A 25-year-old woman presents with a one-day history of a painful and 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?
Correct Answer D: This patient has 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.
Herpes simplex keratitis:
Herpes simplex keratitis most commonly presents with a dendritic corneal ulcer.
Features:
Management:
A 24-year-old man 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 with most support a diagnosis of retinitis pigmentosa?
Correct Answer C:
Retinitis pigmentosa:
Retinitis pigmentosa primarily affects the peripheral retina resulting in funnel vision.
Associated diseases:
A 65-year-old man 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.
What is the most likely diagnosis?
Correct Answer D: Central retinal vein occlusion - sudden painless loss of vision, severe retinal haemorrhages on fundoscopy.
Sudden painless loss of vision: The most common causes of a sudden painless loss of vision are as follows:
Ischaemic optic neuropathy:
Central retinal vein occlusion:
Central retinal artery occlusion:
Vitreous haemorrhage:
Retinal detachment:
Differentiating posterior vitreous detachment, retinal detachment and vitreous haemorrhage:
A 71-year-old man who has recently been diagnosed with macular degeneration asks for advice regarding antioxidant dietary supplements.
Which one of the following may contraindicate the prescription of such supplements?
Correct Answer A: Beta-carotene has been found to increase the risk of lung cancer and hence antioxidant dietary supplements are not recommended for smokers.
Age related macular degeneration:
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.
Traditionally two forms of macular degeneration are seen:
Recently there has been a move to a more updated classification:
Risk factors:
Investigation and diagnosis:
General management:
Dry macular degeneration - no current medical treatments.
Wet macular degeneration:
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