VRICS banner Banner overlay
C-43316

Cases from routine practice

This visual recognition task requires the practitioner to identify the condition and consider the appropriate management of each case

Image A

Imagea

01 The image shows a central disc of grey/white matter on the anterior lens surface. What is this finding associated with?

a) Anterior cortical cataract
b) Pseudoexfoliation syndrome
c) Anterior chamber flare
d) Glaukomflecken

02 Which of the following statements in relation to this condition is incorrect?

a) It can cause obstruction of aqueous outflow at the trabecular meshwork
b) It is a risk for developing primary open angle glaucoma
c) It is a risk for developing secondary glaucoma
d) It is commonly associated with iris sphincter atrophy

03 Which of the following statements in relation to this condition is correct?

a) Typically presents in young patients
b) All patients require topical or surgical treatment
c) It can cause complications during cataract surgery
d) Patients do not require more regular ocular examination

Image B

Imageb

04 What is the likely lesion shown in Image B?

a) Pannus
b) Pinguecula
c) Episcleritis
d) Pterygium

05 Which of the following statements best describes predisposing factors commonly associated with this condition?

a) Long-term use of ocular lubricants
b) Long-term ultraviolet exposure and living in hot climates
c) Continuous wear of soft contact lenses
d) Family history

06 In terms of management which of the following statements is incorrect?

a) Optometrists should advise on UV protection including wearing wrap-around style sunglasses and brimmed hat
b) 
Patients may be advised to use ocular lubricants to relieve symptoms
c) 
Referral to an ophthalmologist is never required
d) 
Referral to an ophthalmologist may be required for intervention

Image C

Imagec

07 Image C shows a corneal lesion stained with fluorescein. What is the likely diagnosis?

a) Microbial keratitis
b) Acanthamoeba keratitis
c) Fungal keratitis
d) Herpes simplex keratitis

08 Which of the following statements regarding this condition is incorrect?

a) Rose Bengal stain can also be used to aid diagnosis
b) If inappropriately managed this lesion can enlarge to form an amoeboid or geographic ulcer
c) Debridement of the corneal ulcer in conjunction with topical anti-viral agents is effective treatment
d) Independent prescribing optometrists may treat recurrent episodes

09 Which of the following statements regarding management is incorrect?

a) Topical steroids are always required
b) Topical anti-viral agents, such as aciclovir are predominantly used
c) Debridement of the corneal ulcer in conjunction with topical anti-viral agents is effective treatment
d) Independent prescribing optometrists may treat recurrent episodes

Image D

Imaged

10 Which of the following signs and symptoms are not usually associated with the condition in Image D?

a) Burning, itching and irritation
b) Reduced visual acuity
c) Hyperaemia of the superior palpebral conjunctiva
d) Increased mucous production

11 When related to contact lens wear which of the following statements is incorrect?

a) Occurs more with rigid lens wear compared to soft contact lens wear
b) Predisposing factors include poor lens fitting, hygiene and design
c) Often presents bilaterally
d) May be the result of an immunological response to protein deposits on the lens surface

12 Which of the following is not a viable management option for this condition?

a) Reduce contact lens replacement frequency
b) 
Cold compresses and artificial tears

c) Increase contact lens replacement frequency
d) Use of a mast cell stabiliser


About the author

Neelam Patel graduated from the University of Manchester with a Masters of Optometry in June 2011. She then joined Aston University as a Knowledge Transfer Partnership associate and PhD candidate working on a practice-based research project at BBR Optometry, Hereford. She is now in the final stages of her PhD and predominantly works in independent practice as well as supervising final year students at Aston University.

Your comments

You must be logged in to join the discussion. Log in

Comments (3)