Opthalmology

Question 1

Features of viral conjunctivitis

Answer 1

Bilateral
Watery discharge
Easy to spread
Normal vision
Itchy
Preauricular adenopathy
No Rx

Question 2

Features of bacterial conjunctivitis

Answer 2

Unilateral
Purulent, thick discharge
Hard to spread
Normal vision
Not itchy
No adenopathy
Rx w/ topic ABX

Question 3

Features of subconjunctival hemorrhage

Answer 3

Doesn’t affect sight

Spontaneously resolves

Question 4

Features of Uveitis

Answer 4

Caused by autoimmune diseases
Photophobia
Dx - Slit lamp exam
Rx - Topical steroids

Question 5

Quick features of Glaucoma

Answer 5

Presents w/ pain
Fixed midpoint pupil
Dx - Tonometry
Rx - Acetazolamide, mannitol, pilocarpine, laser trabeculoplasty

Question 6

Features of ocular trauma

Answer 6

Feels like sand in the eyes
Dx - Fluorescein stain
Rx - None

Question 7

Presentation of chronic glaucoma

Answer 7

Asymptomatic, found on routine screening

Question 8

Confirmation of chronic glaucoma

Answer 8

Tonometry

Question 9

Rx chronic glaucoma

Answer 9

Prostaglandin analogs
Topical BBs
Topical carbonic anhydrase inhibitors
Alpha-2 agonists
Pilocarpine
Laser trabeculoplasty (medicine fails)

Question 10

Presentation of acute angle closure glaucoma

Answer 10

Sudden onset extremely painful red eye hard on palpation
Pain precipitated by going from light to dark
Pupil doesn’t react to light
Cup to disc ratio > 0.3

Question 11

Dx acute angle closure glaucoma

Answer 11

Tonometry

Question 12

Rx acute angle closure glaucoma

Answer 12

IV acetazolamide
IV mannitol
Pilocarpine, BBs, Apraclonidine to constrict pupil
Laser iridotomy

Question 13

Feature of herpes keratitis

Answer 13

Infection of cornea

Red, swollen and PAINFUL

Question 14

Confirm herpes keratitis

Answer 14

Fluorescein staining showing dendritic pattern

Question 15

What to NEVER give in herpes keratitis

Answer 15

Steroids

Makes it worse

Question 16

Rx herpes keratitis

Answer 16

Oral acyclovir, famcyclovir, valacyclovir
Topical trifluridine, idoxuridine
Resistant - Foscarnet

Question 17

Causes of cataracts

Answer 17

Old age
Light
Trauma

Question 18

Dx early cataracts

Answer 18

Opthalmoscope

Slit lamp

Question 19

Rx cataracts

Answer 19

Surgical lens removal and replacement

No medical therapy

Question 20

What causes diabetic retinopathy

Answer 20

Endothelial lining is damaged by glucose precipitation

Question 21

How often should diabetic retinopathy be screened for

Answer 21

Annually

Question 22

Management of nonproliferative diabetic retinopathy

Answer 22

Tighter glucose control

Question 23

Most accurate test for diabetic retinopathy

Answer 23

Fluorescein angiography

Question 24

Rx proliferative diabetic retinopathy

Answer 24

Laser photocoagulation

Question 25

Control neovascularization in diabetic retinopathy

Answer 25

VEGF inhibitor injection

Question 26

What causes "dot and blot" hemorrhages

Answer 26

Back pressure from obstructed vessel leads to vascular aneurysms that eventually rupture

Question 27

Role of vitrectomy in diabetic retinopathy

Answer 27

Remove vitreal hemorrhage obstructing vision

Question 28

What is % retinopathy associated with

Answer 28

Amount of glucose/A1c

Question 29

What is useless to give with neovascularization in diabetic retinopathy

Answer 29

Aspirin

Question 30

Retinal artery occlusion appearance on opthalmoscope

Answer 30

Pale retina, dark macula ("cherry red")

Question 31

Retinal vein occlusion appearance on opthalmoscope

Answer 31

Extravazation of blood

Question 32

Rx retinal artery or vein occlusion

Answer 32

100% O2, ocular massage, acetazolamide, anterior chamber paracentesis, thrombolytics Ranibizumab for vein occlusion Nothing is conclusive

Question 33

Feature of retinal artery or vein occlusion

Answer 33

Sudden onset monocular vision loss

Question 34

Risks for retinal detachment

Answer 34

Anything stretching the retina - Trauma (including surgery for cataracts) - Extreme myopia - Diabetic retinopathy

Question 35

Presentation of retinal detachment

Answer 35

Sudden onset PAINLESS, UNILATERAL vision loss | "Curtain coming down"

Question 36

Rx retinal detachment

Answer 36

Reattach - Surgery - Laser - Cryotherapy - Inject expansile gas

Question 37

MCC blindness in older people in USA

Answer 37

Macular degeneration

Question 38

Types of macular degeneration

Answer 38

Atopic (dry) | Neovascular (wet)

Question 39

Features of macular degeneration

Answer 39

Older pts Bilateral Normal external eye appearance Loss of CENTRAL vision

Question 40

Which type of macular degeneration is worse

Answer 40

Neovascular

Question 41

Features of neovascular macular degeneration

Answer 41

Vessels grow between retina and Bruch membrane | 90% of permanent blindness from macular degeneration

Question 42

Best initial therapy of neovascular macular degeneration

Answer 42

VEGF inhibitor injection every 4-8 weeks - Ranibizumab - Bevacizumab - Aflibercept

Question 43

Rx atopic macular degeneration

Answer 43

None

Question 44

Deposits in atopic macular degeneration

Answer 44

Drusen