Emergencies

Question 1

what is examined in the anterior segment of the eye?

Answer 1

lid
conjunctiva
cornea
iris
pupil (RAPD)
lens

Question 2

what is examined in the posterior segment of the eye?

Answer 2

vitreous
optic disc
macula
retinal vasculature

Question 3

what are some causes of subconjunctival haemorrhage?

Answer 3

spontaneous
trauma
coagulative disorder
valsalva pressure

Question 4

what is the difference between a subconjunctival haemorrhage and scleral rupture?

Answer 4

can’t see the posterior limit of a scleral rupture and is more severe

Question 5

is episcleritis or scleritis more severe?

Answer 5

scleritis

Question 6

what are the signs of episcleritis?

Answer 6

pain. discomfort, patch of redness

Question 7

what is the treatment of episcleritis?

Answer 7

NSAIDs, topical steroids, lubricants

Question 8

what additional symptoms are experienced with scleritis compared to episcleris ?

Answer 8

severe pain
photophobia
decreased vision

Question 9

what are the three different types of scleritis ?

Answer 9

localised
nodular
diffuse

Question 10

what is scleritis associated with?

Answer 10

systemic autoimmune diseases

Question 11

what investigation can be done for foreign bodies/corneal abrasion in the eye?

Answer 11

fluorescein staining

Question 12

what are the symptoms of corneal abrasion?

Answer 12

pain, watering, photophobia, conjunctiva injection, swollen lids

Question 13

what do cycloplegics do?

Answer 13

paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation.

Question 14

what is the management of corneal abrasions

Answer 14

evert eye lid 
wash 
topical antibiotic 
cycloplegics 
pressure pad and patch

Question 15

what could cause a corneal ulcer?

Answer 15

excessive contact lens

wearing contact lens while swimming, sleeping, showering

Question 16

what are the symptoms of corneal ulcers?

Answer 16

pain, redness, photophobia, watering, discharge

Question 17

what is a sign of viral keratitis?

Answer 17

epithelial dendrites

stromal keratitis

Question 18

what is the treatment for viral keratitis ?

Answer 18

aciclovir 3% ointment for 3 weeks

topical cyclolplegics

Question 19

what are some signs of iritis ?

Answer 19

circumcorneal redness 
keratic precipitates on corneal endothelium 
cells in anterior chamber 
hypopyon 
posterior synaechiae 
peripheral anterior synchiae 
miosis

Question 20

what is hypopyon?

Answer 20

leukocytic exudate, seen in the anterior chamber

Question 21

what is miosis ?

Answer 21

excessive constriction of pupil

Question 22

what is the treatment for iritis ?

Answer 22

topical steroids

cycloplegics

Question 23

do myopic or hypermetropic people get acute angle closure glaucoma and why?

Answer 23

hypermetropic because the eye ball is smaller than normal so the image is projected behind the retina

Question 24

what are symptoms of acute angle closure glaucoma ?

Answer 24

nausea, vomiting
coloured halos around light
red eye
painful

Question 25

does acute angle closure glaucoma have a deep or shallow anterior chamber ?

Answer 25

shallow anterior chamber

Question 26

what type of necrosis does acid produce?

Answer 26

coagulative necrosis

Question 27

what type of necrosis does alkali produce?

Answer 27

liquefactive necrosis

Question 28

what ocular burn is worse?

Answer 28

alkali burn because its liquefactive penetrates cornea faster and rapidly damages intraocular structures

Question 29

what is hyphema?

Answer 29

bleeding in the anterior chamber of the eye

Question 30

what blood system supplied the fovea centralis?

Answer 30

choroid blood supply

Question 31

what is a contraindication of mannitol?

Answer 31

heart failure

Question 32

what retinal sign is present with retinal vein occlusion?

Answer 32

blot haemorrhage

Question 33

what is the management of hyphema?

Answer 33

``` bed rest head elevation analgesia topical steroids topical cycloplegic ```

Question 34

what % of pts rebleed in the first 5 days after hyphema ?

Answer 34

30%

Question 35

what does the cornea look like after an ocular burn?

Answer 35

cloudy

Question 36

once an ocular burn has been irrigated with 2 litres what medication can be given?

Answer 36

``` topical antibiotics lubricants cycloplegics steroids Vitamin C ```

Question 37

what is the presentation of central retinal artery occlusion ?

Answer 37

sudden painless loss of vision

Question 38

what is the presentation of central retinal vein occlusion ?

Answer 38

sudden painless loss of vision | - not as sudden as central retinal artery occlusion

Question 39

what does the retina look like after central retinal artery occlusion ?

Answer 39

pale retina with attenuated (thin) vessels with cherry red spot on fovea

Question 40

what is the management of central retinal artery occlusion ?

Answer 40

``` ocular massage (to try dislodge emboli) reduce intraocular pressure hypoventilate anterior chamber paracentesis infusion of tPA in ophthalmic artery ```

Question 41

what ocular problem does GCA cause?

Answer 41

anterior ischaemic optic neuropathy

Question 42

what visual field defect is seen in GCA?

Answer 42

altitudinal field defect (vision superior to horizontal axis is absent due to inferior retinal defect) blurry vision

Question 43

what signs are seen on retina for central retinal vein occlusion ?

Answer 43

blot haemorrhages in all 4 quadrants dilated tortuous vessels swollen optic disc cotton wool spots

Question 44

what is the presentation of retinal detachment ?

Answer 44

black curtain coming down over visual field sudden onset of floaters flashing lights

Question 45

what are risk factors of retinal detachment ?

Answer 45

myopia | ocular surgery

Question 46

what is the presentation of vitreous haemorrhage ?

Answer 46

sudden painless loss of vision | sudden onset of floaters

Question 47

what are some risk factors for vitreous haemorrhage ?

Answer 47

HTN, DM, proliferative diabetic retinopathy (PDR) | anti coagulant treatment

Question 48

what is the normal ESR meant to be?

Answer 48

male - half of age | females - age +10 divided by 2

Question 49

does orbital cellulitis have RAPD?

Answer 49

yes

Question 50

what are the signs of orbital cellulitis ?

Answer 50

``` severe pain periorbital and lid oedema proptosis chemosis RAPD reduced visual acuity restricted movements fever ```

Question 51

what is a complication of orbital cellulitis ?

Answer 51

meningitis | cavernous sinus thrombosis

Question 52

what is the treatment for orbital cellulitis ?

Answer 52

IV antibiotics

Question 53

what are some risk factors for endophthalmitis ?

Answer 53

post operative patients and history of ocular trauam

Question 54

what is the treatment for endophthalmitis?

Answer 54

intravitreal antibiotics and vitrectomy

Question 55

what causes endogenous endopthalmitis ?

Answer 55

sepsis | immunocompromised patients