trauma and red eye when a patient arrives at the er with a supposed alkali chemical burn to the eye,...
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Trauma And red eye
When a patient arrives at the ER with a supposed alkali chemical burn to the eye, what is your first action,
a)Check visionb)Check pupils for afferent pupillary
defectc)Irrigate eye with normal salined)Check PH of the conjunctival fornix
When a patient arrives at the ER with a supposed alkali chemical burn to the eye, what is your first action,
a)Check visionb)Check pupils for afferent pupillary
defectc)Irrigate eye with normal salined)Check PH of the conjunctival fornix
Chemical burn : Acid , coagulate proteins and inhibit
further corneal penetration Alkali worse prognosis never try to neutralize
If a ruptured globe is suspected, the first action to take is to:
a)Shield the eyeb)Patch the eyec)Give topical or systemic antibioticsd)Assess the vision
If a ruptured globe is suspected, the first action to take is to:
a)Shield the eyeb)Patch the eyec)Give topical or systemic antibioticsd)Assess the vision
R/o intraocular foreign body with orbital CT scan, specially in metal on metal hammering
NPO IV antibiotic Tetanus status
Need to be referred,
Decreased visionShallow anterior chamberHyphemaAbnormal pupilOcular misalignmentRetinal damage
The best study to evaluate a patient with intraocular foreign body is
a)Orbital ultrasoundb)MRI scan of the orbitsc) CT scan of the orbitsd) Plain film of the skull
The best study to evaluate a patient with intraocular foreign body is,
a)Orbital ultrasoundb)MRI scan of the orbitsc) CT scan of the orbitsd) Plain film of the skull
Management of orbital floor fracture
a) Is a surgical emergency that requires immediate repair
b)Includes surgical repair only for persistent diplopia add/or cosmetic issues.
c) Does not require ophthalmology consultation because associated ocular damage is rare
d)Always includes topical and systemic antibiotics
Management of orbital floor fracture
a) Is a surgical emergency that requires immediate repair
b)Includes surgical repair only for persistent diplopia add/or cosmesic issues.
c) Does not require ophthalmology consultation because associated ocular damage is rare
d)Always includes topical and systemic antibiotics
Treatment:No cough , no nose blowingSystemic AB, if sinusitisSurgery if fx more than 50% of the floor, diplopia not improving, enophthalmos more than 2 mm,
There might be a picture of a kid with white eye, who can’t look up., blow out fracture
In the case of the contact lens wearer with this cornea
a) Instills antibiotics, patch the eye, and reexamine in 24 hours
b)Antibiotic coverage for gram-positive organism is important.
c) refer to an ophthalmologist only if the case is complicated by a corneal infiltrate.
d)The risk of ulceration is significantly higher than in not –contact Lens wearer
In the case of the contact lens wearer with this cornea
a) Instills antibiotics, patch the eye, and reexamine in 24 hours
b)Antibiotic coverage for gram-positive organism is important.
c) refer to an ophthalmologist only if the case is complicated by a corneal infiltrate.
d)The risk of ulceration is significantly higher than in not –contact Lens wearer
No patch in contact lens induced abrasions , risk of pseudomonas ulcer
No patch for simple abrasion less than 10mm,
Never prescribe topical anesthetics,
Proper treatment for a corneal abrasion includes which of the following?
a)Topical corticosteroidsb)A tight patch over the eye for 48 to 72
hoursc)Topical anesthetic for less then 12
hours onlyd)Oral analgesic if necessary
Proper treatment for a corneal abrasion includes which of the following?
a)Topical corticosteroidsb)A tight patch over the eye for 48 to 72
hoursc)Topical anesthetic for less then 12
hours onlyd)Oral analgesic if necessary
Conjunctival injection with discharge
a)Should be treated with a topical antibiotic even if discharge is watery.
b)Can be treated with a topical steroid initially if inflammation is significant.
c) Should be treated with parenteral antibiotic if gonococcal.
d) Is probably of viral origin in the presence of prominent itching symptoms
Conjunctival injection with discharge
a)Should be treated with a topical antibiotic even if discharge is watery.
b)Can be treated with a topical steroid initially if inflammation is significant.
c)Should be treated with parenteral antibiotic if gonococcal.
d) Is probably of viral origin in the presence of prominent itching symptoms.
