MSRA Category: Ophthalmology

MSRA-1764

A 45-year-old woman presents to the Ophthalmology department with a 3-day history of an increasingly painful and swollen left eye. She complains of blurring of vision and pain, especially with eye movements.
On examination, visual acuity is 6/24 in the left and 6/6 in the right. The periorbital area of the left eye is very swollen and erythematous. The eye itself is red and proptosed. The conjunctiva is chemosed. Eye movements in the left eye are quite restricted in all directions. There is relative afferent pupillary defect on the left. Fundoscopy shows a swollen optic disc in the left eye. Vital observations are as follows:
Blood pressure 130/80 mmHg
Heart rate 80 bpm
Respiratory rate 20 per minute
Oxygen saturation 97% on air
Temperature 38.2 °C
Computed tomography (CT) scan shows some opacities in the ethmoid sinuses.
What is the definitive treatment for this eye problem?

MSRA-1765

An 80-year-old man presents to you with a complaint of blurred vision that has been worsening over the past 3 months. He has a medical history of type 2 diabetes and takes metformin. During the examination, you observe a shadow in the red reflex. What is the most probable diagnosis?

MSRA-1766

A 52-year-old woman has recently been diagnosed with raised intraocular pressure (IOP) and loss of peripheral vision. She also has diabetes.
Which of the following treatments would ophthalmology have initiated?

MSRA-1767

A 28-year-old man with ankylosing spondylitis (AS) comes in with photophobia and a painful red eye.
What is the most probable diagnosis?

MSRA-1768

Which one of the following statements regarding the Holmes-Adie pupil is incorrect?

MSRA-1769

A 25-year-old woman comes in with recurring headaches. During the cranial nerve examination, it is observed that her right pupil is 3 mm while the left pupil is 5 mm. The right pupil reacts to light, but the left pupil is slow to respond. The peripheral neurological examination is normal except for challenging to elicit knee and ankle reflexes. What is the probable diagnosis?

MSRA-1770

A 40-year-old man comes to the clinic complaining of visual difficulties. He reports having poor vision in low light conditions for a while, but now he is concerned as he is experiencing tunnel vision. He mentions that his grandfather had a similar issue and was declared blind when he was in his 50s. What is the probable diagnosis?

MSRA-1771

A young patient presents with a painful red eye.
Which of the following findings is more suggestive of acute conjunctivitis than anterior uveitis?

MSRA-1772

A 67-year-old woman presents to her general practitioner (GP) complaining of a headache and painless loss of vision in her left eye lasting for 5 minutes. Two days later, she developed sudden-onset, right-sided weakness affecting both upper and lower limbs and lasting for 30 minutes. Her past medical history includes mild hyperlipidemia. She is a non-smoker. There are no neurological abnormalities. Her blood pressure is 150/85 mmHg and heart rate 80 bpm. There are no audible carotid bruits.
Which of the following is the most likely diagnosis?

MSRA-1773

A 35-year-old woman presents to the Emergency Department complaining of right-eye pain. She suspects that something may be stuck in her eye as she has been unable to wear her contact lenses for the past day due to the pain.
On examination, there is diffuse hyperaemia of the right eye. The right cornea appears hazy, and the pupillary reaction is normal. Visual acuity is reduced on the right side and a degree of photophobia is noted. A hypopyon is also seen.
Given the likely diagnosis, which of the following management procedures should be done immediately?
Select the SINGLE most appropriate management from the list below.