Passmed - Ophth key facts

Question 1

Drusen = ?

Answer 1

Dry macular degeneration

Question 2

Meibomian cyst Px?

Answer 2

Firm, painless lump in the eyelid

Question 3

Acute angle closure glaucoma is associated with ?, where as primary open-angle glaucoma is associated with ?
Options = myopia or hypermetropia

Answer 3

Acute angle closure glaucoma is associated with hypermetropia, where as primary open-angle glaucoma is associated with myopia

Question 4

Acute optic neuritis Tx?

Answer 4

High dose steroids

Question 5

Stye 1st line Mx?

Answer 5

Advise regular warm steaming as first line treatment for stye

Question 6

Argyll-Robinson pupil Px?

Answer 6

Argyll-Robertson pupil - the prostitute’s pupil - accommodates but doesn’t react - ARP PRA

Question 7

Beta-blockers mechanism of action for primary open angle glaucoma?

Answer 7

Beta blockers such as timolol work in primary open-angle glaucoma by reducing aqueous production

Question 8

Bilateral grittiness?

Answer 8

Bilateral grittiness - think blepharitis

Question 9

Sudden painless loss of vision, severe retinal haemorrhages on fundoscopy. Dx?

Answer 9

Central retinal vein occlusion - sudden painless loss of vision, severe retinal haemorrhages on fundoscopy

Question 10

Type of field loss in (a)macular degeneration and (b)primary open-angle glaucoma?

Answer 10

Common eye disorders affecting vision:
Macular degeneration is associated with central field loss
Primary open-angle glaucoma is associated with peripheral field loss

Question 11

Dorzolamide class of drug?

Answer 11

Dorzolamide - carbonic anhydrase inhibitor

Question 12

A cause of red eye which is classically not painful, most likely Dx?

Answer 12

Episcleritis is a cause of red eye which is classically not painful

Question 13

Flame haemorrhages and cotton-wool spots are what Grade of hypertensive retinopathy?

Answer 13

Flame haemorrhages and cotton-wool spots are Grade III hypertensive retinopathy

Question 14

Flashes and floaters?

Answer 14

Flashes and floaters - vitreous/retinal detachment

Question 15

Herpes simplex keratitis on fluorescein eye stain shows what?

Answer 15

Herpes simplex keratitis on fluorescein eye stain shows a dendritic ulcer

Question 16

What is Horner’s syndrome?

Answer 16

Horner’s syndrome: miosis + ptosis + enophthalmos +/- anhydrosis

Question 17

Hyper- or Hypo-calcaemia is a cause of cataracts

Answer 17

Hypocalcaemia is a cause of cataracts

Question 18

Key side effects of prostaglandin analogues?

Answer 18

Key side effects of prostaglandin analogues include increased eyelash length, iris pigmentation and periocular pigmentation

Question 19

Mechanism of action of Latanoprost?

Answer 19

Latanoprost is a prostaglandin analogue used in glaucoma. It works by increasing uveoscleral outflow

Question 20

Optic neuritis is associated with relative afferent pupillary defect - True or False?

Answer 20

True

Question 21

Orbital cellulitis differentiated from pre-septal cellulitis by presence of what?

Answer 21

Orbital cellulitis differentiated from pre-septal cellulitis by presence of: reduced visual acuity, proptosis and pain with eye movements

Question 22

Painless, transient monocular blindness together with the description of a ‘black curtain coming down’ is characteristic of what?

Answer 22

Painless, transient monocular blindness together with the description of a ‘black curtain coming down’ is characteristic of amaurosis fugax

Question 23

Papilloedema indicates what grade of hypertensive retinopathy?

Answer 23

Papilloedema indicates grade IV hypertensive retinopathy

Question 24

Papilloedema is associated with what on fundoscopy?

Answer 24

Papilloedema is associated with blurring of optic disc margin on fundoscopy

Question 25

Peripheral curtain over vision + spider webs + flashing lights in vision think of what?

Answer 25

Peripheral curtain over vision + spider webs + flashing lights in vision think retinal detachment

Question 26

Ptosis + dilated pupil = ?

Ptosis + constricted pupil = ?

Answer 26

Ptosis + dilated pupil = third nerve palsy

Ptosis + constricted pupil = Horner’s

Question 27

Red eye - glaucoma or uveitis?

(a) Severe pain, haloes, ‘semi-dilated’ pupil
(b) Small, fixed oval pupil, ciliary flush

Answer 27

Red eye - glaucoma or uveitis?
Glaucoma: severe pain, haloes, ‘semi-dilated’ pupil
Uveitis: small, fixed oval pupil, ciliary flush

Question 28

Children with a squint initial Mx?

Answer 28

Refer children with a squint immediately to ophthalmology

Question 29

Night blindness + tunnel vision, Dx?

Answer 29

Retinitis pigmentosa - night blindness + tunnel vision

Question 30

Severe non-proliferative diabetic retinopathy is characterised by what?

Answer 30

Severe non-proliferative diabetic retinopathy is characterised by blot haemorrhages and micro-aneurysms in all quadrants, venous beading in 2 or more quadrants and intra-retinal microvascular abnormalities in at least one quadrant

Question 31

How to distinguish episcleritis from scleritis?

Answer 31

The presence of pain distinguishes scleritis from episcleritis

Question 32

Those with a positive family history of glaucoma should be screened annually from what age?

Answer 32

Those with a positive family history of glaucoma should be screened annually from aged 40 years

Question 33

Tortuosity and silver wiring are features of what Grade of hypertensive retinopathy?

Answer 33

Tortuosity and silver wiring are features of Grade 1 hypertensive retinopathy

Question 34

Vesicles on tip of nose, likely Dx?

Answer 34

Vesicles on tip of nose = Hutchinson’s sign. Strong risk factor for ocular involvement in herpes zoster ophthalmicus