strabismus + other

Question 1

phoria

Answer 1

latent strabismus
cover recover test
only visible when binocular vision broken and when cover problem eye

Question 2

tropia

Answer 2

manifest strabismus
cover test
visible when cover normal eye

Question 3

exotropia

Answer 3

in childhood/adolescent
when binocular vision already developed so preserved
intermittent

Question 4

esotropia

Answer 4

intermittent or constant
early childhood
caused by reduced vision or hyperopia
associated with loss of binocular vision as occurred before it was developed

Question 5

pupil sparing 3rd nerve palsy

Answer 5

when parasympathetic fibres arent damaged (on top of nerve)
often vascular cause
due to stroke, raised ICP, space lesion

down and out with ptosis

Question 6

pupil including 3rd nerve palsy

Answer 6

down and out, ptosis, miosis.

compressed by aneurysm in posterior communicating artery. urgent CT with contrast

Question 7

6th nerve

Answer 7

abducens
LR6
long intracranial cause

Question 8

4th nerve

Answer 8

thinnest cranial nerve with longest intracranial path -> susceptible to trauma and raised ICP

Question 9

squint surgery

Answer 9

done by strengthening (resection) and weakening (recession) of 2 muscles

Question 10

Metamorphopsia:

Answer 10

crooked or wavy appearance to straight lines - more in wet AMD

Question 11

Photopsia

Answer 11

perception of flickering or flashing lights

Question 12

Laser photocoagulation:

Answer 12

wet amd
May be used in eyes with specific signs on fluorescein angiography and juxtafoveal or extrafoveal lesions only. Persistent or recurrent CNV occurs in ~50% of treated eyes within 3 years of therapy.

Question 13

anti vegf

Answer 13

bevacizumab (Avastin®) and ranibizumab (Lucentis)

Question 14

madarosis

Answer 14

Changes to the eyelashes such as loss of eyelashes

Question 15

trichiasis

Answer 15

misdirection of eyelashes towards the eye

Question 16

Pemphigus

Answer 16

affects the outer of the skin (epidermis) and causes lesions and blisters that are easily ruptured.

Question 17

Pemphigoid

Answer 17

affects a lower layer of the skin, between the epidermis and the dermis, creating tense blisters that do not break easily. Sometimes pemphigoid may look like hives or eczema without blisters.

Question 18

posterior blepharitis

Answer 18

associated with meibomian gland dysfunction and rosacea consider prescribing oral antibiotics (such as doxycycline [off-label] or tetracycline [contraindicated in pregnancy, lactation and in children under 12 years])

Question 19

anterior blepharitis

Answer 19

For anterior blepharitis, consider prescribing a topical antibiotic (such as chloramphenicol) to be rubbed into the lid margin.
The frequency and duration of topical antibiotic treatment depends on the severity of the blepharitis and response.

Question 20

Amblyopia

Answer 20

is a vision development disorder in which an eye fails to achieve normal visual acuity, even with prescription eyeglasses or contact lenses. Also called lazy eye, amblyopia begins during infancy and early childhood. In most cases, only one eye is affected.

Question 21

For congenital cataracts, a critical period for visual development is thought to occur in the first 6 weeks of life, but performing congenital cataract surgery during infancy is associated with a 15–30% risk of developing glaucoma.

Answer 21

□ To optimise prognosis, it is thought that unilateral congenital cataracts should be removed by 4–6 weeks of life and
□ bilateral congenital cataracts within the first 6–8 weeks of life with the aim of preventing the development of irreversible deprivation amblyopia, strabismus and nystagmus

Question 22

treat central retinal artery occlusion acutely

Answer 22

○ Ocular massage
○ Paracentesis: Removing fluid from the anterior chamber to reduce intraocular pressure
○ Inhaling carbogen (5% carbon dioxide and 95% oxygen) to dilate the artery
○ Sublingual isosorbide dinitrate to dilate the artery
○ Oral pentoxifylline: improve blood flow in patients with circulation problems to reduce aching, cramping, and tiredness in the hands and feet. It works by decreasing the thickness (viscosity) of blood. This change allows your blood to flow more easily, especially in the small blood vessels of the hands and feet.
Intra-arterial fibrinolysis through local injection of urokinase into the proximal part of the ophthalmic artery

Question 23

• Intraretinal microvascular abnormalities (IRMA)

Answer 23

is where there are dilated and tortuous capillaries in the retina. These can act as a shunt between the arterial and venous vessels in the retina.

Question 24

symptoms of thyroid eye disease

Answer 24

blurred vision 
diplopia 
strabismus 
chronic bloody eyes 
constant watery eyes 
swelling near upper and lower eyelids 
photophobia 
difficulty movinh eye balls

an lead to fibrosis and tissue remodelling

erode the cornea

treat with decompression surgery, eye lid surgery and muscle surgery