PapillaeAllergic conjunctivitisBacterial conjunctivitis
FolliclesViral conjunctivitisChlamydial conjunctivitis
Remember: Gonococcal conjunctivitis should be
treated with parenteral antibiotic.Why?Risk of corneal perforation
10. which of the following is not characteristic of acute angel closure glaucoma
a)High IOPb)Mild eye painc)Decreased visiond)A fixed and dilated pupil
10. which of the following is not characteristic of acute angel closure glaucoma
a)High IOPb)Mild eye painc)Decreased visiond)A fixed and dilated pupil
Primary angle closure glaucoma, risk factors
HyperopiaAge>70FemaleFamily historyAsian, Inuit peopleMature cataractShallow anterior chamberPupil dilation
What is your next plan:Refer to ophthalmologist for laser
iridotomy
What would be the next planLaser iridotomyAqueous suppression with BACHMiotics to reverse the pupillary block
11. The finding that best distinguishes orbital cellulites from preseptal cellulitis is,
a)Profound skin erythema with swelling extending above the eyebrow
b)Limited ocular motilityc)Feverd)Pain around the eye
11. The finding that best distinguishes orbital cellulitis from preseptal cellulitis is,
a)Profound skin erythema with swelling extending above the eyebrow
b)Limited ocular motilityc)Feverd)Pain around the eye
Ocular motility Vision RAPD Sinusitis can cause orbital cellulitis and
trauma , skin abrasoin any skin lesion can cause preseptal.
All of the following are part of the evaluation and management of orbital cellulitis except
a)Ophthalmologic consultationb)Orbital CT scanc)Blood cultured)Outpatient administration of oral
antibiotics in an immunocompetent patient
All of the following are part of the evaluation and management of orbital cellulitis except
a)Ophthalmologic consultationb)Orbital CT scanc)Blood cultured)Outpatient administration of oral
antibiotics in an immunocompetent patient
Request stat ophthalmology and ENT consultations to rule out a life–threatening fungal infection (mucoromycosis)
Diabetic patient with ketoacidosi, Frozen globe, + RAPD
Request stat ophthalmology and ENT consultations to rule out a life–threatening fungal infection (mucoromycosis)
Diabetic patient with ketoacidosi, Frozen globe, + RAPD
12. which of the following is least consistent with the diagnoses of temporal arteritis?
a)Jaw claudicationb)diabetes mellitusc)age over 65 years d)Scalp or forehead tenderness
12. which of the following is least consistent with the diagnoses of temporal arteritis?
a)Jaw claudicationb)diabetes mellitusc)age over 65 years d)Scalp or forehead tenderness
In a patient who presents with unilateral visual loss with scalp tenderness
a)A temporal artery biopsy should be performed before steroids are started.
b)An erythrocyte sedimentation rate(ESR) should be obtained immediately.
c)Involvement off the second eye is rare.d)Temporal arthritis is unlikely if the
patient is older than 65.
In a patient who presents with unilateral visual loss with scalp tenderness
a)A temporal artery biopsy should be performed before steroids are started.
b)An erythrocyte sedimentation rate(ESR) should be obtained immediately.
c)Involvement off the second eye is rare.d)Temporal arthritis is unlikely if the
patient is older than 65.
In giant cell arteritis all of the following are true except
a)A low or normal sedimentation rate does not exclude the diagnoses
b)The most common cranial nerve paralysis that occur involves the third cranial nerve.
c)A deficit in choroidal circulation is typically seen on fluorescein angiography.
d)This condition typically affects people under age 60.
In giant cell arteritis all of the following are true except
a)A low or normal sedimentation rate does not exclude the diagnoses
b)The most common cranial nerve paralysis that occur involves the third cranial nerve.
c)A deficit in choroidal circulation is typically seen on fluorescein angiography.
d)This condition typically affects people under age 60.
F > 60 y/o Abrupt monocular loss of vision, pain
over temporal artery , jaw claudication, scalp tenderness, PMR, constitutional
Diagnosis : temporal artery biopsy Treatment high dose steroid, start
immediately , before the biopsy
Hx: Jaw claudication and diplopia, On exam: temporal a. beading,
prominence of a. tenderness
13. Possible causes for sudden Visual loss include all of following except
a)Temporal arteritisb)Retinal detachmentc)Glaucomad)Nonarteritic optic neuropathy
13. Possible causes for sudden Visual loss include all of following except
a)Temporal arteritisb)Retinal detachmentc)Glaucomad)Nonarteritic optic neuropathy
. The best method for evaluating a 50-year-old patient for best-corrected vision without his or her glasses is,
a)Near cardb)Distance chart with pinholec)Distance chart with both eye opend)Magazine or newspaper
. The best method for evaluating a 50-year-old patient for best-corrected vision without his or her glasses is,
a)Near cardb)Distance chart with pinholec)Distance chart with both eye opend)Magazine or newspaper
What mechanism of action do cycloplegic use to relieve pain?
