OD week5

Question 1

⚡ What is Vitamin A deficiency and its ocular effects?

Answer 1

Essential for epithelial maintenance and photoreceptor pigment synthesis. Deficiency causes xerosis, xerophthalmia, and keratomalacia.

Question 2

What are the signs of Vitamin A deficiency?

Answer 2

Dry lustreless conjunctiva, Bitot’s spots, keratinisation of cornea, sterile corneal ulceration, keratomalacia, and nyctalopia.

Question 3

What is the treatment for Vitamin A deficiency?

Answer 3

Systemic oral or intramuscular vitamin A, multivitamin supplements, dietary vitamin A, intense lubrication, topical retinoic acid, and manage perforation.

Question 4

What ocular effects occur in Vitamin B1 (Thiamine) deficiency?

Answer 4

Corneal and conjunctival dystrophic changes and retrobulbar neuritis.

Question 5

What ocular effects occur in Vitamin B2 (Riboflavin) deficiency?

Answer 5

Vascularising keratitis and Bitot’s spots.

Question 6

What ocular signs are seen in Vitamin C deficiency?

Answer 6

Conjunctival and retinal haemorrhages, cataract, keratoconjunctivitis, and delayed healing.

Question 7

What are the ocular signs in Vitamin B12 deficiency?

Answer 7

Retinopathy with engorged veins, flame haemorrhages, Roth’s spots, cotton wool spots, and retrobulbar neuritis.

Question 8

⚡ What is Graves’ Disease?

Answer 8

An autoimmune disorder causing hyperthyroidism with excessive T4. More common in women aged 20–45, with goitre and ophthalmopathy.

Question 9

What are the ocular signs of Graves’ Disease?

Answer 9

Upper lid retraction (Dalrymple’s), lid lag (von Graefe’s), staring (Kocher’s), proptosis, conjunctival injection, chemosis, corneal exposure, and superior limbic keratoconjunctivitis.

Question 10

What is Superior Limbic Keratoconjunctivitis?

Answer 10

Chronic inflammation of superior bulbar conjunctiva associated with hyperthyroidism; causes irritation, FB sensation, hyperaemia, superior staining, and pannus.

Question 11

What is the treatment for Superior Limbic Keratoconjunctivitis?

Answer 11

Ocular lubricants and short course topical steroids (e.g., FML QID).

Question 12

What is Restrictive Thyroid Myopathy?

Answer 12

Fibrosis and inflammation of EOMs in hyperthyroidism causing diplopia. IR most affected (elevation defect), then MR (abduction defect).

Question 13

What is Dysthyroid Optic Neuropathy?

Answer 13

Compression of optic nerve at orbital apex causing slow vision loss, RAPD, colour loss, field defects, and vascular congestion of disc.

Question 14

What is the management for Thyroid Eye Disease?

Answer 14

Stop smoking, use lubricants, night ointments, cold compress, systemic steroids for severe cases, IV or oral prednisolone for optic neuropathy, and orbital decompression or radiotherapy if needed.

Question 15

⚡ What are the ocular signs of Hypothyroidism?

Answer 15

Swollen baggy lids, loss of outer 1/3 eyebrow, tear deficiency leading to keratoconjunctivitis, possible retrobulbar neuritis and optic atrophy.

Question 16

What is the treatment for Hypothyroidism?

Answer 16

Thyroid hormone supplementation; improvement usually dramatic.

Question 17

⚡ What is Posterior Uveitis?

Answer 17

Inflammation of choroid and retina. Presents with little or no pain, mild photophobia, minimal redness, diffuse yellow-white fluffy lesions with vitreous haze, and resolves with chorioretinal scar formation.

Question 18

⚡ What is the cause of Toxoplasmosis?

Answer 18

Protozoal infection (Toxoplasma gondii) transmitted congenitally or acquired via cat faeces or undercooked meat.

Question 19

What are the ocular signs of Toxoplasmosis?

Answer 19

Fluffy yellow-white chorioretinal lesion with overlying vitritis (‘headlights in the fog’), vasculitis, and adjacent old scars. Can cause granulomatous anterior uveitis.

Question 20

What are the symptoms of Toxoplasmosis?

Answer 20

Blurred vision, floaters, photophobia, and recurrent attacks leading to pigmented scars and field defects.

