Ophthamology Review

Question 1

What should a primary care provider do for a presumed retinal detachment?

Answer 1

Refer & position patient with head down.

Question 2

In what age range do you expect to most commonly find amaurosis fugax?

Answer 2

Patients older than fifty.

Question 3

What is the #1 cause of retinal artery occlusion?

Answer 3

Carotid atherosclerotic disease.

Question 4

When treating herpes keratitis should you use topical antiviral, topical steroid or both?

Answer 4

Don’t use steroids. Topical antiviral and refer!

Question 5

A patient describes his vision loss as a curtain coming down and then going back up. What might the diagnosis be?

Answer 5

Amaurosis fugax

Question 6

A patient presents with a painful, red nodule on the eyelid. What diagnosis should you be thinking of? What treatment should you begin with?

Answer 6

Hordeolum (sty). Warm compress and progress to topical abx if necessary.

Question 7

A fundal exam shows a cherry red spot. What diagnosis should you be thinking of?

Answer 7

Central retinal artery occlusion

Question 8

A college student presents with a little purulent drainage from one eye and nontender preauricular lymphadenopathy. What diagnosis and pathogen should you be thinking of?

Answer 8

Chlamydia conjunctivitis

Question 9

What should a primary care provider do for presumed central retinal artery occlusion?

Answer 9

Ophthalmic emergency! Refer and intermittent pressure and release of the eye.

Question 10

A patient presents with unilateral blurriness developing over a few days. Fundal exam shows a “blood and thunder” pattern. What is the most likely diagnosis?

Answer 10

Central vein occlusion

Question 11

What is appropriate treatment for central vein occlusion?

Answer 11

Typically self limited. Treat underlying disease.

Question 12

Is glaucoma more prevalent in males or females?

Answer 12

Females 3:1

Question 13

Give two risk factors for glaucoma.

Answer 13

African American descent and diabetes

Question 14

What is the yellow, brown fleshy mass on the conjunctiva which usually does not interfere with vision?

Answer 14

Pinguecula

Question 15

A fundal exam shows a cup to disc ratio of >0.5. There are also vessels bending over the disc. What is the most likely diagnosis?

Answer 15

Glaucoma

Question 16

A patient presents saying that he doesn’t seem to need his glasses anymore after 30 yrs. What is the most likely diagnosis?

Answer 16

Cataract

Question 17

A patient has metamorphopsia and a central blind spot. What is the most likely diagnosis?

Answer 17

Macular degeneration

Question 18

What is the most likely quadrant for a retinal detachment?

Answer 18

Superior temporal

Question 19

A patient presents with pain in one eye. The cornea is hazy and the pupils are fixed. What is the most likely diagnosis?

Answer 19

Glaucoma

Question 20

What is the most common way of testing for metamorphopsia?

Answer 20

Amsler grid

Question 21

You notice drusen deposits on fundal exam. What is the most likely diagnosis?

Answer 21

Macular degeneration

Question 22

A patient presents with irritated, burning and tearing eyes. You notice some scurf and scales. Where do you begin treatment?

Answer 22

This is blepharitis. Treatment begins with good hygiene and moves on to topical antibiotics if necessary.

Question 23

A patient has a history of multiple stys. He now has a painless nodule on his eyelid and minor conjunctivitis. What is the most likely diagnosis?

Answer 23

Chalazion

Question 24

What are the most common colors lost in color blindness?

Answer 24

Red and green

Question 25

What is the term for eyelids that turn in?

Answer 25

Entropion

Question 26

What is the term for bilateral yellow plaques near the eyes?

Answer 26

Xanthelasma

Question 27

A fundal exam shows an opalescent retina and boxcarring of arterioles. What is the most likely diagnosis?

Answer 27

Central retinal artery occlusion.

Question 28

What is the most common preceding event for orbital cellulitis?

Answer 28

URI

Question 29

Vision loss described as curtain coming down should make you think of what diagnosis?

