osce prep

Question 1

MOLES acronym

Answer 1

Mushroom shape, Orange pigment, Large size, Enlargement, Subretinal fluid

Question 2

how does high index materials reduce thickness and weight

Answer 2

they bend light more than standard lenses, so dont need as much material to make your prescription to work

Question 3

how does MAR reduce reflections

Answer 3

light reflects off any surface so front and back of the lens can cause glare. Mar coating uses destructive interference, so designed to reflect light in just the right way so the reflected light wave cancels each other out. When 2 oppoiste waves meet eg 1 up and 1 down - they cancel out so less light bounces back into the eyes

Question 4

how a polarised lens reduces glare

Answer 4

light travels in all directions, when it reflects off a flat surface (glare) it becomes mostly horizontal. Polarised lenses have a vertical filter which blocks horizontal light

Question 5

how a photochromatic lens changes

Answer 5

they have special molecules (silver halide) that react to UV light , so when outdoors these molecules absorb UV light and change shape. The new shape blocks more light making the lens darken.
darkens in around 1 min
clears in around 2-5mins - depends on temperature (slower when colder)

Question 6

Recent CN palsy - referral to who

Answer 6

Neurology or neuro-ophthalomology
emergency due to risk of it being an aneursym (which can burst at any point)

Question 7

drusen - what is it

Answer 7

drusen builds up as the retinas waste clearance system starts to fail as we age, normally the RPE clears the waste but it becomes less efficient so waste accumulates between RPE and bruchs membrane. Drusen can then interfere with O2 and nutrients getting to the retina.

RPE becomes less efficient du to aging, oxidative stress eg poor diet, smoking, genetics, poor blood flow.
drusen made of proteins, lipids, cell waste and minerals

Question 8

what are exudates

Answer 8

they are leaky deposits made of fat and protein build up due to leaky BVs. ( the BVs are weakened or damaged so they leak fluid, as the fluid gets reabsorbed exudates are left behind)
sign of damage - in DR and Hypertensive retinopathy
Retina outer layers

Question 9

what is an ERM

Answer 9

As the vitreous pulls away, it can sometimes leave behind cells or debris on the retinal surface. These cells can multiply and form a membrane, known as an epiretinal membrane, on the retina.

Question 10

ERM management

Answer 10

B1: fovea involving with VA ≤6/12 (or loss of more than two lines from baseline (0.2 logMAR)) or distortion, and no other reason for decreased vision. Routine referral to vitreo-retinal (VR) service.

B2: fovea sparing or fovea involving, with no reduction or change in VA or distortion. Annual monitoring in the community or according to local protocols.

Question 11

ftmh REFERRAL

Answer 11

Urgent referral

PTMH - routine referral if symptomatic. Lamellar hole, VMT, ERM. Macular Pseudohole (MPH) (appearance of a macular hole but no loss of foveal tissue)
PARTIAL THICKNESS MACULAR HOLES
A 2021 Cochrane review of surgery for lamellar holes concluded that there is insufficient evidence to support or refute surgery as an effective management option, although this is an evolving area and many surgeons offer surgery depending on symptoms and type of partial thickness hole present.

Question 12

why is vacuum tint better for high rx compared to solid tint

Answer 12

vacuum tint has an even layer
solid tint - entire lens material dyed, where the rx is higher the tint is darker there. Less even tint

Question 13

chromatic abberations

Answer 13

bigger index of lenses the more abberations

for stronger rx, the lens needs to bend light more to focus clearly, that strong bending can cause small distortions around the edges of the lens. (like looking through a glass of water). To make lenses thinner and lighter we use high index, they can sometimes increase those little distortions. We can reduce these effect by MAR coating and choosing a well fitted frame.

Question 14

trivex vc polycarb

Answer 14

Trivex is a lightweight (compared to polycarb), durable plastic material used for eyeglass lenses, offering excellent optical clarity (compared to polycarb) and impact resistance. Full UV protection. More expensive
- polycarb has higher impact strength still. UV protection

Question 15

spherical vs aspheric

Answer 15

Spherical lenses have a constant curvature, like a section of a sphere, while aspheric lenses have a varying curvature across their surface.
aspheric:
Aberrations, Designed to minimize spherical aberration, potentially leading to sharper, clearer vision, especially in low-light conditions or when looking away from the lens cente

Question 16

why minimise BVD in high myopia

Answer 16

better visual accuracy - high minus lenses diverge light rays more strongly when they are further from the eye. Large BV means the effective power increases - so lens more negative than prescribed. Keeping BVD small ensures the lens power us closer to what was prescribed during refraction.
- thinner lens appearance
- wider field of view - lens closer to visual axis, less peripheral disortion and more natural field of view

Question 17

0.5% chloramphenicol eyedrops dosages

Answer 17

If you’re using 0.5% chloramphenicol eyedrops, put one drop into the affected eye every 2 hours (during waking hours) for the first 2 days. Then every 4 hours for the next 3 days, or as your doctor advises.

