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Play Doctor My Eyes by Jackson Browne

1999, 2000, Mounir Bashour

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PGY-5 Study List Top 100 Ways to Fail the Ophthalmology Royal College Exams
#1 (MB) -- Presenting c/o ptn with severe headache, blown pupil, progressive ptosis and EOM problems --> 2 tylenol and f/u in 6 months.

#2 (MB) -- 7 =.o. boy with recent onset orbital mass with proptosis --> fine needle aspiration.

#3 (FS) -- 6 y.o boy with unilateral optic atrophy >>> counsel him to not bother trying out for sports teams as he will never be great without high grade stereopsis  and follow PRN.
#4 (FS) -- Papilledema in a 24 year old female >>> tell her to increase her BCP's to twice a day and try to increase her weight by 50 lbs with the prednisone pills you are giving her.  Reassure her that the history of TB she keeps nattering on about is not of any consequence as inflammation from TB can be managed in an exciting manner without too much risk to her health.  Besides osteoporosis is the only long term complication!
#5 (FS) -- Bilateral CRVO in 38 year old male >>> emergency bilateral PRP with dense white burns.  The burns should be intense enough so that a holmium full thickness laser sclerostomy will not be an issue in the future.
#6 (FS) -- Immediately after giving a retrobulbar the patient loses consciousness and has a weak thready pulse and begins having a generalized seizure. >>> Panic and mutter under your breath so that the nurses can hear you "I knew I should have taken that %$#@&'n CPR refresher =course."  Then walk out of the room waving your hands in disgust.  Go hang out in the surgeons lounge and wait until some =VT surgeons come in, now you too can finally say "damn I lost another one" (and for once not mean a nucleus).
#7 (MB) -- 62 you Chinese woman comes in to your office c/o of red eye and incidentally complains about never-ending cold and poor sense of smell >>> assure her that it is just a viral conjunctivitis, explain the natural hx and cover her with polysporin drops and don't forget to recommend a good OTC cold medication like Tylenol cold for the runny nose and lots of fluids.
#8 (FS) -- An acute VI nerve palsy in a 10 year old child.  Assume the worst and refer for palliative and hospice care.
#9 (FS) --10 month old child with bilateral RB whose parents both have bilateral RB.  Asked how to manage...bilateral enucleation with follow up radiation. 
#10 (MB) -- Young man shot with a sawn off shot gun with multiple pellets in the head and neck region, must r/o intraocular/orbital pellets, use the most sensitive technique, MRI or even better fMRI, ignore patients screams as a lot of people get claustrophobic in an MRI machine.  Make sure to remove any intraorbital pellets especially if they are in the apex of the orbit, even if asymptomatic.
#11 (MB) -- Old female with longstanding rheumatoid arthritis, has area of asymptomatic pigmented thinning in the sclera.  This is an emergency situation, treat with subconj. injection of steroid and make sure not to over lubricate the eye.

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This page was last modified: Tuesday, May 06, 2003
1999 2000, Mounir Bashour

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