CPO FREE CPO Ocular Emergencies and Triage Questions and Answers 2

Question 1

A patient calls describing symptoms in their right eye that began after a penetrating injury to their left eye two months ago.
They report increasing light sensitivity and blurry vision in the right, uninjured eye.
Which of the following conditions should be suspected, warranting an immediate referral to an ophthalmologist?

Accepted Answer

Sympathetic ophthalmia

Answer

Traumatic cataract in the left eye

Answer

Corneal abrasion in the right eye

Answer

Post-traumatic stress response

Question 2

When triaging a chemical burn, what is the most critical initial action, especially in the case of an alkali burn?

Accepted Answer

Initiating copious and prolonged irrigation with water or saline

Answer

Applying a neutralizing agent to the eye

Answer

Patching the eye immediately to prevent infection

Answer

Assessing visual acuity before any intervention

Question 3

A patient presents with a painful, red eye and blurred vision. On examination, a dome-shaped elevation of a posterior ocular layer is suspected. Which feature would most strongly suggest a choroidal detachment over a rhegmatogenous retinal detachment?

Accepted Answer

The elevation is smooth, dome-shaped, and extends anteriorly to the ciliary body

Answer

The presence of flashes and floaters

Answer

A history of high myopia

Answer

The patient reports a 'curtain' falling over their vision

Question 4

Which of the following telephone triage scenarios presents the HIGHEST risk for a retinal tear or detachment and requires the most urgent evaluation?

Accepted Answer

A 58-year-old myope reporting a sudden onset of hundreds of tiny floaters ('like pepper') and flashes of light in one eye that started 3 hours ago.

Answer

A 65-year-old reporting a few new, stable floaters for the past week in both eyes.

Answer

A 30-year-old with a history of migraines reporting jagged, colorful lights in their vision for 20 minutes.

Answer

A 70-year-old pseudophakic patient reporting a single, large, cobweb-like floater that has been present for months.

Question 5

A patient with a history of a scleral buckle procedure for a past retinal detachment presents for a routine check-up. An ultrasound B-scan shows a smooth, convex elevation in the periphery. What finding would help differentiate the scleral buckle from a new choroidal detachment?

Accepted Answer

The elevation has a fixed, circumferential appearance and lacks after-movement

Answer

The presence of high reflectivity on the B-scan

Answer

A shadow behind the elevated structure

Answer

The patient is asymptomatic

Question 6

A patient calls after being hit in the eye with a racquetball. They report significant pain, photophobia, and slightly blurred vision. There is no visible laceration. In this case of blunt trauma, the presence of white blood cells and protein in the anterior chamber, known as traumatic iritis, is a primary concern. What is another urgent condition that MUST be ruled out, often associated with similar symptoms?

Accepted Answer

Angle-recession glaucoma

Answer

Subconjunctival hemorrhage

Answer

Corneal abrasion

Answer

Dry eye syndrome