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Question 1
Incorrect
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A 38-year-old chef is brought into the emergency department by her husband. He reports that she has been confused for the last 3 days. She has a long-standing history of severe psoriasis but no other past medical history. Basic observations are all within normal range and a CT head is unremarkable. A fundoscopy exam reveals bilateral papilledema. Which of the following is the most likely cause?
Your Answer: Encephalitis
Correct Answer: Vitamin A toxicity
Explanation:Vitamin A toxicity is a rare cause of papilledema. In this case, the patient is likely to have been taking retinoids for psoriasis.
Encephalitis does not usually present with papilledema. Brain abscess, brain tumour and hydrocephalus are all less likely with a normal CT head.
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This question is part of the following fields:
- Ophthalmology
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Question 2
Correct
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A 69-year-old retired veterinarian with type 2 diabetes mellitus presents as she has started to bump into things since this morning. Over the previous two days, she had noticed some 'floating spots in her eyes'. Examination reveals she has no vision in her right eye. The red reflex on the right side is difficult to elicit and you are unable to visualise the retina on the right side during fundoscopy. Examination of the left fundus reveals changes consistent with pre-proliferative diabetic retinopathy. Which of the following is the most likely diagnosis?
Your Answer: Vitreous haemorrhage
Explanation:The history of diabetes, complete loss of vision in the affected eye and inability to visualise the retina, suggest a diagnosis of vitreous haemorrhage (VH). 3 conditions cause 59 to 88.5% of VH cases: proliferative diabetic retinopathy, posterior vitreous detachment (PVD), and ocular trauma
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This question is part of the following fields:
- Ophthalmology
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Question 3
Correct
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Which of the following is not a risk factor for primary open-angle glaucoma?
Your Answer: Hypermetropia
Explanation:Acute angle closure glaucoma is associated with hypermetropia, whereas primary open-angle glaucoma is associated with myopia. Glaucoma is a group of eye disorders characterised by optic neuropathy due, in the majority of patients, to raised intraocular pressure (IOP). It is now recognised that a minority of patients with raised IOP do not have glaucoma and vice versa.
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This question is part of the following fields:
- Ophthalmology
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Question 4
Incorrect
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Which of the following statements regarding macular degeneration is true?
Your Answer: Photodynamic therapy is useful in dry macular degeneration
Correct Answer: Wet macular degeneration carries the worst prognosis
Explanation:Traditionally two forms of macular degeneration are seen:
– Dry (geographic atrophy) macular degeneration is characterized by drusen – yellow round spots in Bruch’s membrane.
– Wet (exudative, neovascular) macular degeneration is characterized by choroidal neovascularization. Leakage of serous fluid and blood can subsequently result in a rapid loss of vision. This carries the worst prognosis. -
This question is part of the following fields:
- Ophthalmology
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Question 5
Incorrect
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A 70 year old female presented with a throbbing and continuous headache and loss of vision. Her ESR was elevated. Which of the following is the most appropriate management?
Your Answer: Scleral buckling
Correct Answer: Corticosteroids
Explanation:Giant Cell Arteritis (Temporal Arteritis) is the most probable diagnosis. GCA should always be considered in the differential diagnosis of a new-onset headache in patients 50 years of age or older with an elevated erythrocyte sedimentation rate. Temporal artery biopsy remains the criterion standard for diagnosis of this granulomatous vasculitis. High-dose corticosteroid therapy is the universally accepted treatment.
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This question is part of the following fields:
- Ophthalmology
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Question 6
Incorrect
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A 59-year-old marketing manager presents with a persistent watery left eye for the past 4 days. On examination there is erythema and swelling of the inner canthus of the left eye. Which of the following is the most likely diagnosis?
Your Answer: Acute angle closure glaucoma
Correct Answer: Dacryocystitis
Explanation:Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac. It causes pain, redness, a watering eye (epiphora), and swelling and erythema at the inner canthus of the eye. Management is with systemic antibiotics. IV antibiotics are indicated if there is associated periorbital cellulitis.
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This question is part of the following fields:
- Ophthalmology
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Question 7
Incorrect
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An 88-year-old retired firefighter presents with loss of vision in his left eye since this morning. He is otherwise asymptomatic and of note has had no associated eye pain or headaches. His past medical history includes ischaemic heart disease but he is otherwise well. On examination he has no vision in his left eye. The left pupil responds poorly to light but the consensual light reaction is normal. Fundoscopy reveals a red spot over a pale and opaque retina. Which of the following is the most likely diagnosis?
