PART II Basic

Question 1

List the visual field defects associated with glaucoma:

Answer 1

Nasal step
Paracentral depressions
Arcuate defects
Ring scotoma
tunnel vision with central vision sparing

Question 2

Steroid response raised IOP usually develops over

Answer 2

2-4 weeks

With intensive courses of topical steroid, raised IOP has been reported to occur over hours, but this is more rare. The IOP usually returns to normal after cessation of steroid but this is not universal.

Question 3

phacoanaphylactic (phaco-antigenic) glaucoma

Answer 3

caused by an auto-immune granulomatous reaction to lens proteins in an eye with a ruptured capsule.

Question 4

Phacolytic glaucoma

Answer 4

caused by high molecular weight lens proteins which have leaked through an intact capsule of a hypermature cataract and have blocked the trabecular meshwork. Findings include an open irido-corneal angle, corneal oedema and pseudo-hypopyon (lens material and macrophages).

Question 5

Phacomorphic glaucoma

Answer 5

caused by secondary angle closure due to an intumescent lens and will demonstrate closed irido-corneal angles on gonioscopy.

Question 6

Generalized myasthenia gravis (auto-antibody)

Answer 6

antibodies binding acetylcholine receptors

Anti-ACh receptor antibodies are found in 90% of patients with generalised myasthenia gravis.

Question 7

Acanthamoeba keratitis Findings

Answer 7

small epithelial cysts (early)
a ring infiltrate corneal ulcer
suppurative ulceration with hypopyon (late)
prominent corneal nerves, because of perineural infiltration
grow best on non-nutrient agar overlaid with E. coli
confocal microscopy can be used to visualize the organisms in vivo

Question 8

Acanthamoeba keratitis is characterised by: (clinical)

Answer 8

pain out of proportion to the clinical exam

risk factors:
contact lenses
cleaning contact lenses in tap water
trauma
direct exposure to soil
exposure to standing water (well water, ponds, lakes)

Question 9

Acanthamoeba keratitis Treatment

Answer 9

polyhexamethylene biguanide

Question 10

Cataract extraction in patients with pseudoexfoliation syndrome (challenging factors)

Answer 10

1. incomplete pupillary dilation
2. abnormally weak lens zonules
3. a brittle anterior capsule

Question 11

marginal keratitis

Answer 11

inflammatory reaction against staphylococcal antigens

Staph epidermis is most frequently associated with hypersensitivity marginal keratitis

Question 12

most common cause of hyperacute purulent conjunctivitis is:

Answer 12

Neisseria gonorrhoeae conjunctivitis

Neisseria gonorrhoeae is the most common cause of hyperacute purulent conjunctivitis. If untreated, it can rapidly progress to corneal ulceration and perforation, since Neisseria gonorrhoeae can progress through intact corneal epithelium to cause ulceration, perforation and endophthalmitis.

Question 13

salt and pepper appearance of fundus

Answer 13

TB
RP sine pigment
myotonic dystrophy

Question 14

Ocular TB feature

Answer 14

uveitis
most common allergic features - phylectular keratoconjunctivitis

Question 15

keratoconus most common refractive error

Answer 15

myopia with irregular astigmatism

Question 16

Sago grain appearance of conjunctival

Answer 16

Trachoma

Chlamydia Trochomatis

Question 17

Trachoma drug of choice

Answer 17

Azithromycin

Question 18

Bitot’s spot

Answer 18

Xerophthalmia

most commonly seen temporally

Question 19

Triachiasis

Answer 19

misdirection of eyelash

Question 20

DIstichiasis

Answer 20

congenital condition -
double row of eyelash

Question 21

hyphema like source of bleeding

Answer 21

circulus arteriosus major

Question 22

mushroom sign / smoke stack pattern

Answer 22

CSR

Question 23

pathonomic viral keratitis

Answer 23

decreased corneal sensation - not absent

Question 24

Arlt’s line

Answer 24

Trachoma