Random key facts

Question 1

In acute angle glaucoma which eye condition predisposes you to it

Answer 1

long sited

Question 2

tool used to measure intraocular pressure

Answer 2

tono metry

Question 3

tool to measure the angle between the iris and cornea

Answer 3

gonio scopy (the angle between the cornea and the iris is GON! in acute angle glaucoma)

Question 4

what is the redness on the eye seen In uveitis

Answer 4

usually around the cornea
will see all the other features on slit lamp
- anterior chamber flare
- anterior chamber cells
- hypopyon
- keratinic precipitate

Question 5

what is the redness seen in conjunctivitis

Answer 5

redness diffuse all over
Discharge, irritation, itchy/burning, no photophobia, vision usually normal

Question 6

what redness seen in scleritis

Answer 6

Deep, violaceous red eye (often sectoral or diffuse)
Severe boring eye pain, worse on movement, may affect vision, globe tenderness

Question 7

redness seen in Acute Angle-Closure Glaucoma

Answer 7

Diffuse redness + corneal haze
Sudden vision loss, fixed mid-dilated pupil, headache, nausea, very high IOP

Question 8

redness seen in Subconjunctival Hemorrhage

Answer 8

Bright red patch, sharply demarcated
Painless, no vision change, often incidental or after trauma/straining

Question 9

what is the difference between scleritis and episcleritis

Answer 9

scleritis is very painful
episcleritis is not supposed to be painful and is also is self limiting

Question 10

what are the three features of keratitis

Answer 10

• inflammation of the cornea
• red eye, photophobia, gritty eye

Question 11

two meds for acute angle glaucoma

Answer 11

pilocarpine
acetazolamide

Question 12

how to tell which blood vessel has been occluded in the retina

Answer 12

branch retinal vein - red patches of haemorrhage confined to certain areas of the retina
branch retinal artery - cotton wool spots and some pallor
CRAO - cherry red spot and some retinal pallor
CRVO - multiple patches of haemorrhage not confined to one place

Question 13

how does age related macular degeneration affect vision vs open angle glaucoma

Answer 13

ARMD - affects central vision (facial recognition, visual acuity)
open angle - affects peripheral vision

Question 14

congenital cataracts vs retinoblastoma

Answer 14

retinoblastoma - malignant tumour of the retinal cells, from RB1 gene (emergency)
cataracts - cloudy haze over the lens of the eye

Investigations
Retinoblastoma -> fundoscopy can see a mass in the retina
Cataracts - lens opacification
US - calcifications in the retinoblastoma, none in the cataracts
genetic testing will show RB1 tumour

Treat:
Retinoblastoma - lifelong chemo, surgical resection
cataracts -> remove lens aspiration, posterior capsulotomy
In infants <6 months, many surgeons leave the eye aphakic (without a lens) and correct vision with contact lenses or glasses until secondary IOL implantation is safer.

Question 15

what is Amblyopia

Answer 15

“lazy eye” when the eye doesn’t develop properly in childhood
The brain favours the stronger eye and reduces input into the weaker eye as it gives blurry / unequal images to the brain
develops usually before the age of 7

TREAT:
patch
glassess to fix refractive error
surgery if caused by cataracts

Question 16

most common cause of amblyopia

Answer 16

Strabismic Amblyopia Caused by a squint (misalignment of eyes); brain ignores the deviated eye.
Deprivation Amblyopia Caused by something blocking vision (e.g., congenital cataract, ptosis).

Question 17

what is the fundoscopy looking at

Answer 17

Retina -> contains rods and cones, light sensitive layer of the eye
Optic disc -> where the optic nerve enters
Macula -> has a high number of cones and rods in the periphery
retinal blood vessels

Question 18

what are some signs a fundoscopy can show

Answer 18

• retinoblastoma - mass on the retina
  -papilledema - swollen optic disc
  -diabetic retinopathy
• hypertensive changes
• diabetic retinopathy

Question 19

what does a slit lamp show

Answer 19

• the patient rests their chin and forehead on a support
• then a small beam of light enters the eye

