Eye

Question 1

Microbes for Bacterial conjunctivitis

Answer 1

Staphylococcus
Streptococci
Haemophilus

Question 2

Pterygium

Answer 2

Benign growth of conjunctiva
UV light

Tx: avoid UV

Question 3

Stye

Answer 3

Bacterial infection of eyelash follicle

Topical ABX +/- drainage

Question 4

Chalazion

Answer 4

Blockage of Meibomian glanf (aka Tarsal gland)

Warm compress, steroid injection, incision and curette

Question 5

Blepharitis

Answer 5

Staphylococcus infection
Bilateral eyelid inflammation
Crusts, oily secretion

Lid hygiene, topical ABX, Tetracycline

Question 6

Hypopyon

Answer 6

Pus in anterior chamber

Question 7

Uvea made of

Answer 7

Iris (outer)
Ciliary body
Choroid

Question 8

DDx of sudden vision reduction (Emergency)

Rev

Answer 8

1. Acute angle closure glaucoma

2. Giant cell arteritis

Question 9

Eye PE

Answer 9

1. Visual acuity
2. Visual field
3. Pupil, RAPD
4. EOM
5. Fundoscopy

Question 10

Giant cell arteritis

Answer 10

Vision blur/loss
Headache
Jaw pain

Question 11

Ischemic optic neuropathy

Answer 11

Microvascular infarction of nerve

Sudden, painless, unilateral vision loss

Optic disc swollen or normal (posterior can’t see)

Anterior (more common) ION

• Ischemic damage to posterior ciliary arteries
• Arteritic or non-arteritic

Posterior ION

• Unilateral or Bilateral
• Systemic hypotension, most common during cardiac bypass, prolonged spinal surgery; also in cranial surgery, trigeminal zoster, systemic vasculitis

Question 12

Isolated CN3 palsy

Answer 12

Deviate Down + Out

CN3 supplies

1. Levator palpebrae
2. Superior/Medial/Inferior rectus
3. Inferior oblique
4. PS fibers to iris sphincter

Nerve to pupil is peripheral - surgical cause if affected

Cause

1. Intracranial aneurysm (esp in P-Com)
2. Microvascular infarction within the nerve (asso w/ DM, HT)
3. Trauma
4. Cerebral herniation
5. Brain tumor

Question 13

Flashers, floaters

Answer 13

Fundoscopy for retinal detachment

If central vision involved (macula) -> irreversible damage

Question 14

Horner syndrome Ix

Answer 14

MRI from base of brain to mid-thoracic

CTA/MRA to r/o carotid a. dissection

Question 15

CN6 palsy

Answer 15

Limited abduction

BP, FG, lipid, fundoscopy for papilledema

Neuroimaging if no resolution

Question 16

BRVO

Branch retinal v occlusion

Answer 16

Arteriosclerosis –> retinal v compression –> thrombotic occlusion

RF: HT, DM

S/S: Retinal hemorrhages, macular edema, ischemia, neovascularization

Question 17

Vitreous hemorrhage VH

Answer 17

Rupture of pre-retinal new vessels

S/S: Vision loss, loss of red-light reflex

No RAPD

Question 18

Uveitis

Answer 18

Keratitic precipitates

Question 19

Scleritis

Answer 19

Painful

Cx

• Scleral melting
• Corneal melting
• Posterior scleritis

Asso w/ RA, Wegener’s granulomatosis

Question 20

Staphylococcal marginal keratitis

Answer 20

• Type 3 HS
• Sterile infiltrate when lid touch cornea
• Must r/o infectious keratitis before steroids
• Treat underlying cause (blepharitis)