Opthalmology

Question 0

Conjunctivitis

Answer 0

Can be infective or allergic
Redness, watery eyes, coating of eyelashes
Bacterial will be pus, viral - watery
Treatment is usually conservative, if lasts more than two weeks prescribe antibiotics in form of eye drops, antihistamines if allergic

Question 1

Chronic open angle glaucoma

Answer 1

Symptoms: gradual loss of peripheral visual field, optic atrophy
Diagnose with checking intraocular pressure: will be raised
Management: eye drops: prostaglandin analogues, beta blockers, carbonic anhydrase inhibitors all to reduce IOP

Question 2

Corneal ulcer

Answer 2

Unilateral, painful, photophobia, watering. Bacterial leads to visible opacity. Viral often herpes simplex so RF are cold sores.
Stain with fluorescein
Treat with antibiotics

Question 3

Iritis

Answer 3

Unilateral pain, photophobia, redness, small pupil, blurred vision, headache.
See cells (WBCs) and flares (particles of protein) in the aqueous humour with slit lamp.
Mx: topical atropine to dilate pupil and steroid eyedrops

Question 4

Acute angle closure glaucoma

Answer 4

Unilateral painful red eye, blurred vision, hazy cornea, fixed semi-dilated pupil, frontal headache, nausea
Treat with topical eye drops and IV acetazolamide

Question 5

Cataracts

Answer 5

Opacity of lens
Leads to gradual loss of vision
Worse in bright light
Reduced red reflex - white pupil
Treat surgically

Question 6

Diabetic retinopathy

Answer 6

Cotton wool spots, hard exudates, micro aneurysms, new blood vessels, dot and blot haemorrhages, treated with anti-VEGF such as lucentis

Question 7

Retinal detachment

Answer 7

Flashes and floaters, reduced vision, visual field defect (curtain or eclipse), normal vision if macula unaffected, loss of red reflex
Treat surgically

Question 8

Acute central retinal artery occlusion

Answer 8

Acute visual loss
Hx of cardiac disease, atheroma/emboli
Whitish opaque retina
Threadlike retinal arterioles
Cherry red spot in centre of white 
Cotton wool spots

Question 10

Retinal vein occlusion

Answer 10

Central retinal vein 
Middle aged or elderly
Flame, dot and blot haemorrhages 
Cotton wool spots
Swollen optic discs
Macular oedema

Question 11

Scleritis

Answer 11

red eye, severe pain may be worse on movement and tenderness

underlying autoimmune disease eg rheumatoid arthritis