a) Topical anestheticb)Paralysis of pupillary dilationc)Paralysis of ciliary spasmd)Decrease production of inflammatory
cells in anterior chamber
What mechanism of action do cycloplegic use to relieve pain?
a) Topical anestheticb)Paralysis of pupillary dilationc)Paralysis of ciliary spasmd)Decrease production of inflammatory
cells in anterior chamber
This patient presents with sudden unilateral vision loss. All of the following are treatment options except
a)Continues digital massage of the globe to dislodge an embolus
b)Topical beta blockersc) AC paracenthesis by an ophthalmologist a) Re-breathing CO2
This patient presents with sudden unilateral vision loss. All of the following are treatment options except
a)Continues digital massage of the globe to dislodge an embolus
b)Topical beta blockersc) AC paracenthesis by an ophthalmologist a) Re-breathing CO2
Emboli from carotid a. Emboli heart( arrhythmia, valvular,
endocarditis)ThrombosisTemporal arteritis
In the elderly the most come source of emboli to ophthalmic or retinal arterioles is
a) Fibrin or cholesterol from an ulcerated carotid plaque.
b)A calcified heart valvec)Fibrin -platelet emboli from mitral valve
prolapse d)Fibrin- platelet emboli from the aorta
In the elderly the most come source of emboli to ophthalmic or retinal arterioles is
a) Fibrin or cholesterol from an ulcerated carotid plaque.
b)A calcified heart valvec)Fibrin -platelet emboli from mitral valve
prolapse d)Fibrin- platelet emboli from the aorta
All of the following statements regarding this trauma case are true except
a)It is the result of a tear in an iris vessel.b)It can be associated with other ocular
injuries.c) It is treated with the antibiotics and
routine activities.d)It should be referred to ophthalmologist.
All of the following statements regarding this trauma case are true except
a)It is the result of a tear in an iris vessel.b)It can be associated with other ocular
injuriesc)It is treated with the antibiotics and
routine activities.d)It should be referred to ophthalmologist.
Risk of re-bleed highest on days 2-5 , resulting in
Increased IOP, corneal staining, iris necrosis,
Never asiprin , risk of re-bleed, no valsalva
Herpes zoster involving the ophthalmic devision of cranial nerve V is more likely to have ocular involvements if
a)The tip of the nose is involvedb)The upper lid is involvedc)The lower lid is involvedd)Either lid margin is involved
Herpes zoster involving the ophthalmic devision of cranial nerve V is more likely to have ocular involvements if
a)The tip of the nose is involvedb)The upper lid is involvedc)The lower lid is involvedd)Either lid margin is involved
In presence of Hutchinson sign there is significantly high risk of eye involvement.
Treatment Oral antiviral In cases of conjunctival
involvement ,erythromycin Refer to ophthalmologist and steroid should
be prescribed by ophthalmologist.
A 30 y/o M, presents withredness, pain photophobia and decreased vision. If this is the photo of his eye,the next step is
a)Patch the eye and give assurance of spontaneous resolution
b)Prescribed a topical corticosteroidc)Prescribed a topical antibiotic
ointmentd)Referral to an ophthalmologist
A 30 y/o M, presents withredness, pain photophobia and decreased vision. If this is the photo of his eye,the next step is
a)Patch the eye and give assurance of spontaneous resolution
b)Prescribed a topical corticosteroidc)Prescribed a topical antibiotic
ointmentd)Referral to an
ophthalmologist
Treatment by ophthalmologist Antiviral preferably oral ,Steroid not at the beginning and with
caution , by the ophthalmologist
Lid laceration repair should include
a)Assessment of possible canalicular injury
b)Foreign body removalc)Tetanus prophylaxisd) All of the above
Lid laceration repair should include
a)Assessment of possible canalicular injury
b)Foreign body removalc)Tetanus prophylaxisd) All of the above
Lid margin laceration Medial lid laceration with canalicular
involvement
Sunconjunctival hemorrhages
a)Are usually a sign of underlying hematologic or coagulation abnormalities, even in the absence of retinal hemorrhages that require extensive Systemic workup.
b)Are sometimes associated with severe pain and or loss of vision.
c)Require cessation of any NSAID or Systemic anticoagulant for resolution.
d)Resolve spontaneously in 2-3 weeks.
