Miscellaneous

Question 1

HPV subtypes associated with conjunctival intraepithelial neoplasia (name 3)

Answer 1

16, 18, 33

Question 2

Chlamydia subtype associated with trachoma

Answer 2

A-C

D onwards: conjunctivitis & STI

L: Lymphogranuloma venereum

Question 3

STUMPED: Causes of congenital corneal opacity

Answer 3

Sclerocornea
Trauma
Ulcer
Mucopolysaccharoidoses
Peter’s anomaly
Endothelial dystrophy (CHED)
Dermoid

Question 4

Lesions in the cerebral peduncle cause…?

Answer 4

Ipsilateral 3rd
Contralateral hemiparesis
(Weber’s syndrome)

Question 5

Rb gene is on which chromosome?

Answer 5

Chromosome 13

Question 6

Aniridia inheritance

Answer 6

PAX6 gene
Chromosome 11
AD (but 1/3 sporadic)

Question 7

Autosomal dominant RP - which gene?

Answer 7

RHO gene
Chromosome 3

Question 8

X-linked RP - which 2 genes?

Answer 8

RPGR, RP2

Question 9

Aniridia - what % sporadic?

Answer 9

20% sporadic and associated with Wilm’s tumour

Question 10

Types of Stickler syndrome (1-4)? And inheritance

Answer 10

All AD inheritance, different gene mutations.
Type 1: ocular features (empty vitreous, lattice, RD, megophthalmos) + arthropathy, deafness, Pierre-Robin sequence
Type 2: Type 1 but with beaded vitreous
Type 3: systemic involvement only
Type 4: ocular involvement only

Question 11

Inheritance of posterior polar cataracts?

Answer 11

Autosomal dominant
Familial in 50% (rest sporadic)

Question 12

Optic nerve hypoplasia associated with which hormone deficiencies?

Answer 12

Hypopituitarism:
Growth hormone deficiency is most common > hypothyroidism > adrenal insufficiency > posterior pit issues (diabetes insipidus)

Question 13

Are hydrophobic or hydrophilic lenses associated with a higher rate of PCO?

Answer 13

Hydrophilic = worse for PCO

Question 14

Silicone oil: what sort of refractive shift in (a) pseudo/phakic and (b) aphakic eyes?

Answer 14

A) Hyperopic shift
B) Myopic shift

If lens is there, the thicker oil reduces the focusing power of the lens
If no lens - the oil acts as a lens

Question 15

Myopic / hyperopic laser refractive surgery - what impact on IOL?

Answer 15

Myopic LRS: underestimates IOL power > hyperopic shift
Hyperopic LRS: overestimates IOL power > myopic shift

Question 16

Congenital rubella triad (which 3 body systems affected)

Answer 16

Ocular, cardiac abnormalities and sensorineural deafness

Question 17

Congenital rubella ophthalmic manifestations

Answer 17

Cataract
Salt and pepper retinopathy
Microphthalmia
Glaucoma

Question 18

Anterior lenticonus is associated with which syndrome?

Answer 18

Alport syndrome

Question 19

Posterior lenticonus is associated with which syndrome?

Answer 19

Lowe syndrome, causes an oil drop cataract

Question 20

Which 4 gonioscopy lenses are indrect?

Answer 20

Goldmann, Zeiss, Posner, Sussman

(Stuff on the slitlamp: Goldmann and Zeiss, and ‘Posner-Schlossmann”

Question 21

What is the 5 year risk for fellow eye for NAION?

Answer 21

15%

Question 22

What is the SJS / TEN criteria by body surface area involved?

Answer 22

SJS: <10%
TEN: >30%

Question 23

When do corneal EDs appear after onset of skin lesions in SJS/ TEN?

Answer 23

2-3 weeks

Question 24

Inheritance of ocular vs oculocutaneous albinism?

Answer 24

Ocular - X-linked recessive
Oculocutaneous - autosomal recessive

Question 25

What eyedrop is used to confirm Adie's tonic pupil?

Answer 25

Pilocarpine 0.125% (muscarinic hypersensitivity)

Question 27

Birdshot chorioretinopathy ERG changes

Answer 27

Reduced b wave (bipolar cells)

Question 28

Screening criteria for ROP?

Answer 28

Gestational age 31 weeks or birthweight <=1.5kg

Question 29

Hering's Law

Answer 29

Equal innervation of yoke muscles (Dissociated vertical deviation violates this)

Question 30

Sherrington's Law

Answer 30

Reciprocal innervation - contraction of one with relaxation of antagonist (Duane's violates this)

Question 31

Rhabdomyosarcoma subtypes - most common, best and worst prognosis?

Answer 31

Most common - embryonal Best prognosis - pleomorphic Worst prognosis - alveolar

Question 33

PHACES syndrome stands for?

