Episodes

  • Achilles Tendon Disorder: Free MSRA Podcast

    Achilles Tendon Disorder: Free MSRA Podcast
    May 21 2025
    🎧 MSRA Deep Dive: Achilles Tendinopathy — Persistent Heel Pain ExplainedA common overuse injury, Achilles tendinopathy causes pain at the back of the heel — especially in runners and active individuals. This episode simplifies what you need to know for exams and clinics.🦶 DefinitionChronic injury to the Achilles tendon (connects calf muscles to the heel). Can affect:• Mid-portion (more common)• Insertional (at the heel bone)🔥 Causes• Repetitive overloading• Sudden increases in activity• Poor biomechanics• Tight calves• Inflammatory/enthesitis-linked conditions📌 Risk Factors – Mnemonic: A MAN POOR SHIFTERAgeMale sexActivity (running, jumping)Non-compliance with warm-upPoor biomechanicsObesityOveruseRepeated injurySystemic disease (e.g. diabetes, AS)Heel wear/footwearInflammatory diseaseFamily historyToxic meds (fluoroquinolones)🔬 Pathophysiology• Degeneration > inflammation• Disorganised collagen, tendon thickening• Mid-portion: poor vascularity = poor healing🩺 Differentials• Retrocalcaneal bursitis• Posterior ankle impingement• Plantaris tear• Sural nerve entrapment• DVT (always rule out)📊 Epidemiology• Affects ~52% of long-distance runners• Common in men >40• Linked to BMI, training volume, footwear👣 Clinical Features• Gradual posterior heel pain• Worse with activity, mornings• Tender, thickened tendon• Pain with resisted plantarflexion• Thompson’s Test – exclude rupture!🔎 Investigations• Clinical diagnosis• Ultrasound → tendon thickening, neovascularity• MRI if unclear or pre-surgery💊 Management1st Line: Conservative• Activity modification• Ice, short NSAID course• Heel lifts, orthotics• Eccentric exercises (Alfredson protocol): – 3×15 reps, knee bent/straight, twice daily, 12 weeksAvoid: Steroid injections → ↑ rupture riskAdjuncts:• Shockwave therapy (ESWT)• Topical GTN• PRP (limited evidence)Surgery• For >6 months refractory cases• Options: debridement, tenotomy + rehab📈 Prognosis• ~85% regain full function over time• Long rehab, but excellent outcomes if compliant• Recurrence possible without proper management⚠️ Complications• Rupture• Chronic pain• Functional impairment• Recurrent tendinopathy🧠 MSRA Tips• Risk factors = A MAN POOR SHIFTER• Prioritise eccentric loading in treatment• Use Thompson’s test to exclude rupture• Don’t inject steroids into tendon• Differentiate from bursitis, DVT, impingement📚 Achilles Tendon MSRA Resources📝 Revision Notes🃏 Flashcards📖 Accordion Q&A🎯 Rapid Quiz🧠 Practice Quiz🌐 More:www.passthemsra.comwww.freemsra.com🏁 Key TakeawayAchilles tendinopathy is common, chronic, and highly manageable. Recognise it early, manage it properly — and avoid unnecessary injections!#MSRA #AchillesTendinopathy #PosteriorHeelPain #ThompsonsTest #AlfredsonProtocol #TendonDisorders #MSRAMSK #PassTheMSRA #FreeMSRA #MSRAQuiz #MSRAFlashcards #GPRevision #MedicalEducation
    Show More Show Less
    21 mins
  • Visual Disturbance: Free MSRA Podcast

