Opthalmology Flashcards

Question

High ocular pressure in uveitis - Tx

Answer 1

High ocular pressure - Tx 1. Steroids - Take baseline level (can increase) - Priority is inflammation

Answer 2

Sympathetic opthalmitis 1. Trauma to eye 2. Antigens to uveal pigment - Inflammation in contralateral eye - Vitiligo patches - Deafness - Meningism

Answer 3

Bony orbit borders 1. Medial wall 2. Lateral wall 3. Floor 4. Roof

Answer 4

Orbital foramina 1. Optic foramen - nerve 2. Superior orbital fissure - most vessels 3. Infra-orbital foramen - Infra-orbital nerve - Infra orbital artery 4. Supra orbital notch - supra orbital nerve 5, Lacrimal groove - Naso-lacrimal duct 6. Lacrimal gland fossa - Lacrimal gland

Answer 5

Orbital bones 1. Roof - frontal 2. Lateral wall - zygomatic - sphenoid 3. Medial - lesser sphenoid - ethemoid - Lacrimal bone - nasal process of maxilla 4. Floor - maxilla

Answer 6

Nasal duct opening - Below inferior meatus

Answer 7

Orbital compartment syndrome - Retrobulbar haemorrhage 1. Proptosis 2. Pain 3. Blindness 4. Ophthalmoplegia 5. Miosis

Answer 8

Orbital septum - Continuous with periosteum of orbit

Answer 9

Horner's syndrome - Muscle Superior tarsal muscle

Answer 10

Blowout fracture - Symptoms 1. Pain 2. Numbness to cheek, upper lip and gum - Infra-orbital nerve

Answer 11

Blowout fracture 1. Eye breaks bones - medial - inferior 2. Infra-orbital nerve damage

Answer 12

Stye Vs Chalazion (meimobian cyst) 1. Sebaceous 2. Meimobian

Answer 13

Orbital Growths - inside Vs Outside cone 1. Axial proptosis 2. Non-axial proptosis

Answer 14

Proptosis and lid-retraction - Cause 1. Thyroid eye disease 2. Effects the muscles

Answer 15

Superior rectus and levator - share... Tendon sheath

Answer 16

Ocular muscles - insertion 1. Rectus in front of axis 2. Oblique behind axis

Answer 17

Sixth nerve palsy - Anatomy 1. Small nerve 2. Passes over the clivus - Easily compressed

Answer 18

Black on the eye - Choroid

Answer 19

Slit lamp - 3D viewing 1. View straight ahead 2. Light beam at an angle

Answer 20

Fundus 1. Optic nerve - Blind spot area 2. Fovea - No vessels area

Answer 21

Eye symptoms 1. Foreign body sensation 2. Photophobia 3. Eye Pain 4. Headache 5. Lid irritation

Answer 22

Evert an eye 1. Look down 2. Cotton bud 3. Pull up and over

Answer 23

Eye symptom - Foreign body sensation 1. Foreign body 2. Corneal abrasion

Answer 24

Photophobia 1. Meningitis 2. Iritis 3. Migraine

Answer 25

Photophobia vs light sensitivity - Discomfort -> Photophobia

Answer 26

Eye pain ddx 0. Acute angle glaucoma 1. Trauma 2. Orbital cellulitis 3. Scleritis 4. Optic neuritis 5. Corneal abrasion

Answer 27

Ophthalmology - Headaches ddx 1. Migraine 2. Cluster headache - Eye watering 3. Trigeminal neuralgia 4. ICP - VI palsy - Bilateral optic disc swelling (papilloedema) - Postural change - Presence on waking - Pulsatile tinnitus 5. GCA - Temporal and tender - Jaw claudication - Scalp tenderness - Eye exam and markers

Answer 28

Lid irritation Ddx 1. Stye - Follicle/seb gland - Edge of eyelid and sore - Fusillic acid ointment 2. Chalazion - Meim gland - Anywhere and painless - Warm compress 3. Blepharitis 4. Meimobian gland disease 5. Eczema/skin conditions

Answer 29

Conjunctivitis - Allergic 1. Bilateral 2. Trigger linked 3. Itchy - Viral 1. Often bilateral 2. Coryzal symptoms 3. Watery discharge - Bacterial 1. Generally unilateral 2. Purulent discharge

Answer 30

Visual disturbances - Generalised blurring ddx 1. Refractive errors 2. Cataracts 3. Medications - steroids - tetracycline 4. Hormonal - pregnancy - period

Answer 31

Ophthalmology - Central blurring ddx 1. Macular diseases - Age related - Diabetic T2 2. Drugs - Ethambutol - Hydroxychloroquine - Tamoxifen (deposits)

Answer 32

Ophthalmology - Black spots, blobs, and curtains 1. Vitreous 2. Retina traction and detachment - Flashing (immediate or ongoing) 3. TIA - Transient!

