Opthamology

Question 1

Define anisometropia

Answer 1

Difference in visual acuity between two eyes

Question 2

Define papillitis

Answer 2

Inflammation of the optic nerve

Question 3

Define amblyopia

Answer 3

defect of central vision processing

Question 4

How should a history be conducted for eye problems?

Answer 4

Double vision
Discharge
Pain
Redness
Flashers and floaters
Distortion
Photophobia

Question 5

What are the stages of an eye exam?

Answer 5

Acuity
Fields
RAPD
Ophthalmology
H-test

Question 6

When should a pinhole be used for visual acuity testing?

Answer 6

If vision is <6/6

Question 7

What are the values of a snellen chart?

Answer 7

6m/60 line

Question 8

What medication is used to dilate the eye?

Answer 8

Tropicaimide

Question 9

What should always be ruled out when there is sudden vision loss or blurring?

Answer 9

Temporal arteritis

Question 10

What simple iris abnormalities are there?

Answer 10

Sectoral iris heterochromia

Question 11

What is normal IOP?

Answer 11

12 - 21 mmHg

Question 12

What are some key features of acute closed angle glaucoma?

Answer 12

IOP >30
large pupil, hazy vision
either after eye drops for dilating or being in a dark room, canal of schlemm
Tx - urgent referral to eye treatment centre
Lie flat, beta blocker, alpha agonist, carbonic anhydrase inhibitor
More common is Asian
Not so much photophobia

Question 13

What glaucoma medications increase uveoscleral outflow?

Answer 13

Prostaglandin
Timolol

Question 14

What are some associations with anterior uveitis?

Answer 14

Ankolosing spondylitis
Behcets
Sarcoidosis

Question 15

What are the features of anterior uveitis?

Answer 15

Photophobia
Small pupil
Blurred vision
Pain
Posterior synchenia
Limbal injection
TX - cycoplegics and corticosteroids

Question 16

What changes are seen in orbital cellulitis?

Answer 16

May have proptosis, painful eye movements, loss of VA, loss of colour vision, may have RAPD

Question 17

How is thyroid eye disease mananged?

Answer 17

Treat thyroid dysfunction
In severe cases may need decompression

Question 18

How can you distinguish between episcleritis and scleritis?

Answer 18

Use 10% phenylephrine and if episcleral vessels move then likely episcleritis.

Question 19

How is episcleritis treated?

Answer 19

NSAIDs

Question 20

What is episcleritis linked with disease wise?

Answer 20

SLE, connective tissue disorder

Question 21

How are corneal ulcers and keratitis managed?

Answer 21

Urgent eye clinic referral

Question 22

How is bacterial conjunctivitis managed?

Answer 22

Can be one eye
Use chloramphenicol

Question 23

How is allergic conjunctivitis treated?

Answer 23

Olopatadine
Azelastine

Question 24

What is pinguecula and pterygium?

Answer 24

Question 25

What is the most common cause of arteritic AION?

Answer 25

GCA

Question 26

What are the symptoms of GCA?

Answer 26

Jaw claudication,, malaise, jaw/ tongue claudication, chewing pain, tender scalp

Question 27

What is associated with central retinal artery occlusion?

Answer 27

Look for signs of atherosclerosis, atrial fibrillation, heart valve disease, diabetes, smoking and lipids. Pale retina and cherry red spot

Question 28

How is CRAO treated?

Answer 28

If seen within 100 minutes of onset, attempt to increase retinal blood flow either by occular massage or by reducing intraocular hypertension. There is no universally accepted treatment

Question 29

What are some features of diabetic retinopathy?

Answer 29

Question 30

How is CRVO tested?

Answer 30

Flourescein fundus angiography

Question 31

T or F, glaucoma is responsible for 10% of all blind registrations?

Answer 31

True

Question 32

How does glaucoma affect vision?

Answer 32

Reduces peripheral vision

Question 33

What are the risk factors for POAG?

Answer 33

Afro-carribean Family history Age Diabetes

Question 34

How does the NHS manage patients with a family history of glaucoma?

Answer 34

Eye tests every 2 years over the age of 40 with a family history

Question 35

What are the treatments for POAG?

Answer 35

Beta blocker Alpha agonists Carbonic anhydrase inhibitors Prostaglandin analogues

Question 36

How does prostaglandin differ from the other treatments for glaucoma?

Answer 36

Prostaglandin increases uveoscleral outflow

Question 37

Which gluacoma medication is avoided in pregnancy?

Answer 37

Carbonic anhydrase inhibitors

Question 38

What is a cost effective treatment for POAG?

Answer 38

Trabeculoplasty

Question 39

What is normal IOP and cup to disc ratio?

Answer 39

12-21 0.4-0.7

Question 40

What is the leading cause of blindness worldwide?

Answer 40

Cataracts

Question 41

What are some risk factors for cataracts?

Answer 41

Smoking Alcohol UV light Trauma Radiotherapy Myotonic dystrophyv in younger patients

Question 42

T or F, cataracts can affect the red reflex?

Answer 42

Mature cataracts can affect the red reflex

Question 43

What are the types of cataracts?

Answer 43

Question 44

What is the most common sign of cataracts?

Answer 44

Seeing haloes/ dazzling effect around street lights

Question 45

What are the complications of cataracts surgery?

Answer 45

Astigmatism Posterior capsule opacification Endopthalmitis

Question 46

What protection or prophylaxis is there against catarcts?

Answer 46

Stop smoking, use sunglasses and reduce oxidative stress

Question 47

What can be done to assist with posterior capsule opacification

Answer 47

YAG capsulotomy

Question 48

What is the macula?

Answer 48

An area 5.5mm across from the optic disc. It contains the fovea centralis which is very high in cones

Question 49

T or F, ARMD is the leading cause of blindness in the developed world of those over 50?

Answer 49

T

Question 50

What are some risk factors for ARMD?

Answer 50

Deficiency in omega 3 and 6, carotoneoids, and minerals, a lack of exercise, increasing age, family history and smoking

Question 51

What tests can be done to identify macular degeneration?

Answer 51

OTC scan Flourescein fundus angiography Opthalmoscopy

Question 52

What are the types of retinal detachment?

Answer 52

Question 53

What are the features of retinal detachment?

Answer 53

Floaters, flashers, field loss, fall in vision

Question 54

List treatments for retinal detachment

Answer 54

Laser surgery: Laser beam is used to burn the retinal tear that further welds into underlying tissue. Freezing (Cryopexy): Freezing probe is directly applied over the tear causing a scar that helps retina secure to the eye wall. Pneumatic retinopexy: In the case of small tear, a tiny gas bubble is inserted into the vitreous that will seal the tear. Scleral buckle: A silicon band is sewed around the white of eye. This pushes it towards the tear until it heals. Vitrectomy: It is required in case of large tears where vitreous is removed and replaced with saline solution.