OCANZ Written exam 100% questions and answers 2024

OCANZ Written exam 100% questions and answers 2024 A 75 y/o F comes in for her annual check complaining of reduced vision and increased intolerance to glare. She has had a myopic shift and has cataracts. a) What factors should you consider when referring for cataract surgery? - ANSWERS Cataract Cause of visual complaint Compramising Lifestyle Driver Anisometropia Visual Acuity Other Ocular Pathology General Health and Medications Patient wants to have operation b) What type of cataract is most likely from the above description? - ANSWERS Nuclear Sclerotic c) Describe a cataract op in laymans terms - ANSWERS Outpatient Basis Before surgery seen by a specialist doctor 30-40 minutes on local anaesthetic The Surgeon will make a tiny cut in your eye to get to the lens High-frequency ultrasound device that breaks up the cloudy lens into small pieces Small pieces gently removed from the eye with suction. Cloudly lenses replaced by a clear plastic one d) What are the post op drops (names and concentration) and common post-op complications you would look out for weeks after? - ANSWERS Postoperative regimens of topically applied antibiotics, corticosteroids, NSAIDs, and oral analgesic agents vary among practitioners. From Incision - wound leak Corneal Astigmatism Keratopathy IOP rise Endopthalmitus IOL disslocation Sunset syndrome Iris epithelial ingrowth Pupil Capture CMO Retinal Detachment Signs of Glaucoma - ANSWERS Disc Signs: Asymetric Cupping, Disc Haemorrhage , Increased cuppping, RNFL changes, PPA, NRR thining. Visual field loss characteristic to ONH changes, notching, superior arcuate defect. How is glaucoma diagnosed. - ANSWERS Progression analysis, visual fields and RNFL scanning using OCT Medisoft plot, RE: false +ve 3% fixation losses 7/10 Le: false +ve 7% fixation losses 2/10. What is the reliability of the fields? - ANSWERS Fixation loss higher than about 20% is deemed unreliable. A false positive rate around 20% or higher is considered to indicate low patient reliability Medisoft plot showing a right homonymous hemianopia with macular sparing. What is the full name and classification of the condition? Where in the visual pathway is the loss? - ANSWERS Right homonymous hemianopia with macular sparing indicating a legion in the posterior occipital lobe and optic radiations or optic tracts Medisoft plot showing a right homonymous hemianopia with macular sparing. What is the likely cause? - ANSWERS Vascular episode Tumour Medisoft plot showing a right homonymous hemianopia with macular sparing. What is the appropriate management? - ANSWERS Prisms (field expanders) Managment of cause if possible and review. Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye adduction but no problems converging to read. What is the neurological lesion and syndrome shown? - ANSWERS Internuclear ophthalmoplegia is caused injury or dysfunction in the medial longitudinal fasciculus (MLF) Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye adduction but no problems converging to read. What is the aetiology? - ANSWERS In the elderly, typically caused by stroke and is unilateral In young people, commonly caused by multiple sclerosis and may be bilateral Patient with horizontal diplopia and a picture of a patient's eyes having problems with right eye adduction but no problems converging to read. What is the management? - ANSWERS Systemic work up and management Prism Fogging Strabismus surgery 64 y/o F complains of pain on chewing and headaches 2 weeks. Loss of vision in one eye today. a) What is your diagnosis and immediate response? - ANSWERS Refer as emergency for systemic steroids e.g prednisolone 64 y/o F complains of pain on chewing and head