Common Presenting Features

Question 1

Acute Angle Closure Glaucoma

Answer 1

• Severe pain (may be ocular or headache)
• Decreased visual acuity, patient sees haloes
• Semi-dilated pupil
• Hazy cornea

Question 2

Anterior Uveitis

Answer 2

• Acute onset
• Pain
• Blurred vision and photophobia
• Small, fixed oval pupil, ciliary flush

Question 3

Scleritis

Answer 3

• Severe pain (may be worse on movement) and tenderness

- May be underlying autoimmune disease e.g. rheumatoid arthritis

Question 4

Conjunctivitis

Answer 4

• Purulent discharge if bacterial, clear discharge if viral

Question 5

Subconjunctival Haemorrhage

Answer 5

• History of trauma or coughing bouts

Question 6

Ischaemic Optic Neuropathy

Answer 6

• Sudden painless loss of vision
• May be due to arteritis (e.g. temporal arteritis) or atherosclerosis (e.g. hypertensive, diabetic older patient)
• Due to occlusion of the short posterior ciliary arteries, causing damage to the optic nerve
• Altitudinal field defects are seen

Question 7

Central Retinal Vein Occlusion

Answer 7

• Sudden painless loss of vision
• Incidence increases with age, more common than arterial occlusion
• Causes: glaucoma, polycythaemia, hypertension
  severe retinal haemorrhages are usually seen on fundoscopy

Question 8

Central Retinal Artery Occlusion

Answer 8

• Sudden painless loss of vision
• Due to thromboembolism (from atherosclerosis) or arteritis (e.g. temporal arteritis)
• Features include afferent pupillary defect, ‘cherry red’ spot on a pale retina

Question 9

Vitreous Haemorrhage

Answer 9

• Causes: diabetes, bleeding disorders

- Features may include sudden visual loss, dark spots

Question 10

Retinal Detachment

Answer 10

• Dense shadow that starts peripherally progresses towards the central vision
• A veil or curtain over the field of vision
• Straight lines appear curved
• Central visual loss