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Exam (elaborations)

Rafi Ophthalmology- Questions & Answers

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Rafi Ophthalmology- Questions & Answers

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  • November 23, 2024
  • 55
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
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Rafi Ophthalmology- Questions &
Answers
A 32-year-old patient comes into your clinic saying that she noticed a difference in her pupil
sizes this morning when she was putting on her makeup. On examination, you confirm
anisocoria, with the right pupil being bigger than the normal left pupil. There is more than
0.5mm difference in pupil sizes.



The most likely cause of this presentation is?



There is no pathology

Sympathetic ganglionic pathology (Horner's syndrome)

Cranial nerve III (occulomotor nerve) palsy

Cranial nerve II (optic nerve) neuralgia" Correct Ans-Cranial nerve III (occulomotor nerve)
palsy

"



Joan O'Connell, a 28-year-old female, presents to A&E with a 2-month history of headache. She
reports that her headache is at its worse in the morning and that it wakes her up around 05:00
AM; she is usually nauseated at this time and has vomited once. Additionally, sneezing or
coughing precipitates her headache. She has also felt unusually tired over the last 2 months. She
is overweight, with a BMI of 31. Fundoscopy shows no papilloedema, but retinal venous
pulsations are absent. Her temperature is 37 oC and her inflammatory markers are normal.



Which of the following is the most appropriate next step?

,Advise weight loss

Brain MRI

Lumbar puncture

Prescribe propranolol

Empirical antibiotics Correct Ans-Brain MRI



Which of the following is least likely to cause a relative afferent pupillary defect (RAPD)?



Cataract

Advanced glaucoma

Total retinal detachment

Anterior ischaemic optic neuropathy

Optic neuritis Correct Ans-Cataract



A 40-year-old woman presents to her GP due to changes in her vision. She says that the vision in
her right eye has become progressively more cloudy over the past two weeks. She also describes
some pain in the right eye. On examination, she has a reduction in colour vision in her right eye.
Her visual acuity is normal. The light reflex in her right eye is slow, and she has a relative
afferent pupillary defect (RAPD).



What is the MOST likely cause of her problem?

,Optic neuritis

Giant cell arteritis

Dry macular degeneration

Central retinal artery occlusion

Wet macular degeneration Correct Ans-Optic neurtitis



A patient presents with diplopia. When asked to look straight ahead, his left eye is stuck looking
inferolaterally, the pupil is dilated and there is ipsilateral ptosis.



What is the most likely cause of this presentation?



Oculomotor nerve (CNIII) palsy

Horner's syndrome

Trochlear nerve (CNIV) palsy

Abducens nerve (CNVI) palsy" Correct Ans-Oculomotor nerve (CNIII) Palsy

"



A 50-year-old woman has a left corneal abrasion. When the left cornea is touched with cotton,
neither eye blinks. When the right cornea is touched with cotton, both eyes blink.



Selected the cranial nerve most likely to be affected.



CN II

, CN X

CN III

CN IV

CN VII

CN IX

CN I

CN V

CN VIII

CN VI Correct Ans-CN V



The colour of fluorescein staining in corneal ulcer is



Yellow

Blue

Green

Royal Blue" Correct Ans-Green

"



Which of the following organisms can penetrate intact corneal epithelium



Strep pyogenes

Staph aureus

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