Your Answer: Ischaemic optic neuropathy
Correct Answer: Central retinal artery occlusion
Explanation:The most common causes of a sudden painless loss of vision are:
– ischaemic optic neuropathy
– occlusion of central retinal vein or artery
– vitreous haemorrhage
– retinal detachment.
Central retinal artery occlusion is due to thromboembolism (from atherosclerosis) or arteritis (e.g. temporal arteritis). Features include afferent pupillary defects, and a ‘cherry red’ spot on a pale retina. -
This question is part of the following fields:
- Ophthalmology
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Question 8
Incorrect
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A 23 year old girl presented with complaints of diplopia on looking towards her right side. Which of the nerves will be effected?
Your Answer: Right trochlear
Correct Answer: Right abducens
Explanation:This patient has complaints of diplopia in the right eye, when looking towards the right. Eyeball movements towards the right side are controlled by right lateral rectus muscle which is supplied by the abducent nerve.
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This question is part of the following fields:
- Ophthalmology
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Question 9
Incorrect
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A 76-year-old retired store owner presents with severe pain around his right eye and vomiting. On examination, the right eye is red and decreased visual acuity is noted. Which of the following options is the most appropriate initial treatment?
Your Answer: Topical pilocarpine + topical steroids
Correct Answer: Topical pilocarpine + intravenous acetazolamide
Explanation:In acute angle closure glaucoma (AACG) there is a rise in IOP secondary to an impairment of aqueous outflow. Management options include reducing aqueous secretions with acetazolamide and inducing pupillary constriction with topical pilocarpine.
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This question is part of the following fields:
- Ophthalmology
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Question 10
Incorrect
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A 61-year-old chef with a known history of Paget's disease is noted to have irregular dark red lines radiating from the optic nerve. Which of the following is the most likely diagnosis?
Your Answer: Malignant hypertension
Correct Answer: Angioid retinal streaks
Explanation:Angioid retinal streaks are seen on fundoscopy as irregular dark red streaks radiating from the optic nerve head. They are caused by degeneration, calcification and breaks in Bruch’s membrane. They are typically associated with Paget’s disease.
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This question is part of the following fields:
- Ophthalmology
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Question 11
Incorrect
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A 54-year-old man experienced a gradual decrease in vision of one eye after being diagnosed with type 2 diabetes mellitus. Macula oedema is noted on his fundoscopy. Which of the following is the most likely diagnosis?
Your Answer: Macula degeneration
Correct Answer: Diabetic retinopathy
Explanation:Macular disease can affect central vision at any stage of diabetic retinopathy and may be seen in type 2 diabetic patients. Diabetic retinopathy affects up to 80 percent of those who have had diabetes for 20 years or more. Macular oedema occurs when damaged blood vessels leak fluid and lipids onto the macula, the part of the retina that lets us see detail. The fluid makes the macula swell, which blurs vision.
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This question is part of the following fields:
- Ophthalmology
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Question 12
Incorrect
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A 60-year-old librarian presents for review. She has recently been diagnosed with dry age-related macular degeneration. Which of the following is the strongest risk factor for developing this condition?
Your Answer:
Correct Answer: Smoking
Explanation:Age-related macular degeneration is the most common cause of blindness in the UK. Degeneration of the central retina (macula) is the key feature with changes usually bilateral. Smoking and genetic factors are risk factors for macular degeneration. The severity is divided into early, intermediate, and late types. The late type is additionally divided into dry and wet forms with the dry form making up 90% of cases.
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This question is part of the following fields:
- Ophthalmology
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Question 13
Incorrect
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A 30-year-old female diagnosed with rapidly progressive glomerulonephritis complains of pain and redness in the right eye. Which part of the eye is causing these symptoms in this case?
Your Answer:
Correct Answer: Sclera
Explanation:Rheumatoid Scleritis is a painful inflammatory condition of the sclera in patients with rheumatoid arthritis. It might be diffuse, nodular, or necrotizing in nature. This occurs mostly in the sixth decade of life and mostly when the rheumatoid disease is in remission. Sclera is the first ocular manifestation in a patient of rheumatoid arthritis. This inflammation might later spread to the adjacent ocular structures like the cornea, causing keratitis, the uveal tract causing uveitis and the lens causing cataracts.
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This question is part of the following fields:
- Ophthalmology
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Question 14
Incorrect
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Which of the following is associated with heterochromia in congenital disease?
