Treatments

Question 1

Viral Conjunctivitis

Answer 1

Carbomer 0.2% gel

• A lubricant, relief from the grittiness
• Purely supportive - viral tends to be self-limiting

Advice (aim to reduce transmission):

• Good hygiene e.g. good hand washing
• Don’t share face cloths and towels - wash after use
• New contact lenses after

Question 2

Retinal detachment

Answer 2

• Laser therapy or cryotherapy: To seal retinal tears or holes
• Vitrectomy: To remove the vitreous and replace it with a gas bubble or silicone oil
• Scleral buckling: To push the sclera toward the retinal tear
• Pneumatic retinopexy: To push the retina back into place using a gas bubble.

Question 3

Herpes Simplex Keratitis

Answer 3

Topical Ganciclovier (anti-viral) or something systemic if they cannot tolerate eye drops

Refer to ophthalmology - same day referral and they should treat w above

Question 4

Anterior uveitis

Answer 4

• Cycloplegic mydriatic drops e.g. cyclopentolate - These cause iris dilation and help to break/prevent posterior synechiae
• Corticosteroids (topical, oral, IV, or IM), typically starting on an hourly regimen and then gradually tapered - for intraocular inflammation
• Analgesia

*Assoc. w inflammatory causes e.g. Ankolysing spondylitis so investigate later on and refer onto Rheumatology as required *

NOTE: don’t give a topical anaesthetic as it can melt cornea

Question 5

CRAO

Answer 5

treatment after 90-100mins -> vision unlikely to improve
AIM: reperfuse ischaemic retina asap

• Ocular massage - aim to dislodge e,bolus
• Vasodilation with Isosorbide dinitrate
• Anterior chamber paracentesis - to reduce IOP to help dislodge embolus

Question 6

Endophthalmitis

Answer 6

• Intravitreal administration of antibiotics, usually vancomycin. This is due to the predominance of gram-positive bacteria as the causative organisms.
• In severe cases, vitrectomy may be required.
• Prompt treatment is crucial to prevent permanent vision loss.

Question 7

Scelritis

Answer 7

• NSAIDs such as fluriprofen PO 100 mg TDS for mild cases
• Corticosteroids such as oral prednisolone or pulsed IV methylprednisolone for severe or necrotising cases
• Steroid-sparing therapies for long-term treatment

Question 8

Wet Age-Related Macular Degeneration (ARMD)

Answer 8

• intra-vitreal anti- VEGF injectons - anti-vascular endothelial growth factor
• Smoking secassion

Question 9

Dry age-Related Macular Degeneration (ARMD)

Answer 9

• Zinc and antioxidant vitamin A, C and E supplements have been shown to reduce progression by up to 30%
• smoking secassion