    Visual Disturbance: Free MSRA Podcast
    May 21 2025
    🎧FREE MSRA PODCAST –Visual Disturbance: Causes, Clues & Clinical Thinking 👁️Welcome to the Deep Dive. Today we unpack Visual Disturbance — one of the most broad and important symptoms in ophthalmologyand neurology for the MSRA. Whether it's blurriness, flashes, or total visionloss, we'll guide you through how to think clearly when your patient says, “Ican't see properly.” 🧠What You'll Learn inThis Episode:✅Definition• Visual disturbance = any abnormal change invision• Can be transient or permanent, mild blurring to fullvision loss• Not a diagnosisitself – it's a red flag symptom 🔍Mnemonic for Causes –RUNMSR – Refractive errors (myopia, hyperopia)U – Underlying ocular diseases (cataracts,glaucoma, macular degeneration)N – Neuro causes (migraine, TIA, stroke, MS)M – Medications (e.g. digoxin, topiramate,hydroxychloroquine)S – Systemic disease (diabetes, hypertension,vasculitis) 👁️‍🗨️Risk Factors• Ageing – ↑ risk of cataracts, AMD• Diabetes – retinopathy• Neurological history – MS, stroke• Family history – glaucoma, macular degeneration• Contact lenses or toxins – drug-induced changes 🧬PathophysiologySimplified• Refraction errors – light not focused correctly• Retinal damage – diabetic or hypertensivedamage• Optic nerve problems – inflammation,compression• Visual pathway disruption – central causes(e.g. occipital lobe stroke)• Systemic insults – affect ocularmicrovasculature ⚠️DifferentialDiagnosis Must-Knows• Retinal detachment(flashes, curtain falling down)• Optic neuritis(painful vision loss, colour desaturation)• Migraine with aura• TIA or stroke(sudden monocular or hemianopic vision loss)• Giant CellArteritis in elderly• Toxic ordrug-induced (e.g. ethambutol, amiodarone) 📊Epidemiology Notes• Very commonpresenting complaint in primary care and A&E• True prevalencedepends on the cause• Refractive errors are the most common• Retinal and opticnerve causes much less common but more serious 🩺Symptoms (HighlyVariable)• Blurred vision• Visual fielddefects (e.g. tunnel vision, altitudinal loss)• Diplopia (doublevision)• Photophobia• Flashes orfloaters• Complete visionloss (central or peripheral) 🧪Investigations• Visual acuity testing• Fundoscopy & slit lamp examination• Visual fields (Humphrey)• OCT for retina• Bloods – FBC, ESR, CRP, glucose, autoimmunescreen• Neuroimaging (MRI/CT) if neurological causesuspected 💊Management Approach🔹Refractive error → glasses/contact lenses🔹Cataracts → lens replacement surgery🔹Retinal issues → urgent ophthalmology referral🔹Neurological causes → specialist input (TIA clinic, neurology)🔹Diabetes-related → optimise sugar control + retinal screening🔹Medication-related → stop the offending drug if safe 📈Prognosis• Excellent in most refractive or temporary cases• Guarded in progressiveor untreated conditions like glaucoma or diabetic retinopathy• Emergency if sudden painless loss of vision –refer immediately 💥Complications• Permanent visualloss• Reducedindependence• Impact on driving,reading, working• Emotional impact –anxiety, depression• Risk of systemiccomplications if cause is untreated (e.g. stroke, vasculitis) 📎More MSRA Resourcesfor Visual Disturbance:📝 Revision Notes:https://www.passthemsra.com/topic/visual-disturbance-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/visual-disturbance-flashcards/📖 Accordion Q&A Notes:https://www.passthemsra.com/topic/visual-disturbance-accordion-qa-notes/🎯 Rapid Quiz:https://www.passthemsra.com/topic/visual-disturbance-rapid-quiz/🧪 Visual Disturbance Quiz:https://www.passthemsra.com/quizzes/visual-disturbance_/🌐https://www.passthemsra.com🎁https://www.freemsra.com#MSRA #MSRARevision#VisualDisturbance #BlurredVision #MSRAOphthalmology #MSRANeurology#MSRAFlashcards #MSRAQuiz #MSRATextbook #PassTheMSRA #FreeMSRA
    Show More Show Less
    7 mins
  • Red Eye: Free MSRA Podcast

    Red Eye: Free MSRA Podcast
    May 21 2025

    🎧FREE MSRA PODCAST –Red Eye: Not Just ‘Pink Eye’ 👁️

    Ever looked in themirror and thought: “Why is my eye suddenly sored?” In this MSRA-focused Deep Dive, we go beyond the surface andunpack red eye: what it means, why ithappens, and how to confidently assess it — from simple conjunctivitis to sight-threatening emergencies like acuteglaucoma.

