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Full Review Flashcards

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1
Q

During gestation, when does the eye form?

A

Between 1st and 4th months of gestation

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2
Q

What forms during gestation weeks 3-4?

A

Eye fields

Optic vesicle

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3
Q

What forms during gestation weeks 5-6?

A

Optic cup
Lens vesicle
Choroid fissure
Hyaloid artery

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4
Q

What forms during gestation weeks 7-8?

A

Cornea
Anterior chamber
Lens
Retina

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5
Q

What forms during gestation weeks 8-10?

A

Eyelids

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6
Q

What forms during gestation weeks 9-15?

A

Iris

Ciliary body

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7
Q

The eye fields form from a population of what cells?

A

Cells from the anterior neural plate

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8
Q

In humans, when do the frontal eye fields begin to form?

A

Around 17 days

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9
Q

Where do the eyefields start to form?

A

In the prosencephalon

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10
Q

As the eyefields get pushed forward, what begins to occur?

A

Folding, bringing the eyefields together

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11
Q

After folding of the eyefields, what beings to form?

A

Optic groove

Eye fields are invaginating and forming a sulcus

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12
Q

How long does it take for the neural folds to meet at the top?

A

25 days

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13
Q

What structure forms the optic vesicle?

A

Optic groove

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14
Q

When the neuroectoderm and the surface ectoderm come in close contact (around day 25), what happens?

A

The optic groove begins to push itself out (evaginates), creating the optic vessicles

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15
Q

Neuroectoderm coming in contact with surface ectoderm induces what?

A

Lens placode

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16
Q

What does the lens come from?

A

Surface ectoderm

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17
Q

True or false: formation of the optic vesicle occurs at the same time as induction of the lens placode.

A

True

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18
Q

When the lens placode is induced, does it begin on the outside, or the inside?

A

Outside

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19
Q

How does the lens get inside the eye?

A

Lens placode and and optic vessicle invaginate

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20
Q

When the lens vesicle invaginates with the optic vesicle, what forms?

A

A bi-fold

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21
Q

When the optic vesicle invaginates, what is formed?

A

Optic cup

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22
Q

When the lens placode invaginates, what is formed?

A

Lens vesicle

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23
Q

As the optic vesicle and cup form, what is occurring to the optic stalk?

A

Also ingavinating

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24
Q

Where the optic stalk invaginates, what is created?

A

Choroid fissure

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25
Q

What grows within the choroid fissure?

A

Hyaloid artery

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26
Q

What feeds the lens vesicle during formation?

A

Hyaloid artery

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27
Q

What surrounds the back of the lens?

A

Hyaloid artery

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28
Q

What is the role of the posterior lens fiber?

A

Obliterate the lens cavity

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29
Q

When does the cornea differentiate?

A

After the differentiation of the lens and retina - around one month

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30
Q

What serve as the scaffolding for creating the iris?

A

Iridopupilary membranes

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31
Q

When do we first see something that actually resembles an eye?

A

After one month

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32
Q

When do the pupilary membranes usually go away?

A

After birth

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33
Q

What happens if the pupilary membranes persist after birth?

A

They may fix the pupil, and make it so it can’t change size

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34
Q

What keeps the lens nice and smooth?

A

Crystallines

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35
Q

During development, is the cornea clear or opaque?

A

Opaque

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36
Q

What cells form the outer corneal epithelium?

A

Surface ectoderm

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37
Q

What cells form the inner portions of the cornea?

A

Neural Crest Cells

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38
Q

All of the structures of the eye, with the exception of _____, come from the ectoderms.

A

Hyaloid artery

Inner layer of the cornea

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39
Q

During weeks 7-8, what is occuring in the retina?

A

There is a gap between RPE and neural retina. Neural retina begins to differentiate into the 10 total cell types

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40
Q

When the eyelid first is formed, is there a fissure?

A

Nope. It is just one structure

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41
Q

During what trimester do the eyelids un-fuse?

A

3rd trimester

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42
Q

From what tissues does the iris form?

A

Optic cup tissues

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43
Q

The folding of the “rim” of the optic cup forms what two structures?

A

Iris

Ciliary processes

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44
Q

What are the two principle pathways from progenitor cell to retinal cell?