Your Answer:
Correct Answer: Horner's syndrome
Explanation:Heterochromia (difference in iris colour) is seen in congenital Horner’s syndrome, as well as anhidrosis. Other features of non-congenital Horner’s include miosis, ptosis and enophthalmos.
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This question is part of the following fields:
- Ophthalmology
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Question 15
Incorrect
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A 40-year-old male patient, who is otherwise healthy and without a significant family history, presents with a history of early morning headache and visual field defects, When asked, he said that he has been having these complaints for three months now. What is the most possible diagnosis?
Your Answer:
Correct Answer: Pituitary tumour
Explanation:The most possible diagnosis is a pituitary tumour. Pituitary tumours compress the optic chiasm inferiorly and can cause visual field defects (bitemporal hemianopia or quadrantanopia). Temporal arteritis usually develops in older people and acute glaucoma usually requires a family history. Amaurosis fugax is classed as a stroke and usually leads to reversible unilateral vision loss. A subconjunctival haemorrhage does not typically produce the symptoms described.
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This question is part of the following fields:
- Ophthalmology
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Question 16
Incorrect
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A 45-year-old male patient came to the OPD with a complaint of severe headache on the right side, with right-sided jaw pain, and additional blurred vision in the right eye. The headache was throbbing in character. Which investigation will you prefer next?
Your Answer:
Correct Answer: Erythrocyte sedimentation rate (ESR)
Explanation:Age of the patient, headache only on one side, and loss of vision on that side suggest temporal arteritis, also known as giant cell arteritis. The laboratory hallmark of this condition is a raised ESR.
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This question is part of the following fields:
- Ophthalmology
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Question 17
Incorrect
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A 8 year old boy presented with pain and swelling around the right eye. On examination there was no proptosis or ophthalmoplegia. Which of the following is the most probable diagnosis?
Your Answer:
Correct Answer: Peri orbital cellulitis
Explanation:Infections of the superficial skin around the eyes are called periorbital, or preseptal, cellulitis. It is predominantly a paediatric disease. Erysipelas is a bacterial skin infection involving the upper dermis which extends into the superficial cutaneous lymphatics. Sinusitis is in sinuses. Orbital infections and conjunctivitis are within the eye.
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This question is part of the following fields:
- Ophthalmology
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Question 18
Incorrect
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An 87-year-old woman presents with 'funny spots' affecting her vision. Over the past week she has noticed a number of flashes and floaters in the visual field of the right eye. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Posterior vitreous detachment
Explanation:Posterior vitreous detachment is thought to occur in up to 50-75% of the population over 65 years and is the most likely diagnosis here. Patients should be reviewed by an ophthalmologist to assess the risk of progressing to retinal detachment. Flashes of light (photopsia) occur in the peripheral field of vision while floaters often occur on the temporal side of the central vision.
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This question is part of the following fields:
- Ophthalmology
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Question 19
Incorrect
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A 70-year-old female presented to her ophthalmologist with a complaint of weakening eyesight despite continued use of her corrective glasses. She also had a history of mild headaches for a few weeks. On fundoscopy, the disc had blurred margins with mild cupping and a sickle shaped scotoma in both eyes. What is the most appropriate treatment in this case?
Your Answer:
Correct Answer: Pilocarpine eye drops
Explanation:Frequent change of eye glasses, scotoma, and mild cupping are suggestive of primary open angle glaucoma. This means that the anterior angle of the eye is normal but there is a problem in the trabecular meshwork, where the Schlemm’s Canal is not allowing the drainage of the aqueous humor. Pilocarpine should be given to the patient because it is a parasympathomimetic agent. It causes the ciliary muscle of the eye to contract, causing the trabecular meshwork to open up, allowing the aqueous humor to drain again.
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This question is part of the following fields:
- Ophthalmology
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Question 20
Incorrect
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A 45-year-old pharmacist with a history of rheumatoid arthritis presents with a two day history of a red right eye. There is no itch or pain. Pupils are 3mm, equal and reactive to light. Visual acuity is 6/5 in both eyes. What is the most likely diagnosis?
Your Answer:
Correct Answer: Episcleritis
Explanation:Ocular manifestations of rheumatoid arthritis are common, with 25% of patients having eye problems. These manifestations include keratoconjunctivitis sicca (most common), episcleritis (erythema), scleritis (erythema and pain), corneal ulceration, and keratitis.
