Vorbereitung EBO¤sentationen...candidates (there is a pool of 500-600 MCQ-Questions, questions used...

Affiliated Academic Hospital of the Faculty of Medicine at the University of Zurich

Vorbereitung EBOKatarakt, Konjunktiva, Cornea

Jörg Stürmer

Augenklinik Kantonsspital Winterthur

[email protected]

EBOD examination• Every year in may during the SFO, during 1 day• Morning: 3h MCQ’s

52 subjects, 5 questions pro subject = 260 responses

• After-noon: 1h oral partDiscussion among specialists in ophthalmology: between the candidate and thetwo examiners

G. Sunaric Mégev

https://www.ophthoquestions.com/

Online Fragensammlung:

Sehr gutes Review, sehr ausführlich

MCQ zum Review

Buch:

Beste Kombi würde ich sagen

Leseempfehlungen von Drazen Jurjevic

Wenn man Zeit hat

Inhaltlich super leider keine Bilder + Bilder

gering weniger Inhalt gegenüber Oxford

Viel Zeit mitbringen

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MCQ Important:

Consist allways of a statement followed by 5 questions

Language is English

All questions have to be answered with «true» or «false»

Do only answer questions you are shure because every wrong answer will be counted negatively («Minuspunkte»)

None of these questions are available for training of candidates (there is a pool of 500-600 MCQ-Questions, questions used in the 2018 exams are banned for 5 years)

You have ample time, but please reserve at least 20 minutes at the end to fill in the card with your answers

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Questions Cataract Cataract

Cataract is the leading cause of preventable blindness worldwide

true false

More than 5 Million worldwide are blind due cataractstrue false

Tabac smoking is a major risc factor for cataract developmenttrue false

Cataract formation is less common in the 2. and 3. world

true false

Unilateral mature cataract in the absence of previous ocular trauma is very likely to bea due to Fuchs Uveitis Syndrome

true false

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Questions Cataract Cataract

Cataract is the leading cause of preventable blindness worldwide

true false

More than 5 Million worldwide are blind due cataractstrue false

Tabac smoking is a major risc factor for cataract developmenttrue false

Cataract formation is less common in the 2. and 3. world

true false

Unilateral mature cataract in the absence of previous ocular trauma is very likely to becaused by Fuchs Uveitis Syndrome

true false

9


Questions Cataract Cataract surgery

Extracapsular cataract extraction has been introduced in 1748 by Jacques Daviel

true false

Implantation of IOL's has been introduced in the late 1970 by Sir Harold Ridley

true false

Intracapsular cataract extraction was the method of choice until the 1970iestrue false

Phacoemulsification was introduced in 1967 by Charles Kelman and adopted as thetechnique of choice soon thereafter

true false

The first foldable IOL's were introduced 1987true false

10


Questions Cataract Cataract surgery

Extracapsular cataract extraction has been introduced in 1748 by Jacques Daviel

true false

Implantation of IOL's has been introduced in the late 1970 by Sir Harold Ridley

true false

Intracapsular cataract extraction was the method of choice until the 1970iestrue false

Phacoemulsification was introduced in 1967 by Charles Kelman and adopted as thetechnique of choice soon thereafter

true false

The first foldable IOL's were introduced 1987true false

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Questions Cataract Cataract surgery today

Phakoemulsification and PC-IOL-Implant is the standard procedure today

true false

The standard material used to produce IOL's is flexible hydrophobic PMMA

true false

For the comfort of the patient the best anaestetical technique is topical anaesthesiatrue false

Immediate sequential bilateral cataract surgery is dangerous because several cases ofbilateral endophthalmitis are reported

true false

Adapting the IOL-power of the second eye should allways be performed in the case ofrefractive surprise in the first eye

true false

12


Questions Cataract Cataract surgery today

Phakoemulsification and PC-IOL-Implant is the standard procedure today

true false

The standard material used to produce IOL's is flexible hydrophobic PMMA

true false

For the comfort of the patient the best anaestetical technique is topical anaesthesiatrue false