A

Ganglion cell pathway

Cone/horizontal cell pathway

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45
Q

What cells can arise from the ganglion cell pathway?

A

Ganglion cells
Amacrine cells
Rods
Bipolar cells

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46
Q

What cells can arise from the cone pathway?

A 
Cones
Horiztonal cells
Muller glial cells
Rods
Bipolar cells
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47
Q

Both the ganglion and cone cell pathways may differentiate into what?

A

Bipolar cells

Rods

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48
Q

Which retinal cell types migrate more than the others?

A

Bipolar cells

Rods

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49
Q

Which cells are “born” at about the same time?

A

Amacrine
Cone
Ganglion
Horizontal

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50
Q

Which cell type begins to form after the amacrine, cone, ganglion, and horizontal cells are formed?

A

Rods

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51
Q

What retinal cell type is born after rods?

A

Bipolar cells

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52
Q

What is the last retinal cell type born?

A

Muller glial cells

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53
Q

What is the order of retinal cell birth?

A
  1. Amacrine, cone, ganglion, horizontal
  2. Rods
  3. Bipolar cells
  4. Muller glial cells
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54
Q

Which cells continue to be born after birth?

A

Amacrine, rods, bipolar, Muller cells

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55
Q

Which cells are largely born before birth?

A

Cones
Ganglion cells
Horizontal cells

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56
Q

What does the retina start as?

A

A mass fo progenitor cells

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57
Q

Where to the progenitor cells reside?

A

In the ciliary regions

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58
Q

What creates the optic nerve?

A

Axons of the ganglion cells

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59
Q

Where do the ganglion cells migrate to?

A

Thalamus

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60
Q

What cells are responsible for forming the barrier of the outer nuclear layer/outer plexiform layer?

A

Horizontal cells

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61
Q

Which retinal cell layer is one of the first specified?

A

Ganglion cell layer

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62
Q

Which cells “give a ride” to many of the migrating retinal cells?

A

Radial glial cells

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63
Q

Which cells start having the first neurotransmitter vesicles forming?

A

Horizontal and amacrine cells

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64
Q

Cones make contact with which cells first?

A

Horizontal cells

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65
Q

What forms the second synapses?

A

Off BP cells to cones

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66
Q

After off BP cells synapse to cones, what other synapses begin?

A

Ribbon synapses (on BP to cones)

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67
Q

Where do glutamate receptors appear first?

A

Off BP cells

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68
Q

Which cells have the strongest on response?

A

Amacrine cells

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69
Q

As the vision system develops, there are many connections being made all over the place. What must occur before it functions properly?

A

Pruning

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70
Q

What are the first responses that occur in the developing eye?

A

Excitatory - occurs in the dark

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71
Q

Center-surround organization of receptive fields is apparent as soon as ___ are detected.

A

Light responses

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72
Q

Turtles are initially ___. (anisotropic; isotropic)

A

Anisotropic

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73
Q

Dark-rearing mice until about 3 weeks after birth leads to an increase in the fraction of what?

A

Bistratified, On-Off ganglion cells in the retina

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74
Q

If you suture a kitten’s left eye, what happens in the cortex?

A

The ocular dominance columns will shift, so that there aren’t any cells for the left eye, and they all go to the right.

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75
Q

What happens if you suture a cat’s left eye closed 12 weeks after birth?

A

The response of cells is even in each ocular dominance column, but the number of cells is reduced.

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76
Q

If you suture both eyes closed at birth, what happens to the cells in the cortex?

A

There is a normal distribution of cells; ocular dominance columns are in tact, but they don’t work correctly. Many don’t work at all.

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77
Q

If you suture an eye during the critical period, but open it before the critical period ends, what will happen?

A

They affected eye will not recover

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78
Q

After suturing an eye during the critical period, what is the only way to recover brain function?

A

Reverse suturing before the critical period ends

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79
Q

What happens if you raise monkeys in darkness (binocular occlusion) from 2 weeks old up to 3-6 months?

A

Deterioration of the visual cortex - they behave as if they are blind, and never fully recover

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80
Q

After 1 year, what effect will reverse suturing have on a monkey?