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This question is part of the following fields:
- Ophthalmology
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Question 21
Incorrect
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A 29-year-old accountant presents to the emergency department complaining of left eye pain. He has not been able to wear his contact lenses for the past 24 hours due to the pain. He describes the pain as severe and wonders whether he has 'got something stuck in his eye'. On examination, there is diffuse hyperaemia of the left eye. The left cornea appears hazy and pupillary reaction is normal. Visual acuity is reduced on the left side and a degree of photophobia is noted. A hypopyon is also seen. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Keratitis
Explanation:Hypopyon can be seen in anterior uveitis, however the combination of a normal pupillary reaction and contact lens use make a diagnosis of keratitis more likely. Keratitis describes inflammation of the cornea, and features include red eye with pain and erythema, photophobia, and foreign body/gritty sensation.
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This question is part of the following fields:
- Ophthalmology
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Question 22
Incorrect
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A 70 year old male complained of poor vision at night which has gradually worsened with time. He has changed his glasses several times but there has been no improvement. On examination his pupils and cornea were normal. Which of the following is the most probable diagnosis?
Your Answer:
Correct Answer: Cataract
Explanation:Senile cataract is an age-related, vision-impairing disease characterized by gradual progressive clouding and thickening of the lens of the eye. Patients with senile cataracts often present with a history of gradual progressive visual deterioration and disturbance in night and near vision.
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This question is part of the following fields:
- Ophthalmology
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Question 23
Incorrect
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A 30-year-old lawyer presents with a one-day history of a painful, red left eye. She describes how her eye is continually streaming tears. On examination, she exhibits a degree of photophobia in the affected eye and application of fluorescein demonstrates a dendritic pattern of staining. Visual acuity is 6/6 in both eyes. What is the most appropriate management?
Your Answer:
Correct Answer: Topical acyclovir
Explanation:This patient has a dendritic corneal ulcer. Herpes simplex keratitis most commonly presents with a dendritic corneal ulcer. Topical acyclovir and ophthalmology review is required. Giving a topical steroid in this situation could be disastrous as it may worsen the infection.
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This question is part of the following fields:
- Ophthalmology
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Question 24
Incorrect
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A 70-year-old retired software developer with a history of primary open-angle glaucoma presents with sudden painless loss of vision in his right eye. On examination of the right eye, the optic disc is swollen with multiple flame-shaped and blot haemorrhages. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Occlusion of central retinal vein
Explanation:Central retinal vein occlusion includes features such as sudden painless loss of vision, but is distinguished from central retinal artery occlusion by the presence of severe retinal haemorrhages on fundoscopy examination.
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This question is part of the following fields:
- Ophthalmology
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Question 25
Incorrect
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A 60-year old female suddenly started seeing a curtain-like shadow in her field of vision with flashes of lights and subsequent loss of vision, which prompted her to visit her ophthalmologist. What do you think is the most appropriate treatment in this case?
Your Answer:
Correct Answer:
Explanation:Flashes of light, presence of floaters and loss of vision (often described as a black curtain closing in on the visual field) are symptoms that strongly indicate retinal detachment. The fundoscopy findings of retinal tears support this diagnosis. Therefore, surgery of retina must be done to treat this patient.
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This question is part of the following fields:
- Ophthalmology
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Question 26
Incorrect
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A 55 year old man experiences sudden loss of vision preceded by the perception of something he describes as jagged lines or 'heat waves'. He's known to be myopic. What is the best treatment?
Your Answer:
Correct Answer: Scleral buckling
Explanation:The clinical picture is characteristic of retinal detachment, which should be treated immediately to prevent permanent loss of vision. Scleral buckling is a surgical procedure used to repair a retinal detachment, where the surgeon attaches a piece of silicone or a sponge onto the white of the eye at the spot of a retinal tear pushing the sclera toward the retinal tear or break, promoting repair. Signs of detachment include an increase in the number of eye floaters, flashes of light in the field of vision, and reduced peripheral vision.
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This question is part of the following fields:
- Ophthalmology
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Question 27
Incorrect
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A 27 year old female has been taken to A&E from a cinema after complaining of sudden severe pain in the eyes. This is followed by seeing coloured halos and vomiting. She has a history of reoccurring headaches which used to resolve themselves. She is examined and is found to have a fixed, dilated ovoid pupil. Choose the most appropriate first investigation from the list.
Your Answer:
Correct Answer: Applanation tonometry
Explanation:The darkness of the cinema room will have caused halfway dilation of the pupil. This can cause an acute attack of angle closure glaucoma. The appropriate test to diagnose this is applanation tonometry.