Immediate sequential bilateral cataract surgery is dangerous because several cases ofbilateral endophthalmitis are reported

true false

Adapting the IOL-power of the second eye should allways be performed in the case ofrefractive surprise in the first eye

true false

13


Questions Cataract Femtolaser-assisted cataract surgery (FLACS)

Femtolaser-assisted cataract surgery (FLACS) is the state of the art treatment

true false

The capsulorhexis created by the Laser is much more solid than a manualcapsulorhexis

true false

All patients profit from the better centration of the Laser-assisted capsulorhexistrue false

There is strong evidence that FLACS has less complications than manualPhakoemulsification

true false

There is some evidence that patients with Fuchs endothelial Dystrophy benefit fromFLACS

true false

14


Questions Cataract Femtolaser-assisted cataract surgery (FLACS)

Femtolaser-assisted cataract surgery (FLACS) is the state of the art treatment

true false

The capsulorhexis created by the Laser is much more solid than a manualcapsulorhexis

true false

All patients profit from the better centration of the Laser-assisted capsulorhexistrue false

There is strong evidence that FLACS has less complications than manualPhakoemulsification

true false

There is some evidence that patients with Fuchs endothelial Dystrophy benefit fromFLACS

true false

15


Questions Cataract Late-onset IOL luxations/subluxation

The incidence of IOL subluxation/luxation is approximately 1%

true false

Main risc factor is Pseudoexfolation syndrome

true false

Massive shrinking of the anterior capsule especially in the presence of a rather smallcapsulorhexis is often seen in these cases

true false

The implantation of a capsular tension ring during cataract surgery does prevent thisproblem

true false

The average time between cataract surgery and subluxation is 3.5 years

true false

16


Questions Cataract Late-onset IOL luxations/subluxation

The incidence of IOL subluxation/luxation is approximately 1%

true false

Main risc factor is Pseudoexfolation syndrome

true false

Massive shrinking of the anterior capsule especially in the presence of a rather smallcapsulorhexis is often seen in these cases

true false

The implantation of a capsular tension ring during cataract surgery does prevent thisproblem

true false

The average time between cataract surgery and subluxation is 3.5 years

true false

17


Questions Conjunctiva

Which of the following conjunctival pathologies are caused byClamydia trachomatis

Ligneous conjunctivits true false

Adult inclusion conjunctivitis true false

Lymphogranuloma venereum true false

Trachoma true false

follicular conjunctivitis true false

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Which of the following conjunctival pathologies are caused byClamydia trachomatis

Ligneous conjunctivits true false

Adult inclusion conjunctivitis true false

Lymphogranuloma venereum true false

Trachoma true false

follicular conjunctivitis true false

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Conjunctival cicatrisation is associated with

ocular cicatricial pemphigoid true false

atopic kertoconjunctivitis true false

Stevens-Johnson syndrome true false

superior limbal keratoconjunctivits true false

Chemical burns true false

20



Conjunctival cicatrisation is associated with

ocular cicatricial pemphigoid true false

atopic kertoconjunctivitis true false

Stevens-Johnson syndrome true false

superior limbal keratoconjunctivits true false

Chemical burns true false

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Pterygiummay cause astigmatism by flattening the involved meridian true false

may cause destruction of Bowman’s layer true false

A pigmented iron line (Ferry’s line) is found at the corneal edge of the lesiontrue false

simple excision leaving bare sclera is the best surgical optiontrue false

Mitomycine C application may reduce recurrence-rate true false

23



Pterygiummay cause astigmatism by flattening the involved meridian true false

may cause destruction of Bowman’s layer true false

A pigmented iron line (Ferry’s line) is found at the corneal edge of the lesionStocker true false

simple excision leaving bare sclera is the best surgical optiontrue false

Mitomycine C application may reduce recurrence-rate true false

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Questions Cornea

Bullous keratopathyis an inherited disease of the corneal epithelium true false

Is often painful true false

Is rarely associated with visual loss true false

May require DSEK or DMEK true false

Starts in the early childhood true false

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Questions Cornea

Bullous keratopathyis an inherited disease of the corneal epithelium true false

Is often painful true false

Is rarely associated with visual loss true false

May require DSEK or DMEK true false

Starts in the early childhood true false

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Questions Cornea

Which is/are true: KeratokonusThe disease is inherited as a x-linked recessive trait true false

