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Cases of red eye: a range of red eye conditions, which may be encountered in routine clinic, is presented to test the practitioner's recognition and interpretation skills.

Optometrists

Therapeutic optometrists

1 CET POINT

01 Which other clinical sign is least likely to be found with this presentation?

a) Dalen-Fuchs nodules

b) Busacca nodules

c) Koeppe nodules

d) Posterior synechiae

02 Which of the following diseases is most likely to be associated with this ocular finding?

a) Ankylosing spondylitis

b) Tuberculosis

c) Behcet's disease

d) Reactive arthritis

03 Which of the following laboratory tests is least helpful in diagnosing this presentation?

a) HLA-B27

b) Purified protein derivative test

c) Chest x-ray

d) Full blood count

04 Which of the following is not a common risk factor for the above condition?

a) Increasing age

b) Long term UV exposure

c) Female gender

d) Dry climate

05 Which of the following is not a differential diagnosis of the condition?

a) Pseudopterygium

b) Pannus

c) Pinguecula

d) Band keratopathy

06 Which of the following management options is associated with the lowest rate of recurrence?

a) Limbal conjunctival autograft with mitomycin C

b) Bare sclera resection

c) Amniotic membrane graft

d) Short course of FML drops

07 Which of the following is not usually a cause of this type of presentation?

a) Facial nerve palsy

b) Overriding of the preseptal over the pretarsal portion of the orbicularis oculi muscle

c) Tumour near lid margin

d) Weakness of the medial and lateral canthal tendons

08 Which sign is unlikely to be present on examination?

a) Corneal abrasion by the eyelashes

b) Inferior corneal exposure keratopathy

c) Epiphora

d) Conjunctival hyperaemia

09 Which of the following treatment options is suitable for this condition?

a) Epilation of eyelashes

b) Taping to skin of cheek to pull the lid away from the globe

c) Lateral tarsal strip procedure

d) Bandage contact lens to protect the cornea from eyelashes

Exam questions and references

Under the enhanced CET rules of the GOC, MCQs for this exam appear online at www.optometry.co.uk. Please complete online by midnight on 28 December 2016. You will be unable to submit exams after this date.

Images permission

Thanks to the University of Iowa and EyeRounds.org

10 Which of the following conditions is least likely to present with the above signs?

a) Herpes Zoster keratoconjunctivitis

b) Chlamydial infection

c) Molluscum contagiosum infection

d) Bacterial keratitis

11 Which treatment option is suitable in the majority of cases?

a) Topical antiviral

b) Supportive care such as cold compresses and artificial tears

c) Topical prednisolone

d) Chloramphenicol 1% drops

12 What other signs may the patient have?

a) Watery discharge

b) Oedematous lids

c) Preauricular lymphadenopathy

d) All of these options are correct

Prashant Shah MCOptom, PGDipOphth, DipCIinOptom and Yashita Shah MCOptom, PGDipOphth

Prashant Shah is an optometrist with postgraduate diplomas in ophthalmology and in clinical optometry. He works in routine practice and at a laser clinic.

Yashita Shah is an optometrist working in independent practice. She holds a postgraduate diploma in ophthalmology.

Course code: C-53883 Deadline: 28 December 2016

Learning objectives

* Understand the appropriate management response for a range of anterior eye presentations (Group 2.2.5)

* Be able to recognise and investigate the presenting signs and symptoms of the patient (Group 6.1.2)

* Understand the presentation of a range of anterior eye conditions and the likely prognosis for the patient (Group 1.1.1)

* Understand the differential diagnosis for a range of anterior eye presentations (Group 2.1.4)
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Title Annotation:VRICS
Author:Shah, Prashant; Shah, Yashita
Publication:Optometry Today
Date:Dec 1, 2016
Words:558
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