Fundamentals of Ophthalmology

Question 1

what is the conjunctiva

Answer 1

clear epithelial cells laying on top of the sclera
should be able to move the conjunctiva over the sclera (you will see blood vessels moving over the white)

Question 2

sclera is a continuation of the

Answer 2

cornea

Question 3

choroid is a continuation of the

Answer 3

iris
the iris is a pigmented vascular structure that continues as the choroid

Question 4

lifecycle of aqueous humour

Answer 4

biological salk water creted by the ciliary body
pumped into the posterior chamber
enters anterior chamber
drains out through the trabecular meshwork

Question 5

what happens if the iris gets stuck to the lens

Answer 5

fluid is pumped through this gap, if the iris and the lens are closed then the fluid cannot flow
fluid accumulates in the intraoccqular space
increases intraoocular pressure and pushes the iris forward
call Acute angle closer glaucoma

Question 6

acute angle closure glaucoma

Answer 6

the iris becomes attached to the lens
very painful, not uncommon
blurred vision, peri-orbital ache
increase in intraoccqular pressure

Question 7

how do we drain tears

Answer 7

drains through the upper and lower punctae (singular punctum)
into the cannulinculus into lacrimal sack and down the naso-lacrimal duct

Question 8

what are punctae

Answer 8

tiny holes in the eyelid for draining tears

Question 9

what happens if the lacrimal sack gets infected

Answer 9

lacro-cystitis
can extend posteriorly and cause orbital cellulitis which is a threat to life

Question 10

what is orbital cellulitis

Answer 10

infection
potential threat to life

Question 11

peri-orbital cellulitis

Answer 11

peri-orbital erythema and oedema
you have to check: is this Peri-orbital cellulitis or orbital cellulitis
orbital cellulitis is a threat to life, peri-orbital cellulitis just needs oral antibiotics
peri-orbital cellulitis is just an infection of the skin and unusually co-incides with a sinus infection

Question 12

what would peri-orbital cellulitis look like on a CT

Answer 12

Question 13

peri-orbital cellulitis is an infection of

Answer 13

the skin

Question 14

how would you know if there was orbital cellulitis on CT

Answer 14

check the tissue in the orbit - does it look symmetrical
the optic nerve loses its kink
may also be clogged up sinuses

Question 15

which cranial nerves do eye movement

Answer 15

3, 4 and 6

Question 16

lateral rectus is supplied by

Answer 16

6

Question 17

superior oblique is supplied by

Answer 17

4

Question 18

all other eye muscles are supplied by

Answer 18

3

Question 19

if a patient has double vision only on lateral gaze

Answer 19

6th nerve palsy
horizontal diplopia on lateral gaze of the affected eye

Question 20

4th nerve palsy causes

Answer 20

vertical diplopia usually on down gaze

Question 21

4 nerve is responsible for

Answer 21

downward movement in adduction
looking in and down

Question 22

3rd nerve palsy makes eye go

Answer 22

down and out with ptosis

Question 23

muscles of the eye

Answer 23

Question 24

on fundoscopy, nerve is closest to

Answer 24

the nose

Question 25

fovea is the centre of

Answer 25

the macula

Question 26

where is the macula

Answer 26

macula is temporal to the optic nerve

Question 27

optic cup is

Answer 27

within the optic disc

Question 28

outline of the optic cup is called

Answer 28

neuroretinal rim

Question 29

in glaucoma what happens to the optic cup

Answer 29

the ratio of the diameter of the optic cup and the optic disc is increased the cup should be less than half of thee disc

Question 30

myopia is when

Answer 30

light is focussed in front of the retina the eye is too long

Question 31

hypermetropia is when

Answer 31

light is focussed behind the retina

Question 32

myopia is correct with

Answer 32

concave lens

Question 33

hypermetropia is corrected with

Answer 33

convex lens

Question 34

hypermetropia is when you can see

Answer 34

far away but not close by

Question 35

presbyopia

Answer 35

losing reading (close) vision with age

Question 36

astigmatism

Answer 36

eyeball is not perfectly round like an AFL ball

Question 37

medications relevant on the ophthalmic history

Answer 37

hydroxychloroquine/plaquenil prednisolone amioderone ethambutol these can have toxic eye effects

Question 38

things important on family history

Answer 38

squint/strabismus glaucoma ARMD

Question 39

if a patient has flashes/floaters you should be oncerced about

Answer 39

detached retina

Question 40

differential for acute painless loss of vision

Answer 40

usually unilateral retinal vein/artery occlusion, wet ARMD, ischaemic optic neuropathy, diabetic macular oedema/vitreous haemorrhage, retinal detachment

Question 41

central retinal artery occlusion looks like

Answer 41

Question 42

central retinal vein occlusion looks like

Answer 42

Question 43

swollen optic disc/optic neuropathy looks like

Answer 43

Question 44

pain on eye movements may be

Answer 44

optic neuritis

Question 45

glare by be

Answer 45

uveitis

Question 46

distortion (metomorphopsia) may be

Answer 46

things look wonky macular disease

Question 47

diplopia, pupil or eyelid bay be

Answer 47

cranial nerve palsy, raised ICP

Question 48

scintillating scitoma

Answer 48

classic migraine

Question 49

chronic onset painless loss of vision differentials

Answer 49

gradual onset months to years usually bilateral refractive error, cataract, glaucoma, dry ARMD

Question 50

the big four causes of chronic onset painless loss of vision

Answer 50

dry ARMD, glaucoma, refractive error, cataract

Question 51

drusen are

Answer 51

deposits in macular degeneration

Question 52

binocular painful red eye is usually

Answer 52

conjunctivitis or may also be allergic (if history of atopy)

Question 53

discharge or watering WONT be caused by

Answer 53

discharge is not associated with uveitis, episcleritis, and scleritis more likely to be conjunctivitis

Question 54

recent dental or sinus infection is a risk factor for

Answer 54

orbital cellulitis

Question 55

painful red eye differential

Answer 55

trauma infections inflammation glaucoma (acute angle closure)

Question 56

what is an Amsler grid chart

Answer 56

a chart given to patients with macular degeneration so that they can monitor their distrotion at home

Question 57

who gets distortion

Answer 57

diabetic macular oedema age-related macula ddegeneration

Question 58

ectropion

Answer 58

sagging lower lid at risk of eye drying out happens to older people

Question 59

chlazion

Answer 59

collection of waxy oily fluid pro-inflammatory to the sourrounding tissue

Question 60

exopthalmos

Answer 60

proptosis thyroid eye disease

Question 61

you should never discharge patients with

Answer 61

topical anaesthetic drops topical steroid drops (unless directed by ophthalmology)

Question 62

why cant a patient have topic anaesthetic for more than 1 or 2 days

Answer 62

it's toxic causes toxic keratitis