teach

Question 1

which wall of the bony orbit is most commonly affected by blow-out fracture? - this on the eye

Answer 1

inferior wall

Question 2

what extra ocular muscle elevates the eyeball

Answer 2

inferior oblique

Question 3

which 2 structures form the outer fibrous coat of the eyeball

Answer 3

sclera and cornea

Question 4

which 3 structures make up the uvea( 2nd layer of the eye)

Answer 4

iris, ciliary body , choroid

3 layers
outer fibrous coat - sclera and cornea
uvea next layer made up of iris, ciliary body and choroid
retina

Question 5

cones ( distinguish between different colours) are mainly found in the fovea/macula

Answer 5

true

rods are for not vision and low light Vision

Question 6

in which structure is aqueous humour produced

Answer 6

ciliary body

Question 7

50yr old lady present with very painful red eye, cause and vomit, halos around Leith and blurry vision. she has hazy cornea and visual acuity

Answer 7

acute glaucoma

temporal arthritis - scalp tenderness and proximal muscle weakness

Question 8

treatment for acute angle glaucoma

Answer 8

IV acetazolamid and timolol and apraclonidine and predinsiolve

Question 9

buzz word

fixed mid-dilated pupil

Answer 9

acute angle glaucoma

also blurry vision
red painful eye
N+V and fixed mid-dilated pupil

diagnosed via a slit lamp

Question 10

in acute angle closure glaucoma do you give treatment to both eyes or the affected

Answer 10

both due to the fact they are high risk

Question 11

is hypermetropia(long sited) a rf for acute glaucoma

Answer 11

yes

myopia short sited - does not predispose them to it

Question 12

a man present with 2 weeks of a painless rubbery eyelid lump what is it

stye
chalazion
pterygium
dacrocystitis

Answer 12

chalazion

more likely than a stye

painful Lump would have been a stye

Question 13

a chalazion is granuloma due to blocked meibomian gland. RF include blepharitis and rosacea what are the symptoms and treatment

Answer 13

painless lump which is rubbery

hot compress, usually self resolves in 6 months , curettage is option

Question 14

what is a stye

Answer 14

infection of lash follicle glands by staph

Question 15

RF for stye include acne vulgarisms and DM

what are symptoms and treatment

Answer 15

painful lump in lid margin and swelling
maybe eyelash coming out

hot comrpee, topical antibiotics and eyelid hygiene and eyelash removal

Question 16

68yr old man with several months of itchy sore eyes in the morning

trichiasis
corneal abrasion
blepharitis
entropion

Answer 16

blepharitis - inflamed lash line or lid margin

Question 17

blepharitis is chronic inflammation of eyelid margin with infection or not - flakey

RF are atopic eczema dn seborrhaeic dermatitis

clinical features include

treatment

Answer 17

itchy sore eyes in the morning, crusty/scaly/oily lid margin

eyelid hygien and topical doxycycline if infection

Question 18

is blepharitis is chronic condition

Answer 18

yes

Question 19

35 woman with kitty eyes tremor on outstretched hands and pulse of 110bpm

parkinsons
thyroid eye diseas e
ectropion
bacterial endophthalmitis

Answer 19

thyroid eye disease

Question 20

thyroid eye disease can result from people with graves disease with antibodies against TSH causing orbital inflammation

what are the sytmtposm and treatment

need to check TFTs

Answer 20

exophthalmos( immune response not the thyroid hormones causing this) ( kitty eyes) and lid lag accompanied
tremor and pusle
( symptoms same of hyperthryosidim )

antithyroid medications and surgery

TSH levels not raised in grave

Question 21

6oyr odl man presents following seizure, left parietal mass what visual defect is he most likely to have?

Answer 21

right inferior quadrantopia

Question 22

damage in cranial nerve get

Answer 22

monocular vision loss

Question 23

damage to optic chaism

Answer 23

bitemporal hemianopia

Question 24

damage to optic tract

Answer 24

homonymous hemianopia

Question 25

optic tract meet maternal geniculate uncles. one goes through temporal and one through parietal lobe. temporal lobe is inferior to parietal lobe it takes things form the superior optic radiation and the partial lobe gets it from the inferior optic radiation

Answer 25

visual field defects

Question 26

pituitary tumour classically cause what visual field defect

Answer 26

bitemporal hemianopia

Question 27

60yr old patient with diabetes preens with gradual deterioration of vision and dazzling of view in well lit places

Answer 27

cataracts

Question 28

cataracts is lens opacity, risk facts are age and diabetes and stereo smoking and alto sue and genetics diagnosis's via slit lamp treatment via phaecoemulfificaiton and lens implant symtposm

Answer 28

bilateral painless blurring of vision over years, glare whilst driving at night cataracts does not require urgent surgery

Question 29

RA severe eye pain and dominant blood vessels on either side of eyes

Answer 29

scleritis

Question 30

scleritis is inflammation of the sclera and RF include ocdntions such as RA, GP And polyarteritis ndoosa symptoms are diagnosis are ophthalmology examination and rheumatology review - could be flare

Answer 30

red eye, deep boring pain on the eyes, pain on movement , photophobia and decreased acuity Treatment with high dose seteriods and DMARDS

Question 31

sudden loss of vision in right eye. hypertension , hyperlipidemain and diabetes and carotid bruit on examination

Answer 31

central retinal artery occlusions pale retina with cherry red spot - stroke int eh artery

Question 32

central retinal artery occlusion is stroke of central retinal artery RF including CVD and stroke and carotid disease symptoms are