Increasing irregular astigmatism is a common finding true false

The main progression of the disease usually occurs after the age of 40 true false

Corneal cross-linking is a treatment option for progressive keratokonus true false

When good visual acuity is no longer achieved with glasses,

rigid gas-permeable contact lenses may be an option true false

29


Questions Cornea

Which is/are true: KeratokonusThe disease is inherited as a x-linked recessive trait true false

Increasing irregular astigmatism is a common finding true false

The main progression of the disease usually occurs after the age of 40 true false

Corneal cross-linking is a treatment option for progressive keratokonus true false

When good visual acuity is no longer achieved with glasses,

rigid gas-permeable contact lenses may be an option true false

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Questions Cornea

Which is/are true: Cornea verticillatais a whorl-like deposition of material in the corneal endothelium true false

is allways caused by amiodarone intake true false

may be seen in glycolipidosis (Fabry’s disease) true false

may be seen when Tamoxifen or Chloroquine is used true false

was first described in a patient with Fabry’s disease true false

32


Questions Cornea

Which is/are true: Cornea verticillatais a whorl-like deposition of material in the corneal endothelium true false

is allways caused by amiodarone intake true false

may be seen in glycolipidosis (Fabry’s disease) true false

may be seen when Tamoxifen or Chloroquine is used true false

was first described in a patient with Fabry’s disease true false

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Questions Cornea

Which is/are true: Contact lens associated corneal ulcersOvernight wearing of soft contact lenses is a major risk factor true false

May be prevented by prohylactic use of antibiotics qid true false

Is never seen in patients wearing rigid gas-permeable contact lensestrue false

Infections with Pseudomonas have a worse prognosis true false

Incidence is lower in patients ordering their lenses via the Internet true false

35


Questions Cornea

Which is/are true: Contact lens associated corneal ulcersOvernight wearing of soft contact lenses is a major risk factor true false

May be prevented by prohylactic use of antibiotics qid true false

Is never seen in patients wearing rigid gas-permeable contact lensestrue false

Infections with Pseudomonas have a worse prognosis true false

Incidence is lower in patients ordering their lenses via the Internet true false

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Questions Cornea

Which is/are true: Herpetic KeratitisIs commonly caused by HSV-2 true false

Is the most common cause of corneal blindness worldwide true false

Treatment of epithelial form with antivirals is allways indicated true false

Rose bengal may be used to differentiate HSV from H. zoster lesion true false

Long-term low dose oral treatment with Acylovir reduces recurrence-rate

true false

38


Questions Cornea

Which is/are true: Herpetic KeratitisIs commonly caused by HSV-2 true false

Is the most common cause of corneal blindness worldwide true false

Treatment of epithelial form with antivirals is allways indicated true false

Rose bengal may be used to differentiate HSV from H. zoster lesion true false

Long-term low dose oral treatment with Acylovir reduces recurrence-rate

true false

39


Questions Cornea

Which is/are true: Stromal corneal dystrophiesCorneal dystrophies are all inherited disorders true false

The most common form of stromal dystrophy is macular true false

Stromal deposits in granular dystrophy stain red with trichrome true false

A patient with granular dystrophy can remain asymptomatic for decades

true false

Symptomatic Map-Dot Fingerprint anterior Basement dystrophy may be treated byPhototherapeutic keratectomy with excimer laser true false

40


Questions Cornea

Which is/are true: Stromal corneal dystrophiesCorneal dystrophies are all inherited disorders true false

The most common form of stromal dystrophy is macular

granular true false

Stromal deposits in granular dystrophy stain red with trichrome true false

A patient with granular dystrophy can remain asymptomatic for decades

true false

Symptomatic macular stromal dystrophy may be treated by Phototherapeutic keratectomywith excimer laser true false

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Oral exam

2 experts are examining the candidate in

1 expert will be from Switzerland, the other from abroad

4 different topics

Language English is mandatory (because all other EBO Candidates would be examined also in English)