    🧠What You’ll Learn inThis Episode:

    ✅Definition

    • Red eye = visible dilation or congestion ofconjunctival blood vessels

    • It’s a symptom, not a diagnosis — a signal of deeperpathology

    📋Causes of Red Eye (Mnemonic: “VIP Causes Bleary Sight”)

    • Viral / Bacterial / Allergic conjunctivitis

    • Injury (foreign body, trauma)

    • Pressure (acute glaucoma)

    • Corneal ulcers / abrasions

    • Blepharitis

    • Scleritis / Uveitis

    • 👁️ Contact lens complications

    • 😢 Dry eyes, subconjunctival haemorrhage

    📊Risk Factors

    • 👁️ Contact lens use

    • 🌸 Allergen exposure (pollen, pets)

    • 👶 Poor hygiene in children

    • 🤒 Autoimmune conditions

    • 🛠️ Recent trauma or surgery

    ⚙️Pathophysiology

    • Redness = vascular dilation in conjunctiva

    • Cause-specifictriggers:

      – Inflammation(conjunctivitis)

      – Vessel rupture(haemorrhage)

      – Raised pressure(glaucoma)

    👁️Symptoms &Clinical Presentation

    • Conjunctivalredness

    • Irritation or gritty sensation

    • Watery or purulentdischarge

    • Itchiness = oftenallergic

    • ⚠️Blurred vision or photophobia = possible serious cause

    🩺Investigations

    • 🅰️ Visual acuity check

    • 🔬 Slit-lamp examination

    • 🔄 Intraocular pressure check

    • 🧫 Cultures for discharge (if infected)

    💊Management = Treatthe Cause

    • Bacterial → Antibiotic drops

    • Allergic → Antihistamines

    • Dry eyes → Artificial tears

    • Chemical → Immediate irrigation

    • Vasoconstrictors only offer temporary relief

    • 🔄 Educate on contact lens hygiene & eye safety

    🚨Red Flags for URGENTReferral (Mnemonic: “PAINFUL RED EYE”)

    Pain (moderate–severe)

    Altered vision

    Increased IOP / halos

    Neonatal discharge (copious)

    Foreign body / trauma

    Unilateral marked redness

    Lens-related corneal ulcer

    Also refer urgentlyif:

    • Chemical burns

    • Proptosis

    • Suspected uveitis,endophthalmitis, scleritis, HSV, HZV

    • Contact lenswearers with corneal involvement

    🟡Refer within 24h: Anterior uveitis, scleritis

    🟢Primary care: Simple viral/allergic conjunctivitis

    📉Prognosis &Complications

    • 👁️ Most cases resolve with correct treatment

    • ❗Delayedtreatment risks:

     – Corneal scarring

     – Vision loss

     – Chronicinflammation

    • ⚠️Early diagnosis = better outcomes

    📚Red Eye Resources forMSRA:

    📝 Revision Notes:

    https://www.passthemsra.com/topic/red-eye-revision-notes/

    🧠 Flashcards:

    https://www.passthemsra.com/topic/red-eye-flashcards/

    📖 Accordion Q&A Notes:

    https://www.passthemsra.com/topic/red-eye-accordion-qa-notes/

    🎯 Rapid Quiz:

    https://www.passthemsra.com/topic/red-eye-rapid-quiz/

    🎓 MSRA Quiz:

    https://www.passthemsra.com/quizzes/red-eye/

    📎 More MSRA resources to accompany this episode:

    🌐https://www.passthemsra.com

    🎁https://www.freemsra.com

    Hashtags

    #MSRA #MSRARevision#RedEye #OphthalmologyMSRA #MSRAFlashcards #MSRAQuiz #MSRAQANotes #MSRATextbook#PassTheMSRA #FreeMSRA #RedEyeCauses #MSRATips
    Show More Show Less
    13 mins
  • Tunnel Vision: Free MSRA Podcast

    Tunnel Vision: Free MSRA Podcast
    May 21 2025

    🎧Deep Dive: TunnelVision – When Your World Narrows

    Everfeel like your side vision just disappears — like looking through a straw?That’s Tunnel Vision, and today we’re unpacking it in full: causes,clues, complications, and how to spot it before it becomes sight-threatening. 👁️🚧

    Whether you'rerevising for the MSRA or just curiousabout this strange visual symptom, this is your rapid-fireguide to what matters most.