Answer 33

Retina tear pathology 1. Vitreous traction 2. Retina hole 3. Vitreous behind retina 4. Retina detachment

Answer 34

Double vision -DDx 1. Binocular - NMJ - Thyroid 2. Monocular - In eye - Chalazion/stye/abrasion - Detachment - Vitreous 3. Vertical or horizontal? - Nerves involved - Muscles involved? (Thyroid)

Answer 35

Ophthalmology - Colour changes ddx 1. Optic nerve disease 2. Unilateral cataract 3. Red desaturation (unilateral) - Optic neuritis

Answer 36

Ophthalmology - Co-morbidities 1. Diabetes - Retina, CN palsy, ifct, vascular occlusion 2. HTN 3. Thyroid - retraction, lag, dry eye, neuropathy, motility 4. Ankylosing s - Iritis - Steroid SEs 5. Arthritis - RA, PA

Answer 37

Opthalmology Ix 1. Field test 2. OCT 3. Blood

Answer 38

Visual tests 1. Snellen 2. Near visual acuity test 3. Amsler grid 4. Ishihara colour grid

Answer 39

Visual tests - glasses 1. Best corrected vision 2. Distance glasses/reading glasses

Answer 40

Testing eyes - binocular/monocular 1. Each eye - Eye occluder 2. AND both eyes

Answer 41

Recording vision 1. Numerator is distance 2. Denominator is reading

Answer 42

Eye test - Failing tests 1. 6m, pinhole, 3m, 1m 2. Fingers 3. Hand movements - let me know when it stops 4. Light projection - Top/bottom - Left/right 5. Light perception - say yes when you see the light shining

Answer 43

Pupil exam - 5 Stages STAND TO SIDE 1. Inspection 2. Direct light 3. Indirect light - Consensual 4. Swinging lights 5. Accommodation

Answer 44

Pupil abnormalities 1. Drugs - Opiates - Drops 2. Horner's 3. III

Answer 45

Swinging light test 1. Pathology (Afferent pathway) Comparative defect L Vs R - Retina - Nerve 2. Method - Swing over bridge of nose - 1,2,3 seconds

Answer 46

Visual field confrontation - Peripheral method 1. Arm's length 2. Cover one eye - examiner same corresponding 3. How many fingers 4. Keep looking at eye - count fingers in field 5. Can you see pin? - keep looking at my eye 6. Keep your hand. - I will swap hands to use other hand

Answer 47

Visual field confrontation - Central vision 1. Red pin 2. Cover eye 3. Start at centre 4. Move very slowly 5. Acknowledge blind spot 6. Acknowledge return of pin

Answer 48

Fundoscopy - Use 1. Green on button 2. Check position - examine at 0 3. Use diffuse beam in dark Or smallest beam 4. Approach patient from the side 5. Can I rest my hand on your forehead 6. Quick red reflex 7. Very close to eye - follow blood vessels - reach optic disc

Answer 49

Glaucoma - Definition 1. Group of conditions 2. Progressive optic neuropathy 3. Optic nerve damage 4. Visual field defects 5. With/without pressure changes

Answer 50

Glaucoma - Definition 1. Group of conditions 2. Progressive optic neuropathy 3. Optic nerve damage 4. Visual field defects 5. With/without pressure changes

Answer 51

Glaucoma - World significance 1. Lead cause of Irreversible blindness

Answer 52

Glaucoma - World significance 1. Lead cause of Irreversible blindness

Answer 53

Glaucoma - World significance 1. Lead cause of Irreversible blindness

Answer 54

Glaucoma - World significance 1. Lead cause of Irreversible blindness

Answer 55

Glaucoma - progression 1. Nasal step/temporal wedge 2. Arcuate 3. Tunnel vision 4. Complete field loss

Answer 56

Glaucoma - presentation 1. Bumping things 2. Tripping and falling

Answer 57

Glaucoma DDx 1. GCA 2. Anterior ischemic optic neuropathy

Answer 58

Glaucoma - Pathophysiology 1. Blockage of aqueous drainage 2. Poor blood supply to optic nerve

