Opthal 2

Question 1

episcleritis sx

Answer 1

patch of redness or diffuse redness on sclera

no pain

Question 2

how to differentiate between scleritis and episcleritis

Answer 2

phenylphrine eye drops
they cause blanching of episcleral vessels

Question 3

what systemic conditions are associated with scleritis

Answer 3

rheumatoid arthritis
granulomatosis with polyangiitis

Question 4

scleritis mx

Answer 4

urgent referral to specialist

nsaids, steroids, immunosupression may be used

Question 5

what organism are corneal abrasions associated with contact lenses

Answer 5

pseudomonas

Question 6

what is used to diagnose corneal abraisons and what happens

Answer 6

fluorescein stain
yellow/orange colour collects at the abraison

Question 7

corneal abraison mx

Answer 7

usually heal by themselves in 2-3 days if mild

may involve lubricating eye drops, analgesia, removing foreign bodies etc

Question 8

what is keratitis

Answer 8

inflammation of the cornea

Question 9

what organism causes keratitis most commonly

Answer 9

herpes simplex virus

Question 10

how is herpes keratitis diagnosed

Answer 10

fluorescein staining shows a dendritic ulcer on slit lamp examination

Question 11

herpes keratitis mx

Answer 11

urgent opthal referral

topical or oral antivirals

corneal transplant may be needed for permanent scarring/vision loss

Question 12

subconjunctival haemorrhage sx

Answer 12

patch of bright red blood covering white of eye

painless, vision not affected

Question 13

subconjunctival haemorrhage mx

Answer 13

self resolving

Question 14

posterior vitreous detachment sx

Answer 14

flashes
floaters
blurred vision

Question 15

posterior vitreous detachment mx

Answer 15

self resolving

refer to rule out retinal detachment or tear

Question 16

retinal detachment sx

Answer 16

peripheral vision loss- painless, sudden, like a curtain coming down across the vision
blurred vision
flashes/ floaters

Question 17

retinal detachment mx

Answer 17

its sight threatening so immediate review needed

vitrectomy
scleral buckling
pneumatic retinopexy

Question 18

retinal vein occlusion sx

Answer 18

painless blurred vision
vision loss

Question 19

what is seen on fundoscopy in retinal vein occlusion

Answer 19

dilated retinal veins
flame and blot haemorrhages
retinal oedema
cotton wool spots
hard exudates

Question 20

retinal vein occlusion mx

Answer 20

refer to opthal immediately

mx is aimed at lowering macular oedema to prevent neovascularisation with anti VEGF, dexamethasone, laser photocoagulation

Question 21

what causes central retinal artery occulsion

Answer 21

atherosclerosis mainly
can be due to GCA

Question 22

central retinal artery occulsion sx

Answer 22

sudden painless vision loss- like a curtain coming down

relative afferent pupillary defect

Question 23

what is amaurosis fugax

Answer 23

a temporary loss of vision caused by interruption to blood supply

Question 24

central retinal artery occlusion mx

Answer 24

urgent referral to opthalmology

if GCA give steroids

otherwise management is aimed at dilating the artery and reducing intraocular pressure

Question 25

what is retinitis pigmentosa

Answer 25

a genetic condition where there is degeneration of photoreceptors in the retina especially rods

Question 26

retinitis pigmentosa sx

Answer 26

night blindness peripheral vision loss

Question 27

what does retinitis pigmentosa look like on fundoscopy

Answer 27

pigmentation of the retina- looks black and spiky around the peripheries