Opthalmology

Question 1

Argyll Robertson Pupil

and what they are associated with

Answer 1

The pupils are small, irregular, NON-reactive to light and constrict when focussed on a near object

“accommodate but don’t react”

-associated with syphilis

also, diabetes, midbrain lesions: sarcoidosis, encephalitis, Parinaud syndrome

Question 2

Absent red reflex and lens may look like cracked ice

Answer 2

Cataract

Question 3

Findings of senile macular degeneration

Answer 3

Drusen (characteristic yellow deposits) in macula

Exudative changes resulting from blood and fluid under macula

Question 4

Stage 1 HT retinopathy

Answer 4

Arteriolar narrowing and tortuosity

Question 5

Stage II HT retinopthy

Answer 5

AV nicking, silver wiring

Question 6

Stage III HT retinopathy

Answer 6

dot, blot and flame haemorrhages
Cotton wool spots (soft exudates)
Hard exudates
Microanuerysms

Question 7

Stage IV HT retinopathy

Answer 7

Papillodema

Question 8

Background diabetic retinopathy

Answer 8

Microaneurysms, macular oedema, hard exudates, haemorrhages

Question 9

Pre-proliferative diabetic retinopathy

Answer 9

Cotton wool spots, venous beading

Question 10

Proliferative diabetic retinopathy

Answer 10

Neovascularisation, vitreous haemorrhage

Question 11

Glaucoma findings

Answer 11

Increased cup to disc ration (>0.5)

Haemorrhages

Question 12

Central retinal artery occlusion

Answer 12

Pale retina with swelling or oedema

Cherry red spot

Question 13

Central retinal vein occlusion

Answer 13

Widespread haemorrhage throughout the retina with swelling and oedema

“stormy sunset”

Question 14

Papilloedema

Answer 14

Blurring of disc margins, cupping and swelling of the disc, haemorrhages, exudates, distended veins

Question 15

Cataract

Answer 15

Absent red reflex

Lens may look like cracked ice

Question 16

Marcus Gunn pupil

Answer 16

Intermittent pupil constriction (when you are doing the swinging light test)

Suggests a lesion in the optic nerve ANTERIOR to the optic chiasm