1/19
Looks like no tags are added yet.
Name | Mastery | Learn | Test | Matching | Spaced |
---|
No study sessions yet.
1. A 5-year-old child presents with a constant esotropia and poor vision in one eye. You are asked to refract the child. What drug should you administer and why?
→ Administer Cyclopentolate 1% for effective cycloplegia; preferred due to rapid onset and sufficient duration.
2. A patient with anterior uveitis is experiencing photophobia and pain. What drops should you instill, and what is the rationale?
→ Cyclopentolate 1% to break/prevent synechiae and relieve pain by paralysing the ciliary muscle. The doctor will also prescribe topical steroids.
3. An elderly woman presents for a fundus exam. You suspect narrow angles. What precautions should you take before instilling mydriatics?
→ Perform Van Herick test. Avoid phenylephrine if angles are shallow. Use Tropicamide with caution.
4. A contact lens wearer presents with a red, irritated eye and mucopurulent discharge. What is your likely diagnosis and first-line treatment?
→ Acute bacterial conjunctivitis. Instill chloramphenicol 0.5% eye drops every 2 hours if severe and for 48 hours post-clearing of infection. If less severe, 4 times a day is enough, and advise on contact lens hygiene. If allergic/pregnant, use Fusidic acid.
5. A patient is undergoing IOP measurement with Goldmann applanation tonometry. What drop do you instill beforehand?
→ Lidocaine with fluorescein (local anaesthetic + stain). Wait 1 minute before tonometry.
6. A child undergoing amblyopia therapy is not responding to patching. What is an alternative pharmacological treatment and its protocol?
→ Atropine 1% in the better-seeing eye twice weekly. Monitor dilation and visual acuity regularly.
7. A patient with seasonal allergic conjunctivitis presents with severe itching and watery eyes. What non-prescription drop can you recommend?
→ Sodium cromoglycate 2% QID for 2 weeks. Confirm age >6 and advise to stop if no improvement.
8. A patient reports discomfort and blurred vision after recent LASIK surgery. You suspect dry eye. What management plan should you start with?
→ Preservative-free artificial tears (e.g. hyaluronic acid). If symptoms persist, refer for steroid or ciclosporin therapy.
9. You are examining a child for retinopathy of prematurity. What dilation drops do you use?
→ tropicamide 0.5% and phenylephrine 2.5% combo. Ensure no contraindications (e.g. low birth weight, cardiovascular issues).
tropicamide shouldnt be used in a baby however, it is necessary to use for rop
10. A patient presents with a suspected foreign body in the eye. What sequence of drops and tools do you use?
→ Instill topical anaesthetic (e.g. Proxymetacaine). Use fluorescein to highlight abrasion. Remove FB with sterile instrument. Prescribe chloramphenicol afterwards.
11. A teenager presents with photophobia, redness, and blurred vision after playing football. On slit lamp, you observe ciliary injection and anterior chamber cells. What drop do you administer?
→ Cyclopentolate 1% to relieve pain and prevent synechiae; refer urgently for steroid management.
12. You are asked to instil a mydriatic before indirect funduscopy in a patient with diabetes and hypertension. What is your drug of choice and what precautions should you take?
Tropicamide 1% alone is safer; avoid phenylephrine due to cardiovascular risks.
13. An adult with no significant medical history requires a dilated fundus exam for flashes and floaters. What combination of drops is most effective?
→ Tropicamide 0.5% + Phenylephrine 2.5%; assess anterior chamber depth first.
14. A patient presents with dry, gritty eyes and reduced tear breakup time. They are currently using lubricants >6 times daily with no improvement. What is the next step?
→ Consider prescribing a more viscous drop or refer for steroid therapy. Consider punctal plugs
15. A 2-year-old with suspected esotropia is being seen for first refraction. Which cycloplegic should you use and what is the protocol?
Cyclopentolate 0.5% 1 or 2 drops depending on iris colour then wait for 30 mins
Introduce yourself to parents, ask for consent to administer the cyclo drops. Explain that this drop will dilate the pupils so that our colleagues are able to do a better refraction and thereofre more accurate prescription.
Tell parents child will be more light sensitive today and may have slightly blurred vision. Also inform tha tthe pupils may look dilated for multiple days but vision will have returned to normal.
Wash hands, check the expiry date of the cyclo, take a minim, ask parent to hold baby in a doll position. Open eyes gently and administer 1 or 2 drops.
16. A patient presents with symptoms of conjunctivitis and is pregnant. Which antimicrobial should you consider and why?
→ Fusidic acid 1%; safer alternative to chloramphenicol which is contraindicated in pregnancy.
17. During a routine refraction, you notice the child becomes restless and disoriented 30 minutes after Cyclopentolate instillation. What is your management plan?
→ Monitor for systemic anticholinergic effects; ensure no further drops are given; reassure parents; document incident.
18. A 70-year-old woman presents with a red eye and severe headache. You find a fixed mid-dilated pupil. What is your immediate action?
→ Suspect acute angle-closure glaucoma. Check pressures, gonioscopy. Administer acetazolamide 500mg IV and refer immediately.
19. A patient with known open-angle glaucoma requires corneal anaesthesia for Goldman applanation tonometry. What drop do you use and why?
Lidocaine wirt fluorescein to visualise the contact area
20. A young adult with bilateral itchy red eyes and asthma presents during pollen season. Which eye drop is suitable and what advice do you give?
→ Sodium cromoglycate 2%; safe with asthma. Advise consistent use, lens removal before instillation, and avoidance of allergens.