Eye standard conditions

Question 1

Causes of optic neuritis?

Answer 1

Idiopathic
Post-infective
MS
Infectious
Sarcoidosis

Question 2

Symptoms of optic neuritis?

Answer 2

Pain on ocular movement
RAPD
Vision loss
VF defect
Colour desaturation

Question 3

Work-up for optic neuritis?

Answer 3

MRI brain tro MS
TRO intraocular inflammation

Question 4

Mx of optic neuritis?

Answer 4

IV methylpred, then oral pred.
If idiopathic or a/w MS, vision usu improves over 2-3 weeks

Question 5

Symptoms of ischemic optic neuropathy

Answer 5

Non-arteritic = painless LOV on awakening
RAPD
Inferior altitudinal defect
Low colour vision

Arteritic = similar, but bilateral or rapid severe LOV

Question 6

RF of age related macular degeneration

Answer 6

Age
Female gender
Smoking
HTN, hyperlipidemia
Obesity
Caucasian race
Family hx

Question 7

Symptoms of Dry AMD?

Answer 7

Painless metamorphopsia
Missing central vision

Question 8

Mx of dry AMD?

Answer 8

No known tx. Give AREDS 2 formulation
Smoking cessation

Question 9

Mx of wet AMD?

Answer 9

Anti-VEGF injection
PRP

Question 10

Presentation of retinal artery occlusion

Answer 10

Transient vision loss
Sudden onset painless monocular visual loss
RAPD

Question 11

Mx of RAO?

Answer 11

Ocular massage
IV acetazolamide
Anterior chamber paracentesis

Ocular emergency!!

Question 12

Symptoms of CRVO?

Answer 12

Painless monocular visual loss. Onset not as sudden as CRAO.
RAPD

differentiate btw ischemic vs non-ischemic

Question 13

Causes of CRVO?

Answer 13

Extrinsic pressure on vein - Raised IOP
DM, HTN, HLD, SLE etc that affects vessel walls
Hypercoagulability, Hyperviscosity

Question 14

Mx of RVO?

Answer 14

Treat underlying predisposing factors e.g. atherosclerotic RFs
PRP
Anti-VEGF

Question 15

RFs for Rhegmatogenous retinal detachment?

Answer 15

Acute posterior vitreous detachment
High myopia
Previous surgery
Trauma
Retinal degeneration
Aphakia or pseudoaphakia

Question 16

Symptoms of rhegmatogenous retinal detachment?

Answer 16

Sudden onset floaters
Flashes
Partial VF defect corresponding to area of RD
Poor vision
RAPD
Loss of red reflex

Progress to total RD if untreated

Question 17

Causes of vitreous haemorrhage?

Answer 17

Proliferative diabetic retinopathy
Retinal vein occlusion
Trauma
Retinal tear or detachment
Breakthrough bleeding from age-related macular degeneration

Question 18

Symptoms of acute angle closure glaucoma?

Answer 18

Sudden unilateral painful red eye and vision loss
Ipsilateral headache
N/V
Coloured halos
Photophobia
Fixed mid/semi-mid dilated non-reactive pupil
Hazy cornea from corneal edema
Shallow anterior chamber
High IOP

Question 19

Symptoms of anterior uveitis?

Answer 19

Aching ocular pain
Photophobia
BOV
Circumciliary injection
Pupil miotic/less reaction to light

Question 20

Signs of anterior uveitis?

Answer 20

Aching ocular pain
Photophobia
BOV
Circumciliary injection
Pupil miotic/poorly reactive to light

Question 21

What to watch out for in infective conjunctivitis?

Answer 21

Dont use steroids.
Can worsen infection and cause blindness if severe and uncontrolled.

Question 22

Signs of “not safe” conjunctivitis?

Answer 22

Atypical hx e.g trauma
Contact lens users
Poor vision + pain
Purulent discharge
Corneal involvement
Prolonged course > 1week

Question 23

Ocular features of Myasthenia Gravis?

Answer 23

Fatiguability
Variability
Cogan’s lid twitch
Diplopia
Ptosis

Bulbar symptoms
Respi weakness
Proximal weakness

Question 24

Tests for Myasthenia Gravis?

Answer 24

Tensilon test -> Ptosis improves if MG
Ice pack test -> Ptosis improves if MG
Nap test -> ptosis improves if MG
Single fibre EMG
CT/MRI neck tro thymoma

Question 25

Mx of MG?

Answer 25

Ach inhibitor e.g. neostigmine Prednisolone IV human Ig Thymectomy

Question 26

Pathogenesis of diabetic retinopathy?

Answer 26

High GLC level initiates hyperperfusion + direct toxic effect on endothelial cells High blood flow raises shear stress -> capillary leakage -> exudates + retinal edema

Question 27

How does visual loss result from proliferative diabetic retinopathy?

Answer 27

Diabetic maculopathy Vitreous haemorrhage Tractional retinal detachment

Question 28

Symptoms of hypertensive retinopathy

Answer 28

usu asymptomatic Bilateral, symmetrical microangiopathy

Question 29

Pathophysiology of hypertensive retinopathy?

Question 30

Causes of unilateral optic disc swelling?

Answer 30

Optic neuritis Ischemic optic neuropathy Compressive optic neuropathy Sarcoidosis

Question 31

Complications of cataracts?

Answer 31

Uveitis Lens-induced glaucoma

Question 32

AV nipping and silver wiring in what condition?

Answer 32

hypertensive retinopathy on b/g of chronic HTN

Question 33

Symptoms of thyroid eye disease?

Answer 33

Periorbital + lid swelling. Conjunctival edema Proptosis Chemosis Lid retraction Lid lag Binocular diplopia Compressive optic neuropathy -> poor VA, RAPD, red desat Glaucoma Exposure keratitis