Opthalmology

Question 1

Argyll Roberston pupil

Answer 1

Bilaterally small pupils that accomodate but don’t react (Causes incldue neurosyphillis and diabetes)

Question 2

Marcus gunn pupil

Answer 2

RAPD - seen during swinging light examination of a pupil response

Question 3

Treatment of anterior uveitis

Answer 3

Urgent review by opthalmology
Cycloplegics (dilating drops) eg atropine, cyclopentolate
Steroid eye drops

Question 4

Which is more painful - episcleritis or scleritis?

Answer 4

Scleritis

Question 5

What is the role pf phenylephrine drops in differentiating episcleritis and scleritis?

Answer 5

Blanches the conjuntival and episcleral vessels but not the scleral vessels. If the redness improves after phenylephrine then it is episcleritis

Question 6

Treatment of episcleritis

Answer 6

Conservative
Atrificial tears

Question 7

Initial Management of acute closed angle gluacoma

Answer 7

Eye drops
Pilocarpine (direct parasympathomimetic)
Beta blocker eg timolol
Alpha 2 agonist eg apracolinidine
IV acetazolamide

Question 8

Definitive managment of acute closed angle gluacoma

Answer 8

Laser peripheral irodotomy

Question 9

Management of optic neuritis

Answer 9

High dose steroids

Question 10

Horners syndrome

Answer 10

Ptosis (drooping eyelid)
Miosis (Constricted pupil)
Anhidrosis (lack of sweating)

On the affected side

Question 11

What are cotton wool spots

Answer 11

Areas of retinal infarction seen in pre proliferative diabetic retinopathy

Question 12

Management of scleritis

Answer 12

Oral NSAIDS
Oral steroid

Question 13

Holmes adie pupil

Answer 13

Benign condition causing the pupil ro remain small for an abnormally long time once it has constricted.
SLow reaction to accomodation and poor reaction to light
Unilateral in 80% of cases

Question 14

severe eye pain, inability to wear contact lenses, corneal haziness, and reduced visual acuity.
Hypopyon (accumulation of white blood cells in the anterior chamber) commonly seen

Answer 14

keratitis

Question 15

Causes of keratitis

Answer 15

Bacterial (usually staph aureua but also pseudomonas in contact lens wearers)
Fungal
Amoebic
Parasitis

Question 16

Managment of keratitis

Answer 16

Topical antibiotics (quinolines eg levofloxaxin)
cycloplegic (eg cyclopentolate) for pain relief . These cause pupil dilation

Question 17

What is the pupil like in acute closed angle gluacoma

Answer 17

Semi dilated

Question 18

What is the pupil like in anterior uveitis

Answer 18

Small fixed oval pupil

Question 19

Treatment of opthalmic shingles

Answer 19

Oral aciclovir
(Topical aciclovir not given)

Question 20

Treatment for dendritic ulcer

Answer 20

Topical aciclovir

Question 21

What condition do you see drusen in?

Answer 21

Dry ARMD

Question 22

What may help show the progression of dry ARMD?

Answer 22

Zine and anti oxidant vitamins A, C and E

Question 23

Treatment of wet ARMD

Answer 23

anti VGEF injections (ranibizumab) administered by 4 weekly injection

Question 24

painful red eye with photophobia, blurred vision and reduced visual acuity. The affected pupil is often small and there may be pus in the anterior chamber (a hypopyon) on examination.

Answer 24

Anterior uveitis

Question 25

Most common ocular manifestation of rheumatoid arthritis

Answer 25

Keratoconjunctivitis sicca (dry eye syndrome