The Swiss expert may help in case of problems by changing to German or French (but the 2nd Expert may not be able to understand German or French)

Case 3: 61 year old man (Gl 3)

• 21.03.2011 Presented with inflamed red eye RE and pain– Treated previously for 10 days by GP with Maxitrol

• Visual acuity: RE 0.4, LE 1.0 (mild myopia)• IOP: RE 50 mmHg, LE 14 mmHg• AC: RE deep, Cells ++, Flare ++

Demonstration of the signs

Case 3: questions

1. What is your diagnosis ?2. What is the differential diagnosis ?3. How would you confirm the diagnosis ?4. What is your treatment of choice ?

Case 3: Continued• Treatment:

– systemic Valacyclovir 2x 1000 mg p.o.– Diamox 3 x 125 mg p.o.– Topical: Dexafree0.1% hourly, Atropin 1% 3x1, Betablocker/CAI combo

2x1

• AC-Tap for HSV PCR +• 1 Week later: VA 0.6, IOP 10 mmHg, inflammation much less

Case 5: 37 year old woman (R 1)

• Was high myopic and astigmatic in her youth• Had some surgery for this condition in South America when she

was 23 years old• Complains about straylight and some-times blurred vision• Unaided visual acuity has decreased• VA sc RE: 0.5 LE: 0.8• Refraction: RE: -0.75=-1.75/20°, LE: -0.5 =-1.0/45°

Case 5: questions

1. What type of surgery had this patient ?2. How could you improve the present situation ?3. Would you recommend clear lens extraction ?4. What is the main problem if later on cataract

surgery is required ?

Case 6: 57 year old woman (R 2)

• Was high myopic in her youth• Had surgery for this condition 6 years ago• Complains about sudden onset of decreased vision in her left

eyes 5 days ago• VA sc RE: 0.8 LE: 0.3• Refraction: RE: -0.5=-0.75/40°, LE: 0.75=-3.0/30°

Case 6: questions

1. What type of surgery had this patient ?2. What is the cause of the worsening in LE ?3. What is your treatment ?4. Is this an emergency which has to be cured the

same day and if yes why ?

Case 8: 37 year old woman (C 1)

• Presents with loss of vision in her right eye, uncertain about how long and how fast

• VA sc RE Light Perception, LE 1.0• IOP: RE 22 mmHg, LE 12 mmHg• No previous ocular trauma

Case 8: questions

1. What is your diagnosis ?2. What is the most likely cause ? 3. Which additional investigations should be done ?4. What are the important points to discuss with the

patient to get informed consent for cataract surgery ?

Case 9: 9 year old girl (C 2)

• Presents with reduced vision RE• VA sc RE 0.4, LE 0.9• Refraction +- emmetropic• Normal posterior segment

Fellow eye

Case 9: questions

1. What is your diagnosis ?2. Which additional investigations should be done ?3. What is your treatment approach ?4. What are the pros and cons of cataract surgery in

this case ?

Case 12: 76 year old lady (C 5)

• Presents as emergency because of pain and reduced vision RE• Had uncomplicated cataract surgery elsewhere 2 days ago• All findings where normal on the 1st post-op day• VA sc RE 0.1, LE 0.6• IOP 18 mmHg BE

Case 12: questions1. What is your diagnosis ?2. What is your treatment plan?3. What additional investigations should be

performed ?

6 Weeks later (after AC washout and IV AB)

Case 13: 86 year old lady (C 6)

• Presents as emergency because of reduced vision LE• Had uncomplicated cataract surgery 7 years ago LE• VA sc RE 1.0, LE 0.2• IOP RE 18 mmHg, LE 24 mmHg

Case 13: questions

1. What is your diagnosis ?2. Is this a rare complication?3. What are the different options for treatment ?

Vorbereitung EBO¤sentationen...candidates (there is a pool of 500-600 MCQ-Questions, questions used...

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Transcript of Vorbereitung EBO¤sentationen...candidates (there is a pool of 500-600 MCQ-Questions, questions used...