Eyes1. Bilateral sticky eyes, gritty, normal visual acuity, no photophobia. What is the most likely diagnosis?A. ConjunctivitisB. Acute angle-closure glaucomaC. Microbial keratitis from a contact lensD. Papilloedema as the cause of stickinessCheck
Eyes2. High clinical probability of GCA but ESR is 18 mm/h. What is the correct interpretation?A. ESR 18 rules GCA out foreverB. A normal ESR does not exclude GCA if the story is typicalC. No blood test other than ESR is ever used (CRP is useless)D. You must never start steroids if ESR is under 20Check
Eyes3. Sudden distortion on the Amsler grid and a central scotoma in a 78-year-old. What is the most appropriate referral? The most appropriate action is: Urgent wet AMD / medical retina pathway for possible anti-VEGFTRUE. TrueFALSE. FalseCheck
Eyes4. Bilateral gradual central loss, drusen on a recent optometrist letter, no sudden distortion. What advice is high-yield? Select TWO correct statements.Select all that apply.A. Most appropriate: Stop smoking and engage appropriate optometry/ophthalmology follow-upB. The following is not the most appropriate next step: Immediate anti-VEGF in GPC. Most appropriate: Stop all vegetablesD. Most appropriate: Patch the better eyeCheck
Eyes5. A man with type 2 diabetes says his high-street optician visit replaces diabetic eye screening. What is the most appropriate advice? Select TWO correct statements.Select all that apply.A. Most appropriate: Diabetic Eye Screening Programme appointments are still required (England)B. The following is not the most appropriate next step: Any optician visit automatically cancels screening foreverC. Most appropriate: Screening is only for type 1 diabetesD. Most appropriate: Pregnancy means screening can stopCheck
Eyes6. A shower of floaters, flashes, and a curtain across vision in a high myope. What is the most appropriate action? The most appropriate action is: Migraine advice onlyTRUE. TrueFALSE. FalseCheck
Eyes7. Bilateral disc swelling, morning headache, transient visual obscurations. What is the most appropriate action? The most appropriate action is: LP in the treatment roomTRUE. TrueFALSE. FalseCheck
Eyes8. BP 228/124 mmHg with disc swelling and visual symptoms. What is the most appropriate action? The most appropriate action is: Emergency admission for hypertensive emergency with retinopathyTRUE. TrueFALSE. FalseCheck
Eyes9. Contact-lens wearer, painful red eye, photophobia, reduced acuity. What is the most appropriate action? Select TWO correct statements.Select all that apply.A. Most appropriate: Same-day eye casualty for microbial keratitis; stop the lensB. The following is not the most appropriate next step: More contact-lens wear to 'bandage' the eyeC. Most appropriate: Chloramphenicol and continue the lensD. Most appropriate: Topical anaesthetic to take home for 2 weeksCheck
Eyes10. Fluorescein shows a dendritic ulcer. A colleague reaches for steroid drops. What is the most appropriate action?A. Steroid first to 'calm inflammation'B. Urgent ophthalmology; do not start topical steroid on a dendritic ulcer in GPC. Reassure as bacterial conjunctivitisD. Patch and ignoreCheck