    👁️What is TunnelVision?

    A loss of peripheral vision with preserved central clarity – as if looking through atunnel.

    Often a symptom, not a standalone disease.

    💡 Mnemonic: “Eyes, Nerves, Brain, Others” – key categories of causes!

    🧠Causes – Think ENBO:

    Eyes – 👁️ Glaucoma, Retinitis Pigmentosa

    Nerves – ⚡ Optic neuritis, Papilledema

    Brain – 🧠 Lesions, Strokes, Tumours

    Others – 💊 Medications, Toxins, Infections

    ⚠️Risk Factors

    • Family history(esp. RP or glaucoma)

    • History of eyetrauma or optic nerve disease

    • Toxin exposure(e.g. ethambutol)

    • Ageing or chroniceye disease

    🧪Pathophysiology in 10Seconds

    Damage to theretina, optic nerve, or visual processing areas of the brain → reducedtransmission of peripheral input → central vision preserved but the edges fade.

    🩺DifferentialDiagnosis

    • Glaucoma – gradual peripheral loss

    • Optic nerve disease – inflammation, compression

    • Neurological lesions – post-chiasmal strokes ortumours

    • Retinal dystrophies – inherited, progressive

    🔬Investigations

    • Perimetry (Visual Field Testing) – maps theblind spots

    • Fundoscopy/OCT – checks optic nerve &retina

    • MRI brain/orbits – assesses nerve and braincauses

    • 🧪 Bloods – autoimmune or infective markers if needed

    💡 Mnemonic: “POP-M” =Perimetry, OCT, Pupils, MRI

    💊Management – Based onCause

    • Glaucoma – eye drops, laser trabeculoplasty, orsurgery

    • Optic neuritis – steroids, MS workup

    • Retinal disease – often supportive (low visionaids)

    • Tumour/stroke – neurology/oncology input

    • Low vision services – mobility training, visualaids, rehab

    📈Prognosis

    • Varies widely —some cases are progressive (e.g. RP, glaucoma), others may stabilise or improve(e.g. optic neuritis)

    • Key: Earlydiagnosis & management preserves vision

    🧱Complications

    •Falls, mobility difficulty 🚶‍♂️

    • Workor driving restrictions 🚗

    •Psychological impact 🧠

    • Riskof complete vision loss if untreated ❗

    📚Quick Recap for theMSRA:

    🔹Definition: Peripheral vision loss, central vision intact

    🔹Causes: Eyes, nerves, brain, others

    🔹Tests: Perimetry, fundoscopy, OCT, MRI

    🔹Management: Treat underlying condition + rehab support

    🔹High-yield signs: Bumping into things, needing to scan surroundingsmore actively, preserved reading vision

    📎Useful MSRA Resourceson Tunnel Vision

    📝 Revision Notes:

    https://www.passthemsra.com/topic/tunnel-vision-revision-notes/

    🧠 Flashcards:

    https://www.passthemsra.com/topic/tunnel-vision-flashcards/

    📂 Accordion Q&A Notes:

    https://www.passthemsra.com/topic/tunnel-vision-accordion-qa-notes/

    🧪 Rapid Quiz:

    https://www.passthemsra.com/topic/tunnel-vision-rapid-quiz/

    Bonus Quiz: https://www.passthemsra.com/quizzes/tunnel-vision/

    🌐 Main Site: https://www.passthemsra.com

    🎁 Free MSRA Prep: https://www.freemrsra.com

    💬Final Thought

    Tunnelvision might sound straightforward, but it’s often your body whispering thatsomething deeper is wrong — in the eye, the nerve, or the brain. Spotting thatearly could be the difference between preserved vision and permanent loss. Stayalert. Stay curious. 👁️🔍

    #MSRA #MSRARevision#TunnelVision #OphthalmologyMSRA #PeripheralVisionLoss #MSRAFlashcards#MSRAQuiz #PassTheMSRA #FreeMSRA #VisualField #OpticNerve
    Show More Show Less
    6 mins
  • Toxic Optic Neuropathy: Free MSRA Podcast