Answer 32

sudden painless monocular severe visual loss and pale retina dn cherry red spot. treatment is excluded giant cell arteritis ( temporal arteritis - check CRP or ESR) , stroke work up and according to local protocols easily treateded with steroids

Question 33

which is typical appearance of a retina with CRAO

Answer 33

pale retina with cherry red spot

Question 34

CMV retinitis

Answer 34

pizza-pie appearance

Question 35

retinitis pigmentosa

Answer 35

bone spicule pigmentation

Question 36

central retinal vein occlusion

Answer 36

stormy sunset appearance exactly same symptoms as arteries

Question 37

60 yr old man if refereed to you by opticiity after fundoscopy shown eye with big bright spot

Answer 37

(chronic) glaucoma

Question 38

chronic glaucoma is progressive characteristic of optic nerve damage and visual field losss. RF is age , raised intracoular pressure , black African and high myopia symtposm are diagnose is slit lamp exam ( CDR>1/3, gonioscopy , perimetry and tonometry treatment is

Answer 38

none until late acute scotoma peripheral VL spot needs to be bigger than 1/3 topical latanoprost and trabeculoplasty, trabeculectomy advanced cases tunnel vision only can see through there macula

Question 39

myopia is a risk factor for chronic glaucoma

Answer 39

yes but not for acute angle closure glaucoma

Question 40

10 yr old male with right eye difficult to open after sleep, diffuse conjunctival injection and significant mucopuruletn discharge

Answer 40

bacterial conjunctivitis red/pink eye and itchy if allergic , one purulent if bacterial treatment for bacterial is chloramphenicol if docent resolve allergic avoid allergen and antihistamines viral self resolves

Question 41

what is visual acuity

Answer 41

Visual acuity (VA) is a measure of the ability of the eye to distinguish shapes and the details of objects at a given distance.

Question 42

on routine review of diabetic man has this eye cataract diabetic retinopathy age related macular degneraton or glaucoma

Answer 42

diabetic retinopathy

Question 43

diabetic retinopathy one of the microvasuclar complications- include chronic hyperglycaemia causing cap damage RF are DM fro over 20 years clinicla features include painless bilateral VL exudates and haemorrhage treatment is

Answer 43

strict glycemic control panretinal photocoagulation PRP intravitreal anti-VEGF

Question 44

3 microvascular complications of diabetes

Answer 44

retinopathy nephrotpathy neuropahty

Question 45

previously healthy 63yr old man left eye pieced by intermitted flashes and curtain like loss of lateral vision that began when he woke up

Answer 45

retinal detachment

Question 46

retinal detahcenet is neural retina separation from RPE , high myopia, trauma and age and strong sneeze are RF - clinical features treatment

Answer 46

flashes and floaters curtain coming down diagnosed on fundoscopy time critical surgery - gas tamponade

Question 47

does myopia increase the risk of retinal detachment

Answer 47

yes

Question 48

24yr old man acutely with pain in left eye. Temp of 39 and redness and swelling of completely closed left eye

Answer 48

orbital cellulitis if eyes shut means eyelids are shut ifnalmmtion of the skin

Question 49

orbital cellulitis is infection orbital contents and often secondary to sinusitis or ethmoidist as comes in resent with eyelid inflation and pain of eye, proptosis fever and chills. diagnoses via septic screen and CT/MRI treatment is

Answer 49

IV broad spectrum antibiotics | ENT and ophthalmology

Question 50

what infection precedes orbital cellulitis

Answer 50

sinusitis

Question 51

79 yr odl man noticed vision has worsteds over last year treatment of this

Answer 51

age related macular degeneration age main risk factors druse in back of the eye causing loss of central vision ( opposite to glaucoma which is peripheral ) lifestyle changes and Anti-VEGF in wet

Question 52

drusen are pathogenic of macular degeneration

Answer 52

true - more specifically dry macular degeneration

Question 53

40yr old man with cilia injection , hypo-yon , photopbia and a small pupil and eye pain when reading

Answer 53

anteriro uveitis 3rd and 6h never palsy cause diplopia

Question 54

anterior uveitis/ iritis ifnalmtion or the iris major risk factors symtposma re painful red eye with photophobia and hypopyon( pus in cornea) , blurring and perilimbial injection ( redness round the cornea) and cells and flares on slit lamp treatment is what

Answer 54

ankylosing spondylitis and reactive arthritis and RA topical corticosteroids and treat underlying cause of rheumatoid condition

Question 55

which gene is most associated with antihero uveitis

Answer 55

HLA - B27 - the one with ankylosing spondylitis

Question 56

30yr lady with acute blurring visionamdn eye pain fundoscopy revealed blurred disc marginal and an elevate disc

Answer 56

optic neuritis

Question 57

optic neuritis is idiopathic and ifnalmmtion of optic nerve - MS too RF anre MS and NMO and MOG acute unilateral VL , pain on eye movements, RAPD, central scotoma ,and papillitis MRI scan treatment is

Answer 57

steroids and joint ophthalmology and neuroblastoma

Question 58

50yr old women with painful red eye. Dendritic ulcer is diagnosed after flurosecin stain under blue light

Answer 58

keratitis

Question 59

infective keratitis is infection of the cornea - viral bacteria fungal or acanthamoeba rf is people who wear contact lens , cold sores or immunosuppreison symtpsom what is the treatment

Answer 59

round ulcer - bacterial dendritic ulcer if HSV diagnose if corneal scraping to get organism treatment is empriaicla topical antimicrobials and modify based on MCS

Question 60

pain out of proportion to clinic signs what type of keratitis would you suspect

Answer 60

acanthoamoeba the eye looks normal but a lot of pain