Question 18

treatment options for retinal detachments

Answer 18

1. laser tx or freezing - for smalll detachments, this creates a scar that hold retina down
2. gas bubble - small gas bubble injected into eye, bubble floats to press the retina back into place. Need to keep head in certain position for a few days. Often add laser or freezing tx as well
3. scleral buckle - soft band is placed around the outside of the eye to push the wall of the eye inward - helping the retina reattach. often for large or multiple tears. band isnt felt or visible after healing
4. Vitrectomy - jelly removed, takes pressure off the retina allowing it to be repaired and flattened. Gas or oil bubble placed after.

Question 19

safety specs wielder - starting own business

Answer 19

1. needs to provide for employees safety specs, replace etc
2. face sheild - uv and IR protection, risk of melanoma, cataract, photokeratitis
3. polycarbonate - impact resistance lens, or trivex (poly carb best)
4. needs to have BN166 and CE or UKCA mark
5. need to take into consideration rx

Question 20

risk of what with CRVO

Answer 20

100 day glaucoma

Question 21

scleral thinning causes and management

Answer 21

ensure not scleritis! emergency within 24hrs referral
high myopia
post surgical
Systemic autoimmune diseases like rheumatoid arthritis, ehler danlos syndome and other vasculitic disease can manifest with scleral thinning

scleral thinning can be progressive and may lead to scleral perforation
in severe cases, scleral thinning can contribute to vision loss, leads to complications like retinal detachment or globe rupture
may be benign - if significiant or symptomatic should be investigated

Question 22

amsler px instruction

Answer 22

The chart should be used at 30cm and subtending 20degrees of the central visual field
* Each square represents 1 degree
* The patient fixates at the central dot whilst looking at the chart and notes:

1. Is the white dot in the center visible?
2. Can you see the four corners and the four sides of the grid while focusing on the
   dot in the center?
3. Are there any blank or blurry sections of the grid while focusing on the center?
4. Are there any wavy lines (horizontal or vertical) of the grid while focusing on the
   center?

Question 23

heteronymous VF defect

Answer 23

effecting opposite sides of the VF

eg binasal Heteronymous hemianopia

Question 24

How many mistakes can colour normal make ishihara

Answer 24

6 is the max number of mistakes a colour normal can make

12 mistakes mean severe dichromat

In practice colour normals shouldn’t really make more than 2 mistakes

Question 25

City test questioning for part 1

Answer 25

Are all the spots the same colour or is one spot a different colour They may all be the same 6secs per page

Question 26

Part 1 city interpretation

Answer 26

Normal = score of 10 or 9 Deutrans and protons = 4/5 Tristan’s = 7 Acquired can vary

Question 27

City part 2 interpretation

Answer 27

0-2 errors normal or mild 3-4 mild 5-7 mod defect 8-10 severe

Question 28

City difference between part 1 and part 2

Answer 28

Part 1 screening Part 2 type and degree of CVD

Question 29

What distance are the stereo tests done at

Answer 29

40cm Except frisby 30-80cm

Question 30

homonymous VF defect

Answer 30

affecting the same side like left or right

Question 31

congruity meaning

Answer 31

similar defect between RE and LE when comparing - shape, intensity and uniformity. only applies in bilateral more congruity the more posterior

Question 32

vf defect more uniform meaning

Answer 32

poorer prognosis

Question 33

How to explain glare

Answer 33

Glare happens when too much bright light hits your eyes and makes it hard to see clearly

