optho

Question 1

What is the most common cause of uveitis?

Answer 1

Uveitis is most commonly idiopathic.

When it is recurrent or bilateral, it should raise suspicion for rheumatologic diseases.

Question 2

What type of beta blocker is Timolol?

Answer 2

Timolol is a nonselective beta blocker used to treat glaucoma.

Question 3

What are the main side effects of Timolol?

Answer 3

The main side effects are hypotension and bradycardia.

Question 4

What should be suspected in a patient with subacute to chronic vision loss and a pale optic nerve?

Answer 4

Optic atrophy should be suspected

Question 5

What are the symptoms of corneal ulcer?

Answer 5

Purulent discharge, pain, and decreased vision in a contact lens wearer.

Question 6

What is the likely diagnosis for purulent discharge, pain, and decreased vision in a contact lens wearer?

Answer 6

Likely diagnosis: Corneal ulcer.

Question 7

What is the infectious agent likely causing mild conjunctivitis and pain with urination?

Answer 7

Infectious agent is likely Chlamydia.

Question 8

What are injected scleral vessels a sign of?

Answer 8

Injected scleral vessels are a sign of scleritis.

Question 9

What is included in the treatment for acute angle closure glaucoma?

Answer 9

Beta blockers, acetazolamide, and steroids.

Question 10

Is blurry vision an early complaint of glaucoma?

Answer 10

Blurry vision is not an early complaint of glaucoma; peripheral vision loss is.

Question 11

What is the likely diagnosis for an old man with painless vision loss and a history of hypertension and uncontrolled diabetes?

Answer 11

Likely diagnosis: Central Retinal Vein Occlusion (CRVO).

Question 12

What does an image of diffuse retinal hemorrhage with dilated tortuous veins indicate?

Answer 12

It indicates Central Retinal Vein Occlusion (CRVO).

Question 13

What are flashes and floaters signs of?

Answer 13

Flashes and floaters are signs of posterior vitreous detachment.

Question 14

Are steroids used for corneal abrasion usuall?

Answer 14

No

Question 15

What should be done after diagnosing a corneal ulcer?

Answer 15

The ulcer should be cultured, and broad-spectrum antibiotic eye drops should be started.

Question 16

What are the symptoms of a corneal ulcer?

Answer 16

Eye pain, decreased vision, white spot on cornea, and hypopyon.

Question 17

What are the risk factors for corneal ulcer?

Answer 17

Risk factors include advanced age, incomplete lid closure, and excessive air exposure.

Question 18

What type of vision shift do cataracts often cause?

Answer 18

Cataracts often cause a myopic shift in vision.

Question 19

What class of drugs is the first line treatment for diabetic retinopathy?

Answer 19

Anti-VEGF inhibitors such as intravitreal ranibizumab and aflibercept.

Question 20

What is the likely diagnosis for an older patient with difficulties in near vision tasks that do not resolve with bifocal lenses?

Answer 20

Likely diagnosis: Age-related macular degeneration.

Question 21

What is the most likely diagnosis in a young woman with decreased visual acuity and a clear cornea?

Answer 21

Likely diagnosis: Uveitis.

Question 22

What is the infectious agent most commonly associated with viral conjunctivitis?

Answer 22

Most common cause of viral conjunctivitis: adenovirus.

Question 23

What is a classic sign of viral conjunctivitis?

Answer 23

Preauricular lymphadenopathy.

Question 24

What is the typical first line therapy for open angle glaucoma?

Answer 24

Prostaglandin analog class of drugs such as latanoprost.

Question 25

What is the most common origin of uveitis?

Answer 25

Idiopathic.

Question 26

What should be suspected in a patient with sudden severe eye pain, vomiting, and a mid-dilated pupil?

Answer 26

Likely diagnosis: Acute angle closure glaucoma.

Question 27

What is the treatment for acute angle closure glaucoma?

Answer 27

Beta blockers, acetazolamide, and steroids.

Question 28

What is the management for corneal ulcers?

Answer 28

Typically managed with topical antimicrobials and cycloplegics for pain management.

Question 29

What is the likely diagnosis for a subacute, non-tender eyelid mass from an obstructed meibomian gland?

Answer 29

Likely diagnosis: Chalazion.

Question 30

What are the symptoms of retinal detachment?

Answer 30

New floaters, flashing lights, followed by a curtain or shadow over part of the vision.

Question 31

What must be evaluated in a patient presenting with an orbital fracture?

Answer 31

Extraocular muscle function must be evaluated.

Question 32

What is the likely diagnosis for unilateral vision loss, pain with EOM, and a relative afferent pupillary defect?

Answer 32

Likely diagnosis: Optic Neuritis.

Question 33

What is the treatment for a corneal abrasion from a fingernail or contact lens?

Answer 33

Treatment includes antibiotics with pseudomonas coverage, such as fluoroquinolones.

Question 34

What is the next step for a young patient with subacute to chronic vision loss and signs of optic atrophy?

Answer 34

Next step is MRI of brain and orbit to rule out compressive lesions.

Question 35

What are the symptoms of orbital cellulitis?

