Opthomology

Question 1

Loss of rods:
Night blindness
Peripheral visual field loss

Loss of cones:
Decreased central visual acuity (late finding)

Answer 1

Retinitis pigmentosa

Genetic dystrophy | Progressive retinal degeneration

Question 2

Optic disc pallor (optic nerve atrophy and gliosis)

Pigment accumulation (characteristic bone-spicule pattern around vessels)

Answer 2

Retinitis pigmentosa

GENETIC

Question 3

is a refractive error in which the focal point of an image falls anterior to the retina due to an increased anterior-posterior diameter of the eyes.

Answer 3

Myopia (nearsightedness)

*Patients have difficulty seeing objects at a distance and have normal near vision.

Question 4

is a refractive error characterized by a reduced anterior-posterior diameter of the eye, causing the focal point of the refracted image to be positioned posterior to the retina.

Answer 4

Hyperopia (farsightedness)

*causes blurred vision of nearby objects and is corrected by a converging (convex) lens.

Question 5

Hyperopia (farsightedness) causes blurred vision of nearby objects and is corrected by a ___ lens.

Answer 5

converging (convex)

Question 6

acute eye pain
corneal edema
eye appears red with a hazy cornea and dilated pupil that responds poorly to light

Answer 6

angle closure glaucoma

Question 7

may be precipitated by topical and systemic medications that cause pupillary dilation, such as alpha-adrenergic agonists (naphazoline) and drugs with strong anticholinergic effects (TCAs, antihistamines).

Answer 7

angle closure glaucoma

Question 8

Atropine is indicated for the treatment of bradycardia as it decreases vagal influence on the SA and AV nodes. A common side effect is

Answer 8

increased intraocular pressure.

It may precipitate acute closed-angle glaucoma in susceptible individuals.

Question 9

work by diminishing the secretion of aqueous humor by the ciliary epithelium.

Answer 9

Timolol and other nonselective beta blockers

Question 10

Prostaglandin F2α (eg, latanoprost, travoprost) and cholinomimetics (eg, pilocarpine, carbachol) decrease intraocular pressure by increasing the

Answer 10

outflow of aqueous humor

Question 11

Acute and painless monocular vision loss is characteristic of

Answer 11

central retinal artery occlusion (CRAO)

Question 12

The vision loss includes the entire visual field and is often permanent. Funduscopic findings include a pale retina (due to ischemia and edema) and a cherry-red macula (the fovea and foveola are thin and have a separate blood supply from the choroid artery; the red choroid is easily visible underneath).

Answer 12

central retinal artery occlusion (CRAO)

Question 13

The central retinal artery is a branch of the ophthalmic artery, which arises from the __ artery.

Answer 13

internal carotid

Question 14

___ are the most common causes of CRAO

CRAO may also be caused by vasculitic diseases (eg, giant cell arteritis).

Answer 14

Athero- and thromboembolism

*Predisposing conditions include atrial fibrillation and carotid artery stenosis.

Question 15

Anticholinergic effects of ____ on the ocular ciliary muscles impair accommodation and cause blurring of vision for close objects.

Answer 15

1st gen antihistamines

Question 16

Use of concentrated oxygen therapy for neonatal respiratory distress syndrome may be complicated by ____ of prematurity.

Answer 16

retinopathy

*This abnormal retinal neovascularization is a major cause of blindness in developed nations.

Question 17

Blurry distorted vision in Right eye.
Ophthalmologic examination of the right eye shows a grayish- green discoloration of the macula with areas of adjacent hemorrhage.

Answer 17

Macular degeneration

Question 18

Wet age-related macular degeneration is characterized by retinal neovascularization due to increased ___ levels.

Answer 18

vascular endothelial growth factor (VEGF)

Question 19

occurs due to denaturation of structural proteins within the lens, leading to loss of lens elasticity which can result in improved vision in patients with mild myopia.

Answer 19

Presbyopia

Question 20

presents in young obese women with daily headache (which worsens during the Valsalva maneuver), bilaterally symmetric papilledema, and transient visual disturbances.