    Toxic Optic Neuropathy: Free MSRA Podcast
    May 21 2025
    👁️ Toxic Optic Neuropathy – High-Yield Deep DiveDefinitionToxic Optic Neuropathy:Damage to the optic nerve directly from exposure to drugs, chemicals, or toxins, causing vision loss. Not due to pressure, trauma, or inflammation—it’s the substance itself doing the harm. Key Causes – Mnemonic:AABCPHETAlcohols (methanol, ethylene glycol, chronic ethanol abuse)Antibiotics (e.g. chloramphenicol, linezolid, sulfonamides)B Antimalarials (chloroquine, hydroxychloroquine)C Anti-TB drugs (ethambutol—biggest classic; also isoniazid)P PDE inhibitors (e.g. sildenafil)H Heavy metals (lead, mercury)E Antiarrhythmics (amiodarone)T Tobacco/alcohol (especially with poor nutrition)O Others: carbon monoxide, chemotherapy (vincristine), etc. Epidemiology / Risk FactorsMain risk: Exposure to the substances above (chronic use or overdose)At-risk:Long-term use of relevant meds (anti-TB, amiodarone, etc.)Occupational/industrial exposureAlcohol abuse (esp. with poor nutrition/B12 deficiency)Poor diet or malabsorption (B vitamins especially) PathophysiologyDirect toxin damage: Kills/damages optic nerve fibresMitochondrial dysfunction: Disrupts energy supply—especially in papillomacular bundle (central vision)Oxidative stress: Free radicalsMetabolic impairment: Some affect cell metabolism or blood supply Differential DiagnosisGlaucomaOptic neuritis (MS, infection)Ischaemic optic neuropathy (GCA, vascular)Hereditary optic neuropathies (e.g. Leber’s)Compressive lesions (tumour, aneurysm)Nutritional optic neuropathyTrauma, retinal dystrophies Symptoms & SignsBilateral, symmetric, painless, progressive vision lossCentral/cecocentral scotoma (central blind spot) on field testingDyschromatopsia: Poor colour vision, especially red/greenBlurring at fixation (difficulty reading, recognising faces)Visual acuity reducedOptic disc: May be normal early, then pale (optic atrophy)NO RAPD (as both eyes affected equally)History is key: Ask specifically about drug, alcohol, industrial exposure, and nutrition. InvestigationsOphthalmic exam: Visual acuity, colour vision (Ishihara), visual fieldsOCT: Nerve fibre layer thinning (esp. papillomacular bundle)Fundoscopy: May show optic disc pallor (late)Blood tests:B12/folate (rule out nutritional)Toxicology screen (if relevant)MRI/CT of brain/orbits: Rule out compressive or demyelinating lesionsVEP (Visual Evoked Potentials): Delayed responseSlit lamp: For corneal deposits (amiodarone) ManagementIMMEDIATE withdrawal/cessation of causative agentCorrect nutritional deficiencies: B12, folate, general nutritionAntidotes/support:Methanol: Fomepizole, ethanol, correct acidosisEthambutol: Pyridoxine (B6)Heavy metals: ChelationAntioxidants: Sometimes used, but evidence limitedSupportive care: Vision rehab, occupational therapyMonitor: Regular follow-up for acuity, colour, fields, optic nerve appearance PrognosisEarly detection and prompt cessation = best chance of improvementLate diagnosis or severe atrophy: Often permanent lossMost important: Prevent progression, may get partial recovery if caught early ComplicationsPermanent central vision loss (functional impact)Optic atrophySevere, irreversible impairment if not managed quickly Key Takeaway MnemonicAABCPHET for causesBilateral, central, painless, progressive vision lossSTOP the exposure first, then support and supplement MSRA Revision ResourcesToxic Optic Neuropathy Revision NotesToxic Optic Neuropathy FlashcardsAccordion Q&A NotesRapid Fire QuizMain sites:PassTheMSRA.comFreeMSRA.com #MSRA #Ophthalmology#ToxicOpticNeuropathy #PasstheMSRA #FreeMSRA #Revision
    Show More Show Less
    12 mins
  • Sudden Vision Loss: Free MSRA Podcast