Sunconjunctival hemorrhages
a)Are usually a sign of underlying hematologic or coagulation abnormalities, even in the absence of retinal hemorrhages that require extensive Systemic workup.
b)Are sometimes associated with severe pain and or loss of vision.
c)Require cessation of any NSAID or Systemic anticoagulant for resolution.
d)Resolve spontaneously in 2-3 weeks.
Prolonged use of topical ophthalmic anesthetics can cause
a) Iritisb) Corneal damagec) Open-angle glaucomad) Reactivation of a latent herpes
simplex virus infection
Prolonged use of topical ophthalmic anesthetics can cause
a) Iritisb) Corneal damagec) Open-angle glaucomad) Reactivation of a latent herpes
simplex virus infection
Side effects of topical steriod corneal fungal ulcers CataractsOpen-angle glaucomaProgression of herpes keratitis,
dendrites
Treatment of a chalazion , which presents as an acute tender swelling of the lid usually
a)Requires incision and drainageb)Requires topical antibioticsc)Requires a short course of
systemic antibioticsd)Includes warm compresses and
lid hygiene for 2 weeks
Treatment of a chalazion , which presents as an acute tender swelling of the lid usually
a)Requires incision and drainageb)Requires topical antibioticsc)Requires a short course of
systemic antibioticsd)Includes warm compresses
and lid hygiene for 2 weeks
Still a chalazion
Neonatal Chlamydial conjunctivitis
a)Has become rare the advent of silver nitrate prophylaxis
b)Occurs only after 21 days of agec)Maybe treated with topical
erythromycin aloned)Requires two weeks of systemic
erythromycin for effective treatment
Neonatal Chlamydial conjunctivitis
a)Has become rare the advent of silver nitrate prophylaxis
b)Occurs only after 21 days of agec)Maybe treated with topical
erythromycin aloned)Requires two weeks of systemic
erythromycin for effective treatment
Ophthalmia neonatarum
Toxic , 1 day, silver nitrate or erythromycin , no treatment neede
Gonococcal 5-7 days, is the most serious threat 5
Chlamydial , need systemic treatment always
Herpes simplex after 2-3 weeks
Which of the following statements about pterygium is true
a) It is a malignant transformation of bulbar conjunctiva in response to environmental irritants
b) It is prevalent in white collar workers who use computers extensively
c) It is most commonly found on the temporal side of the bulbar conjunctiva
d) In an early stage into maybe managed with use of artificial tears and topical vasoconstrictors
Which of the following statements about pterygium is true
a) It is a malignant transformation of bulbar conjunctiva in response to environmental irritants
b) It is prevalent in white collar workers who use computers extensively
c) It is most commonly found on the temporal side of the bulbar conjunctiva
d)In an early stage into maybe managed with use of artificial tears and topical vasoconstrictors
Patients with episcleritis
a)Usually complain of severe deep pain.b)Are very likely to have a systemic
connective tissue diseasec)Have engorged superficial vessels
overlying the sclera below the conjunctiva.
d)Can develop necrosis and melting of the sclera with perforation.
Patients with episcleritis
a)Usually complain of severe deep pain.b)Are very likely to have a systemic
connective tissue diseasec)Have engorged superficial vessels
overlying the sclera below the conjunctiva.
d)Can develop necrosis and melting of the sclera with perforation.
To differentiate, Place a drop of Phenyephrine 2.5% , re-examine after 10-15 min , episceleral vessel should blanch.