Answer 20

Idiopathic intracranial hypertension (pseudotumor cerebri)

Question 21

Increased intracranial pressure compresses the optic nerves, resulting in impaired axoplasmic flow and ____.

Answer 21

optic disc edema

Question 22

The Kayser-Fleischer ring is an ophthalmologic finding most strongly associated with Wilson’s disease. It is seen most frequently in patients with neuropsychiatric complications.__ atrophy is typically present in these patients.

Answer 22

Basal ganglia

Question 23

Presbyopia is a type of refractive error caused by loss of the normal distensibility of the lens with age. It reduces the ability of the eye to focus on near objects but does not cause loss of

Answer 23

visual acuity

Question 24

Cataracts are characterized by progressive opacification of the lens with chronic loss of )____.

Aging and environmental exposures (eg, UV light) contributeto cataract formation by inducing nuclear sclerosis, photooxidative damage to lens crystallins, and osmotic injury.

Answer 24

visual acuity

*loss of red-reflex

Question 25

Injury to ___ in the temporal lobe results in contralateral superior quadrantanopia (pie-in the sky).

Answer 25

Meyer’s loop

Question 26

Lesions in the ____ causes a contralateral inferior quadrantanopia (pie on the floor) lesion

Answer 26

Dorsal Optic Nuclei

Question 27

Lesions in the ___ cause bitemporal Hemianopesia

Answer 27

Optic Chiasm

Question 28

Lesions of the ___ cause ipsilateral anopesia

Answer 28

optic nerve

whole eye goes blind

Question 29

Lesions at the ____ cause ipsilateral nasal hemianopsia

Answer 29

edge of optic chiasm

Question 30

Lesions in the ____ cause contralateral homonymous hemianopsia with macular sparing

Answer 30

Occipital lobe

Question 31

Lesions in the ____ cause contralateral homonymous hemianopsia w/o macular sparing

Answer 31

optic tract

Question 32

An acute flame-shaped retinal hemorrhage cause by

Answer 32

uncontrolled HTN

Question 33

Ophthalmoscopic examination reveals cupping of the optic disc without hemorrhage.

Answer 33

Closed angle glaucoma

Question 34

Topical prostaglandins (eg, latanoprost) increase outflow of aqueous via the uveoscleral pathway and are the preferred treatment for

Answer 34

open-angle glaucoma

Question 35

It is a form of optic neuropathy and causes progressive loss of ganglion cell axons, which may be visualized as a pale optic disc and enlarged optic cup (compared to normal retina). Symptoms evolve over decades, with progressive loss of peripheral visual fields.

Answer 35

Open-angle glaucoma

Question 36

characterized by increased intraocular pressure due to increased secretion or decreased outflow of aqueous humor.

Answer 36

Open-angle glaucoma

Question 37

glucocorticoids can cause ____ at an early age

Answer 37

cataracts

Question 38

white pupillary reflex

Answer 38

Retinoblastoma

*increased risk for osteosarcoma

Question 39

small yellow Lesions of the __ cause central scotomas (blobs of vision loss)

Answer 39

macula/retinal

Question 40

Funduscopic examination reveals scattered retinal microaneurysms, dot-and-blot hemorrhages, and cotton-wool spots, as well as new blood vessel formation.

Answer 40

Diabetic Retinopathy

Question 41

Chronic ___ can lead to increased permeability and arteriolar obstruction in retinal vessels. The resulting ischemia stimulates production of vascular endothelial growth factor and other angiogenic factors, leading to neovascularization (proliferative diabetic retinopathy).

Answer 41

hyperglycemia

Question 42

Complications include retinal hemorrhage, retinal detachment, and vision loss.

Answer 42

Diabetic retinopathy

Question 43

The most common eye-related complication of congenital cytomegalovirus infection is

Answer 43

chorioretinitis

Question 44

yellow-white, fluffy retinal lesions near the retinal vessels associated with hemorrhage.

Answer 44

CMV Retinitis

*treat with Ganciclovir

Question 45

Pupillary asymmetry increases in a dim room, indicating that the smaller right pupil is unable to dilate due to a lesion in the right ___ pathway.

Answer 45

oculosympathetic (pupillary dilation

*oculoparasympathetic (pupillary constriction) pathway