OCANZ Written | 100% Correct Answers |
Verified | Latest 2024 Version
A 75 y/o F comes in for her annual check complaining of reduced vision and increased intolerance to
glare. She has had a myopic shift and has cataracts.
a) What factors should you consider when referring for cataract surgery? - ✔✔
b) Cataract Cause of visual complaint
Compromising Lifestyle
Driver
Anisometropia
Visual Acuity
Other Ocular Pathology
General Health and Medications
Patient wants to have operation
b) What type of cataract is most likely from the above description? - ✔✔Nuclear Sclerotic
c) Describe a cataract op in laymans terms - ✔✔Outpatient Basis
Before surgery seen by a specialist doctor
30-40 minutes on local anaesthetic
The Surgeon will make a tiny cut in your eye to get to the lens
High-frequency ultrasound device that breaks up the cloudy lens into small pieces
Small pieces gently removed from the eye with suction.
Cloudly lenses replaced by a clear plastic one
d) What are the post op drops (names and concentration) and common post-op complications you would
look out for weeks after? - ✔✔Postoperative regimens of topically applied antibiotics, corticosteroids,
NSAIDs, and oral
analgesic agents vary among practitioners.
,From Incision - wound leak
Corneal Astigmatism
Keratopathy
IOP rise
Endopthalmitus
IOL disslocation
Sunset syndrome
Iris epithelial ingrowth
Pupil Capture
CMO
Retinal Detachment
Signs of Glaucoma - ✔✔Disc Signs: Asymetric Cupping, Disc Haemorrhage , Increased cuppping, RNFL
changes, PPA, NRR thining.
Visual field loss characteristic to ONH changes, notching, superior arcuate defect.
How is glaucoma diagnosed. - ✔✔Progression analysis, visual fields and RNFL scanning using OCT
Medisoft plot, RE: false +ve 3% fixation losses 7/10 Le: false +ve 7% fixation losses 2/10.
What is the reliability of the fields? - ✔✔Fixation loss higher than about 20% is deemed unreliable.
A false positive rate around 20% or higher is considered to indicate low patient reliability
Medisoft plot showing a right homonymous hemianopia with macular sparing.
What is the full name and classification of the condition?
, Where in the visual pathway is the loss? - ✔✔Right homonymous hemianopia with macular sparing
indicating a legion in the posterior occipital lobe and optic radiations or optic tracts
Medisoft plot showing a right homonymous hemianopia with macular sparing.
What is the likely cause? - ✔✔Vascular episode
Tumour
Medisoft plot showing a right homonymous hemianopia with macular sparing.
What is the appropriate management? - ✔✔Prisms (field expanders)
Managment of cause if possible and review.
Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.
What is the neurological lesion and syndrome shown? - ✔✔Internuclear ophthalmoplegia is caused
injury or dysfunction in the medial longitudinal fasciculus (MLF)
Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.
What is the aetiology? - ✔✔In the elderly, typically caused by stroke and is unilateral
In young people, commonly caused by multiple sclerosis and may be bilateral
Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.
What is the management? - ✔✔Systemic work up and management
Verified | Latest 2024 Version
A 75 y/o F comes in for her annual check complaining of reduced vision and increased intolerance to
glare. She has had a myopic shift and has cataracts.
a) What factors should you consider when referring for cataract surgery? - ✔✔
b) Cataract Cause of visual complaint
Compromising Lifestyle
Driver
Anisometropia
Visual Acuity
Other Ocular Pathology
General Health and Medications
Patient wants to have operation
b) What type of cataract is most likely from the above description? - ✔✔Nuclear Sclerotic
c) Describe a cataract op in laymans terms - ✔✔Outpatient Basis
Before surgery seen by a specialist doctor
30-40 minutes on local anaesthetic
The Surgeon will make a tiny cut in your eye to get to the lens
High-frequency ultrasound device that breaks up the cloudy lens into small pieces
Small pieces gently removed from the eye with suction.
Cloudly lenses replaced by a clear plastic one
d) What are the post op drops (names and concentration) and common post-op complications you would
look out for weeks after? - ✔✔Postoperative regimens of topically applied antibiotics, corticosteroids,
NSAIDs, and oral
analgesic agents vary among practitioners.
,From Incision - wound leak
Corneal Astigmatism
Keratopathy
IOP rise
Endopthalmitus
IOL disslocation
Sunset syndrome
Iris epithelial ingrowth
Pupil Capture
CMO
Retinal Detachment
Signs of Glaucoma - ✔✔Disc Signs: Asymetric Cupping, Disc Haemorrhage , Increased cuppping, RNFL
changes, PPA, NRR thining.
Visual field loss characteristic to ONH changes, notching, superior arcuate defect.
How is glaucoma diagnosed. - ✔✔Progression analysis, visual fields and RNFL scanning using OCT
Medisoft plot, RE: false +ve 3% fixation losses 7/10 Le: false +ve 7% fixation losses 2/10.
What is the reliability of the fields? - ✔✔Fixation loss higher than about 20% is deemed unreliable.
A false positive rate around 20% or higher is considered to indicate low patient reliability
Medisoft plot showing a right homonymous hemianopia with macular sparing.
What is the full name and classification of the condition?
, Where in the visual pathway is the loss? - ✔✔Right homonymous hemianopia with macular sparing
indicating a legion in the posterior occipital lobe and optic radiations or optic tracts
Medisoft plot showing a right homonymous hemianopia with macular sparing.
What is the likely cause? - ✔✔Vascular episode
Tumour
Medisoft plot showing a right homonymous hemianopia with macular sparing.
What is the appropriate management? - ✔✔Prisms (field expanders)
Managment of cause if possible and review.
Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.
What is the neurological lesion and syndrome shown? - ✔✔Internuclear ophthalmoplegia is caused
injury or dysfunction in the medial longitudinal fasciculus (MLF)
Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.
What is the aetiology? - ✔✔In the elderly, typically caused by stroke and is unilateral
In young people, commonly caused by multiple sclerosis and may be bilateral
Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.
What is the management? - ✔✔Systemic work up and management
