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Question 1

Optic nerve lesions

Answer 1

Question 1

2 findings and diagnose

Answer 1

Question 2

Diagnose and 2 complications

Answer 2

Question 3

Label

Answer 3

Question 4

Diagnose

Answer 4

OCP

Question 5

Diagnose

Answer 5

SJS/TEN

Question 6

What is this and its condition

Answer 6

GPC, VKC

Question 7

Diagnose

Answer 7

Bacterial keratitis

Question 8

What can be seen, diagnose

Answer 8

Ring infiltration, acanthomoea keratitis

Question 9

Diagnose, manage

Answer 9

Endothelial disciform

Question 10

What is seen, diagnose

Answer 10

Mutton KPs, keratouveitis (HSV)

Question 11

MOA

Answer 11

1. Binds glucocorticoid receptors in cytoplasm
2. Pred.-GR complex moves to nucleus and regulates gene expression
   Phospholipase A2 inhibition and downregulation of IL cytokines

Question 12

Acyclovir and ganciclovir:

Answer 12

Antiviral prodrug, metabolized by viral enzymes to acyclovir/ganciclovir triphosphate
1. Competes with dGTP for incorporation into viral DNA
2. Chain terminator for DNA formation / Faulty DNA replication
Viral enzymes have higher affinity for acyclovir than host cells
- HSV: 3% ointment 5/d (up to 10d)
- HSV: 400mg 5/d (up to 10d)
- HZO: 800mg 5/d (up to 10d)
Ganciclovir has high affinity for cyclomegalovirus enzymes, but also affects host cells moreso than acyclovir

Question 13

Cyclosporin:

Answer 13

Immunosuppressive, used when cortico. non-response or risk
Lipophilic ^Penetration
1. Binds cytoplasmic protein cyclophilin
2. CC complex inhibits calcineurin, which normally
1. Protein phosphate for T-cell activation
2. processes transcription factors for IL-2
Commercially used for organ transplant
Side effects:
- HT, kidney damage

Question 14

Antiglaucoma drugs:

Answer 14

1. B-blockers: First line for POAG > and all others
   inhibit B-adrenergic receptors in ciliary body > decreased aqueous production
   Ocular iritation, corneal desens, DED, macular edema
   Bronchospasm, cough, arrythmia, headache, nausea
   Contra. chronic obstructive PD, asthma, Bradycardia
   
   1. Non-selective (B-1/2)
      
      1. Timolol/Levobunolol
         0.25% BID, IOP decreases 25%
   2. Selective (B-1)
      
      1. Betaxolol
         
         • Less side effect; less efficacy
2. Prost-analogues: All but uveitis glauc: Greater IOP reduction, causes inflammtion
   Prodrug metabolized by corneal esterase > binds PGF2a receptor on ciliary muscle > ECM remodeling/MMP regulation > increase uveoscleral outflow
   Iris heterochromia, lid pigmentation, lash lengthening, redness, SPEE
   Contra. Ocular inflammation (HSK), CMO, allergy
   1. Latanoprost (Xalantan)
   0.005% daily, IOP decreased 30%
   
   1. Bimatoprost (Lumigan): 0.03%
   2. Travoprost (Travatan): 0.004%
3. Adrenergic-agonist:
   Stimulate A-2 receptors > adenylate cyclase inhibition > decreased cMAP in ciliary cells > aqueous production loss
   Stimulation of A-1 receptor > vasoconstriction of CB vessels > reduced aqueous production
   
   • Photophobia, blur, stinging
   • Dry mouth, hypotension, fatigue
     
     1. Apraclonidine: selective A2 (weak A1)
        0.5% BID, IOP decrease 20%
        Causes tachyphylaxis
4. Carbonic anhydrase inhib: CA is critical for aqueous formation
   Decreases bicarbonate ion formation > reduced fluid transport in ciliary epith.
   Causes blood acidosis, renal stones, metalic taste, confusion
   Contra. Heart/kidney disease
   1. Acetazolamide (Diamox/Diazamide): IV for Rapid IOP decrease, oral otherwise
   250mg BID, 20% decrease by 4h
   500mg IV, 20% decrease by 30min
   
