OPTHALMOLOGY

Question 1

from what part of the eye does the vitreous membrane detach from in posterior vitreous detachment?

Answer 1

retina

Question 2

what gender is more likely to develop posterior vitreous detachment?

Answer 2

females

Question 3

what biological process causes the vitreous humour to naturally shrink and peel?

Answer 3

ageing

Question 4

what is photospia? (it is a symptom of posterior vitreous detachment)

Answer 4

flashes of light

Question 5

what visual abnormalities are present in greater number in posterior vitreous detachment?

Answer 5

floaters

Question 6

what is the main complication of posterior vitreous detachment?

Answer 6

retinal detachment/tears

Question 7

what is treatment for posterior vitreous detachment?

Answer 7

watch and wait

Question 8

what is a vitreous haemorrhage?

Answer 8

leakage of blood into spaces around vitreous body

Question 9

give 3 traumatic causes of vitreous haemorrhage

Answer 9

retinal tears
blood vessel tears around retina
SAH

Question 10

give 3 pathological causes of vitreous haemorrhage

Answer 10

choroidal melanoma
age related macular degeneration
neovascularisation of retina
retinal ischaemia

Question 11

what procedure is used to treat vitreous haemorrhage?

Answer 11

vitrectomy

Question 12

what causes inflammation of the optic nerve in optic neuritis?

Answer 12

demyelination

Question 13

what ophthalmological condition is associated with MS and neuromyelitis optica?

Answer 13

optic neuritis

Question 14

where would you expect pain in optic neuritis?

Answer 14

retro-ocular/retro-orbital pain

Question 15

what type of illness often precedes optic neuritis?

Answer 15

viral

Question 16

what 2 visual impairments might you expect with optic neuritis?

Answer 16

rapid impairment

dyschromatopsia (loss of colour vision)

Question 17

what medical imaging might you use to diagnose optic neuritis?

Answer 17

MRI

Question 18

what drug type might you give to treat optic neuritis and why?

Answer 18

corticosteroids

anti-inflammatory

Question 19

in retinal detachment, where does the retina detach from?

Answer 19

pigment epithelium

Question 20

give a traumatic cause of retinal detachment

Answer 20

fluid leakage (vitreous detachment, injury etc)

Question 21

give 2 retinal abnormalities that might cause detachment

Answer 21

traction

exudative

Question 22

give an iatrogenic cause of retinal detachment

Answer 22

cataract surgery complication

Question 23

what two symptoms does retinal detachment share with posterior vitreous detachment?

Answer 23

photospia

new floaters

Question 24

how is the loss of vision characteristic of retinal detachment described?

Answer 24

‘curtains’ - outer to central visual loss

Question 25

what diagnostic technique might you use to visualise the eye in a patient with suspected retinal detachment?

Answer 25

opthalmoscopy

Question 26

name 2 procedures that you might use to treat retinal detachment?

Answer 26

vitrectomy seal retinal breaks relieve vitreoretinal traction

Question 27

what 3 things does prognosis of retinal detachment depend on?

Answer 27

duration of detachment is macula detached too? underlying vascular health

Question 28

what are the two main types of vascular occlusion that can happen in the eye?

Answer 28

retinal artery | retinal vein

Question 29

give 5 causes of vascular occlusions

Answer 29

``` atherosclerosis thrombi glaucoma macular oedema diabetes hypertension smoking hypercholesterolaemia ```

Question 30

what is ranibuzimab and why might you give it in the case of vascular occlusions?

Answer 30

inhibits vascular endothelial growth factor | reduces swelling & neovascularisation in vascular occlusions

Question 31

what other drug type might you give for vascular occlusions?

Answer 31

steroids - swelling

Question 32

give 3 complications of vascular occlusions

Answer 32

macular oedema neovascularisation neovascular glaucoma retinal detachment

Question 33

age related macular degeneration is a __a)__, __b)__ disorder a) regenerative, degenerative b) reversible, irreversible

Answer 33

a) degenerative | b) irreversible

Question 34

what is the leading cause of blindness in developed countries?

Answer 34

age related macular degeneration

Question 35

what causes dry ARMD?

Answer 35

accumulation of pigment epithelial waste - drusen

Question 36

what causes wet ARMD?

Answer 36

accumulation of fluid after neovascularisation of pigment epithelium

Question 37

what happens to pigment epithelium in dry ARMD?

Answer 37

atrophy

Question 38

what happens to pigment epithelium in wet ARMD?

Answer 38

haemorrhage, scarring, swelling

Question 39

what is the difference in progression between wet and dry ARMD?

Answer 39

``` dry = slow wet = fast ```

Question 40

give 4 risk factors for ARMD

Answer 40

``` age smoking alcohol poor diet sun exposure ```

Question 41

what part of the vision tends to be disorder in ARMD?

Answer 41

central (scotoma)

Question 42

name 2 visual actions that are restricted in ARMD

Answer 42

fine print reading facial recognition close vision

Question 43

what is ambler grid testing and what would it show in ARMD?

Answer 43

grid - tests distortion | ARMD lines would be wavy

Question 44

why is ranuzimab given in wet ARMD?

Answer 44

stop further angiogenesis

Question 45

what ophthalmological condition is described as opacification of the lens?

Answer 45

cataract

Question 46

give 4 causes of cataracts

Answer 46

``` age trauma post-inflammatory diabetes congenital ```

Question 47

are cataracts fast or gradual onset?

Answer 47

gradual

Question 48

what is the most common cause of blindness worldwide?

Answer 48

cataracts

Question 49

what ophthalmological condition is characterised by monocular diplopia with glares and haloes?

Answer 49

cataracts

Question 50

how would the red reflex differ from a normal eye in cataracts?

