opthamology treatment

Question 1

optic neuritis treatment

Answer 1

high dose steroids

(recovery usually takes 4-6 weeks)

Question 2

Scleritis management
(4 points and include 1st line management)

when to refer

Answer 2

-same-day assessment by an ophthalmologist

-oral NSAIDs are typically used first-line

-oral glucocorticoids may be used for more severe presentations

-immunosuppressive drugs for resistant cases (and also to treat any underlying associated diseases)

Question 3

anterior uveitis treatment

Answer 3

-urgent review by opthamology
-steroid + cyclopentoate (mydriatic drops: dilate pupil to decrease pain/ photophobia)

Question 4

acute angle closure gluacoma immediate treatment

give drug names

Answer 4

Emergency situation!!

pilorcapine, timolol, IV acetazolamide, steroids

pilo- consticts pupil= inc outflow of A.H
timolol- b-blocker= dec A.H
AZE- carbonic anhydrase inhibitor- dec A.H

all act to reduce intraocular pressure

Question 5

blepharitis management

Answer 5

hot compress twice a day and removal of debris
lid hygiene

artificial tears if they have dry eyes

Question 6

Microbial keratitis treatment
include 1st line
(3 points)

Answer 6

1st: topical ciprofloxacin
and cyclyopentolate for pain relief

-stop using contact lenses until the symptoms have fully resolved

Question 7

proliferative diabetic retinopathy definitive management

Answer 7

pan retinol laser coagulopathy

Question 8

treatment: primary open angle gluacoma
snd give the action of the drugs

give 1st, 2nd and 3rd line

Answer 8

1st line: prostoglandin eg. latanoprost

2nd: beta blocker, carbonic anhydrase inhibitor or sympathomimetic eyedrop (brimonidine)

3rd: 360’ trabeculoplasty

all ^ drugs act to decrease aquous humour apart from prostoglandins which act to inc uveosleral outflow

Question 9

dry macular degeneration treatment

Answer 9

vitamin c,e and beta carotin and zinc

Question 10

Viral conjunctivitis treatment

Answer 10

Supportive treatment
Carbomer 0.2% gel- (lubricant to help with symptoms)

Question 11

Herpes simple. Keratitis management/ treatment

Answer 11

Topical ganciclovir

2nd line: systemic acyclovir (if patient has a tremor etc so hard to use a gel)

Question 12

Allergic conjunctivitis treatment
(1st and 2nd line)

Answer 12

anti-Histamine drops

2nd line: oral anti-histamine

Question 13

endoptholamitis treatment

Answer 13

Intravitreal vancomycin

Question 14

when do you treat chronic open angle gluacoma

Answer 14

if they have risk of vision loss/ if intraocular pressure is greater than 24mmhg

Question 15

definitive treatment of acute closed angle gluacoma

Answer 15

Bilateral iridotomy (bilateral as unaffected eye is at risK)

Question 16

cataracts treatment

Answer 16

phacoemulsification and insertion of an intra-ocular lens.

(obvs only do one eye at a time if both eyes are needing treated)

Question 17

wet age related degenerative maculopathy tx

Answer 17

intra-vitreal anti-vgef

Question 18

Dry ARMD tx

Answer 18

zinc with vitamins a,c and e (antioxidant vitamins)

Question 19

orbital cellulitis management

Answer 19

IV antibiotics.
do this before carrying out the CT to confirm diagnosis
(as it is an emergency)

Question 20

herpes zoster opthalmicus treatment

Answer 20

1st line: oral aciclovir for 7 days

(sometimes oral steroids used to reduce secondary inflammation)

Question 21

purulent eye discharge in babies management

Answer 21

swab samples taken urgently then systemic antibiotic treatment (erythromycin) is started whilst awaiting microbio results.

Question 22

strabismus treatment in a child

Answer 22

surgical however cannot carry out surgery till baby is old enough (mibbe 4 months)

until then cover the good eye for a few hours a day