Opthalmology

Question 1

What is the most common cause of blindness in the UK

Answer 1

Age-related macular degeneration

Question 2

What are the 2 types of macular degeneration?

Answer 2

Dry macular degeneration (early age-related macular degeneration): formation of yellow drusen, accounts for 90% of MD

Wet macular degeneration (late age-related macular degeneration): neovascularisation leads to leakage of serum/blood exudate and can lead to a more rapid decline in vision - accounts for 10% and has worse prognosis

Question 3

What is the typical presentation of macular degeneration?

Answer 3

Presents with loss of visual acuity, especially for near-objects - this is gradual in dry but more sub-acute in wet.
Difficulty with adjusting to darkness / worsened vision at night
Fluctuant visual acuity day-to-day
Notice flickering / flashing lights (photopsia)

Question 4

What is the treatment for macular degeneration?

Answer 4

Dry - Zinc combined with Vits A, C , E

Wet - Anti-VEGF (e.g Ranibizumab, Bevacizumab, Pegaptanib) injection, usually 4 weekly

Question 5

What is the typical presentation of Horner’s syndrome?

Answer 5

Horner’s syndrome - the triad of ptosis / dropping of the eyelid, constricted pupil and anhydrosis (Lack of sweating on the one side)

Caused by lesions that affect the stellate ganglion of the sympathetic nervous system either pre-ganglionic e.g pancoast tumour or postganglionic for example problem with the central nervous system e.g MS