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MD2 Ambulatory Care and Emergency Medicine > Eye Review > Flashcards

Eye Review Flashcards

1
Q

What shape is the orbit?

A

Pyramid

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2
Q

Where do nerves and vessels enter the orbit?

A

Apex

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3
Q

How many bones make up the orbit?

A

7

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4
Q

What proportion of the orbit is the eye?

A

20%

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5
Q

What is the main arterial supply of the orbit?

A

Ophthalmic artery

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6
Q

What is the venous drainage of the orbit?

A

Superior and inferior ophthalmic veins

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7
Q

Which bone is frequently involved in blow-out fractures of the orbit?

A

Maxilla - part of floor

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8
Q

What does the lacrimal gland secrete?

A

Aqueous layer of tear film

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9
Q

What are the main muscles of the eyelid, what do they do, and by which nerve are they innervated?

A 
Levator palpebrae superioris
- Opens lid
- CN III
Obicularis oculi
- Closes lid
- CN VII
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10
Q

What is Muller’s muscle and what does it do?

A

Also known as superior tarsal muscle - smooth not striated

Helps lift eyelid

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11
Q

What are meibomian glands?

A

Special type of sebaceous gland at rim of eyelids inside tarsal plate
Secrete meibum = prevents evaporation of eye’s tear film

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12
Q

What are Zeiss glands?

A

Sebaceous glands on margin of eyelid

Secrete into hair follicle of eyelashes

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13
Q

What are Moll glands?

A

Apocrine glands on margin of eyelid

Secrete into hair follicle of eyelashes

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14
Q

What are the lacrimal puncta?

A

Openings in medial portion of eyelid to lacrimal canaliculi and sac

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15
Q

What is the sclera?

A

Tough fibrous wall of eye

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16
Q

What is the conjunctiva?

A

Clear mucous membrane lining inside of eyelids and sclera

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17
Q

What is the limbus?

A

Where sclera and cornea meet

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18
Q

What are the layers of the cornea from anterior to posterior?

A 
Epithelium
Bowman's layer
Stroma
Decemet's membrane
Endothelium
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19
Q

What is the sensory innervation of the cornea?

A

Ophthalmic division of CN V

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20
Q

What is the blood supply to the cornea?

A

Avascular

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21
Q

What is the anterior chamber full of?

A

Aqueous humour

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22
Q

What produces the aqueous humour?

A

Ciliary body

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23
Q

How does aqueous humour drain out of the eye?

A

Canal of Schlemm > trabecular meshwork

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24
Q

What makes up the uveal tract?

A

Iris
Ciliary body
Choroid

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25
Q

What are the two muscles of the iris, and which arms of the autonomic nervous system are they innervated by?

A

Sphincter muscle > parasympathetic

Dilator > sympathetic

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26
Q

What is the choroid?

A

Blood supply for outer half of sensory retina

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27
Q

Which vessels feed into the choroid?

A

Posterior ciliary arteries

28
Q

What is the blood supply of the lens?

A

Avascular

29
Q

What are the layers of the lens?

A

Capsule > cortex > nucleus

30
Q

What is a cataract?

A

Lens opacity

31
Q

What occupies 80% of the globe?

A

Vitreous humour

32
Q

What makes up the vitreous humour?

A

Complex structure of collagen fibrils

33
Q

What makes up the visual pathway?

A 
Optic nerve
Optic chiasm
Optic tract
Optic radiation
Visual cortex
34
Q

What are the extraocular muscles, and which nerves innervate them?

A 
Rectus
- Medial - CN III
- Lateral - CN VI
- Superior - CN III
- Inferior - CN III
Oblique
- Superior - CN IV
- Inferior - CN III
35
Q

What are the main causes of visual impairment in Australia, in descending order?

A

Refractive error
Macular degeneration
Cataract

36
Q

What is myopia?

A

Short-sightedness

Light focused before hitting retina

37
Q

What is hypermetropia?

