questions

Question 1

pathophysiology of short sightedness

Answer 1

increased axial length of the eye meaning the focal point is anterior to the retina

Question 2

pathophysiology of astigmatism

Answer 2

refractive error which hinders refraction

abnormal curvature of the cornea > resulting in 2 or more focal points which can be anterior or posterior to the retina

Question 3

retinoblastoma

Answer 3

malignant tumour of the retina

caused by mutation on Rb-1 (tumour suppressor gene)

Question 4

presentation of retinoblastoma

Answer 4

leukocoria (white pupil)
deteriorating vision
strabismus (squint)
absent red reflex

Question 5

episcleritis presentation

Answer 5

typically not painful but can be mildly painful 
segmental redness
foreign body sensation
dilated episcleral vessels 
watering of eye 
no discharge

Question 6

management of episcleritis

Answer 6

lubricating of the eye can help with symptoms

simple analgesia, cold compresses

Question 7

scleritis presentation

Answer 7

severe pain 
pain with eye movement 
photophobia 
eye watering 
reduced visual acuity 
abnormal pupil reaction to light 
tenderness to palpation

Question 8

iritis presentation

Answer 8

acute onset pain in eye
photophobia
worsened visual acuity
redness typically circumcorneal

Question 9

keratitis presentation

Answer 9

acute onset pain
redness circumcorneal
worsened visual acuity
with fluorescein staining see uptake of fluorescein under cobalt blue light

Question 10

blepharitis presentation

Answer 10

crusting of both eyelids 
worse first thing in the morning 
redness 
swelling 
itch

Question 11

lesions on the optic tract cause

Answer 11

homonymous hemianopia on the contralateral visual field

Question 12

squamous papilloma

Answer 12

most common benign tumour of the eyelid

typically papillary shape with keratinised surface

Question 13

seborrhoeic keratosis

Answer 13

well demarcated warty plaques

can be removed using cryotherapy, curettage or laser ablation

Question 14

naevus

Answer 14

well demarcated, pigmented lesion may be raised

does not require treatment

Question 15

molloscum contagiosum

Answer 15

small, waxy nodules caused by infection with molloscum virus
no treatment

Question 16

dacryocystitis

Answer 16

cystic lesion caused by blockage of the nasolacrimal gland

topical or oral antibiotics

Question 17

most common cause of central retinal artery occlusion

Answer 17

atherosclerosis

also GCA

Question 18

presentation of CRAO

Answer 18

sudden painless vision loss
relative afferent pupillary defect
pale retina with a cherry red spot

Question 19

management of CRAO

Answer 19

refer to ophthalmologist
ocular massage
lower the intraocular pressure

Question 20

transient CRAO also known as

Answer 20

amaurosis fugax

Question 21

presentation of transient CRAO

Answer 21

transient painless visual loss
like a curtain coming down
lasts 5 mins with full recovery

Question 22

management of transient CRAO

Answer 22

refer to stroke clinic

patient may have AFib

Question 23

CRVO associated with

Answer 23

virchow’s triad

Question 24

pathophysiology of CRVO

Answer 24

blood clot forms in the retinal veins and blocks the drainage of blood from the retina

Question 25

presentation of CRVO

Answer 25

``` sudden vision loss retinal haemorrhages disc swelling and macular swelling flame and blot hamorrhage dilated tortuous veins ```

Question 26

ischaemic optic neuropathy pathophysiology

Answer 26

posterior ciliary arteries become occluded, resulting in infarction of the optic nerve head

Question 27

conditions which may cause optic neuropathy

Answer 27

GCA

Question 28

presentations of ischaemic optic neuropathy

Answer 28

sudden vision loss usually painless swollen optic nerve often have headaches, scalp tenderness, enlarged temporal arteries

Question 29

vitreous haemorrhage

Answer 29

bleeding occurs from abnormal vessels (retinal ischaemia in diabetes) or retinal vein occlusion causes abnormal, fragile vessels to form

Question 30

presentation of vitreous haemorrhage

Answer 30

loss of vision floaters loss of red reflex may see haemorrhage on fundoscopy

Question 31

retinal detachment

Answer 31

retina separates from the choroid underneath | usually due to retinal tear that allows vitreous fluid to get under the retina and fill the space between

Question 32

risk factors for retinal detachement

Answer 32

``` posterior vitreous detachment diabetic retinopathy trauma to the eye retinal malignancy older age family history ```

Question 33

presentation of retinal detachement

Answer 33

painless peripheral vision loss- often sudden blurred or distorted vision flashers and floaters

Question 34

management of retinal detachement

Answer 34

any suspicion of retinal detachment immediate referral to ophthamologist laser therapy cryotherapy

Question 35

wet ARMD

Answer 35

new blood vessels grow under retina- leakage causes build up of fluid/blood and then scarring - key chemical VEGF

Question 36

presentation of wet ARMD

Answer 36

``` rapid central visual loss distortion straight lines appear wavy haemorrhage/exudate neovascularisation ```

Question 37

management of wet ARMD

Answer 37

VEGF inhibitor- ranibizumab | laser coagulation- second line

Question 38

closed angle glaucoma

Answer 38

occurs when iris bulges forward and seals off the trabecular meshwork > aqueous humour cant drain > continual build up of pressure > particularly in posterior chamber

Question 39

presentation of closed angle glaucoma

Answer 39

``` appear generally well severely painful red eye blurred vision halos around light associated headache, nausea and vomiting ```

Question 40

examination of closed angle glaucoma

Answer 40

``` red eye teary hazy cornea decreased visual acuity dilation of affected pupil fixed pupil size firm eyeball ```

Question 41

cataract

Answer 41

lens becomes cloudy and opaque | reduces visual acuitu by reducing the light that enters the eye

Question 42

types of cataract

Answer 42

nuclear | posterior subcapsular

Question 43

presentation of cataract

Answer 43

``` asymmetrical symptoms progressive blurring of vision change of colour of vision- yellow/brown starbursts loss of red reflex ```

Question 44

reduced visual acuity with starbursts around lights

Answer 44

cataract

Question 45

peripheral vision loss with halos around lights

Answer 45

glaucoma

Question 46

central vision loss with crooked or wavy appearance of straight lines

Answer 46

wet ARMD

Question 47

management of cataract

Answer 47

surgery

Question 48

dry ARMD presentation

Answer 48

gradual decline in vision central vision missing drusen- build up of waste products atrophic patch of retina

Question 49

open angle glaucoma presentation

Answer 49

often none cupped disc visual field defects may or may not have high IOP

Question 50

cranial nerve 2 exam includes?

Answer 50

visual acuit pupil exam visual field assessment colour vision

Question 51

acanthamoeba ulcer

Answer 51

central infective ulcer

Question 52

diagnostic test of vestibular schwannoma

Answer 52

MRI