A

No effect

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81
Q

When do babies begin to see clearly?

A

4-6 months

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82
Q

When do babies begin the “hand to mouth” movement?

A

8-12 months

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83
Q

How much accommodation do babies have at birth?

A

None - poor ciliary muscle control

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84
Q

What is a baby’s VA at birth?

A

20/600

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85
Q

At what age are babies capable of focusing an image on the retina, but it is still blurry?

A

2-3 months

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86
Q

At 2-3 months, why is the image still blurry for a baby?

A

The photoreceptors are still getting organized. Some cells are still being “born”

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87
Q

What VA is “expected” around 3 months?

A

20/200

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88
Q

Once photoreceptors are born, they still need to mature. What needs to occur?

A

Their outer segments still need to elongate

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89
Q

Why is a “newborn” photoreceptor less effective than a mature one?

A

The outer segments are short, so there is less surface area to catch photons

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90
Q

According to Ricco’s law, is the threshold area larger or smaller as an adult than as a child?

A

Larger as an adult

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91
Q

Compared to adult levels, in the 1st month, a baby is __ times less sensitive to light.

A

50

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92
Q

Compared to adult levels, in the 3rd month, a baby is __ times less sensitive to light.

A

10

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93
Q

Why are babies more attracted to bright colors?

A

They are less sensitive to light, so the brighter the color, the easier they can see it

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94
Q

During the first week of life, what wavelengths are babies missing?

A

Shorter wavelengths (they already have long wavelength cones)

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95
Q

Which of the cones is last to develop?

A

Blue cones

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96
Q

What contrast difference is a 1 month old able to discriminate?

A

5%

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97
Q

What contrast difference is a 2 month old able to discriminate?

A

0.5-0.75%

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98
Q

When do babies eyes begin to fixate, coordinate movement, and have some smooth tracking?

A

3 months

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99
Q

What develops that allows a baby to track smoothly?

A

Myelination of the axons, allowing signals to travel faster

100
Q

What is an important component of recognition for a baby?

A

High contrast

Ex. hairlines, edges of faces

101
Q

By _ months, fixation occurs.

A

2 months

102
Q

When do babies begin to mimic smiles?

A

2 months

103
Q

What visual developments are occurring around ages 4-6 months?

A

Acuity
Color
Movement
Recognition

104
Q

What is a baby’s VA at 4 months?

A

20/100

105
Q

When do babies begin to see blue hues?

A

Around 4 months

106
Q

When does real tracking and hand-eye coordination begin to occur?

A

4 months

107
Q

At what age will a baby hesitate when presented with false depth cues? (baby checkerboard drop-off experiment)

A

4-6 months

108
Q

At age 4-6 months, saccades and pursuits may occur at a rate of ___.

A

200-250 milliseconds

109
Q

What is the difference between a baby’s saccades/pursuits and an adult’s?

A

There is a lag in initiation

110
Q

When do babies begin to recognize strangers and faces?

A

6 months

111
Q

What change is facilitating the development of saccades, facial recognition and the like?

A

Neuronal branching

112
Q

What causes the brain to grow and branch?

A

Extrinsic factors - retina sending more info to the brain

113
Q

At what age is the optic nerve myelinated?

A

4-5 months (but still not fully functional yet)

114
Q

When do babies start associated and using different depth cues?

A

8-12 months

115
Q

When does VA improve to 20/30?

A

8months-1 year

116
Q

If a child is going to be an emmetrope, when will they see 20/20?

A

Abot 36 months

117
Q

What aspects of vision development are fast?

A

Color

Visuomotor

118
Q

What aspects of vision development are slow?

A

Acuity

Coordination

119
Q

Does a baby have stereo at birth?

A

Nope

120
Q

When does stereo begin to emerge?

A

3-4 months

121
Q

When is adult level stereo reached?

A

6 months

122
Q

Most visual systems have kicked in around 6 months, except for which 4 things?

A

Grating acuity
Color vision
Vernier acuity
Contrast sensitivity

123
Q

What does grating acuity test?

A

Resolution acuity

124
Q

What is another name for Vernier acuity?

