Oppy quick

Question 1

Vitreous haemorrahge RF

Answer 1

DM, trauma, anticoagulant

Question 2

Anterior uveitis

Answer 2

Ank spon and IBD, pupil smaller
Dull aching
Acute onset
Ocular discomfort
Blurred vision
Red eye
Lacrimation

URGEnt REVIEW BY OPTHAL
Cycloplegics e..g atropine and steroid eye drops

Question 3

Open angle Glaucoma

Answer 3

Gradual onset tunnel vision, headaches, haloes around lights

MYOPIA is a risk factor

Tonometry can be normal
Optic disc ratio increases
Optic disc pallor
Cup notching

—> Laser tabeculoplasty

Question 4

Photo coag surgery complications

Answer 4

visual field loss and night vision loss

Question 5

Carotid artery dissection

Answer 5

Localised neck pain, headache, neurological signs e.g. Horners

Question 6

Optic neuritis

Answer 6

Gradual loss of vision
red saturation
scotoma
RAPD
MS
MRI with contrast

High dose steroids

Question 7

Keratitis

Question 8

Retinal detachment

Answer 8

New onset flashers adn floaters
DM, myopia,

RAPD, NOT painful, CURTAIN

Red reflex lost
URGENT referral- vitrectomy adn buckling

Question 9

What do floaters and flashers mean

Answer 9

Detachment or vitreous haemorrhage

Question 10

Cycloplegics

Answer 10

Dilate pupil and relieve pain and photophobia

Question 11

Prostaglandin analogues

Answer 11

Increases uveoscleral outlaw
Can cause brown iris and increased eyelash length

Question 12

Miotics

Answer 12

e.g. pilocarpine
muscarinic receptor agonist
increases the uveoscleral flow

Question 13

Beta blockers and sympthathomimetics

Answer 13

reduces aqueous production

Question 14

Miotics

Answer 14

e.g. pilocarpine
Increases uveoscleral outflow
Can get constricted pupil

Question 15

Angle closure glaucoma

Answer 15

Hypermetropia
Systemically unwell, fixed, dilated, painful, vomiting

Corneal oedema

Gonioscopy

While waiting in ambulance = pilocarpine and acetazolamide

In hosp - timolol and IV mannitol
Laser iriotomy

Question 16

Belpharitis

Answer 16

Inflammation of the eyelid margins
Bilateral gritiness and discomfort
Warm compress

Question 17

Scleritis vs epislcoertis

Answer 17

Scleritis - sever pain, decreased vision, photophobia. same day assessment.

Episcleritis
- IBD and RA associated
Red eye, not painful, phenylephrine drops( if redness improves= epi)

Question 18

SCH

Answer 18

Painless, patch of blood
HTN, thrombocepopenia, whooping cough

Question 19

Central retinal artery occlusion

Answer 19

Thromboembolism or arteritis

Sudden painless vision loss
RAPD
cherry spot
IMmediate referral
IF GCA - steroids
If thrombosis - thrombolysis

Question 20

Central retinal vein occlusion

Answer 20

Sudden painless vision loss
Fundoscopy = flame and blot haemorrhages, optic disc oedema, retinal haemorrhage
—-> immediate referral, anti VEGF.
Laser photocoagulation, dexamethasone

Question 21

Vitreous haemorrhage

Answer 21

PROLIFERATIVE DIABETIC RETINOPAHTY!!!
Also warfarin
Painless vision loss, red hue, flashers and floaters

Question 22

Keratitis

Answer 22

Inflammation of cornea
Viral (HSV), bacterial= pseudomonas ( contact lens),

Hypopyan, reduced acuity, flurosein staining- dendritic corneal ulcer

SAME DAY ASSESSMENT
acyclovir, abx, top steroids

Question 23

Oribital cellulitis

Answer 23

Peri/ pre - eyelid skin infection. CT and ABX

Orbital - URTI, emergency!! Reduced visual acuity. CT. IV ABX

Question 24

RAPD case

Answer 24

retinal/optic nerve damage

Question 25

Cataracts

Answer 25

Eye lens cloudy and opaque asymmetrical slow reduction in vision Lights, starburst, red light reflex defect glasses adn cataract surgery

Question 26

Thyroid eyes

Answer 26

Smoking worsens, radio iodine treatment is a risk factor Exophthalmos, ophthalmoplegia, oedema Lubricans, steroids and radiotherapy

Question 27

Wet macular degeneration

Answer 27

Neovascularisation Subacute central vision loss Anti VEGF e.g. bevacizumab

Question 28

Dry macular degeneration

Answer 28

Drusen Central vision loss Straight line disruption Visual hallucinations = Charles bonnet Stop smoking, vitamin a c e and zinc BP control

Question 29

Diabetic retinopathy

Answer 29

Blot haemorrhages, micro anyerusms, cotton wool, neovascularisation IF proliferative ---> panlaser photocoagulation!! T1dm, neovasculirsation

Question 30

Ocular trauma

Answer 30

Immediate cathothopy

Question 31

Viral vs bacterial conjuncitivitis

Answer 31

Viral is watery

Question 32

Holmes aide

Answer 32

Unilateral pupil, dilated, women, absent knee and ankle reflexes, reacts poorly to light

Question 33

Ectropian vs entropian

Answer 33

ENT = IN