Year 3 EOCP Case 3 Ophthalmology

A 59-year-old right-handed male patient was brought in by family member due to his non-sensical speech. He spoke fluently, but none of his words formed any coherent message. On exam, you realised that he lost his vision on the right superior quadrant in both eyes. Where is the defect on his visual pathway?

• Right optic nerve

• Optic chiasm

• Right temporal lobe

• Left temporal lobe

• Left parietal lobe

A 63-year-old woman comes to A & E due to a severe, right-sided headache that started 2 hours ago. The pain is centred around the right eye and is associated with nausea and vomiting. She is also seeing halos around lights. The patient has never had a headache like this before. Family history is notable for migraine headaches in her mother. Physical examination shows a red right eye with a nonreactive, dilated pupil. Visual acuity is decreased. Which of the following is the most likely diagnosis?

• Acute angle-closure glaucoma

• Optic neuritis

• Temporal arteritis

• Migraine

A 30-year-old woman presented with decreased colour sensation on the right eye (red-colored objects appear “washed-out”). The right eye felt painful, and vision became blurry over the last couple of days What is she most likely to be experiencing?

• Acute-angle closure glaucoma

• Retinal detachment

• Cataract

• Temporal arteritis

• Optic neuritis

A 55-year-old woman with atrial fibrillation, who has not been compliant with her rivaroxaban, presented with acute loss of vision in the last 3 hours. She described a curtain coming down on her LEFT eye. The left eye was painless, and she denied seeing light flashes or floaters. She had no myopia. She had no trauma or surgery done to the eye. What was she most likely to be experiencing?

• Acute-angle closure glaucoma

• Retinal detachment

• Cataract

• Central Retinal Artery Occlusion (CRAO)

• Temporal arteritis

Which structure on the diagram represent new vessel formation?

• A

• B

• C

• D

• E

What type of retinopathy is this?

Hint: this person has type 2 diabetes and his recent HbA1c is 65mmol/mol 

• Hypertensive retinopathy

• Diabetic retinopathy

• What are you talking about?

What is the threshold IOP for initiating glaucoma treatment?

• 6 mmHg

• 11 mmHg

• 21 mmHg

• 23 mmHg

• 26 mmHg

A 65-year-old patient with open-angle glaucoma and COPD presents with high IOP  (35 mmHg) despite current latanoprost therapy. She is reluctant to undergo SLT (laser). What would be an appropriate choice?

• Bimatoprost (topical)

• Timolol (topical)

• Acetazolamide (oral)

• Brinzolamide (topical)