Opthalmology

Question 1

Rheumatoid arthritis: ocular manifestations

Answer 1

Ocular manifestations of rheumatoid arthritis are common, with 25% of patients having eye problems

Ocular manifestations
keratoconjunctivitis sicca (most common)
episcleritis (erythema)
scleritis (erythema and pain)
corneal ulceration
keratitis

Iatrogenic
steroid-induced cataracts
chloroquine retinopathy

Question 2

Beta blockers such as timolol work in primary open-angle glaucoma by reducing aqueous production

Question 3

the affected and normal eye appears to dilate when light is shone on the affected

Answer 3

RAPD

Question 4

Angioid retinal streaks

Answer 4

are seen on fundoscopy as irregular dark red streaks radiating from the optic nerve head. They are caused by degeneration, calcification and breaks in Bruch’s membrane .

Causes
pseudoxanthoma elasticum
Ehler-Danlos syndrome
Paget’s disease
sickle-cell anaemia
acromegaly

Question 5

Holmes-Adie syndrome
association of Holmes-Adie pupil with absent ankle/knee reflexes

Question 6

examples of anti-VEGF agents include

Answer 6

ranibizumab, bevacizumab and pegaptanib,. The agents are usually administered by 4 weekly injection.

Question 7

This condition, also known as *****, is characterised by a dilated pupil that reacts slowly to light but has a normal or near-normal response to accommodation. It often presents unilaterally and may be accompanied by absent tendon reflexes.

Answer 7

Adie’s tonic pupil,

Question 8

The**** is a small, irregular pupil that constricts normally with accommodation but does not react to light. It is typically bilateral and associated with neurosyphilis, specifically tertiary syphilis.

Answer 8

Argyll-Robertson pupil