abnormalities of the optic lens are recognised in

C.dystrophia myotonia
D.wilsons disease
E.congenital rubella


Recognized features of diabetic retinopathy include:

A flame haemorrhages
B arteriovenous nipping
C new blood vessels overlying the optic discs
D macular degeneration
E macular oedema

comment Diabetic retinopathy is associated with exudates (cotton wool spots and hard exudates), haemorrhages, macular oedema, venous changes and neovascularisation. AV nipping is associated with hypertensive retinopathy.


When considering diabetic retinopathy which of the following statements is
most accurate:

1) Microaneurysms represent sacular dilatation of retinal arterioles
2) Hard exudates represent calcium deposites in the retina
3) Cotton wool spots represent infarcts of the nerve fibre layer of the retina
4) Haemorrhages close to the fovea are not potentially sight threatening
5) Laser photocoagulation is applied directly to new vessels to destroy them


MAs are capillary aneurysms.
HEs are collections of exudated lipid and protein.
C is correct, multiple CWS are a pre-proliferative sign.
Haemorrhages (or HEs) close to the fovea represent a risk of macular oedema
and are therefore sight threatening
Laser destroys ischaemic but viable retina to reduce the secretion of
angiogenic growth factors and allow new vesel regresion, it is not applied
directly to new vessels as this would cause bleeding.


A 30-year-old female presents to the eye clinic with an acute history of pain and blurring in the right eye. Examination reveals a visual acuity of 6/36 in the right eye but 6/6 in the left eye, a central scotoma in the right eye, with a right swollen optic disc.

What is the most likely diagnosis?

1) Compression of the optic nerve
2) Cavernous sinus thrombosis
3) Glaucoma

4) Optic neuritis
5) Retinal vein occlusion

The acute presentation with central scotoma, reduced visual acuity and a swollen optic disc in a young female suggests a diagnosis of MS with a retrobulbar neuritis.


left homonymous hemianopia may be caused by which of the following lesions:

A A lesion of the optic chiasm

B A lesion of the right occipital lobe

C Right Optic Neuritis

D An attack of migraine

E Occlusion of the anterior cerebral artery

A left homonymous hemianopia would be associated with a right occipital lobe lesion and also with migraine. The optic chiasmal lesion is likely to cause a bitemporal hemianopia. The anterior cerebral artery supplies the frontal lobes and the superior aspect of the brain and may be associated with a homonymous hemianopia.