A

Hyperacuity

125
Q

What are the 3 ways to assess resolution acuity?

A 
Visual evoked potential (VEP)
Optokinetic Nystagmus (OKN)
Preferential looking (PL)
126
Q

What is the most rudimentary way of assessing resolution acuity?

A

OKN

127
Q

What must occur in order to get a measurement with OKN?

A

Must be able to resolve the bars. If not, it just looks gray, and no fixation will occur.

128
Q

Why is OKN the most rudimentary?

A

You don’t need any V1 processing to get a reading. It is controlled by the region that controls oculomotor response

129
Q

If a stimulus is received using a VEP, where will a response be elicited?

A

Primary visual cortex

130
Q

What does a VEP recording look like 7 days after birth?

A

Nearly a flat line

131
Q

When do you start to see a VEP response in babies?

A

Around 1 month

132
Q

At what age does a VEP response look adult-like?

A

About 6 months

133
Q

When using the VEP method, when does a baby “see” 20/20?

A

6-8 months

134
Q

At one month, what should the FPL visual acuity and the Snellen equivalent be?

A

1 cycle/degree

20/600

135
Q

At three months, what should the FPL visual acuity and the Snellen equivalent be?

A

3 cycles/degree

20/200

136
Q

At six months, what should the FPL visual acuity and the Snellen equivalent be?

A

6 cycles/degree

20/100

137
Q

At twelve months, what should the FPL visual acuity and the Snellen equivalent be?

A

12 cycles/degree

20/50

138
Q

At 3-5 years, what should the FPL visual acuity and the Snellen equivalent be?

A

30 cycles/degree

20/20

139
Q

What is the best card for VA in infants? It is really expensive…

A

Teller Acuity Card

140
Q

What are the three preferential looking cards that can be used for infants?

A

Teller Acuity
Cardiff Acuity
Lea Grating Paddles

141
Q

What does the Cardiff Acuity test for?

A

Contrast

142
Q

When does forced choice preferential looking reach adult levels?

A

5-6 years

143
Q

What are the limiting factors for VA development in infants?

A

Foveal cone immaturity
Incomplete myelination of the optic pathway
Cortical immaturity

144
Q

When does the “macular dip” begin to be seen?

A

At birth

145
Q

How long after birth does it take for the cones to be fully developed?

A

About 45 months

146
Q

What happens in the central retina at about 16 weeks post natal?

A

4-8 fold increase in cone density

147
Q

Volume and density of synapses dramatically ___ after birth.

A

Increase

148
Q

When do foveal cones reach adult length?

A

4 years

149
Q

When does foveal cone density reach adult level?

A

45 months

150
Q

How long does it take for complete myelination of the optic pathway to occur?

A

2 years

151
Q

Why is Vernier acuity called hyperacuity?

A

It is 10 times better than grating acuity

152
Q

Which is worse at birth, Vernier acuity or grating acuity?

A

Vernier acuity

153
Q

At what age does Vernier acuity surpass grating acuity?

A

4 months

154
Q

When does Vernier acuity reach adult levels?

A

6-8 years

155
Q

Which ethnicity has the highest incidence of myopia?

A

Asian (18.5%)

156
Q

What ethnicities have the lowest prevalence of myopia?

A

African Americans

Whites

157
Q

What ethnicities have the highest prevalence of astigmatism?

A

Asians and hispanics

158
Q

What are the risk factors for myopia progression?

A 
Age
Family Hx
Amount of near work
Gender (female>male)
Race
159
Q

When do ocularmotor functions reach adult levels?

A

3-6 months

160
Q

When does accommodation reach adult levels?

A

3-4 months

161
Q

When do convergence and fusion reach adult levels?

A

22 weeks

162
Q

When does stereopsis reach adult levels?

A

6 months

163
Q

Define amblyopia.

A

A condition in which the best corrected visual acuity is poorer than 20/20 in the absence of any obvious structural anomalies or ocular disease

164
Q

Amblyopia is a Dx of ___.

A

Inclusion

165
Q

What are the 3 amblyogenic factors?

A

Srabismus
Anisometropia
Image deprivation

166
Q

What are the five aspects of visual function affected by amblyopia?