    Sudden Vision Loss: Free MSRA Podcast
    May 21 2025
    🎧 MSRA Deep Dive: Sudden Loss of Vision — Know the Red FlagsWelcome to a focused revision session tackling a true emergency: Sudden Loss of Vision. Whether it’s a descending curtain or total blackout, this symptom demands urgent action. Let’s break down what it means and how to act fast.🔍 What Is Sudden Vision Loss?A rapid drop in sight over minutes to hours — partial or complete, painless or painful.🔸 TMVL (Transient Monocular Vision Loss): sudden, brief vision loss in one eye (aka amaurosis fugax) — a vascular red flag.💡 Causes – Mnemonic: VRRT“Vessels Ripped Retina Transiently” for painless causes:Vascular: CRAO, CRVO, ischaemic optic neuropathyRetinal detachment: curtain-like shadowRetinal migraineTMVL or vitreous haemorrhageOther causes:Posterior vitreous detachment (flashes/floaters)Acute glaucoma (painful!)Optic neuritis (pain + colour loss)StrokeTemporal arteritisOcular traumaMedication (e.g. sildenafil)🧠 Pathophysiology Simplified• ↓ Blood flow (e.g. CRAO, GCA)• Retinal damage (e.g. detachment, haemorrhage)• Obstructive (e.g. vitreous blood)📋 Risk Factors• Age >60• Hypertension, diabetes• Glaucoma• Polycythaemia• Smoking• Anticoagulants• Eye trauma or surgery🩺 Key Features✅ Sudden unilateral/bilateral vision loss✅ Curtain descending → retinal detachment✅ Central blackout → vascular cause✅ Flashes/floaters → PVD or detachment✅ Painful red eye → acute glaucoma or GCA✅ Colour vision loss, painful movement → optic neuritis🧪 Investigations• Visual acuity• Pupil reflexes (RAPD)• Slit-lamp + fundoscopy• Tonometry• OCT or fundus imaging• ESR/CRP (for GCA)• Visual fields• Neuroimaging if stroke suspected💊 Management – Urgent & Targeted• CRAO: Ocular massage, thrombolysis (if <6h)• CRVO: Monitor, manage risk factors• Retinal detachment: Emergency surgery• Vitreous haemorrhage: Observe or vitrectomy• Temporal arteritis: IV steroids immediately• Acute glaucoma: Rapid IOP reduction + ophthalmology• Stroke: Urgent neuro team referral🕒 TIME = SIGHT → act fast to save vision📈 Prognosis• Depends on cause + treatment speed• Delays → permanent loss• Emotional impact significant• Prompt diagnosis = best outcomes🧠 Top MSRA Tips• Sudden vision loss = red flag• "Curtain" = retinal detachment• Central blur + haemorrhages = CRVO• Floaters/flashes in older patient = PVD• Raised ESR + vision drop = GCA → steroids NOW• Always assess pain, speed, and associated features📚 Sudden Vision Loss – MSRA Resources📝 Revision Notes: PassTheMSRA.com🃏 Flashcards: Flashcards📖 Q&A Notes: Accordion Notes🎯 Rapid Quiz: Quiz🧠 Practice Quiz: Full Quiz🌐 Explore more:www.PassTheMSRA.comwww.FreeMSRA.com🏁 Final TakeawaySudden vision loss is a clinical emergency until proven otherwise. A focused history, basic eye exam, and fast referral can prevent blindness — or save a life. Don’t miss it.#MSRA #SuddenVisionLoss #Ophthalmology #RetinalDetachment #CRAO #CRVO #MSRARevision #PassTheMSRA #FreeMSRA #MedicalEmergency #TMVL #GCA #OpticNeuritis #MSRAQuiz #MSRAFlashcards #VisionLoss
    Show More Show Less
    17 mins
  • Subconjunctival Hemorrhage: Free MSRA Podcast

