Eye

Question 1

Chorioretinitis causes

Answer 1

infectious: toxoplasmosis ( worldwide recognised cause)
CMV ( in immunocompomised)
Syhpilis
TB

Autoimmune: SLE, Sarcoidosis, Behcets

Question 2

Chorioretinits symptoms

Answer 2

Blurred vision
Scotomos ( blind spots)
Floaters
Pizza pie on fundoscopy i.e Red and white spots

Question 3

Chorioretinitis Mx

Answer 3

Infectious:
Toxo- Sulfadiazine and pyrimethamine
CMV: Gancicylovir
Autoimmune: systemic steroids + MTX or azathioprine for severe or refactory cases

Question 4

Herpes Zoster ophthalmicus

Answer 4

Oral Acyclovir 7-10 days

Question 5

Shadow in red reflex or absent red reflex

Answer 5

Cataract

Question 6

Red eye phototphobia gritty sensation

Answer 6

Keratitis typically s aureus
Pseuds in contact lens wearers
Amoebic, on contact with soil or dirty water pain out of proportion
Herpes

Question 7

Keratitis Mx

Answer 7

Quinolones first line
Stop lenses until resolves
Cycloplegics for pain

Question 8

Dermatofibroma

Answer 8

Solitary firm nodule or papule
Overlying skin dimples on pinching

Question 9

Vitiligo associations

Answer 9

Associations: autoimmune thyroid disease, pernicious anemia, alopecia aereta type 1 DM

Question 10

Vitiligo Mx

Answer 10

Topic corticosteroids
Phototherapy
Topical tacrolimus
Sunblock for affected areas

Question 11

Argyll robertson pupil

Answer 11

ARP- accommodation reflex present
PRA -pupillary reflex absent
Ass with DM, neurosyphilis

Question 12

Holmes adie pupil

Answer 12

uni lateralDilated pupil, non reactive or very slowly reactive to light
Seen in women post infection
Ass with loss or diminished deep tendon reflexes

Question 13

Hutchinsons sign

Answer 13

Unilateral dilated pupil due to compression of occulomotr nerve due to tumor or hematoma

Question 14

Horner’s syndrome

Answer 14

Ptosis, miosis, enopthalmos with kr without ass anhydrosis

Question 15

Marcus gunn pupil

Answer 15

RAPD
Where pupil constricts less or appears to dilate when light is strung from unaffected to affected side most commonly dueto damage of optic nerve

Question 16

Episcleritis vs scelritis

Answer 16

Episcelritis less painful than scleritis, phenylephrine blanches the vessels in scleritis but not in episcleritis

Question 17

Episcleritis ass

Answer 17

IBD
RA

Question 17

SE of typical anti psychotics

Answer 17

Acute dystonia- torticollis and oculgyric crisis, tongue protrusion
Akathisia- inability to sit still
Tardive dyskinesia ( lip smacking, chewing, jaw pouting)
Hyper prolactinemia
Prolong QT ( with haloperidol)
Impaired glucose tolerance
Neuroleptic malignant
syndrome

In elderly- increased risk of VTE , and stroke

Question 18

Optic neuritis

Answer 18

Seen in MS, DM, syphilis
caused RAPD ( decreased responsiveness to light reflex in affected eye.
Pain in eye movement
Funny colour perception
Central scotoma

Question 19

punctuate flourescein of cornea is seen in

Answer 19

dry eye syndrome

Question 20

Glaucoma Tx

Answer 20

first line in people with IOP > 24
Trabeculoplasty SLT
PG analogues ( latanoprost)
second line- Increases flow
1) Timolol ( Beta blockers), CI heart block,asthma)
Decrease production
2) carbonic Anhydrase X ( dorzolamaide)
decrease produtcion
3) Alpha adrenergic agonist -Brimonidine
Increase aqueous outflow and decreased production
Miotic ( Pilocarpic)
Increase outflow

Question 21

painful red eye following surgery and decrease visual acuity

Answer 21

Endopthalmitis

Question 22

Anetrior uveitis

Answer 22

small fixed pupil, BLURRED VISSION, Photophobia
Acute red eye
eye pain

Question 23

Squint Mx

Answer 23

Refer to opthalmology
test by covering one eye and asking the child to foucs on a fixed point, repet with other eye
Eye patch to avoid ambylopia

Question 24

Heprex simplex keratitis

Answer 24

dendritic ulcer photophobia refer to opthalmologist urgently topical acyclovir

Question 25

Mydriasis causes

Answer 25

Third nerve palsy holmes adie pupil pheomchromocytoma congenital cocaine, TCA, amphetamines,

Question 26

abducens 6th nerve palsy

Answer 26

horizontal double vision that worsens when looking towards affected side due to paralysis of lateral rectus

Question 27

third nerve palsy

Answer 27

eye deviated outward and and upward, drooping of eyelid, mydriasis, paralysis of medial rectus

Question 28

ARP

Answer 28

b/l small pupils ARP accomodation reflex present PRA pupillary reflex absent seen in neurosyphilis

Question 29

Orbital lymphoma

Answer 29

red eye, gradualy symptoms, painless and proptosis

Question 30

retinal detachment

Answer 30

curtain from peripheries, ass with floaters,

Question 31

vitreous haemorrhage

Answer 31

reduced red relfex, floaters, sudden or sub acute vision loss

Question 32

Pre proliferative Diabetic retinopathy

Answer 32

cotton wool spots, venous beading and loopin

Question 33

Proliferative diabetic retinpathy

Answer 33

neovacsularization and haemorrhage

Question 34

homonymous hemianopia with macular sparing

Answer 34

Occipital lobe

Question 35

homonymous hemianopia

Answer 35

lesion of optic tract

Question 36

bitemporal hemianopia

Answer 36

lesion of optic chiasm Congrous defect=- optic raditain or occipital cortex incongrous- optic tract

Question 37

cataracts

Answer 37

decreased vidsual acuity faded colour vision glares around bright lights and haloes absent red reflex causes_ age related hypocalcemia DM raditaion Increased alcohol

Question 38

most common ocular manifestation of RA

Answer 38

keratoconjunctivitis sicca

Question 39

Squint

Answer 39

Esotropia- Deviated medially ( nose) Exotropia- Deviated temporaly Hypertropia- Superiorly Hypotropia-Inferiorly If right eye has eso tropia- on covering left eye, the right eye will move laterally for fixation