A

Reduced contrast sensitivity and visual resolution
Increased sensitivity to contour interaction effects (crowding)
Abnormal spatial distortions and uncertainty
Unsteady and inaccurate monocular fixation
Inaccurate accommodative response

167
Q

What is isometropic amblyopia?

A

When both eyes have a similar, high refractive error

168
Q

At how many diopters of cyl do you worry about anisometropia?

A

> 1.50

169
Q

At how many diopters of cyl do you worry about isometropia?

A

> 2.50

170
Q

At how many diopters of plus do you worry about anisometropia?

A

> 1.00

171
Q

At how many dioptes of plus do you worry about isometropia?

A

> 5.00

172
Q

At how many diopters of minus do you worry about anisometropia?

A

> 3.00

173
Q

At how many diopters of minus do you worry about isometropia?

A

> 8.00

174
Q

For amblyogenic strabismus to occur, what conditions must be met?

A

Constant strab
Unilateral strab
Onset before ate 8

175
Q

What would be the expected VAs for a child that had their binocular congenital cataracts removed around 4-6 months of age?

A

20/50

176
Q

With monocular form deprivation, where would you expect to see changes in the brain?

A

Cortex and LGN will both have morphological changes

177
Q

What would be the expected VA for a child having had their monocular congenital cataract removed at about age 4-6 months?

A

20/400

178
Q

When must a monocular congenital cataract be removed to still be able to recover VA up to 20/40?

A

2 months

179
Q

What accounts for more than 90% of all amblyopia?

A

Strab

Aniso

180
Q

Which type of amblyopia doesn’t show any contrast sensitivity loss?

A

Strabismis

181
Q

Anisometropic amblyopes have contrast sensitivity loss at ___ spatial frequencies.

A

High

182
Q

What three things may hyperopic isometropic amblyopia cause?

A 
Accommodative esotropia
Normal vision (if accommodates well)
Bilateral refractive amblyopia if the child maintains binocularity by underaccommodating
183
Q

What induced meridional amblyopia?

A

High astigmatism - usually bilateral

184
Q

Why does WTR astigmatism cause less meridional amblyopia?

A

Pt. can squint to “fix” the blur

185
Q

When is the peak of emmitropization?

A

Around age 6

186
Q

When are the fastest changes occurring in the visual system?

A

Around age 2

187
Q

What is the normal progression rate of myopia?

A

-0.50 per year

188
Q

In strabismic amblyopia, where is VA loss the greatest?

A

At the fovea

Also shows nasal/temporal asymmetry

189
Q

What is the definition of crowding?

A

The recognition of a given character is degraded by the presence of neighboring characters

190
Q

What factors affect the degree of crowding?

A

Separation between the characters
Character size
Location in the visual field

191
Q

What mainly causes the amblyopic reading deficit?

A

Increased crowding effect

192
Q

Describe fixation for anisometropic amblyopes.

A

Central and unsteady

193
Q

Describe fixation for strabismic amblyopes.

A

Eccentric and unsteady.

194
Q

How can fixation be measured in strabismic amblyopia?

A

Maxwell spot/Hadinger’s brush

Visuoscopy

195
Q

Accommodation is __ secondary to amblyopia.

A

Reduced

196
Q

What accommodative issues arise in amplyopic persons?

A

Reduced accommodation
Inaccurate and unsteady accommodation
Affect ability to do sustained reading and fine visual tasks

197
Q

At what age do vehicle accidents increase and why?

A

Age 75 - slower response time

198
Q

A smaller pupil causes people to be less tolerable to what?

A

Glare

199
Q

With age, the smaller pupil causes problems adapting to what?

A

Changing light conditions

200
Q

Elapsed time for glare recovery increases starting at what age?

A

60

201
Q

The yellowing of the lens with age causes problems seeing which colors?

A

Short wavelength - blue, green, violet

202
Q

What things help people with yellowed lenses to perceive color more accurately?

A

Using full spectrum hallogen or fluorescent bulbs

203
Q

Yellowing of the lens may also cause a decrease in what?

A

Depth perception cues - contrast recognition problems

204
Q

Whit is one of the first apparent aging changes in the retina?

