history
Age
smoking
caucasians
women
high cumulative sunlight exposure

Question 13

hypermetropia is associated with which type of glaucoma?

Answer 13

acute angle closure glaucoma

Question 14

myopia is associated with which type of glaucoma?

Answer 14

acute primary open angle glaucoma

Question 15

What would you see on fundoscopy of someone with Primary open angle glaucoma (POAG)

Answer 15

disc cupping
disc pallor - optic atrophy
bayonnetting of vessels - breaks as they disappear and reappear
disc haemorrages and cup notching

Question 16

What is retinitis pigmentosa?

Answer 16

abnormal pigmentation of the peripheral retina causing loss of peripheral vision

black spicule shaped pigmentation on the retina

assocaited with:
refsums disease
alports

Question 17

What are the signs of refsums disease?

Answer 17

cerebellar ataxia
peripheral neuropathy
retinitis pigmentosa
deafness
ichthyosis - dry scaly skin

Question 18

CAuses of a sudden painless loss of vision?

Answer 18

central retinal artery or vein occlusion
retinal detachment
vitreous haemoorhage
ischemic optic neuropathy - arteritis/atherosclerosis

Question 19

central retinal artery occulsioin

Answer 19

caused usually by embolism - atherosclerosis /arteritis

cherry red spot on pale retina

Question 20

causes of an optic neurtis?

Answer 20

MS
diabetes
drugs - ethambutol/chloramphenicol
vitamin deficiency
infection: zoster/lyme

Question 21

what are the presenting symptoms of an optic neuritis?

Answer 21

decreased colour vision
reduced acuity (unilateral)
spain on eye movements

Question 22

What is the treatment for optic neuritis?

Answer 22

hgh dose IV methylpred followed by oral pred

Question 23

Differentials for a red eye?

Answer 23

Glaucoma haloes with hazy cornea
conjuctivitis - discharge (clear or cloudy)
anterior uveitis - fixed oval pupil
scleritis - no eyelid invovlement
subconjuctival haemorrhage - trauma hx or straining
periorbital cellulitis

Question 24

What are normal intraocular pressures?

Answer 24

10-21

Question 25

is glaucoma painful

Answer 25

closed angle yes. open angle no

Question 26

treatment particularly for closed angle glaucoma

Answer 26

pilocarpine - constricts the pupil

Question 27

What symptoms does cataract present with

Answer 27

glare when looking at bright lights and reduced acuity which comes on over a long time - diabetics and steroids
elderly

Question 28

What is a holmes adie pupil

Answer 28

does not constrict for light but does for accomodation

therefore is a large dilated pupil

Question 29

causes of a hypopyon

Answer 29

keratitis

anterior uveitis

Question 30

what is keratitis

Answer 30

inflammation of the cornea

produces: photophobia, painful eye, associated with contact lens use(pseudamonas). foreign body gritty sensation

Question 31

What is dorzolamide?

Answer 31

carbonic anydrase inhibitor - reduces aqueous production

can be used as a diuretic and in gout

Question 32

common first line drug in acute glaucoma

Answer 32

acetozolamide

with pilocarpine

Question 33

Causes of horners syndrome?

Answer 33

SSSTTTCCCC
stroke
syringomyelia
MS

Trauma
thyroidectomy
Tumour(pancoats)
cervial rib

carotid artery dissection
cavernous sinus thrombosis
cluster headache
carotid aneurysm

Question 34

Causes of a marcus gunn?

Answer 34

central retinal artery occlusion