Opthalmology surgery incorrects

Question 1

how does corneal abrasion present?
risk factor
investigation
management?

Answer 1

eye pain with foreign body sensation!! + tearing, photophobia

contact lens is risk factor, truama/foreign body

fluorescien stain!!!

management in contact lens wearers = topical fluroroquinolones - ciprofloxacin!!!

any perforation, corneal infliltrate, ulcer, irregular pupil or foreign body not easily removed -> urgent opthalmology consultation

Question 2

open globe laceration presentation?

cause?

Answer 2

teardrop pupil
extrusion of vitreous - gush of fluid
asyymetric anterior chamber depth
loss of visual acuity
rapd

small high velocity particles sent airborne (particles/trauma can cause corneal abrasion or OGL)

emergency optho consult for surgical repair

Question 3

Most cases of candida/fungal endopthalmitis occur in which group of people?

describe other risk factors

how does it present

Answer 3

hospitalized patients with central venous catheters!!

total parenteral nutrition!!, immunocompromise eg chemo and cancewr, broad spectum antibiotics, recent abdo surgery

fluffy yellow-white chorioretinal lesions with ill defined borders -> spreads to aqueous fluid chamber = floaters and progressive loss of vision, then eye pain later

Question 4

halos around lights, blurring of vision, diagnosis?

age related, scotoma or other type which is unilateral aggressive vision loss often starting with straight line distortion?

Answer 4

cataracts (note halos also seen in aacg)

dry and wet amd

Question 5

orbital compartment syndrome symptoms?
management?

Answer 5

eye pain vision loss
tight orbit - periorbital swelling, hard eyelid, proptosis, resistance to pushing on eye
optic nerve injury can cause RAPD

emergency orbital decompression

Question 6

hyphema presentation

management?

complications?

Answer 6

vision loss
eye pain, photophobia
blood in anterior chamber
aniscoria/ unequal pupils

eye shield, glucocorticoid eye drops, monitor intraoccular pressure

intraoccular hypertension -> optic nerve injury -> glaucoma
other complications = rebleeding

Question 7

what systemic therapy is used for acute angle closure glaucoma?

Answer 7

IV acetazolamide

Question 8

what condition is it when traumatic injury to one eye can lead to inflammation and blindness in the uninjured eye?

treatment?

Answer 8

sympathetic opthalmia - autoimmune condition
T cells become sensitized to previously sequestered eye antigens

corticosteroids

if injured eye has no recovery of vision it is typically removed to prevent this

Question 9

patient eye iritiation and painful eye movements. last few weeks experienced weight loss and fatigue. on examination = proptosis bilaterally. head injury 6 years ago

most likely diagnosis?

Answer 9

orbital tissue expansion!!! = graves disease

raised icp causes papilledema but not proptosis, raises iop causes glaucoma not proptosis

Question 10

patient on long term glucocorticoid eye drops
now develops halos around lights, needing more lights to read

diagnosis?
next step in management?
further management?

Answer 10

steroid induced ocular hypertention/ acute open angle glaucoma

tonometry

steroid cesation - > antiglaucoma meds -> laser trabeculoplasty