Opthalmology

Question 1

A chef presents with 2 day progressive hx of painful eye, poor vision, injected conjunctiva, cloudy anterior chamber, pupil constriction. Dx?
a) Anterior Uveitis
b) Acute glaucoma
c) Dendritic ulcer
d) Foreign body

e) Haemorrhagic conjunctivitis

Answer 1

Anterior uveitis

Cloudy + constricted pupil

Question 2

Answer 2

DOUBLE VISION, PAIN WITH EYE MOVEMENTS = DEEPER INFECTION has to be ORBITAL not PRE-ORBITAL

Question 3

Guy gets hit in the eye in a fight, diplopia on upgaze, numbness on inferior rim/under eyelid. Bruising around the orbit and inferiorly. Cause?
a) Superior rectus haematoma
b) Entrapment of inferior rectus in fracture of orbital floor
c) Retinal detachment
d) Periorbital bruising
e) Paresis of Trochlear nerve due to skull fracture

Answer 3

Entrapment of inferior rectus in fracture of orbital floor

Question 4

Hit in the eye and bright red blood fill 1⁄4 of anterior chamber. What to do?
a) Admit for strict bed rest
b) Aspirin for pain
c) Prednisolone eye drops
d) Antibiotic eye drop
e) Do nothing

Answer 4

Tx: protective eye shield, bed rest, elevate head, topical glucocorticoid drops (severe)

Question 5

Answer 5

This is pre-orbital cellulitis

a) IV amoxicilin + clavulanic acid (amoxiclav)

Question 6

Metalworker gets sudden pain in left eye and reduced vision 18/6. Normal fundoscopy and retinal views (slit lamp). Which investigation?
a) Orbital x-ray
b) CT
c) MRI
d) Angiography

Answer 6

CT

Question 7

Guy has recurrent episodes of L sided vision loss. Like a curtain coming down. Hx of CVD. Cause?
a) Left retinal artery emboli
b) Right retinal artery emboli
c) Left retinal artery haemorrhage
d) Emboli in right visual cortex
e) Haemorrhage in right visual cortex

Answer 7

Left retinal artery emboli

Question 8

Patient with recurrent attacks of loss of vision, describes a curtain covering his eye. What is this?
a) Amaurosis fugax
b) Migraine
c) Glaucoma

Answer 8

Amaurosis fugax

Question 9

Maori guy with blurry vision, pale optic disc, no pain leading up to it. What is the first investigation?
a) MRI angiogram
b) CT brain
c) USS of carotids
d) ESR

Answer 9

ESR for infection/inflammation

Question 10

Samoan lady with injected conjunctival vessels. Rest of eye is normal. Diagnosis?
a) Blepharitis
b) Keratitis
c) Conjunctivitis
d) Episcleritis
e) Corneal abrasion
f) Subconjunctival haemorrhage
g) Uveitis

Answer 10

Conjunctivitis

Question 11

20 year old female, decreased vision in right eye, normal iris, swollen disc, headache worse with eye movement, decrease light reflex in right eye, colour vision reduced. Dx?
a) Optic neuritis
b) Orbital infarction

Answer 11

Optic neuritis

Question 12

Man with sudden flashes, floaters and deteriorating vision. Diagnosis?
a) Retinal detachment
b) Vitreous haemorrhage
c) Corneal abrasion

Answer 12

Retinal detachment

B has no flashes or pain

Question 13

Answer 13

arcus senilis) = cholesterol deposits in outer cornea 􏰀 gray-white opaque ring – normal part of aging (check lipids if present <50 years)