Optometry

Question 1

Why is treating eyes important?

Answer 1

Treating eyes is crucial because we only have one pair of eyes. Issues with eyesight can lead to loss of income, strain relationships, and inadequate development of other senses to compensate for vision loss

Question 2

When should a patient with an ocular condition be referred?

Answer 2

Patients with conditions such as proptosis, abnormal eye movements, embedded foreign objects, chemical burns, sudden changes in vision, and trauma to the eye should be referred to specialists.

Question 3

What are some ocular manifestations of diseases?

Answer 3

Diseases like rheumatoid arthritis, menopause, Parkinson’s, Down syndrome, Steven Johnson syndrome, thyroid disorders, seborrheic dermatitis, diabetes, and others can manifest as ocular conditions.

Question 4

What are some conditions that may be treated over-the-counter (OTC)?

Answer 4

Ocular conditions such as dryness, conjunctivitis, blepharitis, styes, and subconjunctival hemorrhage may be treated with OTC medications.

Question 5

What is the conjunctivitis and how is it treated?

Answer 5

Inflammation of the conjunctiva, caused by infection or allergies. treated using cold compression, artificial tears (optrex)

Question 6

What is blepharitis and how is it treated?

Answer 6

too much bacteria on your eyelids at the base of your eyelashes and oil glands getting clogged or irritated, causes crusty, flaking skin. Lid hygiene, warm compress and massage. Baby shampoo can destabilize tear film

Question 7

What is subconjunctival hemorrhage and how is it treated?

Answer 7

Small burst blood vessel and blood links to conjunctival sack, presents as bright red, give reassurance it will clear up. Ask if reoccurring, and if patient if taking medication that could affect clotting like warfarin (check INR), when was the last review, check BP

Question 7

What are the side effects of ocular products?

Answer 7

Side effects of ocular products can include ocular irritation, blurred vision, dry mouth, headaches, and changes in heart rate, among others. This is due to systemic absorption 60-80% can be absorbed and reach peak plasma conc in 10 mins, elderly and pregnanet women more in risk

Question 8

How to avoid systemic absorption and toxicity when delivering eye products?

Answer 8

Punctum Occlusion, press punctum area for 5 mins, The punctum is the root to systemic absorption, we have the superior and inferior punctum with their own canaliculus which runs into he common canaliculus, which goes into the lacromal-sact and the nasolacromal duct and the nasopahrmageal cavity  the contact with these results in systemic absorption  hence funny taste sensation when eye drops are used

Question 9

What are the difficulties in ascertaining ocular side effects from systemic products?

Answer 9

Diagnosing ocular side effects from systemic products can be complicated due to factors like aging processes, underlying diseases, lack of drug history, and insufficient knowledge about potential ocular effects

Question 10

What are some medications commonly used for ocular conditions?

Answer 10

Common ocular medications include atropine, beta-blockers, alpha-2 stimulants, sympathomimetic agents, prostaglandin analogues, muscarinic stimulants, and antimuscarinics.

Question 11

What are some adverse drug reactions (ADRs) associated with ocular products?

Answer 11

Adverse reactions can include ocular irritation, dry mouth, bronchospasm, blurred vision, headaches, and cardiovascular effects, depending on the type of medication.

Question 12

What are some precautions for patients using certain ocular medications?

Answer 12

Patients using medications like beta-blockers, alpha-2 stimulants, sympathomimetic agents, prostaglandin analogues, muscarinic stimulants, and antimuscarinics should be cautious due to potential side effects.

Question 13

What are some general strategies for promoting eye health?

Answer 13

Strategies for promoting eye health include stopping smoking, maintaining a healthy diet and weight, wearing UV-protective sunglasses, avoiding unnecessary eye products, and using safety goggles in hazardous environments.

Question 14

What are some drugs that require counseling due to ocular effects?

Answer 14

Drugs that require counseling due to potential ocular effects include those associated with Steven Johnson syndrome, as well as various systemic medications with known ocular side effects.

Question 15

Give some examples of drugs known to cause side effects, list 3.

Answer 15

TCA - dry eye
Tamoxifen - Corneal and lens deposits
Phenytoin - Cataracts
Steroids - raise IOP
Vigabatin - retinal and nerve damage

Question 16

What 2 classes of drugs are contraindicated in arrythmias and angle glaucoma?

Answer 16

Beta-Blockers (Timolol) - no in brittle asthma or arrythmias
sympathomimetics (adrenaline) - no in angle glaucoma as increases IOP

Question 17

What is glaucoma?

