Test yourself


1. When does the patient see nothing and the ophthalmologist see nothing?
Retrobulbar neuritis. The presence of central scotoma means that the patient can see nothing and the absence of fundal signs means the ophthalmologist see nothing too.

2. What feels like a bag of worm?

Plexiform neurofibroma. These are peripheral nerve tumours made up of proliferating Schwann cells, endoneural fibroblasts and axons.

3. Why does the woman who complains of sore eyes have difficulty eating biscuits?

Sjogren's syndrome. It is characterized by dry eyes and dry mouth. The reduced saliva secretion makes eating dry food difficult.

4. What type of salmon does the sickle cell patient have?

Smoked salmon. Salmon patch haemorrhages (and therefore red as in smoked salmon cf. with poached salmon which is pink) occur from pre-retinal and internal lining membrane haemorrhages occurring near an occluded arteriole.
5. When can you see Christmas tree in the eye?
Patients with myotonic dystrophy. These patients have polychromatic cataract which is classically described as "Christmas tree" cataract.

6. Why does the arctic explorer develop disc swelling?

Vitamin A toxicity from eating polar bear liver. The liver of polar bear is dangerously high with vitamin A.
7. How does the clever ophthalmologist make the diagnosis in a young patient who cannot stop shaking?
Presence of Kayser-Fleischer's ring in a patient with Wilson's disease. Wilson's disease is caused by high copper content which can damage the liver and the central nervous system. In the central nervous system, copper is accumulated in the basal ganglia and commonly produces parkinsonism

8. How does the clever physician make the diagnosis in a patient with abdominal pain? 

Acute angle closure glaucoma. This can present with abdominal pain with nausea and vomiting.

9. What are crocodile tears?

Following damage to the facial nerve as in Bell's palsy, misdirection of the regenerating fibres may innervate the lacrimal gland rather than the mouth muscles and the parotid glands. Consequently, chewing food causes weeping. Legend has it that the crocodile has compassion and remorse for its prey and wept with sorrow when it eats its prey.

10. Why does the bungee jumper develop blurred vision?

Valsalva's retinopathy. The build-up of pressure in the venous cava causes the retinal vein to burst and produce haemorrhage.

11. What make the tool maker's eyes turn black?

Argyrosis. It is a term applied to the deposition of silver salts in the tissue. In the conjunctiva, the deposition of silver turns black on oxygenation.

12. Foster Kennedy's syndrome is well-known to all ophthalmologist, it is classically produced by a large subfrontal meningioma which compresses one optic nerve (causing ipsilateral optic atrophy) and foramen of Monro (causing hydrocephalus and contralateral papilloedema). Who was Dr. Foster and who was Dr. Kennedy?

This is a trick question. Dr. Foster (first name) Kennedy (last name) was a well-known American neurologist in the beginning of 20th century and was once the president of the American Neurological Association.
13. Name the famous Victorian writer who is also an ophthalmologist.
Sir Arthur Conan Doyle, the creator of Sherlock Holmes. Apparently not a good one, as he had plenty of time for writing due to lack of patients.

14. Which famous scientist's eyes were put up for auction in 1994?

Albert Einstein's eyes. The eyes were removed by his ophthalmologist Dr. Henry Abrams during the autopsy in 1955 and stored in a safety deposit box. The eyes were put up for auction in 1994.

15. What is an uvea?

A grape. The term was first used by Galen, a Roman physician to include both the choroid and the iris because they resemble a grape from which the stalk had been torn out leaving a hole in front, the hole being the pupil of the eye.
16. Carotid artery stenosis is an important cause of retinal artery emboli. What is carotid in Greek?
It is derived from a Greek word meaning "to put to sleep" because pressure on the carotid arteries can cause loss of consciousness. Rufus of Ephsus said (about 100 AD):" The ancients called the arteries of the neck carotid because they believed that when they were pressed hard the animal became sleepy"

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