Answer 59

Aqueous humour - Function 1. Nutrients to cornea 2. Waste from cornea

Answer 60

Glaucoma - Disc signs 1. Cup to disc ratio increase 2. Bayonetting of blood vessels

Answer 61

Glaucoma - Types 1. Acute angle closure - primary or secondary - PAGG 2. Open angle glaucoma - primary/secondary - POAG - NTG, PXF, PG 3. Developmental glaucoma - congenital - reiters 4. Secondary - traumatic - uveitic - steroid

Answer 62

Open angle glaucoma RFs 1. IOP 2. Age 3. African descent 4. FHx 5. Myopia

Answer 63

Angle closure glaucoma RFs 1. Raised IOP 2. Age 3. Far East/Inuits 4. Family history 5. Hyperopia

Answer 64

Glaucoma -Tx principle 1. Increase outflow 2. Reduce inflow

Answer 65

IOP - Normal range 1. Caucasian - 10-21mmHg (mean 16) 2. Black - Higher - greater Central Corneal Thickness

Answer 66

IOP - Measurement 1. Goldmannn Mires - inside of rings just touch

Answer 67

IOP - Reduction measures 1. Laser - Trabeculoplasty - Cyclodiode 2. Drops - Prostaglandins analogue - Beta blockers - Carbonic anhydrase inhibitors - Alpha 2 antagonists 3. Surgery - Trabeculectomy (Enophthalmitis risk lifelong) - Bleb

Answer 68

Acute closed angle glaucoma Sx Red eye Pain Blue tinged cornea

Answer 69

Acute closed angle glaucoma - Mx 1. Stat IV Acetazolamide 2. Laser peripheral iridotomy

Answer 70

Glaucoma medication - ADRs 1. Red eyes

Answer 71

Poor vision - Three questions 1. Onset and consistency 2. Distance 3. Glasses? Recent eye test?

Answer 72

Optic refection 1. Cornea - 40 dioptres 2. Lens - 20 dioptres 3. Axial length - 23mm

Answer 73

Accommodation reflex - effect 1. Near distance light - not parallel like distant light 2. Lens changes to refract light

Answer 74

Refractive errors 3 types 1. Anomalous axial length - long or short sighted - most common 2. Anomalous corneal power - eg after corneal graft/transplant 3. Physiological? Pathological?

Answer 75

Myopia 1. Sight - Short sighted 2. Pathophysiology - Long axial length (or high power cornea) 3. Management - Concave lenses

Answer 76

Refractive errors - Hypermetropia 1. Sight - Long- sighted 2. Pathology - Short axial length Or low powered cornea 3. Management - Corrected with convex lens

Answer 77

Refractive errors - Astigmatism 1. Sight - Two foci - Blurred vision 2. Pathology - Two axes of curvature - Two foci 3. Management - Spectacle undercorrection - Spectacle over correction - Refractive surgery

Answer 78

Presbyopia - Pathology 1. Old eye 2. Declining amplitude of accommodation - Mx 1. Reading glasses 2. Bifocals/varifocals

Answer 79

Logarithmic chart - use 1. Precise for treatments requiring a measure Eg. Macular degeneration

Answer 80

Assessment of refraction - Retinoscope (Automated or manual)

Answer 81

Refraction in children 1. Squint - Hypermetropia? 2. Assessment - Retinoscopy under cycoplegia 3. Occlusion - Patch to make squinting eye develop - Diary for balancing eyes - Glasses for Hypermetropia

Answer 82

Diabetic retinopathy - RFs 1. Duration of disease 2. Glycemic control 3. HTN 4. Nephropathy 5.Pregnancy 6. Obesity 7. Smoking

Answer 83

Diabetic retinopathy - Pathogenesis 1. Occlusion & Ischaemia 2.IRMA - intra retinal microvascular abnormalities 3. Cotton wool spots 4. Irregular retinal veins - venous beading 5. Lipid collection 6. Oedema

Answer 84

Diabetic retinopathy - Leakage vs Occlusion - Leakage 1. Loss of pericytes - Occlusion 1. BM thickening 2. Endothelial damage 3. RBC changes & rouleaux 4. Platelet aggregation