Question 34

how to explain a malingering patient

Answer 34

"I can see that you're really concerned about your child's vision, and I understand why. It's great that you're being proactive about their health. After conducting a full eye exam and assessing all the necessary tests, I can confidently say that your child’s eyes are healthy and there is no evidence of any vision problems. Sometimes, when there are no physical issues detected, but a child continues to report difficulties, it’s possible they might be exaggerating or fabricating their symptoms. This is called malingering. It doesn't mean the child is lying intentionally or maliciously, but sometimes it can be a way for them to express frustration, seek attention, or avoid certain situations (like schoolwork or a particular activity). I noticed that when performing some of the tests, there were moments where their performance was inconsistent, or they seemed to have difficulty only when certain tasks were required, but not others. It’s important to understand what’s driving these complaints. Sometimes, children might not be able to express other underlying frustrations or difficulties that might be affecting their behavior. If you’d like, we can explore other avenues, such as behavioral assessments or looking into other factors like stress or anxiety, that might be contributing to what you’re observing. I’m here to support you and your child, and we can definitely work together to figure out the next steps. Please feel free to reach out if you have any questions or if you'd like to discuss this further."

Question 35

ptergium explaination

Answer 35

A Pterygium is a growth of pink, fleshy tissue on the conjunctive (the clear tissue that lines the eyelids and covers the eyeballs) its usually forms on the side closest to your nose and grows towards the pupil. It can look scary but it isnt cancer. The growth may spread slowly throughout your life or stop after a certain point. In extreme cases can cover the pupil and cause vision problems. You can have a growth in one or both eyes. Although it can cause discomfort this isnt usually a serious condition. Fibrovasular tissue, degenerative

Question 36

pinguecula explanation

Answer 36

A pinguecula is a yellowish, slight raised thickening of the conjunctiva on the white part on the eye, close to the edge of the cornea. Pinguecula are non-cancerous bumps on the eyeball on the white of the eye between the lids and appear on the side closer to the nose generally. Degeneration of collagen fibres, thinning of epithelium

Question 37

AMD explaination

Answer 37

when the macula at the back of your eye becomes damaged. This can make it harder to see finer detail such as recognising faces, read or watch TV. the edge of your vision should not be affected. What causes Macular Degeneration? DRY AMD: As we get older the light sensitive cells in the macula can start to break down this occurs gradually over many years. Waste products begin to build up form deposits called drusen. As the condition progresses so does the amount and size of drusen. As dry AMD progresses you have less of these light sensitive cells and causes your central vision to deteriorate and a blurred spot will develop in the centre of your vision. WET AMD: Tiny new blood vessels begin to grow underneath the macula. These blood vessels form in the wrong place and can leak blood and fluid into the eye pushing the macula away from its blood supply at the back of the eyes causing rapid loss of vision and damage and can lead to scarring of the macula. Wet AMD progresses a lot faster than Dry AMD and it is this scarring and damage which causes the more severe symptoms. wet happens because eye doesn’t get enough oxygen and nutrients because of aging and damage t

Question 38

glaucoma explanation

Answer 38

Glaucoma is a group of eye diseases in which the optic nerve, which connects the eye to the brain is damaged by the pressure of the fluid inside your eye. This may be because the pressure is higher than normal, or because the the nerve is more susceptible to damage from pressure. This may affect one or both eyes. There is chronic glaucoma which slowly and acute glaucoma with happens more quickly. In normal tension glaucoma, the optic nerve gets damaged even though eye pressure is “normal”. This usually happens because the nerve is more fragile or doesn’t get enough blood flow.

Question 39

papilloedema explanation

Answer 39

Papilloedema is swelling of the optic nerve in both eyes. This is a serious eye condition which require investigation to determine the underlying cause which needs to be treated as soon as possible as it could cause serious harm if left untreated. Papilloedema is a sign of elevated intracranial (pressure build up inside the head) causes can include: Brain tumour or abscess, cerebral trauma or haemorrhage, meningitis, cavernous sinus thrombosis, encephalitis or idiopathic but due to potential sinister cause any suspect cases need prompt and immediate investigation.

Question 40

cataract explanation

Answer 40

A cataract is when the clear lens inside your eye becomes cloudy. The lens sits just behind your pupil and normally helps focus light onto the retina so you can see clearly. When it gets cloudy, light can’t pass through properly, and vision becomes blurry or misty

Question 41

retinal detachement explanation

Answer 41

A retinal detachment is when the retina peels away from the back of the eye. The retina acts like the film in a camera — it captures light and sends visual signals to the brain. If it comes away (detaches), it can’t work properly, and vision can be permanently lost if it’s not treated quickly

Question 42

PVD explanation

Answer 42

A PVD is when the jelly-like substance inside the eye (called the vitreous) naturally pulls away from the retina at the back of the eye. The vitreous is a clear, gel-like substance that fills the space between the lens and the retina — it helps the eye keep its shape. As we age, this jelly shrinks and becomes more watery. When it shrinks enough, it comes away from the retina — this is a posterior vitreous detachment.

