ophthalmology

Question 1

What is spasmus nutans?

Answer 1

Benign transient disorder with pendular nystagmus, intermittent head tilting and head bobbing

Question 2

What eye problem is common in patients with sturge weber?

Answer 2

Glaucoma

Question 3

What are two important conditions to consider in a newborn with congenital cataracts?

Answer 3

Rubella

Galactosemia

Question 4

How can you rule out pseudostrabismus?

Answer 4

Cover test

Symmetrical light reflex

Question 5

What is the problem with untreated strabismus?

Answer 5

Amblyopia will develop with loss of binocular vision if not detected by age 6

Question 6

What is the appropriate treatment for an external hordeolum?

Answer 6

Aka stye - warm compresses and topical antibiotics (no PO antibiotics needed)

Question 7

at what point would you refer a patient with dacryostenosis to a specialist ?

Answer 7

Is not resolved by 12 months

Question 8

What is the appropriate treatment for a 2 month old with excess tearing of left eye with mucoid discharge and occasional cough and nasal congestion ?

Answer 8

Nasolacrimal duct massage (chlamydial conjunctivitis would be bilateral)

Question 9

What bacterial infection should you consider in a patient from a developing country who presents with high fever and decreased extra-ocular motion with proptosis?

Answer 9

H influenza type B (orbital cellulitis)

Question 10

How would you diagnose and treat and patient with intermittent sharp eye pain with photophobia and excessive tearing?

Answer 10

Fluorescein staining then topical antibiotic (pressure patch no longer recommended treatment)

Question 11

You are presented with a patient with a 4 month hx of painless module on upper eyelid, what is the appropriate treatment?

Answer 11

Consult ophthalmology

Question 12

What should you do for a patient who wears contacts and presents with a red eye?

Answer 12

Referral to ophthalmology

Question 13

What diagnosis presents with unilateral decrease in visual acuity after viral illness and what do you expect to see in funduscopic exam?

Answer 13

Papillitis - engorged & inflamed optic disc

Question 14

What diagnosis presents as an enlarged blind spot with normal visual acuity and loss of arteriovenous pulsations?

Answer 14

Papilledema

Question 15

What diagnosis presents with pallor of the optic disc, narrow arterioles and peripheral retinal pigment deposition? What syndrome can be associated with this finding?

Answer 15

Retinitis pigmentosa - usher syndrome

Question 16

When should jnfants be screened for ROP?

Answer 16

At 31-34 weeks gestational age OR 4-6 weeks after birth (whichever is later)

Question 17

What infants need to be screened for ROP?

Answer 17

Birthweight <1500g or GA <32 wks
Or
Birthweight 1500-2000g plus unstable clinically

Question 18

What is the greatest risk factor for developing ROP ??

Answer 18

Prematurity (gestation <28 weeks) - don’t be tricked into picking oxygen therapy which is a contributing factor but no the primary risk factor

Question 19

What is the term associated with nystagmus in both directions and what is it a sign of?

Answer 19

Pendular nystagmus - sign of multiple sclerosis or spinocerebellar disease