Opthalmology

Question 1

What are the most common causes of permanent blindness in the Western World?

Answer 1

Senile cataract, glaucoma, age-related macula degeneration, trauma and diabetic retinopathy

Question 2

What are the most common causes of sudden visual loss?

Answer 2

Amaurosis fugax (occlusion of opthalmic artery) and migraine

Question 3

What causes ‘flashing lights’ in vision?

Answer 3

Traction on the retina (e.g. retinal detachment)

Question 4

What do floaters or ‘blobs’ in the visual fields indicate?

Answer 4

Pigment in the vitreous (e.g. haemorrhage, vitreous detachment)

Question 5

Is retinal detachment more likely to occur in myopic or hyperopic people?

Answer 5

Myopic (short-sighted)

Question 6

What is myopia?

Answer 6

Short-sightedness (light focuses in front of retina)

Question 7

What is hyperopia?

Answer 7

Far-sightedness (light focuses behind retina)

Question 8

What do coloured halos around lights often indicate?

Answer 8

Glaucoma, cataracts

Question 9

What diagnoses should be considered if a patient has visual disturbance and a headache?

Answer 9

Raised ICP, migraine, temporal arteritis

Question 10

What is the upper limit of normal intraocular pressure?

Answer 10

22mmHg

Question 11

What are the grades of hypertensive retinopathy?

Answer 11

Grade I: Silver wiring Grade II: AV nipping Grade III: cotton wool spots, flame haemorrhages Grade IV: papilloedema

Question 12

What are the features of diabetic retinopathy?

Answer 12

Background Retinopathy: - Microaneurysms - Haemorrhages - Hard exudates - Cotton wool spots (soft exudates) Proliferative Retinopathy: - Neovascularisation

Question 13

How does optic neuritis present?

Answer 13

Pain on ocular movements Central scotoma over days Swollen optic disc (if anterior nerve affected) Optic atrophy and disc pallor (late)

Question 14

What is the difference between dry and wet macular degeneration?

Answer 14

Dry: cellular debris (duress) between choroid and retina, central scotoma, no treatment available Wet: neovascularisation between choroid and retina, central scotoma acutely, treated with anti-VEGF

Question 15

How does retinal detachment present?

Answer 15

Floaters, flashes, blurred vision, grey cloud / black spot, loss of visual field

Question 16

What is the difference between open and closed angle glaucoma?

Answer 16

Open (90%): chronic, painless, gradual loss of vision, optic disc cupping Closed: acute, painful, red eye, nausea + vomiting, fixed pupil

Question 17

What is the cause of a pale retina with pink or cherry red macula?

Answer 17

Central retinal artery occlusion

Question 18

Which condition is commonly described as flashes of light followed by a curtain over vision?

Answer 18

Retinal detachment

Question 19

Give 3 differentials for a black cloud descending over a patient’s vision.

Answer 19

Retinal detachment Aura (seizure, migraine) TIA

Question 20

What is this lesion and what is it caused by?

Answer 20

Roth spot (red spot with white halo), caused by Infective Endocarditis

Question 21

What is the visual requirement for a car licence in Australia?

Answer 21

6/12

Question 22

How do pinhole glasses improve visual acuity?

Answer 22

Reduce the size of the blurring circle of the retina and correct refractive errors.

Question 23

What is the first-line antibiotic therapy for bacterial conjunctivitis?

Answer 23

Chloramphenicol (topical, broad-spectrum)