Ocular Diseases and Disorders
What the exam tests
Ocular Diseases and Disorders tests recognition of common anterior- and posterior-segment conditions and the urgency of referral. You are not expected to diagnose independently, but you must identify red flags.
Anterior segment
Cataract is lens opacity, commonly nuclear sclerotic, cortical or posterior subcapsular; surgery is considered when vision interferes with daily life. Bacterial conjunctivitis produces purulent discharge; viral conjunctivitis is watery and highly contagious; allergic conjunctivitis is itchy. Keratitis shows pain, photophobia, staining and infiltrate; in contact-lens wearers it may be microbial and needs urgent review. Uveitis causes cells and flare, photophobia and miosis.
Posterior segment and glaucoma
Open-angle glaucoma is usually asymptomatic early and is detected by optic-disc and field assessment. Acute angle closure presents with severe pain, red eye, haloes, hazy cornea, a mid-dilated fixed pupil, nausea and high pressure; it is an emergency. Diabetic retinopathy shows microaneurysms, dot-blot haemorrhages and later neovascularisation. Age-related macular degeneration shows drusen and pigmentary change; sudden distortion suggests the wet form. Retinal detachment causes flashes, floaters and a curtain.
Worked example
A 60-year-old arrives with a painful red eye, haloes and vomiting; pressure is 48 mmHg and the pupil is mid-dilated. Reasoning: these are classic features of acute angle closure. Do not dilate; arrange immediate ophthalmology review and follow the emergency protocol.
Traps
Do not label every red eye as conjunctivitis, miss painless progressive vision loss, or dilate a patient with a shallow anterior chamber without checking the angle risk.