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Describe Horners - ANSWER Constricted pupil due
to sympathetic disorder
Also may have ptosis
Causes could be lung tumor, carotid artery dissection, or even a congenital
malformation
Associated with decreased sweating on the effected side
Constricted pupil
Will not dilate to cocaine
A px comes in to the store, he got cement in his eye 10 minutes ago.
Outline your work up of this patient
On examination you decide he needs immediate referral. What details would you
include in the referral letter? - ANSWER NaFl examination of the cornea to determine
extent and depth of alkaline injury
Palpebral fissure checks
Initial PH
IOP
Details in referral letter should include - chemical, duration since initial incident, initial
PH, IOP, however immediate emergency attention is required and irrigation.
What are potential treatments for diabetic retinopathy? - ANSWER laser
photocoagulation anti vegf
vitrectomy
How quickly would you refer a patient with proliferative diabetic retinopathy (PDR) or
diabetic macula oedema (DMO)? - ANSWER Urgent to Ophthalmologist (within 4
weeks) unless under review
Describe the management of GPC in a silicone hydrogel contact lens wearer. -
ANSWER improve lens hygeine
Increase lens replacement frequency
DD if possible
Reduce modulus of lens material (Swap to hydrogel lens, be aware more difficult to
handle)
Manage lid margin disease
If sever - topical Mast cell stabalisers
, 28 y/o overweight female has 6/6 vision and IOPs are normal. On examination, she has
bilaterally woollen optic discs that are hyperaemic and with flame haems. a) What
optometric tests would you perform
b) What non-optometric tests would you perform
c) What is your primary concern? - ANSWER Visual fields
Pupils
Colour Vision
Motility
Stereo Disc images
Primary concern Papilloedema due to raised intercranial pressure, caused by sub
arachnoid haemorrhage or space occupying legion, refer emergency
HES tests - Urgent neuro imaging (MRI CT) and CBC count, blood sugar, angiotensin-
converting enzyme, erythrocyte sedimentation rate
What is the typical retina feature of RP? - ANSWER Bone spicule
What visual field loss would you expect in RP? - ANSWER Tunnel vision
What genetic factors and other factors affect this condition? - ANSWER May be
sporadic or progressive, autosomal dominant -20%, recessive -13%, or X-linked 8%
What formula for back vertex correction? - ANSWER Fc=F/(1-xF)
Fc is the power corrected for vertex distance,
F is the original lens power
x is the change in vertex distance in meters.
How does this change when you are working out i there is cylindrical correction? -
ANSWER Carry out Fc=F/(1-xF) for each meridian and than convert into notation
required (+/- cyl)
What is the first rule of thumb relating to changing the BOZR of a RGP? - ANSWER
Change BOZR by 0.1mm then change power of 0.50D to keep NaFL pattern?
What is the rule of thumb when increasing the TD of an RGP to keep same NaFl
pattern? - ANSWER Increase TD by 0.1mm then flatten BOZR by 0.05mm
Px attends asking for an appointment complaining of flashes & floaters started