Question 43

iris colomboma explanation

Answer 43

An iris coloboma is when there’s a gap or notch in the iris (the coloured part of the eye). It’s usually shaped like a keyhole or cat’s eye, and it’s there from birth. last section to form and it it doesn’t close fully, it leaves a missing piece. usually at the bottom part of the pupil. If only the iris is affected, many people have normal vision No treatment is needed if vision is fine. If light sensitivity is a problem, people may use tinted glasses or contact lenses with an artificial iris to cover the gap. If there’s a larger coloboma affecting deeper structures, vision checks and monitoring are needed. eg choriod, disc, lens not always genetically linked but can be surgery can be done but usually cls used instead

Question 44

retinal vein occlusion explanation

Answer 44

A retinal vein occlusion happens when a vein in the retina gets blocked. If a vein gets blocked (occluded), blood can’t drain properly → pressure builds up → fluid and blood leak into the retina → vision gets blurred. injections into the eye (anti-VEGF) to reduce swelling (macular oedema). Laser treatment to prevent abnormal blood vessels from growing.

Question 45

Ischaemic optic neuropathy

Answer 45

Ischaemic optic neuropathy (ION) means damage to the optic nerve due to poor blood supply (ischaemia). It’s one of the most common causes of sudden vision loss in older adults. aion can be aaion (Due to inflammation of arteries — almost always GCA) or naion (Small blood vessel disease (e.g. diabetes, hypertension). posterior ion less common -disc looks normal but become pale after (still has sudden vision loss, altiudinal defect, rapd. Can happen during or after events that cause severe blood loss or low blood pressure (e.g. major surgery, trauma). No pain with eye movement.

Question 46

CN palsy explanation

Answer 46

A cranial nerve palsy is when a nerve that controls eye movement is weak or damaged, causing double vision and sometimes a droopy eyelid or pupil changes. The cause can be minor or serious, so it often needs checking out.

Question 47

retinal artery occlusion explanation

Answer 47

A retinal artery occlusion happens when an artery that supplies blood to the retina gets blocked. If an artery gets blocked, part of the retina suddenly loses its blood supply, causing sudden vision loss. A retinal artery is usually blocked by a tiny clot or embolus The retina can only survive a few hours without blood supply. After that, the damage is usually permanent. Also, a retinal artery blockage is a warning sign — it means there may be blockages elsewhere in the body (like the brain → stroke risk).

Question 48

amblyopia explanation

Answer 48

Amblyopia is commonly referred to as a lazy eye which is a childhood condition were the vision doesn’t develop correctly usually in one eye. This is usually mean the child can see less clearly out of the affected eye and relies on the “good” eye. A lazy eye occurs when these connections responsible for vision arent made properly. Some of the conditions which can lead to a lazy eye are: a Squint where the weaker eye turns.

Question 49

PSD VFs

Answer 49

indicates a deviation in the shape of the hill of vision

Question 50

MD VFs

Answer 50

Normal expected hill of vision and patients hill of vision

Question 51

trop drops

Answer 51

takes 15-30 mins to work lasts around 6hrs, occasionally the side effects may last until the next day you should not undertake hazardous activities like driving, cycling or operating heavy machinery while your vision is affected. more sensitivity to light, vision might be slightly blurred unlikely event you experience any unusual symptoms like feeling unwell, pain or redness around your eyes or your vision seems misty, contact optom or seek medical advice.

Question 52

cyclo drops

Answer 52

take 30mins to work lasts around 24hrs, should not undertake hazardous activities like driving, cycling until vision is normal objects more blurry, should be able to see close work again after 1/2 hrs. Sometime distance can be blurred as well more sensitivity to light, vision might be slightly blurred unlikely event you experience any unusual symptoms like pain or redness in or around eyes, disorientated, incoherent speech, visual disturbance, racing pulse or palpitations. contact optom or seek medical advice.

