Ophthalmology

Question 1

features of optic neuritis?

Answer 1

unilateral dec in visual acuity over hours or days
poor colour discrimination - red desat
pain worse on eye movt
relative afferent pupillary defect
central scotoma

Question 2

contact lens wearer presents with red painful eye?

Answer 2

could be microbial keratitis -> same day ophth referral

Question 3

sudden onset visual loss, red hue in vision and floaters or shadows in vision?

Answer 3

vitreous haemorrhage

Question 4

features of dry ARMD?

Answer 4

characterised by drusen - yellow round spots in Bruch’s membrane
gradual reduction in visual acuity
difficulties in dark adaptation

Question 5

features of wet ARMD?

Answer 5

same as dry but subacute reduction in visual acuity

Question 6

testing for ARMD?

Answer 6

amsler grid testing
fundoscopy - drusen
slit lamp microscopy

Question 7

features of central retinal artery occlusion?

Answer 7

visual loss
RAPD
‘red spot’ on pale retina

Question 8

features of anterior uveitis?

Answer 8

acute onset
ocular discomfort and pain
pupil small/irregular
photophobia
blurred vision
red eye
lacrimation
ciliary flush
hypopyon

Question 9

mgt of anterior uveitis?

Answer 9

urgent ophth review
steroid eye drops
cycloplegics eg atropine, cyclopentolate

Question 10

conditions associated with anterior uveitis?

Answer 10

ankylosing spondylitis
reactive arthritis
UC/crohns
behcet’s disease
sarcoidosis

Question 11

complication of panretinal photocoagulation (for diabetic retinopathy)?

Answer 11

decrease in night vision

Question 12

management for stye?

Answer 12

hot compresses
analgesia

Question 13

grade 1 HTN retinopathy?

Answer 13

arteriolar narrowing and tortuosity

Question 14

grade 2 HTN retinopathy?

Answer 14

arteriovenous nipping

Question 15

grade 3 HTN retinopathy?

Answer 15

cotton wool exudates
flame and blot haemorrhages

Question 16

grade 4 HTN retinopathy?

Answer 16

papilloedema

Question 17

features of proliferative diabetic retinopathy?

Answer 17

retinal neovascularisation - may lead to vitreous haemorrhage
fibrous tissue forming anterior to retinal disc
more common in T1DM

Question 18

features of horners syndrome?

Answer 18

miosis (small pupil)
ptosis
enophthalmos (sunken eye)
anhidrosis

Question 19

features of blepharitis?

Answer 19

bilateral sx
grittiness and discomfort
sticky eyes in morning

Question 20

mgt for blepharitis?

Answer 20

hot compresses
lid hygiene

Question 21

features of acute angle-closure glaucoma?

Answer 21

severe pain
dec visual acuity
hard red eye
haloes around lights
semi dilated non reacting pupil
corneal oedema
systemic upset
inc IOP

Question 22

management of acute angle closure glaucoma

Answer 22

initial: pilocarpine, BB, alpha 2 agonist
IV acetazolamide
definitive: laser peripheral iridotomy

Question 23

new onset floaters?

Answer 23

urgent ref to ophth ?retinal detachment

Question 24

first line diagnostic ix for MS?

Answer 24

MRI brain
then LP

Question 25

features of cataracts?

Answer 25

reduced vision faded colour vision glare halos around lights

Question 26

what characterises wet mac degen?

Answer 26

choroidal neovascularisation

Question 27

features of open angle glaucoma?

Answer 27

peripheral visual field loss dec visual acuity optic disc cupping

Question 28

side effect of prostaglandin analogues?

Answer 28

prostaglandins make your eyes pretty and pigmented -> inc eyelash length -> iris pigmentation -> periocular pigmentation

Question 29

features of orbital cellulitis?

Answer 29

Redness and swelling around the eye Severe ocular pain Visual disturbance Proptosis Ophthalmoplegia/pain with eye movements Eyelid oedema and ptosis Drowsiness +/- Nausea/vomiting in meningeal involvement (Rare)

Question 30

mgt of orbital cellulitis?

Answer 30

admission for IV abx

Question 31

key ix for diagnosis of acute angle closure glaucoma?

Answer 31

1. tonometry 2. gonioscopy

Question 32

periorbital vs orbital cellulitis?

Answer 32

periorbital - no visual impairment, diplopia or painful movements

Question 33

risk factors for retinal detachment?

Answer 33

DM myopia (near sightedness) age prev surgery for cataracts eye trauma

Question 34

recommended imaging for optic neuritis?

Answer 34

MRI brain and orbits with contrast