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This question is part of the following fields:
- Ophthalmology
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Question 28
Incorrect
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A 67-year-old retired physician presents to ophthalmology clinic after seeing his optician. Raised intra-ocular pressure and decreased peripheral vision was noticed. His past medical history includes asthma and type 2 diabetes mellitus. What is the most appropriate treatment given the likely diagnosis?
Your Answer:
Correct Answer: Latanoprost
Explanation:The majority of patients with primary open-angle glaucoma are managed with eye drops. These aim to lower intra-ocular pressure which in turn has been shown to prevent progressive loss of visual field. A prostaglandin analogue should be used first-line in patients with a history of asthma.
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This question is part of the following fields:
- Ophthalmology
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Question 29
Incorrect
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A 27-year-old consultant who has a family history of retinitis pigmentosa is reviewed in the ophthalmology clinic. He reports worsening vision over the past few months. During fundoscopy, which of the following findings would most support a diagnosis of retinitis pigmentosa?
Your Answer:
Correct Answer: Black bone spicule-shaped pigmentation in the peripheral retina
Explanation:Retinitis pigmentosa is a genetic disorder primarily affecting the peripheral retina resulting in tunnel vision. Night blindness is often the initial sign. Fundoscopy exam reveals black bone spicule-shaped pigmentation in the peripheral retina, and mottling of the retinal pigment epithelium.
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This question is part of the following fields:
- Ophthalmology
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Question 30
Incorrect
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A 30-year-old female presented in the ophthalmology ward complaining of blurry vision for 4 days. Fundoscopy of both eyes revealed cotton wool spots in both the retinas. What is the most likely cause of this condition?
Your Answer:
Correct Answer: CMV infection
Explanation:Fundoscopy findings of cotton wool spots and retinal tears, accompanied by a history of blurred vision, are characteristic of retinitis. Cytomegalovirus is known to cause retinitis.
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This question is part of the following fields:
- Ophthalmology
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Question 31
Incorrect
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A 77-year-old retired engineer presents with a burning sensation around his right eye. On examination, an erythematous blistering rash can be seen in the right trigeminal distribution. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Herpes zoster ophthalmicus
Explanation:Herpes zoster ophthalmicus (HZO) describes the reactivation of the varicella zoster virus in the area supplied by the ophthalmic division of the trigeminal nerve. It accounts for around 10% of case of shingles. Features include a vesicular rash around the eye, which may or may not involve the actual eye itself, and Hutchinson’s sign: a rash on the tip or side of the nose, indicating nasociliary involvement and is a strong risk factor for ocular involvement.
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This question is part of the following fields:
- Ophthalmology
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Question 32
Incorrect
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A 45-year-old patient presents with a red, watering eye, complaining of a severe left sided headache and vision distortion with coloured haloes. What would be the next best step in management of this patient?
Your Answer:
Correct Answer: Measure Intraocular pressure
Explanation:Acute angle closure glaucoma can manifests itself with severe headache, nausea or vomiting, very blurry or hazy vision, seeing rainbows or halos around lights and redness in the white part of the affected eye. It is caused by a rapid or sudden increase in pressure inside the eye – intraocular pressure (IOP). In order to establish the diagnosis and start treatment immediately, IOP should first be measured.
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This question is part of the following fields:
- Ophthalmology
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Question 33
Incorrect
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A 75-year-old retired firefighter with a history of type 2 diabetes mellitus and hypertension presents due to the sensation of light flashes in his right eye. These symptoms have been present for the past 2 days and seem to occur more at the peripheral part of vision. There is no redness or pain in the affected eye. Corrected visual acuity is measured as 6/9 in both eyes. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Vitreous detachment
Explanation:Flashes and floaters are symptoms of vitreous detachment. The patient is at risk of retinal detachment and should be referred urgently to an ophthalmologist.
The most common causes of a sudden painless loss of vision are as follows:
– Ischaemic optic neuropathy (e.g. temporal arteritis or atherosclerosis)
– Occlusion of central retinal vein
– Occlusion of central retinal artery
– Vitreous haemorrhage
– Retinal detachment -
This question is part of the following fields:
- Ophthalmology
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Question 34
Incorrect
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A 20-year-old man presents with a history of sticky greenish discharge, accompanied by redness of the eyes, and difficulty opening his eyes in the morning. What is the single most likely cause of these symptoms?