Question 53

Maddox wing

Answer 53

Need to be 15 degrees depressed. measures horizontal, vertical and torsional at one time. RE sees arrows. LE sees numbers Red scale even number then hyperdeviation White scale odd number esodeviation

Question 54

Maddox rod lighting

Answer 54

Dim

Question 55

why is 2mm added to the blank size calculation

Answer 55

for glazing

Question 56

hyperopic prescription thickness

Answer 56

thickness in centre ordering a surfaced lens to minimum blank size will reduce the centre thickness of the lens compared to a stock lens larger than the minimum blank size

Question 57

myopic rx thickness concerns

Answer 57

need to consider frame eye size to influence edge thickness rather than blank size

Question 58

NTG risk factors

Answer 58

increased age females japanese CCT lower in NTG than POAG migraines raynauds systemic hypertension DM HBP myopia sleep apnoea syndrome thyroid disease

Question 59

POAG risk factors

Answer 59

high iops or OHT (asymmetry of 4) increasing age black sibling parents thinner CCT high myopia DM Vascular Eye surgery/injury long term steroids m=f

Question 60

PACG risk factors

Answer 60

hyperopes >40yrs shallow anterior chamber females FH chinese

Question 61

horners

Answer 61

anisocoria greater in the dark lung tumour reduced iop on affected side triad affected pupil dilates slower

Question 62

holmes adie pupil

Answer 62

anisocoria greater in the light restricts on accommdation reading glare problems urgent referral damage or viral infection

Question 63

argyll robertson pupil

Answer 63

rare bilateral miosed and irregular pupils accommodative but not reactive to light alcholism/DM/ lesion midbrain

Question 64

decentration calculation

Answer 64

frame PD-PX PD/ 2

Question 65

prism

Answer 65

vertical prism - axis wanted at 90 horizontal prim - axis wanted at 180 slab off creates base up (to most minus) slab on creates base down (to most plus)

Question 66

adding prism

Answer 66

if both prism base up or down then add together. If one base up and one base down then add eg 6.50 base up and 0.25 base down would be 6.75 base up. when plus rx then base up when minus rx then base down

Question 67

which hot compress for the types of bleph

Answer 67

Wet warm compresses loosen collarettes and crusts in anterior blepharitis. Dry warm compresses melt meibum in posterior blepharitis

Question 68

Quadrantopia management

Answer 68

Referral to stroke clinic And referral to GP for bloods

Question 69

binasal hemanopia cause

Answer 69

carotid artery aneurysm

Question 70

ocular rosacea symptoms

Answer 70

inflam condition of oil glands of the skin discomfort dryness, irritation itching, FB sensation photophobia frequent facial flushing

Question 71

ocular rosacea signs

Answer 71

hyperaemic thickened lids telangiectasia of the lid margins blepharitis recurrent chalazion, hordeolum tear film instability punctate staining peripheral vascularisation of inferior cornea subepithelial infiltrates around corneal vessels marginal keratitis corneal thinning (may lead to perforation) scarring secondary to corneal involvement sclerokeratitis - link to autoimmune bulbar and/or palpebral hyperaemia chronic hyperaemia of nose, central forehead and upper cheeks telangiectasia of facial blood vessels bullous nosein severe cases

Question 72

management ocular rosacea

Answer 72

manage bleph/ chalazion/hordeolum Consider Omega 3 fatty acid supplementation ocular lubricants or topical antibiotics, Oral tetracyclines, topical steroids urgent referral to an ophthalmologist if keratitis is severe

Question 73

management of anisometropic amblyopia children

Answer 73

referral to orthoptics full rx FT wear picking frame close to patients pd eyes sitting centerally, vertically and horizontally plastic frame, spring hing straps for younger children thinning for lenses, MAR coating curved edges for frame? trivex lenses mono pds

Question 74

visual migraines management

Answer 74

refer to GP for investigation, they could manage with possible medications or refer to neurology keep diary to spot triggers, avoid triggers record results dilated fundus exam to rule out PVD/ RD flashes and floaters advice, leaflet?

Question 75

AC/A ratio

Question 76

mechanism of action drops

Answer 76

trop + cyclo - antimuscarinic, trop - paralysis of ciliary muscle cyclo paralysis of ciliary muscle and sphincter phenylephrine - sympathomimetic contraction of dilator

Question 77

meniscus lens form

Answer 77

2 cured surfaces, used to minimise spherical aberrations - leading to sharper images , aka convex - concave lenses positive meniscus thicker in centre, neg meniscus thinner centrally

Question 78

chalazion and hordeolum location difference

Answer 78

chalazion = center of lid hordeolum = closer lid margins

Question 79

CMV retintis

Answer 79

eye infection- progressive and sight threatening AIDS, advanced immosuppression starts unilateral and becomes bilateral floaters, blurred vision, flashes, sudden visionloss ,painless. necrosis emergency referral