   1. Dorzolamide (trusopt): topical, fewer systemic affects
      2% 3/d, 20% IOP decrease
5. Hyperosmotics: ^Plasma osmolarity > fluid uptake from ocular tissue
   Nausea, heart faliure, confusion, kertoacidosis
   Contra. DM
   
   1. Glycerol: oral dose 4ml/kg
      20 onset, poor ocular penetration
   2. Mannitol: 20%
      Not contra. for renal faliure (no renal metabolism)
6. Cholinergic agonist: Stimulate muscarinic receptors in CB > Miosis > TM opening > increased outflow
   Accomodative spasm, pupil block, cataract
   Contra. cataract, myopia, young Px
   
   1. Pilocarpine: 2% QID, 15% IOP decrease

Question 15

diagnose

Answer 15

RP

Question 16

Diagnose

Answer 16

PAC

Question 17

label

Answer 17

Question 18

diagnose

Answer 18

Acute Angle Closure

Question 19

Diagnose, assoc. condition

Answer 19

Bleb, blebitis

Question 20

Diagnose

Answer 20

Baerveldt implant for glaucoma

Question 21

diagnose, manage

Answer 21

NPDR and PDR
Needs PRP

Question 22

what Sx was this

Answer 22

penetrating keratoplasty

Question 23

what Sx was this

Answer 23

DSEK
Decemets stripping endtoh. kerat.

Question 24

Diagnose

Answer 24

retinoblastoma

Question 25

Diagnose

Answer 25

AMD

Question 26

Diagnose

Answer 26

dry > wet AMD

Question 27

Diagnose based on oct

Answer 27

Dry > wet amd

Question 28

what am i looking at

Answer 28

Type 1,2,1+2 Macula NV

Question 29

this

Answer 29

AMD

Question 30

This and its condition

Answer 30

Pneumatic displacement ARMD management; AMD mac haem

Question 31

this

Answer 31

Subretinal TPA retinotomy to manage ARMD; and its resolution

Question 32

this

Answer 32

diffuse > nodular episcleritis

Question 33

this

Answer 33

anterior scleritis

Question 34

this

Answer 34

Diffuse; Nodular Anterior scleritis

Question 35

this; and its U/cause

Answer 35

Anterior ischemic optic neuropathy; GCA

Question 36

This

Answer 36

NAION; and fellow disc at risk

Question 37

this

Answer 37

Choroidal melanoma and progression

Question 38

This and how to differentiate

Answer 38

Nevis; Thickness > 2mmm SRF Visual symptoms Orange pigment 3mm of OD Hollow No drusen

Question 39

Answer 39

Papilledema

Question 40

This and what it shows

Answer 40

Pseud-oedema Elevation only at disc, sharp NFL reflex, no CWS

Question 41

Answer 41

Atrophic stage of papilledema

Question 42

Answer 42

Nodular > nonulcerative BCC

Question 43

Answer 43

lipid keratopathy; Yellow/creamy

Question 44

Answer 44

Pellucid marginal generation

Question 45

Answer 45

acute anterior uveitis

Question 46

Answer 46

Synechiae W/acute anterior uveitis

Question 47

Answer 47

Papillary and nodular OSSN

Question 48

Answer 48

FFA of sarcoidosis w/peripheral ischemia and NV FFA of CMO

Question 49

Answer 49

masquerade

Question 50

Answer 50

Multiple evanascent white dot syndrome

Question 51

Answer 51

tocoplasmosis

Question 52

Answer 52

Toxocarasis

Question 53

Answer 53

Acute retinal necrosis

Question 54

Answer 54

CMV retinitis

Question 55

Answer 55

TB posterior uveitis

Question 56

Answer 56

Acute posterior multifocal placoid pigmentary epitheliopathy (APMPPE)

Question 57

Answer 57

Multiple evanescent white dot syndrome (MEWDS)

Question 58

Answer 58

Punctate inner choroidopathy (PIC)

Question 59

Answer 59

Birdshot choroidopathy

Question 60

Answer 60

Serpiginous choroidopathy

Question 61

Answer 61

Progressive outer retinal necrosis