Scleritis, causses vision loss , sever pain , wakes patient up at night tiem, thining(blue hue) and necrosis of sclera
Glaucoma
POAG
Common 95% Chronic Painless Moderate IOP Normal cornea , pupil No symptom
PACG
Rare 5% Acute onset Painful red eye Extremely IOP Haze cornea,
middilated pupil , N/V, halo around light
Risk factor for open-angel glaucoma include each of the following except
a)African racial heritageb)genderc)Age greater than 60 yearsd)Positive family history for glaucoma
Risk factor for open-angel glaucoma include each of the following except
a)African racial heritageb)genderc)Age greater than 60 yearsd)Positive family history for glaucoma
Primary open angel glaucoma is defined by each of the following except
a)Adult onsetb)Open and normal appearing anterior
chamber angelsc)The absence of secondary causes for
glaucomad)An IOP of 25 mm Hg
Primary open angel glaucoma is defined by each of the following except
a)Adult onsetb)Open and normal appearing anterior
chamber angelsc)The absence of secondary causes for
glaucomad)An IOP of 25 mm Hg
Secondary a glaucoma is caused by each of the following except
a)Myopiab)Uveitisc)Chronic steroid used)Trauma
Secondary a glaucoma is caused by each of the following except
a)Myopiab)Uveitisc)Chronic steroid used)Trauma
Remember IOP is a risk factor not a definition
Remember myopia is a risk factor not a cause
, (even a minor risk factor )
An optic nerve with glaucomatous damage may have all of the following except
a)A disc hemorrhageb)Marked pallor of the neuroretinal rimc)Displacement of the retinal vessels
to the margin of the discd)Thinning of the neuroretinal rim
An optic nerve with glaucomatous damage may have all of the following except
a)A disc hemorrhageb)Marked pallor of the neuroretinal
rimc)Displacement of the retinal vessels to
the margin of the discd)Thinning of the neuroretinal rim
All of the following statements regarding topical beta blockers are true except
a)Beta blockers can worsen congestive heart failure
b)Betaxolol is relatively selective beta 1 blockers
c)Topical beta blockers increase the outflow of the aqueous humor
d)The duration of action of beta blockers is 12 to 36 hours, thus patients are dosed once or twice a day
Topical medications used in the treatment of glaucoma include•beta-adrenergic agonist•alpha-2 adrenergic antagonists•cholinergic agonists•carbonic anhydrase agonists
All of the following statements regarding topical beta blockers are true except
a)Beta blockers can worsen congestive heart failure
b)Betaxolol is relatively selective beta 1 blockers
c)Topical beta blockers increase the outflow of the aqueous humor
d)The duration of action of beta blockers is 12 to 36 hours, thus patients are dosed once or twice a day
Topical medications used in the treatment of glaucoma include•beta-adrenergic agonist•alpha-2 adrenergic antagonists•cholinergic agonists•carbonic anhydrase agonists
Latanoprost (xalatan) can cause any of the following side effects except
a)Conjunctival hyperemiab)Ptosisc)Increased iris pigmentationd)Lengthening of the eyelashes
Latanoprost (xalatan) can cause any of the following side effects except
a)Conjunctival hyperemiab)Ptosisc)Increased iris pigmentationd)Lengthening of the eyelashes
Topical parasympathomimetic
Decrease the production of aqueous humor
Can produce eye or brow pain from induced ciliary muscle spasm
Such as echothiophate can allow quicker extubation of patients paralyzed with succinylcholine
Have no known effect on the gastrointestinal system
Topical parasympathomimetic
Decrease the production of aqueous humor
Can produce eye or brow pain from induced ciliary muscle spasm
Such as echothiophate can allow quicker extubation of patients paralyzed with succinylcholine
Have no known effect on the gastrointestinal system
CRVO Blood and thunder Second most common
retinopathy after DM,
Risk factor HTN, DM, glaucoma,
arteriosclerotic vascular disease, hyperviscosity, (PV, OCP, sickle cell, lymphoma, leukemia,
Teratment of underlying disease
RD , retinal detachment Rhegmatogeneous (most common) caused by tear or hole,Treatment, scleral buckle, rtinopexy
Tractional In diabetic retinopathy, CRVO, sickle
cell, ROP, trauma
Exudative posterior uveitis, central serous
retinopathy tumor
Retinal tearSupratemporal retina , most
common site for horseshoe tearsCaused by PVD, trauma,
Posterior vitreous detachment may be associated with which of the following?
a)Darkness in the central divisionb)Retinal tear or detachmentsc)Athersclerosisd)Temporal arteritis
Posterior vitreous detachment may be associated with which of the following?