Question 80

candida retintis

Answer 80

fungal infection of retina immunocompromsied blurred vision, flaoters, eye pain, bilateral/uni, white fluffy retinal lesions, vitritis, hypopyon

Question 81

myopic CNV ( choroidal neovascularisation)

Answer 81

high myopia new vessels bleeds and scar. fibrovascular membrane - central vision loss or blurred metamorphopsia lacquer cracks

Question 82

Phthiriasis palpebrarum

Answer 82

crab lice on lashes due to STD red watery eye(s), very itchy, burning, gritty madarosis, spk, reddish-brown deposits at the base of the lashes, adult lice, bites leave red inflamed areas on lid margins. redness, swelling Referral via GP for management of non-ocular aspects, including tracing and screening close contacts; also screening for other sexually-transmitted diseases remove lice with forceps, personal hygiene Application of unmedicated paraffin-based ointment (e.g. Simple Eye Ointment) to the lid margins will suffocate lice

Question 83

bells palsy signs and symptoms

Answer 83

sudden onset, unilateral. common in pregnancy, HIV, DM facial nerve stops functioning/damaged possibly due to inflam maybe due to viral infection? Distressing cosmetic change due to loss of muscle tone on one side of face. May report changes in taste and salivation. Ocular exposure causes: watery, red, discomfort, pain, photophobia, reduced vision unilateral facial weakness including orbicularis oculi leading to: eyebrow droop and inability to raise it incomplete blink leads to corneal drying incomplete closure at night (lagophthalmos) (causes prolonged corneal exposure and dry eye) ectropian loss of lacrimal pump mechanism (produces tear pooling and epiphora) conjunctiva: hyperaemia, oedema, staining Cornea: desiccation signs range from mild superficial punctate erosions to frank ulceration (usually inferior). reduced corneal sensation

Question 84

management bells palsy

Answer 84

New cases, and where there is loss of corneal sensation: A2: first aid measures and emergency (same day) referral to GP or hospital A&E department Recovering and established cases: B2: alleviation/palliation; no referral corticosteroids and antivirals used to tx most cases recover taping lids, lubricants, sunglasses, therapeutic cl

Question 85

photokeratitis management

Answer 85

caused when the eyes are exposed to too much ultraviolet (UV) light Advise against continuing exposure Reassure patient that damage is transitory symptoms typically resolve within 24 to 48 hours (mild photophobia and blurring may persist for a week or longer) Cold compresses, sunglasses for symptomatic relief Advise rest with eyes closed Close monitoring (corneal epithelium should have largely healed by the following day) Advise patient to return/seek further help if symptoms persist Advise patient on future eye protection

Question 86

signs and symptoms of photokeratitis

Answer 86

Delay of 6-12 hours between exposure and onset of symptoms is usual; however, latency varies inversely with exposure dose and can be as short as 1 hour Mild cases: irritation and foreign body sensation Severe cases: pain, redness, photophobia, blepharospasm lacrimation blurring of vision Signs of photokeratitis Typically bilateral (if unilateral, suspect corneal or subtarsal foreign body) Lid oedema and hyperaemia Conjunctival hyperaemia Epiphora Punctate staining of corneal epithelium with fluorescein (may be coalescent) Transitory reduction in visual acuity Associated facial or eyelid erythema (‘skin burns’)

Question 87

when to refer emergency for cornea

Answer 87

Emergency (same day) referral is indicted if any of the following signs are present: infiltrate >1mm 2 or more adjacent lesions location 3mm or less from corneal centre AC reaction (≥10 cells in a 1mm beam (≥ 1+ on the SUN scale) signs suggestive or fungal or acanthamoeba keratitis high likelihood of poor patient compliance to treatment

Question 88

signs of contact lens-associated infiltrative keratitis

Answer 88

Peripheral anterior stromal infiltrate, single or multiple (multiple infiltrates more likely in CLARE) Usually small (generally less than 1.0mm in diameter) Overlying epithelium may stain with fluorescein (ulcer formation in CLPU) Conjunctival hyperaemia Adjacent limbal hyperaemia Epiphora, mild (or absent) Anterior chamber quiet or mildly inflamed No lid oedema Usually unilateral

Question 89

Symptoms of contact lens-associated infiltrative keratitis

Answer 89

Red and watery eye Foreign body sensation Photophobia