Opthamology Investigations

Question 1

Globe rupture Ixs
(2 points)

Answer 1

MRI is 1st line

Then do examination under anaesthetic

Question 2

Chemical injury of eye ix

Answer 2

check toxbase, check pH, **irrigate then assess at slit lamp

Question 3

Ix for infraorbital foregin bodies

Answer 3

X ray

Question 4

suspected optic neuritis, diagnostic investigation

Answer 4

MRI of the brain and orbits with contrast is usually diagnostic

Question 5

when does a foreign body in the eye need to be referred to opthamology (instead of removing in practise for eg)

(6 points)

Answer 5

-high velocity, penetrating injury
-sigfig. orbital trauma
-chemical injury (irrigate for 20-30 mins b4 referring)
-foreign bodies composed of organic materials
-foreign bodies in cornea
-red flag symptoms

Question 6

anterior uveitis investigation (include diagnostic test)

(2 points)

Answer 6

all patients w/ suspected A.U should be referred to opthamology for:
slit lamp examination (best diagnostic test)
and
dilated fundoscopic exam (to rule out panuveitis)

Question 7

microbial keratisis investigations
and when to refer to opthamology

Answer 7

same day referral to an opthamologist

corneal scrapings for microscopy and culture and flourescein dye in eye to check for corneal ulcers

Question 8

inital investigation for orbital cellulitis

Answer 8

CT scan

(to assess if absess has occured)

Question 9

what type of referral to make for anterior uveitis eg urgent or same day etc

Answer 9

patient to be seen within 24 hours

Question 10

diagnostic test for primary open gluacoma

Answer 10

increased cup to disc ratio

Question 11

age related macular degeneration Ixs

Answer 11

initial Ix- slit lamp microscopy

• ocular coherence tomography

-flourescein angiography ustilised if neovascular ARMD suspected.

Question 12

when to do same day referrals to opthamology

Answer 12

any vision deterioration

Question 13

Ix for dilated pupil and ptosis of the eye

Answer 13

CT angiogram

(as this indicates occulomotor nerve damage from an external cause: possibly a posterior communicating artery anyuersm)

Question 14

what does the accommodation reflex test

Answer 14

tests, constriction, convergence and contraction (of lens) reaction to an object moving closer to the eye

Question 15

what does a light near association indicate

give differentials

Answer 15

problem with the parasympathetic pathway

3rd nerve palsy, (ptosis and down and out eye)
holmes adie pupil (affected eye would constrict in reaction to low dose pilocarpine)

Question 16

cause of mixed hearing loss

Answer 16

head injury

occasionally otosclerosis

Question 17

gold standard test for intraocular pressure

Answer 17

goldman’s tonometry

Question 18

investigation for posterior vitreous detachment

Answer 18

b-scan ultrasound of the orbit