Answer 17

Glaucoma is a group of diseases and is the leading cause of blindness. It can affect all age groups, but is often associated with aging. Glaucoma is typically characterized by IOP, optic disc cupping, and visual field loss. Once visual loss occurs, it cannot be regained. it is from the periphery to the middle opposite of ARMD

Question 18

How is glaucoma classified?

Answer 18

Glaucoma can be classified as primary or secondary, open or closed, and congenital or acquired.

Question 19

What is meant by optic cupping?

Answer 19

Optic cupping refers to the measurement of the ratio of space occupied by the cup compared to the optic disc. It is typically measured to assess damage to the optic disc, with severe cupping indicating significant changes and visual field loss.

Question 20

What are the risk factors for glaucoma?

Answer 20

Risk factors for glaucoma include age (risk increases after age 60), race (with Afro-Caribbean individuals at highest risk), family history, diabetes, trauma or sporting injuries, near-sightedness, and prolonged corticosteroid usage.

Question 21

What is primary open-angle glaucoma?

Answer 21

Primary open-angle glaucoma is characterized by an open angle in the trabecular meshwork, allowing for outflow of aqueous humor. However, despite appearing normal, there is reduced drainage, leading to increased intraocular pressure.

Question 22

What is the first-line treatment for primary open-angle glaucoma according to NICE guidelines?

Answer 22

According to NICE guidelines, the first-line treatment for primary open-angle glaucoma is selective laser trabeculoplasty (SLT), which involves using a laser to increase drainage through the trabecular meshwork.

Question 23

What are the drug treatment options for glaucoma?

Answer 23

Drug treatment options for glaucoma include prostaglandin analogues, beta-blockers, alpha-2 stimulants, carbonic anhydrase inhibitors, and muscarinic stimulants. Prostaglandin analogues are typically recommended as first-line treatment.

Question 24

What is trabeculectomy?

Answer 24

Trabeculectomy is a surgical procedure that involves creating a surgical hole in the trabecular meshwork to facilitate drainage. Mitomycin is often used to prevent fibrosis and keep the hole open.

Question 25

What is closed-angle glaucoma?

Answer 25

Closed-angle glaucoma occurs when there is obstruction of outflow from the anterior chamber, usually due to bunching up of the iris and closure of the angle. It can lead to sudden increases in intraocular pressure.

Question 26

What are the symptoms of acute glaucoma?

Answer 26

Symptoms of acute glaucoma include severe pain, redness of the eye, corneal swelling, halos around lights, blurred vision, and potentially vomiting.

Question 27

What treatments are used for acute glaucoma?

Answer 27

Treatments for acute glaucoma include miotics, IV mannitol, IV/PO acetazolamide to reduce intraocular pressure, pilocarpine to open the angle, and iridectomy (laser or surgery) to create a new outflow channel.

Question 28

What is laser peripheral iridotomy (LPI)?

Answer 28

Laser peripheral iridotomy involves creating an extra outflow channel by making a small hole in the iris. It is well tolerated but may require repeated procedures if the hole closes.

Question 29

What precautions are necessary after eye surgery?

Answer 29

After eye surgery, precautions such as antibiotic and steroid use, rest, and follow-up appointments are necessary. Patients may also be counseled on the use of eye drops.

Question 30

What is age-related macular degeneration (ARMD)?

Answer 30

Age-related macular degeneration (ARMD) is the most common cause of blindness in the developed world. It affects central vision and can be bilateral.

Question 31

What are the risk factors for ARMD?

Answer 31

Risk factors for ARMD include genetic factors, smoking, hypertension, sunlight exposure, obesity, and nutrition deficiencies.

Question 32

What are the symptoms of ARMD?

Answer 32

Symptoms of ARMD include blurry vision, wavy lines, difficulty recognizing faces, dark spots in central vision, and eventual loss of central vision.

Question 33

What are the differences between wet and dry ARMD?

Answer 33

Dry ARMD is characterized by the presence of drusen, while wet ARMD involves increased vascularization and abnormal blood vessel formation in the macula.

Question 34

What treatments are available for late dry ARMD?

Answer 34

Treatment options for late dry ARMD are limited and mainly involve conservative measures such as reassurance, vision aids, and nutritional supplements. High dose of anti-oxidants, vits and zinc to prevent new waste products from forming and preventing new drunes

Question 35

What treatments are available for late wet ARMD?

Answer 35

Treatment for late wet ARMD typically involves anti-vascular endothelial growth factor (anti-VEGF) injections to inhibit angiogenesis and reduce visual loss. Like Avastin

Question 36

Where can individuals with glaucoma or ARMD be directed for further assistance?

Answer 36

ndividuals with glaucoma or ARMD can be directed to low vision services, support groups, and specialist eye clinics for further assistance and management.