Lens and cataract
        • What are the factors which influence the design of intraocular lens implants for use in extracapsular cataract surgery

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        • Discus the factors which would determine your choice of power of intraocular lens in a patient requiring cataract extraction

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        • Discuss the cause, recognition and management of an expulsive haemorrhage during cataract surgery

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        • Discuss the management of subluxation and dislocation of the crystalline lens.

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        • Write detailed notes on each of the following:

          • a. the embryological development of the lens with reference to developmental abnormalities
          b. the various forms of visco-elastic substances
           
        • Discuss the intraoperative complications of phacoemulsification and their management

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        • Discuss the management of a unilateral traumatic cataract in a child aged two years.

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        • Write short notes on:

          • a. the complications of YAG laser capsulotomy
          b. surgical management of vitreous loss in the course of an extracapsular cataract extraction
           
        • Describe the factors that contribute to opacification of the posterior lens capsule, its consequences and their management

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        • 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?

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        • What influences your recommendation to a patient to undergo a cataract extraction? How would you select a technique appropriate to each case?

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        • 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.

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        • 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?

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        • Discuss the causes and management of raised intraocular pressure after cataract surgery

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        • Discuss the causes of visual deterioration in the operated eye of a patient with previously good vision following cataract surgery

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        • Discuss the diagnosis and management of a patient who develops an hypopyon two days after cataract surgery

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        • 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.
           
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