a)Darkness in the central divisionb)Retinal tear or detachmentsc)Athersclerosisd)Temporal arteritis
Posterior vitreous detachmentNormal aging of vitreous liquefaction Floater , flasheh Complication:Tear, RD, more in high myopes
Refere to ophthalmologist, dilated exam , F/U
No specific teratment
Drusen sign of :
Leading cause of blindness, cause metamorphopsia,
Risk factors F, age, family hx, smoking,
caucasian, blue eye
Dry (non-exudative): medical. Monitor, antioxidants
Wet (exudative): laser, PDT, intravitreous injection of anti-VEGF
In diabetic retinopathy vision loss may be caused by
a)macular edema b)macular ischemiac)vitreous hemorrhaged)all of the above
In diabetic retinopathy vision loss may be caused by
a)macular edema b)macular ischemiac)vitreous hemorrhaged)all of the above
All of the following are signs of nonproliferative diabetic retinopathy except
a)Microaneurysmb)Hard exudatesc)Neovascularization of the discd)Intraretinal hemorrhages
All of the following are signs of nonproliferative diabetic retinopathy except
a)Microaneurysmb)Hard exudatesc)Neovascularization of the discd)Intraretinal hemorrhages
Patient with type 2 diabetes should be evaluated by an ophthalmologist
a)Beginning five years after diagnosesb)Every two years after diagnosesc)At the time of diagnosesd)Not before puberty
Patient with type 2 diabetes should be evaluated by an ophthalmologist
a)Beginning five years after diagnosesb)Every two years after diagnosesc)At the time of diagnosesd)Not before puberty
A diabetic patient with symptoms of floaters needs to be examined by an ophthalmologist
because of
a)These are typical symptoms of macular edema
b)Probably has suffered a retinal detachmentc)Needs to be evaluated by an
ophthalmologist to rule out the presence of a retinal detachment or vitreous hemorrhage
d)Does not need to be seen by an ophthalmologist because symptoms are usually short-lived
A diabetic patient with symptoms of floaters needs to be examined by an ophthalmologist
because of
a)These are typical symptoms of macular edema
b)Probably has suffered a retinal detachmentc)Needs to be evaluated by an
ophthalmologist to rule out the presence of a retinal detachment or vitreous hemorrhage
d)Does not need to be seen by an ophthalmologist because symptoms are usually short-lived
Dx? Triad?
Dx? Triad?APOArteriolar
narrowingPerivascular
bony-spiculeOptic disc pallor
Remembre that 3th nerve palsy:Exotropia and
hypotropia , ptosis,
6th: Esotropia
4th :hypertropia and head tilt
Remember that need imaging if in young pt or associated with
neurological signs,
Amblyopia ,Reductoin of best corrected visual
acuity due to cortical suppression of sensory input
Etiologies Strabismus , Refractive, Deprivation
TreatmentOcclusion of the good eye
PtosisMiosisAnhydrosisHeterochromia
DDx
DDx Retinoblasto
ma Cataract Retinal
coloboma ROP Toxocariasis Retinal
detachment
Kawasaki disease No to steroid Yes Aspirin
conjunctivits
Conjunctivitis
Oral mucosal rash
Manifestations of systemic diseases
All of the following are false regarding ocular malignancies except
a)The most common intraocular malignancy in adult is a primary ocular melanoma.
b)The most come primary site of origin of cancer metastatic to the eye in males is the colon.
c)The most common primary site or origin of cancer metastatic to the eye in females is the breast
d)Enucleation is the primary treatment for solitary metastases to the eye.
All of the following are false regarding ocular malignancies except
a)The most common intraocular malignancy in adult is a primary ocular melanoma.
b)The most come primary site of origin of cancer metastatic to the eye in males is the colon.
c)The most common primary site or origin of cancer metastatic to the eye in females is the breast
d)Enucleation is the primary treatment for solitary metastases to the eye.
The most common site for metastasis to the eye is the
a)Irisb)Choroidc)Retinad)Optic nerve
The most common site for metastasis to the eye is the
a)Irisb)Choroidc)Retinad)Optic nerve
Metastasis , most common intraocular malignancy in adult
Breast in F, lung in M , Neuroblastoma in children
Malignant melanoma , most common primary intraocular tumor in adult
BCC of lid most common lid malignany
All of the following are true regarding intracranial hypertension except
a)The most common ocular manifestation is optic disc edema.
b)Visual deficits that occur during presentation are usually sever.
c)The most common visual symptoms are transient visual obscurations.
d)Idiopathic intracranial hypertension can be associated with vitamin A or D toxicity, tetracycline therapy, and steroid withdrawal.
All of the following are true regarding intracranial hypertension except
a)The most common ocular manifestation is optic disc edema.
b)Visual deficits that occur during presentation are usually sever.
c)The most common visual symptoms are transient visual obscurations.
d)Idiopathic intracranial hypertension can be associated with vitamin A or D toxicity, tetracycline therapy, and steroid withdrawal.