A

Overall thinning

205
Q

What things cause retinal thinning with age?

A

Loss of neuronal cells

Shortening of the outer segments

206
Q

What is usually the only real aging change in the fovea?

A

Change in the cones

207
Q

Where are cones lost the quickest due to age? The slowest?

A

Quickest in the periphery

Slowest in the fovea

208
Q

What are the two pigments found in RPE?

A

Melanin

Lipofuscin

209
Q

What is the origin of lipofuscin?

A

Phagocytized PR outersegments

210
Q

Which pigment increases the most with age: Lipofuscin or melanolipofuscin?

A

Melanolipofuscin (MLF)

211
Q

Lipofuscin may be a causative agent for what?

A

AMD

212
Q

Where does drusen form?

A

Between RPE and Bruch’s membrane

213
Q

Which type of drusen is a normal biproduct of age?

A

Hard drusen

214
Q

When does color vision really start to go downhill?

A

Ages 65-90 - have a 50/50 shot at failing a D15 test

215
Q

Stereo begins to decline at what age?

A

About 60

216
Q

What factors contribute to a loss of contrast sensitivity around age 65?

A

Senile myosis

Nuclear sclerosis

217
Q

When does useful field of view drop off the most?

A

70-80

218
Q

Why isn’t aging a disease?

A

It isn’t fully treatable

219
Q

What is the most widely used aging strategy?

A

Replenishing

220
Q

What are the 4 aging strategies?

A

Wishful thinking
Fixing
Replenishing
Strengthening

221
Q

What are the four major age-related eye diseases?

A

Glaucoma
Cataracts
AMD
Diabetic retinopathy

222
Q

What is the major problem that arises from diabetes?

A

Diseased blood vessels

223
Q

What leads to a risk of developing diseases like diabetic retinopathy and glaucoma?

A

Blood vessels not function correctly, making it so that nutrients cannot reach the retina

224
Q

What are the 3 stages of diabetic retinopathy?

A

Background diabetic retinopathy
Diabetic macular edema
Proliferative diabetic retinopathy

225
Q

What occurs in diabetic retinopathy?

A

Blood vessels get blocked and cause small hemorrhages in the retina
New blood vessels are poor, and can lead to microaneurysms and leak

226
Q

Which type of glaucoma can lead to rapid vision loss?

A

Acute glaucoma

227
Q

What are the 4 types of glaucoma?

A

Chronic open-angle
Acute closed angle
Low-tension
Congenital

228
Q

What is the most common cause of blindness in the United States?

A

AMD

229
Q

Which form of AMD is less serious?

A

Dry - more common (90% of cases)

230
Q

What occurs in wet AMD?

A

Neovascularization with blood leakage

231
Q

Which AMD causes faster vision loss?

A

Wet AMD

232
Q

Which gene is more associated with wet AMD?

A

CFH

233
Q

Which gene is more associated with dry AMD?

A

HTRA1

234
Q

People with both alleles had an increased chance of __% to get AMD by age 65.

A

47%

235
Q

AMD generally affects whom?

A

Caucasian males ove age 50

Smokers

236
Q

What treatments are there for dry AMD?

A

None

237
Q

What treatments are there for wet AMD?

A

Anti-VDGF (avastin, lucentis..)
Implantable telescope
Laser photocoagulation
Visudyne therapy

238
Q

What is the cause of cataracts?

A

Sclerosis of the lens

239
Q

What things increase the risk of cataracts?

A

Any Smoking

Heavy Alcohol use

240
Q

What is the cause of Fuch’s dystrophy?

A

Deterioration of endothelial cells, leading to poor water drainage

241
Q

What does Fuch’s usually cause?

A

Swelling and shape change of the cornea

242
Q

Why do patients with Fuch’s usually wake up with blurry vision?

A

When the eyes are closed, the water cannot evaporate

243
Q

What might you do to treat early Fuch’s?

A

Salt-water eye drops to dry the eye
Blow hot air on cornea
Sof-bandage CL for corneal blisters

244
Q

What is the treatment for severe Fuch’s?

A

Corneal transplant

245
Q

What is the first thing patients will notice if their RPE is dying?

A

Glare

Vision Science III (2 decks)

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