QUIZ 1:-

Diagnosis:- Episcleritis

Definition:- It is a benign, self-limiting inflammatory disease of the episclera.

Aetiology:-

1.Idiopathic

2.Found in association with:

 RA
 Inflammatory Bowel Disease (IBD)
 Acne rosacea
 Atopy
 Gout
 Syphilis
  TB
 Herpes zoster virus

Types:-

1.Simple Epicleritis may be:

 Sectorial (70%)
 Diffuse (30%)

2.Nodular Episcleritis

Pathology:

It is a non-granulomatous inflammation with vascular dilatation and perivascular infiltration of

lymphocytes.

Clinical Features:-

 Sudden in onset, more common in females and the redness of the eye is usually
sectioral.
 The lesion appears to be salmon pink colour in light.
 Straight inflamed vessels radiate posteriorly from the limbus.
 The lesion moves with cotton tipped applicator over the deeper tissue.

Diagnosis:-

 Clinical
 Topical phenylephrine 2.5% will blanch episcleral vessels but not deeper vessels

Treatment:-
  Self limiting, resolves spontaneously with 1-2 weeks
 Topical artificial tears
 Topical steroids and Topical vasoconstrictors
 Oral NSAIDs (dicofenac sodium and naproxen)

QUIZ 2:-

Diagnosis:- Pterygium

Definition:- It is a degenerative condition of the conjunctiva in which there is a triangular

fibrovascular connective tissue over growth conjunctiva to the cornea in the interpalpebral
region.

Aetiology:-

 Drying of the interpalpebral tear film

  Damage by ultraviolet light to corneal epithelium, Bowman’s membrane and underlying
cornea.
 Chronic infection of conjunctiva
 Dusty Atmosphere

Pathology:-

It’s a degenerative and hyperplastic condition of the conjunctiva in which the sunconjunctival
tissues undergo elastonic degeneration and proliferate as vascularized granulation tissues
under the epithelium which encroaches the cornea.

Types:-

1.Progessive pteryguim

2.Stationary pterygium

2.Regressive pterygium

Clinical Features:-

 Asymptomatic in the early stage

 A Fibrovascular growth in the triangular fashion at the limbus with the apex towards the
cornea.
 Stocker line
 Deterioration of vision
 Diplopia

Treatment:-

 Topical steroids for inflammation

 Sunglasses to reduce exposure to UV light
 Surgical Exicison if progressed to stage 2 and 3.
QUIZ 3:-

Diagnosis:- Subconjunctival Haemorrhage

Definition:-It is a benign condition usually asymptomatic until noticed by the patient or others.

Aetiology:-

 Idiopathic
 Post surgical
 Vitamin K deficiency
 Scurvy
 Severe Hypertension

Clinical Features:-

 Diffuse or localized area of blood under the conjunctiva

  Vision is not affected
 Sudden in onset
 Deep, red haemorrhage is present beneath the conjunctiva in one quadrant or whole of
it.

Diagnosis:-

 Local Ocular examination to rule out ocular cause

 Blood pressure checkup
 Lab investigations to rule out systemic cause

Treatment:-

 Self limiting condition, spontaneous resolution occurs with 1-2 weeks

 Artificial tears maybe applied 3-4 times a day
QUIZ 4:-

Diagnosis:- Optic Atrophy

Definition:-It is the atrophy of the optic disc,resulting from the degeneration of the retinal
ganglion cells or their axons.

Aetiology:-

 Retrobulbar optic neuritis due to MS

 Compressive neuropathy i.e. pituitary tumour, optic nerve tumour and aneurysm
 Ischaemic optic neuropathy
 Traumatic optic neuropathy
 Hereditary optic neuropathies
 Toxic optic neuropathies
 Nutritional optic neuropathies

Types:-
 1. Primary optic atrophy
2. Secondary optic atrophy
3. Consecutive optic atrophy
4. Glaucomatous optic atrophy

Clinical features:-

 Disc is chalky white in appearance with clear margins.

 Lamina cribrosa is more visible.
 Retinal vessels are normal
 Sheathing of vessels is absent

Investigations:-

 Neuroimaging-CT scan and MRI

 Electroretinogram (ERG)
 Visually Evoked Potential (VEP)
 CBC, ESR, Blood Glucose levels, BP, Carotid Doppler ultrasound

Treatment:-

Depends upon the underlying cause and visual acuity, however there is no absolute cure for
optic atrophy.
QUIZ 5:-

Diagnosis:- Age Related Macular Degeneration

Definition:-It is a degenerative disease of the macula causing irreversible vision loss.

Aetiology:-

 It is the most common form of ARMD comprising of 90% of cases

 Caused by progressive atrophy of the photoreceptors, RPE and choricapillaries

Stages:-

1.Early stage (asymptomatic)

a)Well defined small Drusen

b)Focal hyperpigmentation

2.Intermediate stage:-
a)Less defined soft large Drusen

b)Sharply circumscribed small circular areas of RPE atrophy.

3.Advance Stage:-

a)Geographical Atrophy

Clinical Features:-

 Gradual impairment of central vision over a period of time, months to years

 Patient may complain of distorted vision
 Both eyes are generally involved
 Severity of symptoms depends upon the stage of the condition.

Investigations:-

 Typical Findings of the Fundus

 FFA would show window defects characterized by hyperflourescene.

Treatment:-

 Control risk factors and Prophylactic management.

 Photodynamic therapy maybe helpful
 Anti-VEGF monoclonal antibody (RHU-FAB V2)