Papilledema , bilateral disc swelling Nausea/Vomiting/HeadacheTransient visual obscurationPulsatile tinnitus
Sjogren syndrome
a)Is a complex disorder involving the retina and choroid.
b)Is associated with antibodies such as anti -SS-A antibodies
c)Requires surgical excision as primary treatment
d)Effects man five times more often than woman
Sjogren syndrome
a)Is a complex disorder involving the retina and choroid.
b)Is associated with antibodies such as anti -SS-A antibodies
c)Requires surgical excision as primary treatment
d)Effects man five times more often than woman
In patients with connective tissue disorder, dry eye
a)Are the most common ocular manifestations.
b)Are usually associated with permanent visual loss.
c)Can be appropriately treated initially topical antibiotics solutions.
d)Occur most commonly during acute inflammatory episodes.
In patients with connective tissue disorder, dry eye
a)Are the most common ocular manifestations.
b)Are usually associated with permanent visual loss.
c)Can be appropriately treated initially topical antibiotics solutions.
d)Occur most commonly during acute inflammatory episodes.
Keratoconjunctivitis sicca,
Visual symptoms in migraine
a)Are always accompanied by headache
b)Usually have a poor Visual prognosis.c)Vary from scintillations to total
bilateral loss of vision.d)Are always accompanied by
photophobia.
Visual symptoms in migraine
a)Are always accompanied by headache
b)Usually have a poor Visual prognosis.c)Vary from scintillations to total
bilateral loss of vision.d)Are always accompanied by
photophobia.
Optic disc swelling in the malignant hypertension
a)Often occurs even in the presence of mild hypertension.
b)Should be treated the high-dose steroids.c) Indicates that the patient is at increased
risk for developing heart failure and hypertensive encephalopathy.
d)Occurs only in the setting of renal failure.
Optic disc swelling in the malignant hypertension
a)Often occurs even in the presence of mild hypertension.
b)Should be treated the high-dose steroids.c)Indicates that the patient is at
increased risk for developing heart failure and hypertensive encephalopathy.
d)Occurs only in the setting of renal failure.
Retinopathy the most common ocular manifestation of HTN.
Key features of chronic HTN: AV nicking, blot hemorrhages, cotton wool spots, microaneurysm
Thyroid eye disease
a)Occurs only when the patient has abnormal serum thyroid hormone level.
b)Can result in severe visual loss from optic nerve compression or corneal damage.
c)Should be treated surgically in its early congestive phase.
d)Will always improve with maintenance of a euthyroid state
Thyroid eye disease
a)Occurs only when the patient has abnormal serum thyroid hormone level.
b)Can result in severe visual loss from optic nerve compression or corneal damage.
c)Should be treated surgically in its early congestive phase.
d)Will always improve with maintenance of a euthyroid state
NO SPECS No sign Only sign lid retraction, lag Soft tissue swelling periorbital edema Proptosis Extraocula muscle weakness (diplopia) Corneal exposure Sight loss
Manifestations of systemic diseases
All of the following are false regarding ocular malignancies except
a)The most common intraocular malignancy in adult is a primary ocular melanoma.
b)The most come primary site of origin of cancer metastatic to the eye in males is the colon.
c)The most common primary site or origin of cancer metastatic to the eye in females is the breast
d)Enucleation is the primary treatment for solitary metastases to the eye.
All of the following are false regarding ocular malignancies except
a)The most common intraocular malignancy in adult is a primary ocular melanoma.
b)The most come primary site of origin of cancer metastatic to the eye in males is the colon.
c)The most common primary site or origin of cancer metastatic to the eye in females is the breast
d)Enucleation is the primary treatment for solitary metastases to the eye.
The most common site for metastasis to the eye is the
a)Irisb)Choroidc)Retinad)Optic nerve
The most common site for metastasis to the eye is the
a)Irisb)Choroidc)Retinad)Optic nerve
Metastasis , most common intraocular malignancy in adult
Breast in F, lung in M , Neuroblastoma in children
Malignant melanoma , most common primary intraocular tumor in adult
BCC of lid most common lid malignany
All of the following are true regarding intracranial hypertension except
a)The most common ocular manifestation is optic disc edema.
b)Visual deficits that occur during presentation are usually sever.
c)The most common visual symptoms are transient visual obscurations.
d)Idiopathic intracranial hypertension can be associated with vitamin A or D toxicity, tetracycline therapy, and steroid withdrawal.
All of the following are true regarding intracranial hypertension except
a)The most common ocular manifestation is optic disc edema.
b)Visual deficits that occur during presentation are usually sever.
c)The most common visual symptoms are transient visual obscurations.
d)Idiopathic intracranial hypertension can be associated with vitamin A or D toxicity, tetracycline therapy, and steroid withdrawal.
