Ophthalmology

Question 1

What are chloramphenicol eye drops used for?

Answer 1

Hordeolum (stye) with conjunctivitis, Dacryocystitis, Bacterial conjunctivitis, Corneal abrasion.

Question 2

hat conditions benefit from lid hygiene with warm compresses?

Answer 2

Blepharitis, Hordeolum, Viral non-herpes conjunctivitis.

Question 3

When are artificial tears (hypromellose) used?

Answer 3

Keratoconjunctivitis sicca (dry eye) - bilateral dryness and grittiness often in the elderly, worse at the end of the day.

Question 4

What are the symptoms of cataracts?

Answer 4

Gradual painless vision loss globally, faded color vision, glare with halos around lights, defect in red reflex, cloudy lens.

Question 5

How is macular degeneration managed?

Answer 5

Amsler grid, fundoscopy, antioxidants for dry type, anti-VEGF injections for wet type.

Question 5

What are the symptoms of primary open-angle glaucoma?

Answer 5

Bilateral gradual painless vision loss peripherally to centrally, impaired adaptation to darkness, halos around lights, headaches.

Question 5

What are the symptoms of macular degeneration?

Answer 5

Unilateral or bilateral gradual painless vision loss centrally, metamorphopsia, scotoma, impaired adaptation to darkness.

Question 6

What is the management for primary open-angle glaucoma?

Answer 6

Prostaglandin analogue eye drops (e.g., latanoprost).

Question 7

How is cataract managed?

Answer 7

Phacoemulsification.

Question 8

How is diabetic retinopathy classified?

Answer 8

Non-proliferative (NPDR), proliferative (PDR), or maculopathy.

Question 9

What are the treatment options for NPDR?

Answer 9

NPDR mild - observation, NPDR moderate/severe - focal laser photocoagulation.

Question 10

What is the treatment for PDR?

Answer 10

Pan-retinal photocoagulation + anti-VEGF injections.

Question 11

What are the symptoms of acute closed-angle glaucoma?

Answer 11

Unilateral acute painful vision loss, hard red eye, halos around lights, headaches, N&V, cloudy cornea.

Question 12

How is acute closed-angle glaucoma treated?

Answer 12

Pilocarpine eye drops + acetazolamide

Question 13

What are the symptoms of uveitis?

Answer 13

Unilateral acute painful red eye, blurry vision, photophobia, epiphora, hypopyon.

Question 14

What are the symptoms of retinal detachment?

Answer 14

Unilateral sudden acute painless vision loss like a curtain or black shadow moving across vision with preceding floaters and flashes.

Question 14

What is periorbital and orbital cellulitis associated with?

Answer 14

Inflammation of tissues anterior and posterior to the orbital septum, often secondary to local infection (e.g., sinusitis, dacryocystitis).

Question 14

What is the association of hypermetropia with acute closed-angle glaucoma?

Answer 14

Hypermetropia (long-sighted, Asian).

Question 15

What is amaurosis fugax?

Answer 15

Essentially a transient central retinal artery occlusion

Question 15

What are the symptoms of vitreous detachment?

Answer 15

Floaters (cobwebs) and flashes (photopsia), blurry vision, red hue to vision.

Question 16

What is the characteristic appearance of central retinal vein occlusion (CRVO)?

Answer 16

Cheese and tomato pizza’.

Question 16

Describe the appearance of central retinal artery occlusion (CRAO).

Answer 16

‘Pale retina with cherry-red spot in fovea’.

Question 17

What is optic neuritis associated with?

Answer 17

Unilateral acute or gradual visual loss often causing scotomas, red desaturation, pain on eye movements.

Question 18

What is the imaging modality used for optic neuritis?

Answer 18

MRI.

Question 19

What is the treatment for optic neuritis?

Answer 19

Prednisolone.

Question 20

How is temporal arteritis diagnosed?

Answer 20

Temporal artery biopsy.

Question 21

What is the treatment for temporal arteritis?

Answer 21

Prednisolone.

Question 22

What is the first-line management for bacterial conjunctivitis?

Answer 22

Chloramphenicol eye drops.

Question 23

What is the hallmark symptom of blepharitis?

Answer 23

Bilateral grittiness.

Question 24

What is the characteristic symptom of keratoconjunctivitis sicca?

Answer 24

Bilateral dryness and grittiness often in the elderly, worse at the end of the day.

Question 25

What is the primary complaint in keratoconjunctivitis sicca?

Answer 25

Dryness.

Question 26

What is the visual symptom often associated with macular degeneration?

Answer 26

Metamorphopsia (straight lines appear wavy).

Question 27

Features of keratitis

Answer 27

Red eye, photophobia and gritty sensation

Question 28

Which condition is both tonometry and gonioscopy needed for diagnosis?

Answer 28

acute angle-closure glaucoma

Question 29

Of scleritis and episcleritis, which one is painful?

Answer 29

Scleritis is painful

Question 30

How do we treat cellulitis near the eyes?

Answer 30

Co-amoxiclav (rather than flucloxacillin)

Question 31

Opthalmoscope changes in hypertension

Answer 31

AV nipping, flame / blot haemorrhage, cotton wool spots, hard exudates, papilledema

Question 32

Patient has no symptoms, but is extremely bradycardic - what is the most likely diagnosis and underlying cause

Answer 32

3rd degree / complete heart block; sino-atrial disease

Question 33

What are the risk factors for macular degeneration?

Answer 33

Smoking / Family History / Cardiovascular Disease or Hypertension / Obesity / Poor Diet / increased age

Question 34

Anti VEGF role in wet macular degeneration

Answer 34

Prevents neovascularisation

Question 35

Which type of visual loss is associated with temporal arteritis?

Answer 35

anterior ischaemic optic neuropathy

Question 36

What is the presentation of anterior ischaemic optic neuropathy (temporal arteritis) on examination

Answer 36

shows a swollen pale disc and blurred margins (secondary to optic nerve ischaemia)

Question 37

Treatment of anterior ischaemic optic neuropathy

Answer 37

Urgent IV steroids

Question 38

Which ophthalmological condition presents with choroidal neovascularisation

Answer 38

Wet macular degeneration

Question 39

What happens to pupil size in anterior uveitis?

Answer 39

Constricted

Question 40

Treatment for anterior uveitis / iritis

Answer 40

steroid + cycloplegic (mydriatic) drops

Question 41

Which visual problem is a RF for retinal detachment?

Answer 41

Myopia (nearsightedness)

Question 42

Differentiate between wet and dry ARMD and why is one worse than the other?

Answer 42

In wet ARMD there is retinal neovascularisation from the choroid Which leak and cause oedema and faster vision loss than dry

Question 43

Ophthalmological signs of shaken baby

Answer 43

Retinal haemorrhages

Question 44

Pathophysiology of acute angle closure glaucoma

Answer 44

The iris bulges forward and seals off the trabecular meshwork from the anterior chamber This prevents aqueous humour from draining Increasing the ocular pressure Which further exacerbates the angle closure, and places pressure on the optic nerve

Question 45

Why is timolol used in acute angle closure glaucoma?

Answer 45

Reduce production of aqueous humour

Question 46

Definitive management of acute angle closure glaucoma?

Answer 46

Laser iridotomy

Question 47

What investigation is recommended for corneal injury?

Answer 47

Fluorescein staining