Each one of the following are associated with angioid retinal streaks, except:
Correct Answer D: Kearns-Sayre syndrome is a mitochondrial disorder associated with retinitis pigmentosa.
Angioid retinal streaks:
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.
Causes:
Which one of the following is not a risk factor for primary open-angle glaucoma?
Correct Answer E: Acute angle closure glaucoma is associated with hypermetropia, where as primary open-angle glaucoma is associated with myopia.
Primary open-angle glaucoma:
Glaucoma is a group disorders characterized by optic neuropathy due, in the majority of patients, to raised intraocular pressure (IOP). It is now recognized that a minority of patients with raised IOP do not have glaucoma and vice versa.
Primary open-angle glaucoma (POAG, also referred to as chronic simple glaucoma) is present in around 2% of people older than 40 years. Other than age, risk factors include:
POAG may present insidiously and for this reason is often detected during routine optometry appointments.
Features may include:
A 23-year-old female presents with recurrent headaches. Examination of her cranial nerves reveals the right pupil is 3 mm whilst the left pupil is 5 mm. The right pupil constricts to light but the left pupil is sluggish.
What is the most likely diagnosis?
Correct Answer D: Holmes ADIe = DIlated pupil, females, absent leg reflexes.
Holmes-Adie pupil:
Holmes-Adie pupil is a benign condition most commonly seen in women. It is one of the differentials of a dilated pupil.
Overview:
A 70-year-old man is investigated for blurred vision. Fundoscopy reveals drusen, retinal epithelial and macular neovascularization. A diagnosis of age related macular degeneration is suspected.
What is the most appropriate next investigation?
Correct Answer D:
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:
Leakage of serous fluid and blood can subsequently result in a rapid loss of vision. Carries worst prognosis.
Recently there has been a move to a more updated classification:
Risk factors:
Features:
Investigation and diagnosis:
General management:
Dry macular degeneration - no current medical treatments.
Wet macular degeneration:
During routine follow-up at renal clinic a man is noted to have corpuscular pigmentation of the left retina.
Which one of the following conditions is associated with retinitis pigmentosa?
Retinitis pigmentosa:
Retinitis pigmentosa primarily affects the peripheral retina resulting in funnel vision.
Associated diseases:
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