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Ocular oncology.

This visual recognition feature presents a series of ocular malignancies to test the practitioner's ability to identify each case and understand the likely outcome for the patient.

01 Which of the following would not be a differential diagnosis of the lesion above?

a) Benign reactive lymphoid hyperplasia

b) Squamous papilloma

c) Uveitis

d) Conjunctival lymphoma

02 Which of the following treatments is associated with the highest recurrence risk for the lesion above?

a) Excisional biopsy

b) External beam radiotherapy

c) Interferon alpha-2b

d) Rituximab injection

03 Which of the following is the patient least likely to present with?

a) Foreign body sensation

b) Ptosis

c) Epiphora

d) Severe ocular pain

04 Which of the following tests is least useful in the diagnosis of the condition shown?

a) Optical coherence tomography

b) Fundus autofluorescence

c) Contact tonometry

d) B scan ultrasound

05 Which of the following is not a risk factor for malignancy for these types of lesions?

a) Greater than 2mm thickness

b) Lipofuscin on surface

c) Subretinal fluid

d) Location greater than 3mm from optic nerve

06 What is the most common site of systemic metastasis for the lesion shown?

a) Liver

b) Bone

c) Kidney

d) Lung

07 Which of the following is least likely to be present alongside this condition?

a) Glaucoma

b) Cataract

c) Strabismus

d) Leukocoria

08 What is the least common site of systemic metastasis for the lesion shown?

a) Lung

b) Central nervous system

c) Bone

d) Liver

09 Which of the following is a differential diagnosis of the condition shown?

a) Persistent hyperplastic primary vitreous

b) Coats' disease

c) Toxocariasis

d) All options are correct

10 Which of the following statements is incorrect?

a) The lesion can arise de novo

b) The lesion can arise from an existing naevus

c) The lesion is always pigmented

d) The lesion can arise from pre-existing primary acquired melanosis

11 What is the most common systemic site of metastasis for the lesion shown?

a) Lung

b) Brain

c) Liver

d) Bone

12 Which of the following is not a commonly used adjuvant therapy to surgical excision of the lesion?

a) Topical chemotherapy

b) Radiotherapy

c) Cryotherapy

d) Riboflavin

Questions and acknowledgements

Under the enhanced CET rules of the GOC, MCQs for this exam appear online at Please complete online by midnight on 9 June 2017. You will be unable to submit exams after this date. The authors and publishers acknowledge the University of Iowa and for permission to reproduce this copyrighted material from for Image A.

Course code: C-55548 Deadline: 9 June 2017

Learning objectives

* Be able to recognise cases of ocular malignancy and undertake differential diagnosis (Group 6.1.5)

* Be able to recognise cases of ocular malignancy, establish the severity and undertake differential diagnosis (Group 2.1.3)

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 A 55-year-old female patient presents with a pink swollen lesion in her left eye.

Caption: Image B A 60-year-old Caucasian male patient presents with symptoms of flashing lights and floaters.

Caption: Image C A three-year-old girl presents for an eye exam with the fundus appearance shown.

Caption: Image D A 55-year-old Caucasian patient presents with a dark lesion on his eye.
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Title Annotation:VRICS
Author:Shah, Prashant; Shah, Yashita
Publication:Optometry Today
Date:May 1, 2017
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