MTB Opthalmology

Question 1

“must know” subjects in ophthalmology are:

Answer 1

• The red eye (emergencies)
• Diabetic retinopathy
• Artery and vein occlusion
• Retinal detachment

Question 2

Chronic glaucoma is

Answer 2

most often asymptomatic on presentation and is diagnosed by routine screening. Confirmation is with tonometry indicating extremely elevated intraocular pressure. 
Treat with medications to decrease the production of aqueous humor or to increase its drainage.
• Prostaglandin analogues
• Topical beta blockers
• Topical carbonic anhydrase inhibitors 
• Alpha-2 agonists
• Pilocarpine
• Laser trabeculoplasty

Question 3

Acute Glaucoma

Answer 3

Look for the sudden onset of an extremely painful, red eye that is hard to palpation. Walking into a dark room can precipitate pain because of pupilary dilation. The cornea is described as “steamy” and the pupil does not react to light because it is stuck. The cup-to-disc ratio is greater than the normal 0.3. The diagnosis is confirmed with tonometry.

Question 4

Acute Glaucoma treatment

Answer 4

• Intravenous acetazolamide
• Intravenous mannitol to act as an osmotic draw of fluid out of the eye
• Pilocarpine, betablockers, and apraclonidine to constrict the pupil and enhance drainage
• Laser iridotomy

Question 5

Keratitis is an

Answer 5

infection of the cornea. The eye may be very red, swollen, and painful, but do not use steroids.
Treat with oral acyclovir