Answer 50

reduced

Question 51

how do you treat cataracts?

Answer 51

surgery - lens implant

Question 52

what eye pathology is glaucoma linked to?

Answer 52

raised intra-ocular pressure

Question 53

what part of vision in lost in glaucoma?

Answer 53

peripheral

Question 54

what is the second greatest cause of visual loss worldwide?

Answer 54

glaucoma

Question 55

is glaucoma familial or does it have no inheritance pattern?

Answer 55

familial

Question 56

at what point in the progression of glaucoma does visual acuity start to be affected?

Answer 56

end stage

Question 57

name 3 optic disc changes that you might observe in glaucoma

Answer 57

cupping palor splinter haemorrhages

Question 58

RAPD is a clinical sign of glaucoma - what is it?

Answer 58

relative afferent pupillary defect | pupils will constrict less when a light is shone in the affected eye compared to a healthy eye

Question 59

what simple test might you recommend for a patient with suspected glaucoma?

Answer 59

visual fields

Question 60

what drug might you give to slow progression of glaucoma?

Answer 60

ocular hypotensive agent

Question 61

why might you give prostaglandins to treat glaucoma? give an example of a drug

Answer 61

latanoprost | improve uveoscleral outflow

Question 62

why might you give beta blockers to treat glaucoma?

Answer 62

reduce production of aqueous fluids

Question 63

name 2 other types of drug that you might give to reduce aqueous production of fluids in glaucoma

Answer 63

alpha agonists | carbonic anhydrase inhibitors

Question 64

what is myopia?

Answer 64

short sightedness

Question 65

where does the light focus in myopia?

Answer 65

just in front of retina

Question 66

would distant or close objects be out of focus in myopia?

Answer 66

distant

Question 67

place the following words in the sentence in myopia, the retina is ____, with lattice ____ and choroidal ________ thin/thick degeneration/hypertrophy atherosclerosis/neovascularisation

Answer 67

thin retina lattice degeneration choroidal neovascularisation

Question 68

what shape lens would you use to correct myopia?

Answer 68

concave

Question 69

what is hypermetropia?

Answer 69

long sightedness

Question 70

what eyeball/lens abnormalities cause hypermetropia?

Answer 70

eyeball too short | lens not round enough

Question 71

where does the light focus in hypermetropia?

Answer 71

behind retina

Question 72

what shape are corrective lenses for hypermetropia?

Answer 72

convex

Question 73

what type of condition is retinitis pigmentosa? does it have an inheritance pattern?

Answer 73

degenerative | is inherited

Question 74

what 2 types of cells are broken down in retinitis pigmentosa?

Answer 74

rod cells first | then cone cells

Question 75

``` fill in the blanks: retinitis pigmentosa results in reduced ___ vision, loss of ____ vision and loss of ____ vision, leading to ________ vision and _____phobia photo colour ultraviolet long-distance peripheral latticework night ```

Answer 75

``` reduced night vision loss of colour vision loss of peripheral vision leading to latticework vision photophobia ```

Question 76

what does syndromic retinitis pigmentosa mean?

Answer 76

occurs with other neurosensory disorders

Question 77

what is treatment for retinitis pigmentosa?

Answer 77

no cure

Question 78

does optic nerve compression lead to permanent or temporary visual loss?

Answer 78

permanent

Question 79

what would visual loss in optic nerve compression look like if the damage was anterior/distal to the optic chasm?

Answer 79

monocular

Question 80

what visual loss might you expect if the optic chiasm was damaged?

Answer 80

bitemporal heteronymous hemianopia

Question 81

what visual loss might you expect if the optic tract was damaged?

Answer 81

homonymous hemianopia

Question 82

what can cause damage to the optic chiasm?

Answer 82

pituitary tumour

Question 83

give a vascular cause for optic nerve compression

Answer 83

aneurysm

Question 84

chronic use of what drug group can cause cataracts?

Answer 84

steroids

Question 85

what antibiotic group can increase the risk of retinal detachment?

Answer 85

fluoroquinolones

Question 86

what drug can cause the tears to appear orange/red?

Answer 86

rifampin

Question 87

give 2 examples of medical emergencies that cause headaches

Answer 87

papilloedema | GCA

Question 88

what is aniscoria?

Answer 88

difference in pupil sizes

Question 89

hornet's syndrome arises from a defect in what nervous system?

Answer 89

sympathetic

Question 90

describe the pathway of the sympathetic chain from the chest into the eyes

Answer 90

lung apex carotids cavernous sinuses into eye

Question 91

what are the 3 main features of horner's?

Answer 91

mitosis ptosis anhydrosis

Question 92

acute horner's presents with pain in the jaw or neck. what pathological abnormality is this assumed to be until proven otherwise?

Answer 92

carotid dissection

Question 93

how is acute horner's treated?

Answer 93

anticoagulation

Question 94

what is the main cause of a third nerve palsy with pupillary involvement?

Answer 94

intracranial aneurysm

Question 95

what is the pain cause of vascular third nerve palsy where the pupil is spared?

Answer 95

diabetes

Question 96

where does the eye rest in third nerve palsy? why?

Answer 96

down and out | only LR and SO muscles working

Question 97

what occurs to the eyelid in third nerve palsy? why?

Answer 97

ptosis | levator palpabrae superiors is paralysed

Question 98

what occurs to the pupil in third nerve palsy? why

Answer 98

dilates | sphincter pupillae paralysed

Question 99

what movement will the patient use to compensate in bilateral fourth nerve palsy?

Answer 99

chin depression

Question 100

what movement will the patient use to compensate in unilateral fourth nerve palsy?

Answer 100

face tilt to contralateral side

Question 101

where does the eye deviate in 6th nerve palsy?

Answer 101

inwards