It looks at front of eye
Eyelids and lashes
Conjunctiva (thin layer covering the white of your eye)
Cornea (clear front surface)
Iris (colored part)
Lens (just behind the iris)
Sometimes the vitreous and retina (with additional lenses)

Question 20

what are some conditions a slit lamp may be used to diagnose

Answer 20

Cataracts
Corneal injuries or infections
Dry eye
Glaucoma
Macular degeneration
Retinal detachment
Uveitis

Question 21

what are 4 conditions that must be ruled out with ocular pain

Answer 21

Acute angle closure glaucoma
Anterior uveitis
Scleritis
Corneal ulcer

Question 22

what are the main causes for papillodema

Answer 22

Unilateral:
- glaucoma
- optic neuritis (MS)
-diabetic retinopathy
-CRVO

Bilateral:
- Raised ICP - tumour, Brain haemorrhage
-hydrocephalus
-malignant HTN

Question 23

key signs and symptoms of papillodema

Answer 23

symptoms :
Headache (worse on coughing or standing)
longsightedness
Transient vision loss (particularly when standing)

signs
-Blurring of optic disc margin
- Absent venous pulsation on fundoscopy, Haemorrhages over or near to the optic disc,
- Increase in size of the blind spot, - – -Diplopia (if there’s a sixth nerve palsy)

Question 24

what is the common bacteria of bacterial keratinitis in contact lens wearers

Answer 24

pseudomonas aeruginosa

this is a sight threatning emergency

Question 25

Pain on eye movement → think Pain worsened by light (photophobia) → Pain + red eye + sudden vision loss Pain + proptosis/swelling

Answer 25

- optic neuritis - consider uveitis or corneal issues - be alert for glaucoma or scleritis - orbital cellulitis

Question 26

ocular pain vs periocular pain

Answer 26

ocular - pain from the eye itself, often dull, sharp or stabbing periocular - around the eye—in the eyelids, orbit, or surrounding structures. Often a dull ache or deep pressure sensation

Question 27

what is the key feature to look out for on a herpes keratinitis

Answer 27

An acute painful red eye with a dendritic corneal ulcer on slit-lamp examination is characteristic of herpes simplex keratitis. This is caused by HSV 1, which commonly infects the face, lips and eyes.

Question 28

if your suspecting a patient has a penetrating eye injury and you want to do imaging what would be the best

Answer 28

CT orbits

Question 29

afferent vs efferent

Answer 29

afferent is input from eye into the brain Light hits the retina → photoreceptors convert it into a signal Signal travels via the optic nerve (CN II) → to the optic chiasm → then to the pretectal nucleus in the midbrain efferent: response from the brain to the eye eg causing dilation or constriction From the Edinger–Westphal nucleus (in midbrain) → via oculomotor nerve (CN III) → to the ciliary ganglion → then to the sphincter pupillae muscle, causing pupil constriction

Question 30

what is a A relative afferent pupillary defect (RAPD) (prompts urgent CT of orbit)

Answer 30

asymmetric or unilateral optic nerve dysfunction or severe retinal disease as they are not relaying the signals to the brain properly it is shown when

Question 31

test for relative afferent pupillary defect

Answer 31

How do you test for RAPD? Using the Swinging Flashlight Test: Shine a light in the normal eye → both pupils constrict (normal consensual response). Swing the light to the affected eye: If there’s an RAPD, both pupils dilate slightly, because the brain receives less afferent input from that eye.

Question 32

if pupils are different in size what are you dealing with

Answer 32

efferent pathway issue usually due to oculomotor nerve palsy Is the larger pupil abnormal? If yes, the problem is likely in the parasympathetic system → think CN III palsy more obvious in bright light eye is down and out 👇 Is the smaller pupil abnormal? If yes, the problem is likely in the sympathetic system → think Horner’s syndrome more obvious in dim light

Question 33

If a patient presents with a red, painful eye after recent intraocular surgery, and there’s vision loss think

Answer 33

endophthalmitis until proven otherwise. this is an infection inside the eye either within the aqueous or vitreous humor Decreased visual acuity (rapid onset) Severe eye pain Red eye Hypopyon (pus in anterior chamber — white fluid level) Swollen eyelids Vitreous haze (cloudy view on fundoscopy) Photophobia, floaters