5. Long-term use of oral aciclovir reduces the
recurrence rate of epithelial and stromal
herpes keratitis. Generalized seizers,
hemiparesis or hemianopia
6. In a patient with a linear corneal
abrasion, search for a small foreign body
on the tarsal surface of the upper lid.
7. In a patient with a small lid wound who
has been working with tools, always lift
the lids to check for a small penetrating
injury in the sclera.
8. Investigate any asymptomatic middle-
aged individual with a prominent episcleral
(sentinel) vessel, as this can be a subtle
sign of ciliary body melanoma
9. Migraine is the commonest cause of visual
aura with and without headache
15. In the event of vitreous loss in cataract
surgery and raised IOP, avoid
prostaglandin drops as this increases the
risk of cystoid macular oedema.
16. To achieve accurate preoperative
biometry, contact lenses should not be
worn for 1–2 weeks before the
measurements are taken.
17. In a patient with acute corneal graft
rejection, early intensive treatment greatly
improves the likelihood of reversing the
episode of rejection.
18. Peripheral ulcerative keratitis is caused by
an infection until proven otherwise. In the
absence of an infection investigate for
systemic autoimmune disease
19. Vesicles involving the tip or side of
the nose precede the development of
ophthalmic herpes zoster (Hutchinson
sign).
20. Acanthamoeba infection of the cornea
results in pain that is often severe and
disproportionate to the clinical signs
21. Herpes simplex is the commonest infectious
cause of corneal disease in developed
countries
22. Topical drug and preservative toxicity may
cause a failure of corneal re-
epithelialization, which can be confused
with persistent infection
25. In a patient with adult chlamydial
conjunctivitis, other sexually transmitted
infections should be excluded
26. In dry eye syndrome lissamine green
solution is preferable to 1% rose Bengal
solution as it stains in a similar fashion,
but causes less irritation.
27. Visual acuity, pupillary responses and
ocular motility are unimpaired, and
proptosis is absent in preseptal cellulitis.
28. Surgical orbital decompression should be
considered when there is sight-threatening
compressive optic neuropathy in thyroid
eye disease.
29. To reduce the risk of endophthalmitis
postpone intraocular surgery if there are
any signs of lacrimal drainage system
infection
30. Chronic canaliculitis should be suspected
in a patient with unilateral mucopurulent
conjunctivitis that is refractory to
conventional treatment.
31. A congenital dacryocoele should not be
confused with an encephalocoele, which is
characterized by a pulsatile swelling above
the medial canthal ligament.
32. Involutional ptosis may be confused with
ocular myasthenia gravis because it
frequently gets worse towards the end of
the day.
33. A capillary haemangioma can be easily and
successfully treated by regular application
of a topical beta-blocker to the affected
lesion.
34. In a patient with a corneal graft, broken
or loose sutures should be removed as this
reduces the risk of localized
vascularization and graft rejection.
35. The organisms involved in fistula-related
endopthalmitis tend to be more virulent
than after cataract surgery. Vitreous and
aqueous samples should be obtained
immediately on presentation