Answer 35

Pain with EOM, proptosis, diplopia, and constitutional signs.

Question 36

What is the likely diagnosis for redness, crusting, itching, burning, and tearing of the eyelid margin?

Answer 36

Likely diagnosis: Blepharitis.

Question 37

What is the classic sign of herpes zoster ophthalmicus on the cornea?

Answer 37

Pseudodendrites on the cornea.

Question 38

What is the next step for a patient with pre-septal cellulitis and systemic symptoms?

Answer 38

Next step: Admit for IV antibiotics.

Question 39

What are signs of the oculocardiac reflex?

Answer 39

Symptoms of nausea, vomiting, and bradycardia.

Question 40

What is the diagnosis for a patient with red, painful, photophobic, and miotic eye 2-3 days post trauma?

Answer 40

Likely diagnosis: Post traumatic iritis.

Question 41

Is the cornea typically clear without infiltrates in corneal abrasion?

Answer 41

Yes, the cornea is typically clear without infiltrates.

Question 42

What may be seen in corneal ulceration?

Answer 42

Hypopyon and a white spot on the cornea.

Question 43

What is the difference between internal hordeolum and chalazion?

Answer 43

Internal hordeolum is an acute, tender purulent inflammation, while chalazion is typically nontender and non-purulent.

Question 44

What is the treatment for anterior uveitis?

Answer 44

Steroids and cycloplegics.

Question 45

What condition describes clear vision for close objects but not for far ones?

Answer 45

Myopia.

Question 46

What are the symptoms of scleritis?

Answer 46

Severe eye pain, deep injection, bluish hue to sclera, and no change in redness upon application of 2.5% phenylephrine.

Question 47

What is the likely diagnosis for a young woman with decreased visual acuity and a clear cornea?

Answer 47

Likely diagnosis: Uveitis.

Question 48

What is the significance of the presence of rash alongside the nose in herpes zoster?

Answer 48

It is called Hutchinson sign and is a predictor of ocular involvement.

Question 49

What is the diagnosis for itching, burning, and foreign body sensation in the eye with repeated chalazion?

Answer 49

Likely diagnosis: Blepharitis.

Question 50

Is optic neuritis commonly associated with a pale optic nerve upon examination?

Answer 50

No, optic atrophy will commonly have a pale optic nerve.

Question 51

Is vitreous detachment a normal part of the aging process?

Answer 51

Yes, vitreous detachment is a normal part of the aging process.

Question 52

What is acute angle-closure glaucoma associated with?

Answer 52

Severe pain or photophobia and a hazy cornea.

Question 53

What are common symptoms of acute angle-closure glaucoma?

Answer 53

Severe pain, photophobia, hazy cornea, fixed mid-dilated pupil, and elevated intraocular pressure.

Question 54

What is the likely diagnosis for a patient presenting with decreased visual acuity, eye pain, clear cornea, miotic pupil, and photophobia?

Answer 54

Uveitis

Question 55

What makes conjunctivitis unlikely?

Answer 55

Conjunctivitis is unlikely if tearing or mucus discharge are not present.

Question 56

What is the likely diagnosis for a patient with recurrent uveitis and lacrimal gland enlargement?

Answer 56

Sarcoidosis

Question 57

What is the definitive diagnostic procedure for lacrimal gland enlargement?

Answer 57

Lacrimal gland biopsy. Chest CT or CXR is also indicated to detect hilar lymphadenopathy.

Question 58

What is the likely diagnosis for a large spot on the sclera that developed after sneezing with no other symptoms?

Answer 58

Subconjunctival hemorrhage

Question 59

What are the first-line treatments for diabetic retinopathy?

Answer 59

Intravitreal ranibizumab and aflibercept, both are anti-VEGF inhibitors.

Question 60

What is commonly associated with blepharitis?

Answer 60

Staph aureus bacteria and demodex infestation when chronic.

Question 61

What is the most appropriate initial step in any ocular chemical injury?

Answer 61

Irrigation of the eye with saline, even if the patient previously washed his eye with soap and water.

Question 62

What is the goal of irrigation in ocular chemical injuries?

Answer 62

To irrigate until the pH normalizes, typically 1 to 10 liters.

Question 63

What is the first step in the workup of unilateral optic neuritis?

Answer 63

MRI of the brain and orbits to rule out potential multiple sclerosis.

Question 64

What is the likely diagnosis for an older patient with problems with glare and decreasing visual acuity?

Answer 64

Cataracts, which typically begin to develop around age 50 but become significant around age 60 to 70.

Question 65

What are common characteristics of anterior uveitis?

Answer 65

Extreme photophobia, eye pain, injection, decreased vision, and may see cells floating in the anterior chamber on slit lamp.

Question 66

How does blepharitis typically present?

Answer 66

Usually affects both eyes and is typically chronic.

Question 67

What is the likely diagnosis for painless vision loss with retinal whitening and a cherry red spot?

Answer 67

Central retinal artery occlusion (CRAO), unlikely to see hemorrhage unlike in central retinal vein occlusion (CRVO).