Papilledema , bilateral disc swelling Nausea/Vomiting/HeadacheTransient visual obscurationPulsatile tinnitus
Sjogren syndrome
a)Is a complex disorder involving the retina and choroid.
b)Is associated with antibodies such as anti -SS-A antibodies
c)Requires surgical excision as primary treatment
d)Effects man five times more often than woman
Sjogren syndrome
a)Is a complex disorder involving the retina and choroid.
b)Is associated with antibodies such as anti -SS-A antibodies
c)Requires surgical excision as primary treatment
d)Effects man five times more often than woman
In patients with connective tissue disorder, dry eye
a)Are the most common ocular manifestations.
b)Are usually associated with permanent visual loss.
c)Can be appropriately treated initially topical antibiotics solutions.
d)Occur most commonly during acute inflammatory episodes.
In patients with connective tissue disorder, dry eye
a)Are the most common ocular manifestations.
b)Are usually associated with permanent visual loss.
c)Can be appropriately treated initially topical antibiotics solutions.
d)Occur most commonly during acute inflammatory episodes.
Keratoconjunctivitis sicca,
Visual symptoms in migraine
a)Are always accompanied by headache
b)Usually have a poor Visual prognosis.c)Vary from scintillations to total
bilateral loss of vision.d)Are always accompanied by
photophobia.
Visual symptoms in migraine
a)Are always accompanied by headache
b)Usually have a poor Visual prognosis.c)Vary from scintillations to total
bilateral loss of vision.d)Are always accompanied by
photophobia.
Optic disc swelling in the malignant hypertension
a)Often occurs even in the presence of mild hypertension.
b)Should be treated the high-dose steroids.c) Indicates that the patient is at increased
risk for developing heart failure and hypertensive encephalopathy.
d)Occurs only in the setting of renal failure.
Optic disc swelling in the malignant hypertension
a)Often occurs even in the presence of mild hypertension.
b)Should be treated the high-dose steroids.c)Indicates that the patient is at
increased risk for developing heart failure and hypertensive encephalopathy.
d)Occurs only in the setting of renal failure.
Retinopathy the most common ocular manifestation of HTN.
Key features of chronic HTN: AV nicking, blot hemorrhages, cotton wool spots, microaneurysm
Thyroid eye disease
a)Occurs only when the patient has abnormal serum thyroid hormone level.
b)Can result in severe visual loss from optic nerve compression or corneal damage.
c)Should be treated surgically in its early congestive phase.
d)Will always improve with maintenance of a euthyroid state
Thyroid eye disease
a)Occurs only when the patient has abnormal serum thyroid hormone level.
b)Can result in severe visual loss from optic nerve compression or corneal damage.
c)Should be treated surgically in its early congestive phase.
d)Will always improve with maintenance of a euthyroid state
NO SPECS No sign Only sign lid retraction, lag Soft tissue swelling periorbital edema Proptosis Extraocula muscle weakness (diplopia) Corneal exposure Sight loss
Cotton-wool Patches in AIDS patients
a)Indicate obstruction of the pre-capillary arterioles with infarction of the superficial retina
b)Occur only in patient with advanced disease
c) Represent active cytomegalovirus (CMV) retinal infection.
d)Often result in profound vision loss
Cotton-wool Patches in AIDS patients
a)Indicate obstruction of the pre-capillary arterioles with infarction of the superficial retina
b)Occur only in patient with advanced disease
c) Represent active cytomegalovirus (CMV) retinal infection.
d)Often result in profound vision loss
DDFx of CWS Diabetic retinopathyHTN retinopathyHIV
All of the following statements about optic neuritis are false except
a)It is painless.b)It always spontaneously resolves.c) It may be initial manifestation of
multiple sclerosisd)It usually results in permanent visual
loss
All of the following statements about optic neuritis are false except
a)It is painless.b)It always spontaneously resolves.c) It may be initial manifestation
of multiple sclerosisd)It usually results in permanent visual
loss * In MS diplopia can be 2º to internuclear ophthlmoplegia (INO)
Young female Blurred vision , decreased color vision,
2º to optic neuritis, Diplopia 2º to internuclear
ophthalmoplegia RAPD, ptosis, uveitis, optic atrophy,
nystagmus, optic neuritis
In optic neuritis, treatment with oral steroid will increase the risk of MS
mabtahi@toh.on.caToronto notes
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