Ophthalmology
Red eye, sudden visual loss, eye trauma and chronic eye disease. The AMC tests the red-flag eye that must be referred the same day.
High-yield points
Red flags in red eye: reduced vision, pain, photophobia, fixed or irregular pupil, corneal opacity, contact lens wearer.
Acute angle-closure glaucoma: painful red eye, halos, mid-dilated fixed pupil, vomiting; lower pressure (acetazolamide, topical agents) and urgent referral.
Chemical eye injury: irrigate immediately and copiously before anything else.
Retinal detachment: flashes, floaters, curtain over vision; same-day referral.
Central retinal artery occlusion: sudden painless visual loss, cherry-red spot; consider GCA in older patients.
Diabetic retinopathy screening: every 2 years if no retinopathy; yearly for Aboriginal and Torres Strait Islander people with diabetes.
Herpes zoster involving the tip of the nose (Hutchinson's sign) signals eye involvement.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Trachoma | Declared eliminated as a public health problem. | Still endemic in some remote Aboriginal communities; controlled with the SAFE strategy (surgery, azithromycin, facial cleanliness, environment). |
| Diabetic retinopathy screening | Opportunistic, often at eye camps. | Regular retinal checks (usually every 1-2 years, more often in higher-risk and First Nations people), including retinal photography in general practice. |
| Red eye in general practice | Topical steroid-antibiotic drops are sometimes used empirically. | Don't start topical steroids without slit-lamp examination. Refer urgently for reduced vision, severe pain or suspected angle closure. |
Trachoma
India (MBBS)
Declared eliminated as a public health problem.
Australia (AMC): what the exam expects
Still endemic in some remote Aboriginal communities; controlled with the SAFE strategy (surgery, azithromycin, facial cleanliness, environment).
Diabetic retinopathy screening
India (MBBS)
Opportunistic, often at eye camps.
Australia (AMC): what the exam expects
Regular retinal checks (usually every 1-2 years, more often in higher-risk and First Nations people), including retinal photography in general practice.
Red eye in general practice
India (MBBS)
Topical steroid-antibiotic drops are sometimes used empirically.
Australia (AMC): what the exam expects
Don't start topical steroids without slit-lamp examination. Refer urgently for reduced vision, severe pain or suspected angle closure.
The Australian context
Australia is the only high-income country with endemic trachoma, found in some remote Aboriginal communities. It is controlled with the WHO SAFE strategy (surgery, antibiotics with azithromycin, facial cleanliness, environmental improvement).