Answer 85

Diabetic retinopathy stages 1. Background 2. Pre proliferative 3. Proliferative

Answer 86

Background diabetic retinopathy - Features 1. Micro aneurysm 2. Dot and blot haemorrhages 3. Hard exudate 4. Cotton wool spots Management - Observation

Answer 87

Diabetic retinopathy - Pre-proliferative features 1.IRMA - Intra-retinal microvascular abnormalities 2. Venous loops 3. Venous beading 4. Clusters of large blot haemorrhages 5. Multiple CW Spots Management - FU 4/12

Answer 88

Diabetic retinopathy - Proliferative phase 1. NVD - Neo-Vascularisation of the Disc 2. >1/3 of NVD - or any vitreous haemorrhage 3. NVE (neo-vasc elsewhere) - >1/2 disk area - with vitreous or pre-retinal haemorrhage

Answer 89

Proliferative Diabetic retinopathy - Treatment 1. Pan-Retinal-Photocoagulation (PRP) 2. Within 2 weeks

Answer 90

Diabetic maculopathoes 1. Focal 2. Diffuse 3. Ischemic 4. Mixed 5. CSMO - Clinically significant macular oedema 6. Centrally involving

Answer 91

Diabetic maculopathy Focal - Features 1 Well circumscribed areas of leakage 2 Oedema 3 Full/part rings of exudates - surrounding micro aneurysm - Treatment 1 Focal laser

Answer 92

Diabetic maculopathy Diffuse - Features 1. Diffuse retinal thickness 2. Cystoid oedema 3. MA - Treatment 1. Grid laser

Answer 93

Diabetic maculopathy Ischemic - Features 1. Reduced VA 2. Normal clinically 3. Macular ischemia on FFA - Management 1. Observe

Answer 94

Clinically significant macular oedema - Definition 1. retinal thickening 2. within 500 microns of fovea Mx 1. Anti VEGF injections 2. Intra vitreal steroid implants

Answer 95

Diabetes - ocular complications 1. Retinopathy 2. Iridopathy 3. Unstable refraction 4. Orbital infection 5. Ocular ischaemic syndrome 6. Recurrent stye

Answer 96

Retinopathy treatment 1. Background - 9-12/12 hospital FU 2. Pre-proliferative - 4-6/12 FU 3. Proliferative - Active ( PPR i 2/52) - Stable 4-6/12 FU - DMO (Macular laser and PRP +- anti VEGF +- steroid implants)

Answer 97

Vitreous haemorrhage 1 sx 2. Mx - PRP same day for 2/52 - Vitrectomy +endolaser + anti VEGF if persistent

Answer 98

Rubeosis Sx Tx

Answer 99

Pupil reflexes 1. APD - Afferent pupillary defect 2. RAPD - Relative afferent pupillary defect - Swinging light reflex test

Answer 100

Afferent pupillary defects - Causes 1. Optic neuritis 2. Demyelination 3. Trauma 4. Tumours 5. Retinal abnormality 6. Retinal detachment 7. Glaucoma 8. Artery/vein occlusion

Answer 101

3rd nerve palsy - Presentation 1. Binocular diplopia 2. Anisocoria 3. Ptosis 4. Compensation - Abnormal head posture - Turn to one side

Answer 102

CN III Palsy - Differentials 1. Microvascular - DM - HTN 2. Trauma 3. SoL 4. Aneurysm (PCom.Art.) 5. ICP 6. Horner's 7. Myasthenia gravis 8. Thyroid eye 9. Inter-nuclear ophthalmoplegia

Answer 103

Papilledema - S&S 1. Headaches - Worse on leaning forward 2. N&V 3. Visual changes and defects - DDx 1. SoL 2. Trauma 3. Haemorrhage 4. IIH - High BMI - COCP - Tetracycline 5. Venous sinus thrombosis - Perform MR venogram

Answer 104

Optic neuritis - S&S 0. Pain on eye movements 1. RAPD 2. Poor colour vision 3. Large blind spot - Ix 1. MRI - Tx 1. Steroids

Answer 105

Pediatric visual tests - Charts 1. Sheridan Gardner Test - Picture cards 2. Age-dependent 3. Observation - Fixing on objects - Following objects 4. Refractive errors - Cycloplegia

Answer 106

Red Reflex - Ix 1. Opthalmoscope - Direct/indirect white reflex - DDx 1. Cataracts - TORCH - Galacktokinase - DM 2. Coats disease - Telangiectic neo-vascular disease 3. Retinoblastoma 4. RoP 5. Retinal detachment

