Opthalmology

Question 1

red eye, dilated pupil, and a hazy cornea, pain, haloes, history of long sightedness, worse with midrasis

Answer 1

Acute angle glaucoma closed. TX - timolol, acetazolamde, pilocarpine, brimonidine

Question 2

acute painful red eye
blurred vision and photophobia
small, fixed oval pupil, ciliary flush, hypopyon

Answer 2

anterior uveitis - TX atropine, C/s drops, cyclo

Question 3

miosis (small pupil)
ptosis
enophthalmos* (sunken eye)
anhidrosis (loss of sweating one side)

Answer 3

Horner’s syndrome

Question 4

Horner’s syndrome with heterchromia

Answer 4

Congenital horner’s syndorme

Question 5

sudden or gradual vision loss, widespread retinal haemorrhages (‘blood and thunder’ appearance) and cotton wool spots due

Answer 5

Central retial vein occlusion -CX HTN, polycythaemia, glaucoma,

Question 6

sudden, painless, unilateral vision loss. (RAPD),
pale retina with a cherry-red spot at the fovea

Answer 6

Central retinal A occlusion - due to vTE RF, arteritis

Question 7

Gradual central VL, loss of near objects, adaptation to night, flickering of lights, distortion of line perception

Answer 7

subacute - wet macular degen, Anti VEGF
Gradual - drusen and dry mac degen

Question 8

6 month old, recurrent, sticky eye

Answer 8

congenital nasolacrimal duct obstruction - reassure, resolved by 1 YO

Question 9

discomfort due to light sensitivity and difficulty focusing on close objects, benign, single dilated pupil, abscent knee jerk reflex, women

Answer 9

Holme-Adie pupil (Huge add pupil), slow to react to light, can be benign

Question 10

18 YO F, ataxia, eye pain on movement, cant see red, central scotoma

Answer 10

Optic neuritis. AF: MS, DM, syphillis. TX- 4-6 weeks steroids, MRI

Question 11

bilateral dry, gritty and sore eyes. finds minimal relief with the frequent use of lubricating eye drops.

Answer 11

Meibonium gland blepharitis (need oily and watery part of tears). differs from chalazion

Question 12

Flashes of light (photopsia) - in the peripheral field of vision
Floaters, often on the temporal side of the central vision

Answer 12

Posterior vitreous detatchment

Question 13

Dense shadow that starts peripherally progresses towards the central vision
A veil or curtain over the field of vision
Straight lines appear curved
Central visual loss
myopia - near sighted. (distant objects blurry)

Answer 13

Retinal detatchment

Question 14

Large bleeds cause sudden visual loss
Moderate bleeds may be described as numerous dark spots
Small bleeds may cause floaters

Answer 14

Vitreous haemorrhage

Question 15

Blurring of vision again years after cataract surgery

Answer 15

Posterior capusle opacification

Question 16

Associated conditions of episcleritis

Answer 16

IBD, RA

Question 17

Causes of peripheral VL? Tunnel vision?

Answer 17

Glaucoma
Retinal detatchment - dark shadow starts peripherally and central VL
Chorioradioretinitis - do IHV
Bitemp haemianopia - pit tumour
Retinitis pigmentosa

Question 18

Causes of papilledaema? (usually bilateral)

Answer 18

space-occupying lesion: neoplastic, vascular
malignant hypertension
idiopathic intracranial hypertension
hydrocephalus
hypercapnia
Rare causes include
hypoparathyroidism and hypocalcaemia
vitamin A toxicity

Question 19

painless, gradual swelling caused by a blocked oil gland, typically on internal eye lid

Answer 19

Chalazion

Question 20

painful, red, and sudden bump caused by a bacterial infection in a hair follicle or oil gland

Answer 20

Stye - external hordeolum
Internal - could lead to a chalazion

Question 21

Red/green colour change, eye swelling, pain eye movements, mild proptosis

Answer 21

Orbital cellulitis - common cause is ethmoidal sinusitis, lack of HiB influenzae vaccine, Recent eyelid infection/ insect bite on eyelid (periorbital cellulitis)

Question 22

TXof bacterial conjuctivitis? pregnant women?

Answer 22

Chloramphenicol normally
Fusidic acid for pregnant women