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OCANZ Written 100% Correct Answers Verified Latest 2024 Version

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OCANZ Written | 100% Correct Answers | Verified | Latest 2024 Version A 75 y/o F comes in for her annual check complaining of reduced vision and increased intolerance to glare. She has had a myopic shift and has cataracts. a) What factors should you consider when referring for cataract surgery?...

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  • July 3, 2024
  • 19
  • 2023/2024
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OCANZ Written | 100% Correct Answers |
Verified | Latest 2024 Version
A 75 y/o F comes in for her annual check complaining of reduced vision and increased intolerance to
glare. She has had a myopic shift and has cataracts.

a) What factors should you consider when referring for cataract surgery? - ✔✔
b) Cataract Cause of visual complaint

Compromising Lifestyle

Driver

Anisometropia

Visual Acuity

Other Ocular Pathology

General Health and Medications

Patient wants to have operation



b) What type of cataract is most likely from the above description? - ✔✔Nuclear Sclerotic



c) Describe a cataract op in laymans terms - ✔✔Outpatient Basis

Before surgery seen by a specialist doctor

30-40 minutes on local anaesthetic

The Surgeon will make a tiny cut in your eye to get to the lens

High-frequency ultrasound device that breaks up the cloudy lens into small pieces

Small pieces gently removed from the eye with suction.

Cloudly lenses replaced by a clear plastic one



d) What are the post op drops (names and concentration) and common post-op complications you would
look out for weeks after? - ✔✔Postoperative regimens of topically applied antibiotics, corticosteroids,
NSAIDs, and oral

analgesic agents vary among practitioners.

,From Incision - wound leak

Corneal Astigmatism

Keratopathy

IOP rise

Endopthalmitus

IOL disslocation

Sunset syndrome

Iris epithelial ingrowth

Pupil Capture

CMO

Retinal Detachment



Signs of Glaucoma - ✔✔Disc Signs: Asymetric Cupping, Disc Haemorrhage , Increased cuppping, RNFL
changes, PPA, NRR thining.



Visual field loss characteristic to ONH changes, notching, superior arcuate defect.



How is glaucoma diagnosed. - ✔✔Progression analysis, visual fields and RNFL scanning using OCT



Medisoft plot, RE: false +ve 3% fixation losses 7/10 Le: false +ve 7% fixation losses 2/10.

What is the reliability of the fields? - ✔✔Fixation loss higher than about 20% is deemed unreliable.



A false positive rate around 20% or higher is considered to indicate low patient reliability



Medisoft plot showing a right homonymous hemianopia with macular sparing.



What is the full name and classification of the condition?

, Where in the visual pathway is the loss? - ✔✔Right homonymous hemianopia with macular sparing
indicating a legion in the posterior occipital lobe and optic radiations or optic tracts



Medisoft plot showing a right homonymous hemianopia with macular sparing.



What is the likely cause? - ✔✔Vascular episode

Tumour



Medisoft plot showing a right homonymous hemianopia with macular sparing.



What is the appropriate management? - ✔✔Prisms (field expanders)

Managment of cause if possible and review.



Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.



What is the neurological lesion and syndrome shown? - ✔✔Internuclear ophthalmoplegia is caused
injury or dysfunction in the medial longitudinal fasciculus (MLF)



Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.



What is the aetiology? - ✔✔In the elderly, typically caused by stroke and is unilateral



In young people, commonly caused by multiple sclerosis and may be bilateral



Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye
adduction but no problems converging to read.



What is the management? - ✔✔Systemic work up and management

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