What are the factors which influence the design of intraocular lens
implants for use in extracapsular cataract surgery
Discus the factors which would determine your choice of power of intraocular
lens in a patient requiring cataract extraction
Discuss the cause, recognition and management of an expulsive haemorrhage
during cataract surgery
Discuss the management of subluxation and dislocation of the crystalline
Write detailed notes on each of the following:
a. the embryological development of the lens with reference to developmental
b. the various forms of visco-elastic substances
Discuss the intraoperative complications of phacoemulsification and
Discuss the management of a unilateral traumatic cataract in a child
aged two years.
Write short notes on:
a. the complications of YAG laser capsulotomy
b. surgical management of vitreous loss in the course of an extracapsular
Describe the factors that contribute to opacification of the posterior
lens capsule, its consequences and their management
A man of 45 years is found to have a dense unilateral cataract. What
are the possible causes? How would you investigate the patient? What are
the management options?
What influences your recommendation to a patient to undergo a cataract
extraction? How would you select a technique appropriate to each case?
Give a critical evaluation of the surgical techniques currently available
for the management of senile cataract. INdicate the factor which influence
your choice in different cases.
Write short note to include aetiology and pathology on:
a. lens induced uveitis
How would you investigation and manage a patient with endophthalmitis
following cataract extraction?
Discuss the causes and management of raised intraocular pressure after
Discuss the causes of visual deterioration in the operated eye of a
patient with previously good vision following cataract surgery
Discuss the diagnosis and management of a patient who develops an hypopyon
two days after cataract surgery
The following is a summary of a case history from a patient's notes.
No salient facts have been omitted.
" A 35 year old male, brittle diabetic underwent appropriate and
routine left cataract surgery (extracapsular extraction with posterior
chamber lens implantation via a limbal incision) one month previously.
He was taking G Maxitrol (dexamethanosone and neomycin combination drop)
three times per day
On Friday evening, he felt a sudden pain in his left eye and a gush
of fluid running down his cheek. In the Accident and Emergency Department
the general casualty officer noted "Reduced visual acuity, a peaked pupil
and something black under the conjunctiva". He was referred immediately
to the locum SHO in ophthalmology who confirmed these findings only noting
in addition that the material under the conjunctiva appeared to be the
haptic of the lens implant. He refereed the patient to the next consultant
clinic the following Monday morning.
At this clinic, the visual acuity was perception of hand movements:
a 1 mm hypopyon was noted. A diagnosis of would rupture was made and the
patient was taken to theatre that afternoon. Under local anaesthesia (peribulbar),
the iris and lens were replaced, aqueous was sampled for culture and the
wound was resuture with 10/0 nylon. A sub-conjunctival injection of gentamicin
and betamethasone was given at the end of the procedure.
The following day, the vision was no perception of light and there
was a total hypopyon and corneal oedema. Subsequent treatment failed to
restore vision and the became phthisical"
Give a critical appraisal of the case giving reasons for your opinions.
return to the main index