ophthalmology

Question 1

What device measures intraocular pressure?

Answer 1

Goldmann tonometer

Question 2

long-sightedness

Answer 2

Hypermetropia

Question 3

short-sightedness

Answer 3

myopia

Question 4

elderly female, history of haloes around lights presents to A&E in evening with N+V, blurred vision and pain over eye

Answer 4

acute glaucoma

Question 5

fixed and mid-dilated pupil, cloudy iris and lens, reduced visual acuity

Answer 5

acute glaucoma

Question 6

where does aqueous humour drain into in a healthy eye

Answer 6

trabecular meshwork into canal of schlemm

Question 7

tunnel vision (gradual loss of peripheral vision)

Answer 7

open angle glaucoma

Question 8

what is IOP in acute angle closure glaucoma?

Answer 8

> 60mmHg (normal 10-20ish)

Question 9

management of acute angle closure glaucoma

Answer 9

topical BB (timolol) and carbonic anhydrase inhibitors (acetazolamide)- decreases aqueous production
oral glycerin and IV mannitol
pilocarpine (constricts pupil)
laser iridotomy

Question 10

what is presbyopia?

Answer 10

long-sightedness occuring in old age

Question 11

when should you consider cataract surgery?

Answer 11

when the cataract is causing visual acuity of <6/12

Question 12

how to record snellen chart results

Answer 12

Top number = distance at which the test chart was presented (usually 6m), Bottom number identifies the position on the chart of the smallest line read by the ‘patient’. Eg; 6/60 means the subject can only see the top letter when viewed at 6m

Question 13

name 3 RFs for cataracts

Answer 13

age
trauma
UV exposure
smoking
DM
systemic corticosteroids
congenital

Question 14

cataract surgery

Answer 14

phaecoemulsification

Question 15

complications of phaecoemulsification

Answer 15

bleed (choroidal)
endophthalmitis
vitrous loss
opacification of capsule
glaucoma

Question 16

causes of corneal ulceration

Answer 16

bacterial: chlamydia/ pseudomonas
viral: HSV (dendritic)/ HZV
fungal: candida
protozoan: acanthamoeba (contacts)

Question 17

causes of conjunctivitis

Answer 17

bacterial- chlamydia (neonates)/ staph/ strep
viral- adenovirus/ HSV
allergic

Question 18

name topical ABx eyes

Answer 18

chloramphenical/ fusidic acid

Question 19

what dies the uveal tract consist of?

Answer 19

anterior: iris and ciliary body
posterior: choroid

Question 20

photophobia, reduced visual acuity, pain, constricted pupil

Answer 20

anterior uveitis

Question 21

name some causes of anterior uveitis

Answer 21

seronegative arthropathies: ank spond, IBD, psoriatic arthritis
infection: TB, syphilis, HIV, toxoplasmosis
AI: sarcoidosis
malignancy: NHL, leukaemia

Question 22

what is a complication of anterior uveitis?

Answer 22

hypopyon

Question 23

what is Talbot/s test?

Answer 23

pain increases as eyes converge (follow finger to nose) positive in anterior uveitis

Question 24

redness and nodular swelling in 1 quadrant of eye, mild pain

Answer 24

episcleritis, self-limiting 1-2 weeks

Question 25

deep boring pain, wakes patient at night, photophobia, red swelling, reduced visual acuity, systemically unwell

Answer 25

scleritis

Question 26

conditions which may present with scleritis

Answer 26

collagen vascular disorders- RA, ank spond, SLE, wegener's granulomatosus sarcoidosis IBD gout

Question 27

what is a stye?

Answer 27

infection of lash follicle aka hordeolum

Question 28

how is a stye managed?

Answer 28

warm compress and chloramphenicol

Question 29

inflamed lid, crusting, gritty sensation

Answer 29

blepharitis

Question 30

management of blepharitis

Answer 30

chronic condition- baby shampoo and cotton wool treat infections with ABx cream tear replacement

Question 31

what stain can be used to visualise corneal abrasions

Answer 31

fluorescin

Question 32

management of corneal abrasion

Answer 32

analgesia | prevention of secondary infection with topical ABx and tetanus prophylaxis

Question 33

pathophysiology of diaabetic retinopathy

Answer 33

microaneurysms ischaemia of retina AV shunt formation

Question 34

non-proliferative diabetic retinopathy

Answer 34

``` Microaneurysms Dot and blot haemorrhages Cotton wool spots Hard exudates normal vision ```

Question 35

proliferative diabetic retinopathy

Answer 35

Macular oedema- gradual reduction in vision New vessel growth (neovascularisation) Retinal haemorrhage Vitreous haemorrhage- sudden loss of vision

Question 36

black curtain descending in one eye

Answer 36

Amaurosis Fugax

Question 37

how often are retinal photos taken for screening in DM?

Answer 37

5 yrs after diagnosis DM1, immediately DM2, | photos taken every year (every trimester in pregnancy)

Question 38

in what circumstances might treatment be offered for diabetic retinopathy?

Answer 38

macular oedema- focal laser treatment to seal aneurysm | proliferative retinopathy- pan retinal photocoagulation to regress new vessels

Question 39

name some changes that may be present in hypertensive retinopathy but not in diabetic retinopathy

Answer 39

AV nipping sliver wiring papilloedema

Question 40

cherry red spot on fundoscopy

Answer 40

retinal detachment

Question 41

drusen spots on fundoscopy

Answer 41

age related macular degeneration