Answer 107

Squint/Strabismus - Types 0. Pseudo-squint 1. In-turn-esotropia 2. Out-turn-exotropia 3. Hypo/hypertropia - Complications 1. Amblyopia 2. Refractive error

Answer 108

Squint - Examinations 1. Cover test - Cover one eye 2. Cover-uncover test - Quickly moving - For latent squint (when shut)

Answer 109

Strabismus - DDx 1. Coloboma (keyhole pupil) - Failure of optic fissure to close - Nystagmus and squints 2. Ptosis 3. Horner's syndrome - Neuroblastoma - Syringomyelia - Pheochromocytoma

Answer 110

Epiphora - Pathology 1. Nasolacrimal duct non-canalisation 2. Watery eye - Mx 1. Self-resolving in first year 2. Reassure and massage 3. Syringe and probe

Answer 111

LogMAR Chart - Scoring 1. 0.1 per line 2. 0.02 per letter - Advantages 1. Uniform reduction in size 2. Reduced letter crowding

Answer 112

Visual acuity 1. Driving score - 0.3 LogMAR - 6/ Snellen 2. Perfect score - 6/6 - 0.0

Answer 113

Visual acuity Preferential looking based tests 1. Keeler preferential looking cards 2. Cardiff acuity cards 3. Kay's pictures - 2-4 yo 4. LogMAR Keeler book - 4+ yo - letter based

Answer 114

Testing low vision 1. Counting fingers (CF) 2. Hand movements (HM) 3. Perception of light (PL) 4. No perception of light (NPL)

Answer 115

Cover test - Additional observations 1. Compensatory head posture 2. Lid aperture 3. Ptsosis 4. Pupils

Answer 116

Cover test 1. Pen torch for reflections 2. Fix on 3m target - non accommodation 3. Occlude eye

Answer 117

Strabismus - measuring deviation size 1. Prism cover test

Answer 118

Ocular motility test - Grading 1,2,3,4 - 4 if not moving past midline

Answer 119

Visual development 4-6 mo - fovea development 7-9yo - visual cortex plasticity ends

Answer 120

Amblyopia - Definition - 'lazy eye' 1. Reduction in vision in one eye - absence of any structural abnormality or ocular disease 2. Cortical adaption - abnormal binocular environment - In adulthood can lead to functional blindness

Answer 121

Amblyopia and strabismus - mx 1. Refractive adaption to prescription -18-20 weeks 2. Patching - sight based dosing 3. Surgery -can reccur

Answer 122

Types of diplopia 1. Monocular double vision - ghosting/blurry overlapping 2. Horizonal binocular 3. Vertical binocular 4. Oblique binocular

Answer 123

Occulomotor Nerve - Branches - Superior 1. LPS 2. Superior rectus - Inferior 1. MR. IR. IO 2. Cilliary ganglion

Answer 124

CN III Palsy Mx 1. Microvascular - underlying issue eg. DM - 6-9 mo recovery 2. ...

Answer 125

CN IV Palsy - Causes 1. RTC 2. Horse riding 3. Fall from height 4. Congenital - Lax SO tendon - NB childhood head tilt

Answer 126

CN IV Palsy - Pres 1. Hypertropia 2. CHP head tilt w/chin depression 3. Vertical diplopia 4. Torsion

Answer 127

CN VI Palsy - Pres 1. Esodeviation - especially distance 2. CHP - face turned 3. Horizontal diplopia 4. Limited abduction -Causes 1. Microvascular 2. ICP 3. Trauma

Answer 128

Thyroid eye disease - Mx 1. Euthyroid status - Radio - Medical anti-thyroid - Thyroidectomy 2. Synthetic thyroid hormones

Answer 129

Graves' orbitopathy - Pattern of myopathy 1. IR 2. MR Others

Answer 130

Ocular myasthenia gravis (OMG) - Pattern 1. Precedes generalised MG 2. Mimics any palsy

Answer 131

Myasthenia gravis - Ix 1. Orthoptic - Sustained up gaze - Cogans lid switch - saccades - peek test - ice pack test 2. General - AChR - MuSK - Electrodiagnostics

Answer 132

Myasthenia gravis Mx 1. Anti cholinesterase - Pyridostigmine 2. Immunosuppression