Answer 29

Retinal detachment

Question 30

You notice a bowing of the iris on exam. What is the most likely diagnosis?

Answer 30

Glaucoma

Question 31

A CT scan of the head shows broad infiltration of orbital fat. What is the most likely diagnosis?

Answer 31

Orbital cellulitis

Question 32

A patient presents with watery bilateral discharge from the eyes and nontender preauricular adenopathy. What is the most likely diagnosis? What is the most common pathogen?

Answer 32

Viral conjunctivitis. Adenovirus.

Question 33

How do you test for color blindness?

Answer 33

Ishihara plates

Question 34

A patient with a history of asthma presents complaining of stringy discharge from both eyes and severe swelling around the eyes. What is the most likely diagnosis?

Answer 34

Allergic conjunctivitis

Question 35

What is the name for the the triangular or wedge shaped growth on the conjunctiva that may interfere with vision?

Answer 35

Pterygium

Question 36

What is the name of the test for dry eyes?

Answer 36

Schirmer's test

Question 37

A patient having recently undergone cataract surgery presents complaining of vision loss in the operative eye. What is the most likely diagnosis?

Answer 37

Retinal detachment

Question 38

A patient presents with sudden painless complete unilateral vision loss. What is the most likely diagnosis?

Answer 38

Central retinal artery occlusion

Question 39

A dendritic lesion is seen with fluorescein stain. What is the most likely diagnosis?

Answer 39

Herpes keratitis

Question 40

Which nerve is involved in herpes zoster ophthalmicus?

Answer 40

Trigeminal nerve, CN 5

Question 41

Your attending asks you to come and see an excellent example of Hutchinson's sign. What diagnosis does the patient have?

Answer 41

Herpes zoster ophthalmicus

Question 42

A patient presents with a dense corneal infiltrate and an epithelial defect seen with fluorescein stain. What diagnosis should you be thinking of?

Answer 42

Corneal ulcer

Question 43

A feathery border in an eye exam should make you think of what diagnosis?

Answer 43

Fungal infection

Question 44

A patient in the recovery room following foot surgery is complaining of severe photophobia. She feels as though there is something in her eye. What is the most likely diagnosis?

Answer 44

Corneal abrasion (pt's scratch their eyes before they are completely awake from anesthesia).

Question 45

What is the treatment for subconjunctival hemorrhage?

Answer 45

Reassurance

Question 46

A 19 year old male took an elbow to the face while playing basketball this morning. The whole left side of his face is swollen and he can't look up. What is the most likely diagnosis?

Answer 46

Orbital fracture

Question 47

A patient complains of seeing halos and rainbows around lights. She also complains of moderate photophobia? What is the most likely diagnosis?

Answer 47

Glaucoma

Question 48

What is the first thing you should be thinking of if a pediatric patient comes in with blood in the anterior chamber of the eye (hyphema).

Answer 48

Child abuse until proven otherwise.

Question 49

How long after a radiant energy burn do symptoms typically show?

Answer 49

6-12 hours

Question 50

What is the term for eyelids that turn out?

Answer 50

Ectropion

Question 51

What is the initial treatment for a chemical burn to the eyes.

Answer 51

Irrigate, irrigate, irrigate

Question 52

Colorblindness is transmitted through what genetic pattern?

Answer 52

Dominant X linked

Question 53

What is the term for being nearsighted? What type of lens do you use to correct it?

Answer 53

Myopia, concave lenses

Question 54

A college student presents with copious purulent drainage from one eye. What is the most likely diagnosis?

Answer 54

Neisseria conjunctivitis

Question 55

What is the first line treatment for orbital cellulitis?

Answer 55

IV antibiotics, followed by 2 weeks of oral antibiotics.

Question 56

What is the term for being farsighted? What type of lens do you use to correct it?

Answer 56

Hyperopia, convex

Question 57

What is tonometry used for?

Answer 57

Determining intraocular pressure.