    Subconjunctival Hemorrhage: Free MSRA Podcast
    May 21 2025
    🎧 MSRA Deep Dive: Subconjunctival Haemorrhage — The Dramatic but Benign Red EyeA sudden red eye can be alarming, but not all causes are dangerous. This episode unpacks subconjunctival haemorrhage — a classic example of a striking but often harmless presentation. A must-know for MSRA revision and clinical triage.🔍 DefinitionBleeding beneath the conjunctiva, appearing as a painless, bright red patch on the sclera.➡️ Usually unilateral, self-limiting, and benign.💥 Common CausesGrouped for clarity:• Trauma: Rubbing, minor injuries, contact lens use• Valsalva: Coughing, sneezing, straining• Medical: Hypertension, diabetes, bleeding disorders• Medications: Aspirin, NSAIDs, anticoagulants• Spontaneous: ~50% have no known cause• Surgical/Post-op: esp. after intraocular procedures• Neonates: Pressure during delivery🩺 Risk Factors• 👁️ Trauma or eye rubbing• 💊 Anticoagulants or antiplatelets• 📈 Uncontrolled hypertension• 😮‍💨 Valsalva strain• 👶 Vaginal delivery (neonates)• 👁️‍🗨️ Contact lens use🧠 PathophysiologyTiny conjunctival blood vessels rupture → blood collects beneath the clear conjunctiva.💡 “Like red paint under cling film.”🟢 Blood is reabsorbed in 1–3 weeks.🔍 Differential Diagnosis of Red Eye• Conjunctivitis – discharge, gritty sensation• Episcleritis – mild tenderness• Uveitis – pain, photophobia, blurred vision• Keratitis – corneal pain• Acute angle-closure glaucoma – vision loss, halos, headache• Kaposi’s/neoplasms – rare, if mass present❗ Red flag signs (pain, photophobia, vision loss) → urgent referral📊 Epidemiology• Affects ~2.6% of population• Spontaneous cases ~0.6% annually• All age groups affected; common in elderly & neonates🧾 Clinical Features• Sudden, painless red patch over sclera• No discharge, photophobia, or vision change• May change colour as blood reabsorbs (red → yellow-green)• Usually well-demarcated, flat• Visual acuity, pupils, and fundoscopy = normal🔺 Red Flag: No posterior border? → suspect deeper extension, esp. post-trauma🧪 InvestigationsOften not needed. Do if:• On anticoagulants → check INR• Hypertension suspected → check BP• Bilateral/recurrent → clotting screen, FBC• Infants with petechiae → consider non-accidental injury• Trauma → consider CT orbit/head💊 Management• 🟢 Reassure: Self-resolves in 1–3 weeks• Artificial tears if irritation present• Avoid eye rubbing• Continue meds unless clinically indicated otherwise📌 Refer if:• Persistent >3 weeks• Recurrent or bilateral• History of trauma• Suspicion of underlying pathology📈 Prognosis✅ Excellent.• No visual impairment• No lasting complications• Reassurance + simple advice usually all that’s needed🧠 MSRA Tips• Sudden painless red eye + normal vision = subconjunctival haemorrhage• Rule out serious causes if pain, discharge, or visual symptoms present• Always check BP & INR if relevant• Red flags = refer (bilateral, trauma, infants)📚 MSRA Learning Resources📝 Notes: https://www.passthemsra.com/topic/subconjunctival-haemorrhage-revision-notes/🃏 Flashcards: https://www.passthemsra.com/topic/subconjunctival-haemorrhage-flashcards/📖 Q&A Notes: https://www.passthemsra.com/topic/subconjunctival-haemorrhage-accordion-qa-notes/🎯 Rapid Quiz: https://www.passthemsra.com/topic/subconjunctival-haemorrhage-rapid-quiz/🧠 Quiz: https://www.passthemsra.com/quizzes/subconjunctival-haemorrhage/🌐 Main Sites: https://www.passthemsra.com | https://www.freemsra.com🏁 Final ThoughtIt may look scary — but subconjunctival haemorrhage is usually benign and self-resolving. The key is recognising when it’s simple… and when it’s not.#MSRA #RedEye #SubconjunctivalHaemorrhage #Ophthalmology #PasstheMSRA #FreeMSRA #MSRAQuiz #MSRAFlashcards #MSRARevision #BenignRedEye #MedicalEducation
    Show More Show Less
    16 mins
  • Squint (Strabismus): Free MSRA Podcast

    Squint (Strabismus): Free MSRA Podcast
    May 21 2025

    🎧FREE MSRA PODCAST –Squint (Strabismus): Spot It, Treat It, Save Sight 👁️

    Welcome to the Deep Dive. Today we’re decoding Squint (aka Strabismus) — a vital paediatricand ophthalmology topic that regularly shows up in the MSRA exam. From tropiasto phorias, and from patching to surgery, this is your go-to high-yieldsummary.