Answer 133

Orbital tumours 1. Optic nerve glioma 2. Schwannoma 3. Sarcoma

Answer 134

Eye muscle surgeries 1. Resection - Strengthen action 2. Recession - Weaken action

Answer 135

Age-related Macular Degeneration - Stages 1. Early AMD 2. Intermediate AMD 3. Advanced Dry AMD 4. Advanced Wet AMD

Answer 136

Early AMD - Features 1. Medium-sized drusen 2. Pigmentary abnormalities

Answer 137

Intermediate AMD -Features 1. >1 Large druse/numerous medium drusen 2. Geography atrophy - not extending to maular centre

Answer 138

Advanced Dry AMD -Features 1. Non-exudative atrophic 2. Drusen and GA extend to the macular centre 3. Gradual vision loss

Answer 139

Advanced Wet AMD -Features 1. Exudative/Neovascular 2. Choroidal neovascularisation 3. Rapid loss of vision - Days/weeks

Answer 140

Macular degeneration - Drusen - Characteristics 1. Yellow/white material 2. Between RPE and Bruch's membrane - Types 1. Hard drussen - Small, hard, solid 2. Soft drusen - Larger soft deposits

Answer 141

AMD - Progression 1. Soft drusen lift RPE from Bruch's membrane 2. Hypoxia 3. Inflammation

Answer 142

Dry AMD - Cascade of Events 1. Drusen 2. Inflammation 3. Monocytes/macrophages 4. VEGF 5. Neovascularisation - Wet AMD

Answer 143

AMD - RPE Hyper-hypopigmentation 1. Phagocytic and metabolic insufficency - Post-mitotic RPE Cells 2. Accumulation of lipfuscin - Age-pigment granules 3. Damage - Proteins - Lipids - DNA

Answer 144

Dry AMD - Epidemiology 1. 80-90% of AMD - Early Features 1. Initially no symptoms 2. Drusen present - Advanced features 3. Drusen then separate RPE from Bruch's membrane 4. Confluent drusen 5. Macular degeneration - Gradual loss of VA - Loss. of contrast sensitivity - Abnormal dark progression - Mild occasional metamorphosia 6. Geographic atrophy - Significant visual loss

Answer 145

Dry AMD - Features with high risk of progression 1. Large drusen 2. Reticular drusen 3. Vitelliform lesions 4. Atropy 5. Scotomas

Answer 146

Dry AMD - Mx 1. Self monitor - Amsler Grid (Metamorphosia) 2. Routine sight tests - Community optometrist

Answer 147

Wet AMD - Prognosis 1. Rapid visual loss in 3 months 2. Functional blindness in 2 years - Untreated 3. Monocular disease risk of binocular disease

Answer 148

Wet AMD - Pathology 1. VEGF stimulation - through Bruch's membrane 2. Fluid and blood leaks into retina 3. Fibrous scar tissue - Disciform - Scotoma (blind spot) 4. Central vision loss

Answer 149

Wet AMD - Anti-VEGF Agents 1. Ranibizumab (Lucentis) 2. Aflibercept (Eylea) 3. Bevacizumab (Avastin) 4. Brolucizumab) (Beovu)

Answer 150

Wet AMD - Fundoscopy 1. Oedema 2. Elevation of retina 3. Cystic oedema of sensory retina

Answer 151

Wet AMD - OCT 1. Fibrous scaring 2. Sub-foveal atrophy/fibrosis - Secondary to scar 3. Atrophy - RPE - Retina 4. Cystic degeneration - Presence of fluid (dark space) below RPE

Answer 152

Wet AMD - Visual acuity and treatment 1. VA ≤ 6/96 - If benefit expected - Anti-VEGF tx for nAMD only 2. VA < 6/96 - Refraction prior to ARMD 3. VA > 6/12 - Anti-VEGF tx

Answer 153

Charles Bonnet Syndrome - Features 1. People/animals 2. Light patterns - Epidemiology 1. 50% of ARMD 2. Usually aware they aren't real

Answer 154

Eye exam - Opthalmoscope 1. Stabilise 2. 15° - optic disc - macula

Answer 155

Diabetic retinopathy - R Staging R0 R1 Early disease - Dot haemorrhage R2 Moderate/advanced disease (Pre-proliferative) - Blot haemorrhages - Tortuous and beading vessel - IRMA R3 Proliferative

Answer 156

MaculopathyStaging M0 - M1 - Oedema - Exudates greater/equal to half disc space