Question 21

What is the treatment for Toxoplasmosis?

Answer 21

Systemic steroids, clindamycin (warn about diarrhoea), pyrimethamine (with folic acid), sulfonamides, and tetracyclines. Topical steroids and cycloplegics if AC reaction.

Question 22

⚡ What causes Toxocariasis and who is affected?

Answer 22

Infection by roundworm (Toxocara canis), usually in children <3 years via ingestion of contaminated soil or faeces.

Question 23

What are the ocular signs of Toxocariasis?

Answer 23

Unilateral yellow-white granuloma with vitreous bands, vitreoretinal traction, leucocoria, and risk of retinal detachment.

Question 24

What is the management for Toxocariasis?

Answer 24

Systemic and periocular steroids for active lesions, antihelmintics if unresponsive, and prevention via hygiene and pet deworming.

Question 25

⚡ What is Behçet’s Disease?

Answer 25

Rare chronic multisystem inflammatory disorder causing anterior and posterior uveitis and retinal vasculitis. Triad: iritis, genital and oral ulcers.

Question 26

What are the ocular signs of Behçet’s Disease?

Answer 26

Severe bilateral recurrent uveitis with hypopyon, vitritis, chorioretinitis, and occlusive retinal vasculitis.

Question 27

What is the management for Behçet’s Disease?

Answer 27

Refer. Topical and systemic steroids, plus immunosuppressants such as cyclosporine, cyclophosphamide, or thalidomide.

Question 28

⚡ What is VKH Disease?

Answer 28

Idiopathic autoimmune inflammation of melanocyte tissues causing bilateral uveitis, chorioretinitis, skin depigmentation, alopecia, and hearing loss.

Question 29

What are the ocular signs of VKH?

Answer 29

Bilateral granulomatous anterior uveitis, diffuse choroidal infiltration, multiple exudative retinal detachments, and optic disc oedema.

Question 30

What is the management for VKH?

Answer 30

High dose oral prednisolone, IV methylprednisolone pulse if severe, topical steroids and cycloplegics for anterior uveitis, with slow taper.

Question 31

⚡ What is Endophthalmitis?

Answer 31

Severe intraocular inflammation after surgery (0.1% incidence), usually due to Staph or Strep. Presents with pain, redness, blurred vision, hypopyon within 24–48 hrs.

Question 32

What is the management for Endophthalmitis?

Answer 32

Immediate referral. Intravitreal, topical and systemic antibiotics, therapeutic vitrectomy, topical steroids after infection controlled. Prophylaxis with intracameral cefuroxime or vancomycin.

Question 33

⚡ What is Retinitis and its causes?

Answer 33

Inflammation of retina, usually secondary to choroiditis. Causes include TB, syphilis, herpes, SLE, sarcoid, Behçet’s, MS.

Question 34

What are the signs of Retinitis?

Answer 34

Sheathing of vessels, cotton wool spots, haemorrhages, and disc oedema.

Question 35

⚡ What is Eales’ Disease?

Answer 35

Idiopathic occlusive peripheral periphlebitis, common in young men in India/Middle East. Causes retinal haemorrhages, neovascularisation, and scarring.

Question 36

What is the management for Eales’ Disease?

Answer 36

Steroids (systemic, periocular, topical, intravitreal) during inflammation; laser photocoagulation and anti-VEGF injections for neovascular stages.

Question 37

⚡ What is HIV Retinopathy?

Answer 37

Non-infectious microangiopathy in AIDS with cotton wool spots, haemorrhages, and microaneurysms; often asymptomatic.

Question 38

What is CMV Retinitis?

Answer 38

Most common opportunistic ocular infection in AIDS. Haemorrhagic necrotising retinitis with confluent white necrotic patches and retinal atrophy.

Question 39

What is the treatment for CMV Retinitis?

Answer 39

Antiviral drugs. Without treatment, severe vision loss is inevitable. One-third progress to retinal detachment.

Question 40

⚡ What is MEWDS?

Answer 40

Multiple Evanescent White Dot Syndrome – rare acute unilateral multifocal retinitis affecting young women, often post-viral.

Question 41

What are the signs and prognosis of MEWDS?

Answer 41

Small grey-white patches in outer retina and RPE, mild vitritis. No treatment needed. Vision recovers in weeks, may recur in ~10% of cases.