A

Long-sightedness

Light focused after hitting retina

38
Q

What is astigmatism?

A

Non-spherical curvature of cornea
Regular = 2 different curves at 90 degrees to each other
Irregular = variable degrees of curvature along each axis

39
Q

Can astigmatism be corrected with glasses?

A

Regular can, irregular cannot

40
Q

What is presbyopia?

A

Loss of lens flexibility with age > long-sightedness

41
Q

What is glaucoma?

A

Group of diseases that cause progressive damage to optic nerve

42
Q

What is the major contributing factor to glaucoma?

A

Increased intra-ocular pressure

43
Q

What are the symptoms of acute glaucoma?

A 
Acute pain
Redness
Blurred vision
Haloes around lights
Nausea
Usually sudden onset
44
Q

What are the symptoms of open angle glaucoma?

A

Minimal

45
Q

What is the normal cup-disc ratio?

A

0.3

46
Q

What does an abnormally large cup-disc ratio indicate?

A

Glaucoma

47
Q

What are the major clinical features of primary open angle glaucoma?

A

Progressive visual field loss
Progressive increase in cup-disc ratio of optic disc
Elevated intra-ocular pressure

48
Q

What are the main causes of cataracts?

A 
Age
Congenital
Traumatic
Secondary
Drug induced
49
Q

What are some diseases common to the retina?

A

Macular degeneration
Diabetic retinopathy
Vascular occlusions

50
Q

What are the symptoms of macular degeneration?

A

Distortion of central vision = metamorphopsia

51
Q

What are the signs of mild non-proliferative diabetic retinopathy?

A

Microaneurysms

52
Q

What are the signs of moderate non-proliferative diabetic retinopathy?

A 
Microaneurysms
Intra-retinal
Haemorrhages
Hard exudates
Cotton wool spots
53
Q

What are the signs of the severe non-proliferative diabetic retinopathy?

A

Any one feature of 4-2-1 rule

  • Intra-retinal haemorrhages in 4 quadrants
  • Venous beading in 2 quadrants
  • Intra-retinal vascular abnormalities in 1 quadrant
54
Q

What are the signs of very severe non-proliferative diabetic retinopathy?

A

Any two features of 4-2-1 rule

  • Intra-retinal haemorrhages in 4 quadrants
  • Venous beading in 2 quadrants
  • Intra-retinal vascular abnormalities in 1 quadrant
55
Q

What is the classification of low risk proliferative diabetic retinopathy?

A

Less than 1/3 of disc neovascularised

56
Q

What is the classification of high risk proliferative diabetic retinopathy?

A

Neovascularised disc + vitreous haemorrhage
More than 1/3 of disc neovascularised
Neo-vascularisation everywhere

57
Q

What is the management for proliferative diabetic retinopathy?

A

Pan-retinal photocoagulation
Burns away areas of peripheral retina
Decreased drive of VEGF production > reduced neovascularisation
Peripheral vision sacrifice

58
Q

What is the history of retinal venous occlusions?

A

Sudden, painless unilateral loss of vision

59
Q

What is the history of central retinal arterial occlusions?

A

Sudden, painless unilateral loss of vision

60
Q

What is the main causative factor of central retinal arterial occlusions?

A

Atherosclerotic changes

61
Q

What is the main causative factor of branch retinal arterial occlusions?

A

Embolism

62
Q

What is the epidemiology of optic neuritis?

A

Typically young adults = 18-45 years

Female predominance

63
Q

What are the symptoms and signs of optic neuritis?

A 
Total/partial sudden loss of vision
Reduced colour vision
Pain - worse on eye movement
Usually unilateral
Afferent pupil defect
64
Q

What does optic neuropathy refer to?

A

Disorders involving ischaemia/toxicity

65
Q

What is ischaemic optic neuropathy associated with?

A

Damage to posterior ciliary artery supply to optic neuropathy head > sudden loss of vision

MD2 Ambulatory Care and Emergency Medicine (29 decks)

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