Your Answer:
Correct Answer: Conjunctivitis
Explanation:Redness of the eyes can present in all of the conditions. However, the green sticky discharge that causes the eyelids to stick together overnight is characteristic of bacterial conjunctivitis. Bacterial conjunctivitis is an inflammatory condition of the conjunctiva in which bacteria commonly Staphylococcus Aureus invade the conjunctiva. The person experiences a foreign body feeling in the eye and mucopurulent or purulent discharge.
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This question is part of the following fields:
- Ophthalmology
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Question 35
Incorrect
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A 39-year-old professor presents with visual problems. He has had very poor vision in the dark for a long time but is now worried as he is developing 'tunnel vision'. He states his grandfather had a similar problem and went blind in his 50's. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Retinitis pigmentosa
Explanation:Retinitis pigmentosa primarily affects the peripheral retina resulting in tunnel vision. Night blindness is often the initial sign. Tunnel vision occurs due to loss of the peripheral retina (occasionally referred to as funnel vision).
Fundoscopy exam reveals black bone spicule-shaped pigmentation in the peripheral retina, and mottling of the retinal pigment epithelium. -
This question is part of the following fields:
- Ophthalmology
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Question 36
Incorrect
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A 42-year-old man presents with a watery eye and some purulent discharge. Mucoid discharge can be expressed from the lacrimal punctum. His eye is painful and red while the nasal end of his lower eyelid is swollen. The redness extends further to reach the nasal peri-orbital area. What is the most likely diagnosis?
Your Answer:
Correct Answer: Acute dacryocystitis
Explanation:Acute dacryocystitis presents as inflammation of the lacrimal sac and is typically caused by infection. Symptoms of acute dacryocystitis can be pain, redness of the eye and swelling of the nasal aspect of the eye. The eye is usually watery and discharge can be expressed through the lacrimal punctum which is generally mucoid but can also be purulent. Patient can also present with fever.
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This question is part of the following fields:
- Ophthalmology
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Question 37
Incorrect
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A 27-year-old female visited the OPD with a complaint of visual disturbance, eye pain, pain in the knee and hands, and a rash on her face. On examination, the rash was the shape of a butterfly, and the joints were mildly swollen. The eyes of the patient were found to be red with irregular pupils. Where do you think the problem lies?
Your Answer:
Correct Answer: Iris
Explanation:The patient’s symptoms are suggestive of ankylosing spondylitis which is often accompanied by iritis, the cause of this patient’s red eye.
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This question is part of the following fields:
- Ophthalmology
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Question 38
Incorrect
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A 49-year-old woman suddenly experienced complete loss of vision in her right eye. Fundoscopy results show a pale retina, and a cherry red spot on the macular region. She also experienced right sided headaches aggravated by chewing. What caused her vision loss?
Your Answer:
Correct Answer: CRAO
Explanation:Central retinal artery occlusion (CRAO) is a disease of the eye where the flow of blood through the central retinal artery is blocked (occluded). There are several different causes of this occlusion; the most common is carotid artery atherosclerosis. It causes sudden vision loss in one eye. Fundoscopic exam will show a red lesion, called a cherry red spot, with surrounding pale retina (the pale colour is caused by ischemia of the retina)
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This question is part of the following fields:
- Ophthalmology
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Question 39
Incorrect
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A 44-year-old physiotherapist with a history of rheumatoid arthritis presents with a painful, red left eye. Visual acuity is normal. Fundoscopy is also unremarkable. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Scleritis
Explanation:Scleritis, or inflammation of the sclera, is usually painful whereas episcleritis is not painful.
Keratoconjunctivitis sicca is usually bilateral and associated more with dryness, burning and itching.
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This question is part of the following fields:
- Ophthalmology
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Question 40
Incorrect
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A 34-year-old woman has had progressive reduction of visual acuity over the past 3 years. She has now almost lost all of her vision. What is the diagnosis?
Your Answer:
Correct Answer: Retinitis pigmentosa
Explanation:Retinitis pigmentosa is a genetic disorder of the eyes that causes loss of vision. Symptoms include trouble seeing at night and decreased peripheral vision. Onset of symptoms is generally gradual.
– In keratitis, there will be pain, redness and photophobia but vision is not affected
– In macular degeneration, near blindness does not occur rather the inability to identify faces or read small print
– Cataracts are more common in elderly
– It is not angle closure glaucoma as angle closure glaucoma occurs usually after the age of 50; In open angle glaucoma visual loss is not gradual but rather occurs suddenly following progression -
This question is part of the following fields:
- Ophthalmology
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SESSION STATS - PERFORMANCE PER SPECIALTY
