This document contains an opthalmology quiz with multiple choice and short answer questions. Some of the topics covered in the questions include cataracts, dendritic ulcers caused by herpes simplex virus, diabetic retinopathy, optic atrophy, CMV retinitis in AIDS patients, angle closure glaucoma, anterior uveitis, central retinal vein occlusion, and lens dislocation which can be associated with Marfan's syndrome. The questions test knowledge of disease identification, associated symptoms, clinical signs, investigations, treatment options and complications.

1. Opthalmology Quiz
Sian Chivers

2. Question 1
•What’s This?
•Name 3 Causes?
•What Symptoms may a
person complain of?
•How is it Treated

3. Answer 1
• Cataract
• Causes
– Senile (Commonest)
– Diabetes, Recurrent Uveitis, Previous ocular surgery
– Drugs – steroids, phenothiazines
– Trauma and foreign bodies
– Ionising radiation – Xray, UV
– Congenital
– Inherited – Myotonic Dystrophy, Marfan’s, Lowe’s, Rubella, high
myopia
• Symptoms
– Reduced acuity, Glare in sunshine, Distortion of lines, Diplopia,
Altered colours
• Mydriatic drops, sunshades and sunglasses. Surgery –
Phacoemulsification and Lens implant (US breaks up lens)

4. Question 2
•What is this?
•What investigation is being
carried out?
•What is the causative organism?
•What are the clinical features?
•What is the treatment?

5. Answer 2
• Dendritic ulcer
• Eye examination under fluorescein stain
• Herpes Simplex virus
• Irritable red eye, watering, photophobic
• Refer to an opthalmologist, Aciclovir 3% eye
ointment 5x daily

6. Question 3
•What is this?
•Name 3 pathological features
shown in the picture and
describe how they occur?
•Name 2 complications of this
eye condition?
•How can this eye condition be
treated and what would you
see when you looked at the
retina post procedure?

7. Answer 4
• Background Diabetic retinopathy
• Microaneurysms – outpouching of retinal caps
Cotton wool spot – microinfarct of retinal nerve fibre
layer
Retinal oedema and exudate – leakage of serum into the
neural retina and lipid accumulation
Neovascularisation (proliferative) new vessels grow
outside the retina along posterior surface of vitreous
• Complications – blindness, vitreous haemorrhage and
retinal detachment. Cataract as part of DM

8. Answer 4 Cont
•Treatment
•Good Glycaemic control
prevents complications
•Laser photocoagulation
indicated for proliferative DR
via argon laser
•Vitrectomy – vitreous is
removed via a trans-pars
incision – to clear vitreous
haemorrhage, to relieve
retinal traction and to treat
diffuse macular oedema

9. Question 5
•What abnormality is seen here?
•Name 3 causes?
•What may be seen when
examining the pupils?

10. Answer 5
• Optic Atrophy
• Causes
– Hereditary – Autosomal dominant/recessive, Leber’s
hereditary
– Retinal Dystrophy – Cone Dystrophy, retinitis pigmentosa
– Vascular – central retinal artery occlusion
– Nutritional – VitB12 deficiency, tobacco, alcohol, drugs –
ethambutol chloramphenicol
– Inflammatory – Sarcoid, PAN
– Demyelination (common)
– Compressive (glioma or meningioma)
• Relative afferent pupillary defect

11. Question 6
This patient has AIDS
What is shown in fig 1
What organism cause this
What other organisms commonly
infect the retina of a patient with
AIDS
What is shown in fig 2
Would you expect lesions elsewhere
What other infections affect the lids
and conjunctiva of a patient with
AIDS

12. Answer 6
• CMV retinitis
• Millions – CMV, EBV, Toxoplasmosis, Syphilis,
Cryptococcus, M.TB, M.aviumintracellulare, Candida,
Aspergillus, histoplasmosis
• Kaposi Sarcoma
• Yes
• Trichomegaly (long eyelashes), molluscum
contagiosum, conjunctivitis, conjunctival granulomas ,
SCC assoc w HPV, herpes zoster opthalmitis

13. Question 7
•What intervention has been carried
out here
•What underlying condition does
this patient have
•What symptoms may the patient
have experienced in the acute phase
•What signs may have been
apparent on examination
•What is the treatment for the acute
phase of the illness?

14. Answer 7
• A peripheral iridotomy
• Glaucoma. Iridotomy is the intervention of choice
to prevent angle closure glaucoma or after an
attack has been broken by medical treatment
• Symps – sudden onset, severely painful red eye,
blurred vision, halos around lights, headache,
nausea and vomiting
• Signs – reduced visual acuity, brick red eye, hazy
cornea, vertically mid-dilated fixed pupil, high IOP
• Treatment – Pilocarpine 2-4% 2h, acetazolamide
500mg iv stat then 250mg/8h, mannitol 20% by
ivi. Topical steroids and antihypertensive drops
may be used

15. Question 8
•What is shown here?
•What symptoms may the patient
complain of?
•What associated condition may the
patient have
•What signs are found on
examination?
•What is the management?
•Complication?

16. Answer 8
• Anterior Uveitis
• Painful red eye, photophobia, blurred vision or
floaters
• Autoimmune disease – ank spond, inflam bowel
disease, sarcoidosis
• Signs – ciliary injection, reduced visual acutiy,
sluggish or irregular pupil, hazy iris details, high
IOP
• refer to opthalmologist, reducing regimen of
topical steroid (dexamethosone 0.1%) and
cycloplegic and dilating drops (cyclopentolate
1%)
• Cataract in recurrent or chronic cases

17. Name to following

18. Conjunctivitis Subconjunctival
haemorrhage
Pterygium

19. Question 10
•Diagnosis
•Signs
•Main cause
•Management
•Diagnosis
•Inherited underlying condition that
may predispose
•Other features of that condition

20. Answer 10
• Central retinal vein occlusion
• Signs – afferent pupillary defect common, retinal haemorrhages,
optic disc swelling, venous dilatation and tortuosity, cotton wool
spots
• Up to 33% are ischaemic assoc with rubeosis iridis or
neovascularisation of disc
• Detect any underlying systemic disease and treat, check IOP, screen
for new vessels, treaat cv risk factors, laser new vessels.
• Lens dislocation
• Marfan’s syndrome
• Aortic dissection or dilatation, dural ectasia, arachnodactly,
armspan greater than height, pectus deformity, pes planus,
scoliosis high arched palate, mitral valve prolapse, joint
hypermobility.

21. Well done, that’s enough
opthalmology for now!!