opthal gallery

Question 1

Patinet presents with conjunctival injection, poorly-reactive mid-dilated, corneal cloudiness or edema. Outline:

• Symptoms you would expect
• findings on examination
• common causes
• gold standard diagnosis
• treatment

Answer 1

Angle-closure glaucoma - ophthal emergency

• Exam:shallow anterior chamber, atrophy of optic nerve head (cupping), peripheral visual defect
• visual loss, headache, severe eye pain, light haloes, N/V
• causes: primary (narrowing of angle), secondary (factors that push/pull anterior chamber closed e.g. fibrosis, drugs, neovascularizations etc)
• gonioscopy - use of special lens with slit lamp to view iridocorneal angle
• treatment
  
  • emergency use of topical beta blocker (timolol), alpha agonist (apraclonidine), pilocarpine. +/- IV acetazolamide, mannitol
  • analgesia and anti-emetics
  • Once acute attack is controlled, definitive tx is laser peripheral iridotomy.
• Prevention - fellow eye should be treated prophylactically within the next few days, avoid decongestants and anticholinergic medication

Question 2

Answer 2

iritis

Question 3

Answer 3

corneal ulcer

Question 4

Answer 4

HSV herpes simplex keratitis

Question 5

Answer 5

stye

Question 6

Answer 6

retinal hemorrhage

Question 7

Answer 7

pterygium

Question 8

Answer 8

preseptal cellulitis

Question 9

Answer 9

pre septal cellulitis

Question 10

Answer 10

penetrating eye injury

Question 11

Answer 11

orbital cellulitis

Question 12

Answer 12

molluscum contagiosum

Question 13

Answer 13

melbomian cyst

Question 14

Answer 14

lower lid ectopion

Question 15

Answer 15

keratitic precipitate - pus in the anterior chamber. late sign in iritis

Question 16

Answer 16

hyphaema

Question 17

Answer 17

entropion

Question 18

Answer 18

basal cell carcinoma

Question 19

Answer 19

diabetic non proliferative

Question 20

Answer 20

diabetic proliferative

Question 21

Answer 21

acute glaucoma

assymetry of cup:disc ratio between eyes

cupping of disc presents with increased cup:disc ratio

ischemic atrophy of optic nerve causing atrophic cupping of the disc

Question 22

Answer 22

age related macular degeneration

Question 23

Answer 23

cataracts on a slit lamp exam

Question 24

Answer 24

central retinal artery occlusion

cherry red spot

Question 25

Answer 25

retinal branch vein occlusion

Question 26

Answer 26

Actie trachoma

• chlamydia trachomatis
• Follicular inflammation visible (>0.5mm)
• Herberts pits - shallow pits in the cornea that form as a result of corneal rupture
• treatment - topical tetracycline BD, or stat dose of azithromcin
• Prevention - SAFE strategy by WHO: Surgery if indicated, abx therapy, facial hygiene, environmental control