Answer 33

Posterior fossa abnormalities Haemangioma Arterial anomalies (cerebral) Cardiac / coarctation of aorta Eye abnormalities (microphthalmia / disc hypoplasia / morning glory / PPFV) Sternal cleft

Question 34

PHACES syndrome - associated with what lid lesion?

Answer 34

Large segmental haemangiomas in frontotemporal region If large >5 cm2, consider MRI first to assess for neurovascular anomalies

Question 35

Vigabatrin field screening

Answer 35

Baseline prior to starting treatment, then every six months for 5 years, then annually

Question 36

Measure to test if data is normally distributed

Answer 36

Shapiro-Wilk test

Question 37

4 notifiable conditions for DVLA

Answer 37

Blepharospasm Nyctalopia Diplopia Visual field defects

Question 38

DVLA Group 1 and 2 horizontal field degrees requirement?

Answer 38

Group 1: 120 degrees, at least 50 right and left Group 2: 160 degrees, at least 70 right and left

Question 39

NF1 is associated with what sort of brain tumour?

Answer 39

Gliomas

Question 40

Simulated divergence excess exotropia: is bilateral LR recess better or unilateral recess / resect

Answer 40

Unilateral recess / resect is better for simulated divergence excess and bilateral LR recess for true divergence excess

Question 41

V pattern strabismus: how many prism dioptres difference? Most common cause?

Answer 41

15 PD IO overaction (over elevation in adduction)

Question 42

A pattern strabismus: how many prism dioptres difference? Most common cause?

Answer 42

10PD SO overaction (Over depression in abduction)

Question 43

What is the formula to calculate number needed to treat?

Answer 43

1/ absolute risk reduction

Question 44

Combined hamartoma of RPE and retina is associated with?

Answer 44

NF2

Question 45

4 causes of dragged optic disc

Answer 45

1. Persistent foetal vasculature 2. Familial exudative vitreoretinopathy 3. Combined hamartoma of retina and RPE 4. Toxocara granuloma

Question 46

Bacteria that can penetrate an intact epithelium (5 total)

Answer 46

CHANLS Corynebacterium (diphtheria) Haemophilus aegyptus Neisseria Listeria Shigella

Question 47

Which organism carries the worst prognosis in traumatic endophthalmitis?

Answer 47

B. cereus (NOT Pseudomonas)

Question 49

Which anti TB drug causes optic neuropathy

Answer 49

Ethambutol

Question 50

What is the most common benign orbital tumour in adults

Answer 50

Cavernous venous malformation

Question 51

Phytanic acid disorder of metabolism causing retinitis pigementosa and ichthyosis?

Answer 51

Refsum’s disease

Question 52

3 physiological adaptations to deal with diplopia in strabismus

Answer 52

1. Suppression 2. Monofixation syndrome 3. Anomolous retinal correspondence

Question 53

Most common cause of light near dissociation?

Answer 53

Bilateral blindness from loss of afferent input Accommodation miosis does not rely on functional photoreceptors or ganglion cells

Question 54

Causes of light near dissociation?

Answer 54

Argyll Robertson pupil Adie’s syndrome Tectal lesions e.g. pinealoma Dorsal midbrain damage e.g. Parinaud syndrome

Question 55

Palinopsia (abnormal persistence of images) is associated with a lesion in what area of the brain?

Answer 55

Parieto-occipital region

Question 56

Which corneal dystrophy is associated with Meretoja syndrome?

Answer 56

Systemic amyloidosis Lattice type 2 dystrophy

Question 57

Inheritance pattern of LHON

Answer 57

Mitochondrial

Question 58

Average age of diagnosis of BILATERAL Rb

Answer 58

12 months (Unilateral - 24 months)

Question 59

Type 1-4 collagen are found in? (Mnemonic)

Answer 59

Type 1 - there’s a tonne (everywhere, including sclera) Type 2 - in the goo (vitreous) Type 3 - heal me (wound healing) Type 4 - in the floor (basement membranes)

Question 60

Congenital glaucoma gene mutation

Answer 60

CYP1B1 “Sip 1 bottle = baby glaucoma”

Question 61

PAX6 gene is associated with?

Answer 61

PPAX6 Posterior embryotoxon Peter’s anomaly Aniridix AXenfeld anomaly

Question 62

Which part of the lacrimal gland should a biopsy be taken from?

Answer 62

Orbital part (palpebral part of the gland contains the ducts)

Question 63

CMV retinitis classically occurs at a CD4 count of less than?

Answer 63

50 cells / uL

Question 64

Owl eye inclusions?

Answer 64

CMV

Question 65

Ectopia lentis, Marfanoid with light hair and intellectual disability - what direction of ectopia?

Answer 65

Inferonasal Homocystinuria

Question 66

Most common location of limbal dermoids?

Answer 66

Inferonasal (Remember closest to earlobe which is also involved in Goldenhar syndrome; preauricular skin tags)

Question 67

When to use Knapp procedure?

Answer 67

Elevator palsy without excyclotorsion