    🧠What You'll Learn inThis Episode:

    ✅Definition

    • Squint (strabismus) = misalignment of the eyes

    • One eye focusesnormally, the other may turn inwards, outwards,upwards or downwards

    • Mnemonic: "Tropia = True (Visible), Phoria = Phantom(Hidden)"

    📚Classification Recap

    🔹Manifest (Tropia) – seen when both eyes are open

    🔹Latent (Phoria) – only appears when fusion is broken (cover test)

    🔹Concomitant – deviation angle is the same in all directions

    🔹Paralytic(Incomitant) – deviation varies withgaze

    🧭 Directional Mnemonics:

    • ESO = Eyes turn inwards(accommodative squint)

    • EXO = Eyes turn outwards(convergence insufficiency)

    • HYPER = One eye turns up, HYPO = One eye turns down

    🔎Causes & RiskFactors

    🔹Idiopathic – most common

    🔹Neurological – e.g. cerebral palsy

    🔹Muscle imbalance – congenital or acquired

    🔹Geneticpredisposition – 30% have a familyhistory

    🔹Prematurity

    🔹Other eye diseases – e.g. childhood cataracts, ROP

    🔬PathophysiologySummary

    • Imbalance of the extraocular muscles or their neurological control

    • In adults: mayfollow stroke, trauma, or thyroid eye disease

    • In children: oftendevelopmental

    🩺DifferentialDiagnosis (Don’t Miss)

    • Pseudostrabismus – looks like a squint but it’snot (e.g. broad nasal bridge)

    • Convergence insufficiency

    • Paralytic nerve palsy (CN III, IV, VI)

    📊Epidemiology

    • 2–5% prevalence inthe UK

    • Diagnosed by age 6in most cases

    • Infantile misalignment often resolves in firstfew months

    • Esotropia common in Caucasian children

    • Exotropia more common in non-White populations

    👁️Clinical Features

    • Visiblemisalignment

    • Diplopia(especially adults)

    • Asthenopia (eyestrain, headaches)

    • Head tilt orabnormal posture

    • Clumsiness or poordepth perception

    • Intermittentlyclosing one eye in bright light (often exotropia)

    🧪Investigations

    🔸Visual acuity (both eyes separately)

    🔸Cover tests (standard, uncover, alternate)

    🔸Corneal light reflex(Hirschberg’s test)

    🔸Ophthalmoscopy

    🔸Refraction

    🔸Orthoptic assessment – definitive evaluation

    💊Management (Mnemonic: "GAPS")

    Glasses – correct refractive error

    Amblyopia treatment – patching or atropinedrops

    Prisms – help with diplopia in some cases

    Surgery – for persistent or severe cases

    🔹Early treatment is essential to prevent amblyopia

    🔹 Botulinum toxin or miotic drops sometimes trialled

    🔹 Orthoptic exercises help in convergenceinsufficiency

    📉Prognosis &Complications

    ✔️ Good with early diagnosis and treatment

    ❌ Untreated = amblyopia, loss of depth perception

    ⚠️ Surgical risks: under/overcorrection, recurrence

    😔 Psychosocial impact (bullying, self-esteem, jobinterviews)

    📎More MSRA Resourcesfor Squint

    📝 Revision Notes:

    https://www.passthemsra.com/topic/squint-strabismus-revision-notes/

    🧠 Flashcards:

    https://www.passthemsra.com/topic/squint-strabismus-flashcards/

    📖 Accordion Q&A Notes:

    https://www.passthemsra.com/topic/squint-strabismus-accordion-qa-notes/

    🎯 Rapid Quiz:

    https://www.passthemsra.com/topic/squint-strabismus-rapid-quiz/

    🧪 Quiz:

    https://www.passthemsra.com/quizzes/squint/

    🎓 More free revision content:

    🌐https://www.passthemsra.com

    🎁https://www.freemsra.com

    Hashtags

    #MSRA #MSRARevision#Strabismus #Squint #MSRAOphthalmology #MSRAFlashcards #MSRAQuiz #MSRATextbook#MSRANotes #PassTheMSRA #FreeMSRA #EyeHealth #OphthalmologyMSRA
    Show More Show Less
    16 mins