Ophthalmology
The red eye, sudden visual loss and chronic eye disease.
- The Red Eye The four discriminators - acuity, pain, pupil and the pattern of redness - plus why ciliary flush means intraocular disease and when to refer the same day.
- Conjunctivitis Separating bacterial, viral and allergic conjunctivitis, why most cases need no antibiotic, and the presentations - neonatal, gonococcal, contact lens - that are not conjunctivitis.
- Corneal Ulcer and Abrasion What fluorescein staining does and does not tell you, the white infiltrate that separates an ulcer from an abrasion, and why recurrent erosion needs three months of ointment.
- Infective Keratitis Matching the organism to the story, the scrape-then-treat-intensively principle, and why every red eye in a contact lens wearer goes to eye casualty today.
- Scleritis and Episcleritis The phenylephrine blanching test, the one symptom that separates the two, and why scleritis means looking hard at the kidneys, lungs and joints.
- Uveitis Cells, flare and keratic precipitates, the HLA-B27 associations worth asking about, and why the cycloplegic matters as much as the steroid.
- Acute Angle Closure Glaucoma Why a mid-dilated pupil is the dangerous one, the drugs that precipitate an attack, and the emergency drug regimen plus iridotomy to both eyes.
- Chronic Open Angle Glaucoma Reading the disc rather than the cup-to-disc ratio, why field defects respect the horizontal midline, and the NICE shift to first-line SLT.
- Cataracts The three morphological types and the symptoms each produces, why cataract never causes an RAPD, and the complications of phacoemulsification worth consenting for.
- Macular Degeneration Drusen and metamorphopsia, why tempo separates dry from wet, and the two-week window for anti-VEGF that makes the Amsler grid worth handing out.
- Diabetic Retinopathy What each fundal sign actually represents, the R and M grades used by NHS screening, and the trade-off patients must be warned about before pan-retinal laser.
- Hypertensive Retinopathy Keith-Wagener-Barker grading, why AV nipping is chronic and cotton wool spots are acute, and why lowering the pressure too fast causes infarction.
- Retinal Detachment Why flashes, floaters and a curtain each occur, the macula-on versus macula-off decision that sets the urgency, and why gas tamponade grounds a patient.
- Central Retinal Artery Occlusion Why the cherry red spot appears, how to exclude giant cell arteritis in the first five minutes, and why this belongs on a stroke pathway rather than in an eye clinic.
- Central Retinal Vein Occlusion Why a stiff artery causes a vein occlusion, separating ischaemic from non-ischaemic disease at the bedside, and the 100-day risk of neovascular glaucoma.
- Optic Neuritis The triad and how to demonstrate an RAPD, what the baseline MRI actually tells you about MS risk, and why oral prednisolone alone is the wrong answer.
- Papilloedema Why axoplasmic stasis causes the swelling, Frisen grading, distinguishing disc drusen, and why you image before you tap.
- Visual Field Defects Localising a lesion in four questions, the vertical-versus-horizontal rule, PITS, and why congruity increases the further back the lesion sits.
- Benign Eyelid Disorders Blepharitis, stye versus chalazion, entropion, ectropion and ptosis - plus the madarosis-ulceration-induration checklist for a lid lump that is not benign.
- Periorbital and Orbital Cellulitis The orbital septum and why it divides the two, the four signs that separate them, and the insistence that you open the eye before discharging anyone.
- Subconjunctival Haemorrhage Confirming it is benign in under a minute, the three things worth checking, and why the blood spreading on day two is not deterioration.
- Sudden Painless Visual Loss Four questions that sort the differential, the five time-critical diagnoses, and a worked vignette showing why steroid precedes the ESR result.