Opthalmology

Question 1

Causes of optic neuropathy

Answer 1

Commonest are MS and glaucoma.

VISION CAC

• Vascular - DM, Temporal arteritis
• Inflammatory - MS
• Sarcoid
• Infection - VZV, TB, syphilis
• Oedema - ↑ ICP
• Neoplastic - lymphoma, leukaema
• Compression - Glaucoma, Pagets, neoplasm
• Alcohol and toxins: ethambutol, Lead, B12
• Congenital - Leber’s, CMT, Friedrich’s

Question 2

Differential of a red eye

Answer 2

Lid

• Mechanical: ectropion
• Inflammatory: blepharitis
• Infective: Cellulitis

Conjunctivitis and subconjunctival haemorrhage

(Epi)scleritis

Cornea
- Foreign body, abrasion

Anterior chamber

• Acute glaucoma
• anterior uveitis

Question 3

Medical treatment of infective conjunctivitis

Answer 3

Topical chloramphenicol

Question 4

What are the types of age related macular degeneration?

Answer 4

Dry - geographic atrophy with Drusen formation

Wet - Sub-retinal neovascularisaiton

Question 5

Investigations for ARMD?

Answer 5

OCT (Optical coherence tomorgraphy) - cross-sectional view of macula

FFA (fundus fluoroscein angiography) - neovascularisation

Question 6

Drugs that can trigger acute glaucoma?

Answer 6

TCA + anti-cholinergics
anti-histamines
Sympathomimetics

Question 7

Initial management of Temporal Arteritis with opthalmic involvement

Answer 7

High dose IV methylprednisolone + opthalmology referral.

Opthalmology may do a biopsy but do NOT wait to start treatment.

Question 8

Blue dot cataracts, Brushfield spots, keratoconus, iris hypoplasia and strabismus

Answer 8

Down syndrome

Question 9

Christmas tree cataract + ptosis, opthalmoplegia, low intraocular pressure, pupillary near-light dissocation.

Answer 9

Myotonic dystrophy

Question 10

Green sunflower cataracts

Answer 10

Wilson’s disease

Also K-F rings

Question 11

Oil droplet cataracts in a 3 year old with LDs and FTT

Answer 11

Galactosemia