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Lasers: indications, contraindications, and complications.

This feature considers the use of lasers in the treatment of various ophthalmic conditions. Readers are invited to complete the MCQs by using existing knowledge and accessing further resources where required.

Optometrists

A 45-year-old female patient attends for a sight test wanting new spectacles. She is under the care of the ophthalmology department at her local hospital.

01 What do the red stars indicate in the image?

a) Panretinal photocoagulation

b) Retinal cryotherapy

c) Pneumatic retinopexy

d) Plaque brachytherapy

02 What are the indications for use of this intervention?

a) New disc vessels

b) New vessels elsewhere

c) New iris vessels

d) All of these options

03 Which of the following is unlikely to arise following treatment?

a) Exudative retinal detachment

b) Visual field defect

c) Improved night vision

d) Macular oedema

Therapeutic optometrists

A 65-year-old female patient with a family history of glaucoma attends for a routine sight test.

04 What is the most common purpose of the treatment shown?

a) To treat angle closure glaucoma

b) To treat open angle glaucoma

c) To remove an iris naevus

d) To open up the trabecular meshwork

05 What are the potential complications of this treatment?

a) Postoperative intraocular pressure spike

b) Anterior uveitis

c) Iris bleed

d) All of these options

06 Which of the following is the most common laser used to perform this treatment?

a) Nd:YAG

b) Argon

c) Excimer

d) Diode

A 30-year-old male patient attends as an emergency with the clinical findings as shown in the image.

07 Which of the following symptoms is this patient unlikely to present with?

a) Photopsia

b) Sudden onset floaters

c) Shadow in vision

d) Severe ocular pain

08 What other signs may arise in this case?

a) Pigment in the anterior vitreous

b) Retinal haemorrhage

c) Detached retina

d) All of these options

09 What are the complications of laser treatment for this condition?

a) Inadvertent laser to the macula

b) Epiretinal membrane formation

c) Choroidal effusions

d) All of these options

A 78-year-old male patient attends for a routine test. He had bilateral cataract surgery five years ago and has a brother with glaucoma.

10 Which of the following is the most common laser used to treat the condition shown?

a) Nd:YAG

b) Argon

c) Excimer

d) Diode

11 What are the potential complications of the treatment?

a) Raised intraocular pressure

b) Cystoid macular oedema

c) Intraocular lens damage

d) All of these options

12 Treatment is contraindicated when the patient presents with:

a) Corneal oedema

b) Active cystoid macular oedema

c) Active uveitis

d) All of these options

Acknowledgement

The authors and publishers acknowledge the University of Iowa and EyeRounds.org for permission to reproduce this copyrighted material

Exam questions

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 21 June 2019. You will be unable to submit exams after this date.

Course code: C-70341 Deadline: 21 June 2019

Learning objectives

* Ability to understand the indications, contraindications, and complications of using lasers to treat a range of ocular pathologies (Group 6.1.11)

* Ability to understand the contraindications and complications of different types of laser treatment (Group 2.1.7)

Prashant Shah MCOptom, PGDipOphth, DipClinOptom and Yashita Shah MCOptom, PGDipOphth

Prashant Shah is an optometrist with postgraduate diplomas in ophthalmology and in clinical optometry and currently works in routine practice.

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

Caption: Image A

Caption: Image B

Caption: Image C

Caption: Image D
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Title Annotation:VRICS
Author:Shah, Prashant; Shah, Yashita
Publication:Optometry Today
Date:May 1, 2019
Words:599
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