Master Specialist Ophthalmology (OPH5841)
for DHA Speciality

A 68-year-old man with type 2 diabetes and proliferative diabetic retinopathy presents with a 3-day history of floaters and a superior visual field defect in the right eye. Visual acuity is 6/60. Fundoscopy shows a fresh vitreous haemorrhage obscuring the retina. He is on warfarin for a metallic mitral valve, INR 3.2. He has no known drug allergies. His blood pressure is 158/92 mmHg. Which is the most appropriate immediate management?

A 34-year-old woman at 28 weeks' gestation presents with a 2-day history of painful, red right eye with photophobia. Slit-lamp examination shows a dendritic corneal ulcer with fluorescein staining. She has no history of genital herpes but reports a similar episode 2 years ago. Her visual acuity is 6/18. She is otherwise well. Which is the most appropriate treatment?

A 72-year-old man with open-angle glaucoma is started on topical timolol maleate 0.5% twice daily. He has a history of asthma requiring salbutamol inhaler use twice weekly and COPD with FEV1 55% predicted. Two weeks later he presents with increased breathlessness and wheeze. His heart rate is 52 bpm and blood pressure 118/74 mmHg. Which is the most appropriate management?

A 45-year-old woman with rheumatoid arthritis on long-term hydroxychloroquine presents for a routine eye review. She has no visual symptoms. Visual acuity is 6/6 bilaterally. She has been on hydroxychloroquine 400 mg daily for 7 years. Which is the most appropriate next step?

A 58-year-old man presents with a 6-hour history of sudden painless loss of vision in the left eye. He has a history of hypertension and atrial fibrillation not on anticoagulation. Visual acuity is counting fingers. Fundoscopy shows a pale retina with a cherry-red spot at the macula. His blood pressure is 172/98 mmHg. Which is the most appropriate immediate management?