Theme: Autoimmune disorders

Options:
A. Psoriatic arthritis
B. Reiter syndrome
C. Rheumatoid arthritis
D. Steven-Johnson syndrome
E. Cicatricial pemphegoid
F. Polyarteritis nodusa
G. Systemic Lupus erythematosus
H. Ankylosing spondylitis
I. Systemic sclerosis
J. Tuberous sclerosis
K. Ulcerative colitis
L. Chron’s disease


Lead in statement: The following patients all presented with red-eyes. Please choose the most appropriate systemic diagnosis from the list above.

Stems:

1. A 55-year-old man with known spine problems presents with red-eyes. He was recently discharged from hospital after successful treatment of pulmonary infection. Blood tests showed raised ESR and positive HLA-B27. There was no history of previous eye problems.

2. A70-year-old woman presents to eye casualty with red-eyes. On examination she has multiple mouth ulcers which are healing without scarring. Slit-lamp examination reveals cicatrising conjunctivitis. She is HLA-B12 positive.

3. A 55-year-old man presents with a red eye. On questioning he gives a history of palpitation, joint pains and weight loss. Slit-lamp examination reveals a peripheral ulcerative keratitis. His blood pressure was 190/140 mm Hg. Blood tests reveal signs of renal impairment, additionally a test for hepatitis-B surface antigen was positive.

Theme: Retinal detachment

Options:
A. Macular detachment.
B. Gronblad-Stranberg syndrome
C. Exudative retinal detachment
D. Tractional retinal detachment
E. Sickle cell disease
F. Sarcoidosis
G. Uveal effusion syndrome
H. Vogt-Koyanagi-Harada syndrome
I. CMV infection
J. Rhegmatogenous retinal detachment
K. Old retinal detachment
L. Retinopathy of prematurity
M. Norrie syndrome
N. Stickler syndrome
O. Malignant hypertension



Lead in statement: The following patients all presented with retinal detachment. Please choose the most appropriate diagnosis from the list above.

Stems:

1. A 79-year-old woman with bilateral loss of vision. Fundus examination shows SRF under the maculae. FFA showed RPE rips. She gives a history of left mastectomy 4 years ago.

2. A 40-years-old man with bilateral loss of vision, headaches and nausea. He is pyrexial and complaining of tinnitus. There are +2 cells in AC bilaterally. CSF showed pleocytosis.

3. A 75-year-old man noticed loss of vision in his right-eye on coincidentally covering the other eye. He gives a history of being severely short-sighted before cataract surgeries. Fundus examination of the right-eye shows raised dome shaped macula with a central hole.

Theme: Peripheral retinal degenerations

Options:
A. Salzman nodular degeneration
B. Pavingstone degeneration
C. Degenerative retinoschisis
D. Microcystoid degeneration
E. Lattice degeneration
F. Reticular degeneration
G. White without pressure
H. White-with-pressure
I. Honeycomb degeneration
J. Oral pigmentary degeneration
K. Snowflake degeneration
L. Pallucid marginal degeneration
M. Colloid bodies
N. Snailtrack degeneration


Lead in statement: The following patients all have retinal degenerations. Please choose the most appropriate diagnosis from the list above.

Stems:

1. A 43-year-old hypermetrope was referred by optician for abnormal superior field defects.

2. A 35-year-old lady presented to eye casualty complaining of sudden onset flashes in her right-eye. Peripheral fundus examination showed multiple circumferentially oriented bands of retinal atrophy. She had retinal detachment repair 2 years ago in her left-eye.

3. A 60-year-old asymptomatic man was seen in the eye clinic. Peripheral fundus examination showed circumferentially oriented bands of whitish frost-like islands. There was no associated retinal break.

4. A 40-year-old myope presents with bilateral presenile cataracts. Fundus examination reveals bilateral rhegmatogenous retinal detachment. He has an abnormality on chromosome 2q36.

Theme: Retinal detachment

Options:
A. Wardenburg syndrome
B. Norrie’s disease
C. Raymond syndrome
D. Stickler syndrome
E. ICE syndrome
F. Juvenile best disease
G. Morning Glory syndrome
H. Good syndrome
I. Fabry disease
J. Marfan’s syndrome
K. Rubenstein-Taybi Syndrome
L. Incontinentia pigmenti

Lead in statement: The following patients all presented with retinal detachment. Please choose the most appropriate diagnosis from the list above.

Stems:

1. A 20-year-old man presented to eye casualty concerned about a possible retinal detachment. He gives a family history of retinal detachments. There were multiple, radially oriented, lattice like lesions on both fundi but no retinal detachment.

2. A 25-year-old man with defect on chromosome 15q21. The sclerae are blue and the pupil does not dilate well for peripheral fundus examination.

3. A 27-year-old woman with tractional retinal detachment in the left-eye. Fundoscopy also revealed an enlarged and excavated optic disc. The retinal blood vessels appear to emerge from the periphery of the excavation in a radial pattern. Right fundus was normal.