Common Eye Conditions

Question 1

Most common cause of blindness in adults 35-65years?

Answer 1

diabetic retinopathy

Question 2

treatment options for wet macular degeneration

Answer 2

anti-VEGF injections, laser photocoagulation, intravitreal steroids

Question 3

Which form of macular degeneration carries the worst prognosis?

Answer 3

wet macular degeneration

Question 4

How is orbital cellulitis diagnosed?

Answer 4

CT, ENT with ophthalmology review

Question 5

Features of wet macular degeneration?

Answer 5

choroidal neovascularisation, leakage of serous fluid and blood

Question 6

What causes neovascularisation in the retina?

Answer 6

growth factors released due to retinal ischaemia

Question 7

Prevention of cataracts?

Answer 7

wear sunglasses, decrease oxidative stress and stop smoking

Question 8

common complication of ophthalmic zoster

Answer 8

post-herpetic neuralgia

Question 9

How is Ramsay Hunt Syndrome treated?

Answer 9

aciclovir and prednisolone

Question 10

What is Ramsay Hunt syndrome?

Answer 10

herpes zoster of the facial nerve, often in the elderly

Question 11

Common triad of symptoms with horners syndrome

Answer 11

miosis, ptosis and anhidrosis (inability to sweat on that side)

Question 12

What causes microaneurysms to form in the retina?

Answer 12

pericyte dysfunction

Question 13

presentation of ophthalmic zoster

Answer 13

pain and neuralgia in CN V1 dermatome preceding a blistering inflammaed rash

Question 14

Straight lines starting to appear wavy is a sign of…

Answer 14

macular degeneration

Question 15

Diagnosis of cataract is best made…

Answer 15

with a dilated pupil and slit lamp or ophthalmascope

Question 16

Risk factors for ophthalmic zoster

Answer 16

increasing age, trauma to the area, immunocompromise

Question 17

What is the most common cause of visual impairment worldwide?

Answer 17

cataracts

Question 18

Predictors of ocular involvement with ophthalmic zoster (3)

Answer 18

Hutchinsons sign, around 50% HZO will have globe involvement - purulent conjunctivitis, visual loss, keratitis, episcleritis, scleritis, irititis

Question 19

Horners syndrome affects the eye because of nerve impingement of which nerve roots?

Answer 19

C8-T2

Question 20

Common organisms causing orbital cellulitis?

Answer 20

staph aureus, strep pneumoniae

Question 21

Horners syndrome may affect the eye by causing…

Answer 21

miosis (small pupil) or ptosis (dropping eyelid)

Question 22

How is surgery for cataracts carried out?

Answer 22

one eye at a time, ultrasound to dissolve original lens and then replaced with plastic or silicone lens…should correct refractive error

Question 23

What are common risk factors for cataract development?

Answer 23

age, congenital, trauma, smoking, alcohol, diabetes, uveitis, systemic drugs i.e. steroids, hypocalcaemia

Question 24

signs of diabetic retinopathy on fundoscopy?

Answer 24

blot haemorrhages, cotton wool spots, microaneurysms, neovascularisation

Question 25

How does Ramsay Hunt syndrome present?

Answer 25

severe otalgia preceding CN VII palsy, vesicles form in the ear, deep meatus, +/- soft palate and tongue, may also have vertigo, deafness and tinitus

Question 26

Risk factors for macular degeneration?

Answer 26

age \>60 years, smoking, FHx, caucasian, high cumulative sunlight exposure, female sex

Question 27

Best treatment for cataracts

Answer 27

surgery - although limited outcome if combined with macular degeneration (around 30% patients)

Question 28

Presentation of a child with orbital cellulitis

Answer 28

inflammation around the orbit, fever, lid swelling and decreased eye movements and diplopia

Question 29

Which group is typically affected by orbital cellulitis?

Answer 29

children

Question 30

What is a cataract?

Answer 30

opacification of the lens

Question 31

What is preseptal cellulitis?

Answer 31

infection of the soft tissues anterior to the orbital septum

Question 32

Treatment for preseptal cellulitis

Answer 32

amoxicillin 1g TDS for 7-10 days

Question 33

Presentation of cataracts

Answer 33

blurred vision, bilateral causes gradual painless loss of vision, glare/haloes around street lights, change in refractive error

Question 34

What is reassuring in the presentation of ophthalmic zoster?

Answer 34

visual acuity and normal corneal appearance

Question 35

A subtype of cataract is posterior subcapsular cataracts...how does it differ?

Answer 35

progresses faster and usually is from steroid use

Question 36

Signs of macular degeneration?

Answer 36

reduced visual acuity - blurred and distorted vision, particularly the central vision

Question 37

common causes of preseptal cellulitis

Answer 37

sinusitit or facial skin lesions

Question 38

What distinguishes preseptal cellulitis from orbital cellulitis?

Answer 38

lack of painful eye movments, diplopia and visual impairement - however if in doubt treat as if orbital cellulitis

Question 39

treatment options for dry macular degeneration

Answer 39

none

Question 40

Treatment of orbital cellulitis

Answer 40

Surgical drainage of abscess and antibiotics

Question 41

Features of dry macular degeneration?

Answer 41

Drusen around the macula - yellow round spots

Question 42

What causes exudates in the retina?

Answer 42

endothelial dysfunction --\> increased vascular permeability and protein leakage

Question 43

What is orbital cellulitis?

Answer 43

infection of the soft tissues posterior to the orbital septum - sight and life threatening!

Question 44

Why does Hutchinson's sign predict involvement of the globe?

Answer 44

nasociliary branch of CN V1 affects the globe

Question 45

What is the most common cause of blindness in the UK?

Answer 45

age related macular degeneration

Question 46

What is the main treatment for opthalmic zoster?

Answer 46

oral antivirals within 72 hours of rash appearing

Question 47

What is proptosis?

Answer 47

protrusion of the orbital contents

Question 48

Complications associated with orbital cellulitis

Answer 48

orbital abscesses, visual loss (CRVO, CRAO, optic neuritis), meningitis, brain abscess, thrombosis in the dural or cavernous sinus

Question 49

When should patients with ophthalmic zoster be referred?

Answer 49

any pain, redness or altered vision

Question 50

What are the two forms of age related macular degeneration?

Answer 50

dry and wet