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Anterior Segment 2 > Higa: Dry Eye 1 > Flashcards

Higa: Dry Eye 1 Flashcards

1
Q

What are the functions of the eyelids?

A
  1. cover/protect globe
  2. Move tears medially
  3. spread tears
  4. Contains glands
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2
Q

Which muscle: Causes negative pressue to help drain tears w/ a blink

A

Muscle of horner

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3
Q

Which muscle: found within eyelid, keeps the eyelid on the globe

A

Muscle of Riolan

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4
Q

WIT: Loss of muscle tone, can lead chronic epiphora

A

Ectropion

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5
Q

WIT: due to involutional entropion or an inward turning of lashes, can lead to FBS

A

Trichiasis

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6
Q

Rubbery tarsus and loose upper lids, often seen in obese men and associated with sleep apnea; can result in mechanical GPC

A

Floppy eyelid syndrome

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7
Q

Accessory glands of wolfring & Krause produce?

A

Aqueous

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8
Q

WIT: Preservatives in ophthalmic drugs/sons can cause breaks in epithelial tight junctions resulting in PEE

A

Toxic Keratitis

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9
Q

WIT: Loss of corneal sensory innervation that results in lack of corneal healing and symptoms

A

Neurotrophic Keratitis

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10
Q

What 5 things do the tears contain?

A
  1. Water
  2. Electrolytes
  3. Lysozyme
  4. Lactoferrin
  5. Immunoglobulins
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11
Q

WIT: Acute infection of the meibomian glands

A

Internal hordeolum

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12
Q

WIT: Infection of sebaceous gland (zeiss or moll)

A

External hordeolum

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13
Q

Meibum is thought to be caused by what?

A

Testosterone and Progesterone

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14
Q

What are the functions of the tear film?

A
  1. Lubricant
  2. Traps Debris/Removes Epithelial cells
  3. Oxygen for cornea
  4. Smooth refractive surface
  5. Antibacterial properties
  6. Maintain corneal hydration
  7. Growth factors
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15
Q

What is the average osmolarity of the tear film? ph? thickness?

A

300mOsm
6.2-8.2
2-5.5um

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16
Q

What % of tears pass through lacrimal drainage?

A

75%

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17
Q

What is the length of the ampulla, canaliculus, lacrimal sac & nasolacrimal canal?

A

2mm
8mm
10mm
12mm

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18
Q

A positive Jones 1 test means what?

A
  • the drainage system is open/patent
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19
Q

A positive Jones 2 test means what?

A
  • dye is now present

There was a blockage, but dilation and irrigation removed it

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20
Q

What does a negative Jones 2 test mean?

A

Regurgitation from superior/inferior puncta… obstruction

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21
Q

Receptors sense feeling/abnormality and send signal via what nuclei?

A
  1. Nuclei of V

2. Superior Salvitory Nucleus

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22
Q

WIT: Pain that arises from actual damage to tissue & is due to the activation of nociceptors.

A

Nociceptive pain

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23
Q

WIT: Pain caused by a lesion or disease of the somatosensory nervous system; Pain without biologic value

A

Neuropathic pain

24
Q

What are the 3 types of corneal sensory neurons?

A
  1. Polymodal nociceptors
  2. Specific mechano-nociceptors
  3. Cold thermoreceptor neurons
25
WIT: Respond to chemical, thermal and mechanical insult; sensitized by inflammation
Polymodal nociceptors
26
WIT: Responds only to mechanical injury
Specific mechano-nociceptors
27
WIT: Increase or decrease of firing due to heat/cold of ocular surface; sensitive to changes in tear osmolarity
Cold thermoreceptor neurons
28
What is the most important neuron in DED?
Cold thermoreceptor neurons.
29
What are the new components of DEWS 1 compared to DEWS 2?
1. Loss of homeostasis | 2. Neurosensory abnormalities
30
What are the 2 components of Non-Sjogrens/K.sicca ?
1. Aging | 2. Low Androgens
31
What is found to be decreased in ppl over 80?
Lactoferrin & Lysozyme
32
High levels of what androgen is a risk factor for DED? This is found in post-menopausal women
high levels of estrogen
33
Sjogren's is an autoimmune attack on what? What infiltrates them?
Lacrimal and Salivary glands | - infiltration of T & B lymphocytes
34
What auto-antigens are expressed in Sjogrens?
Ro & La
35
What are the 3 characteristics of primary sjogren's?
1. Reduced salivary production 2. Reduced tear production 3. Presence of autoantibodies (ro & la)
36
What is secondary sjogrens?
Primary sjo + autoimmune disease (RA, SLE, PA, Wegner's)
37
What are the factors leading to ADDE?
1. Non-Sjo/K.sicca 2. Sjogrens 3. Lacrimal Obstruction 4. Inflam. Lacrimal infiltration 5. Systemic Drugs
38
Trachoma causes what 3 things?
1. Tarsal and conjunctival scarring 2 Trichiasis 3. Cicatricial MG obstruction
39
WIT: Mucocutaneous disorder characterized by blistering of skin/mucous membranes
Cicatricial Pemphigoid
40
WIT: Acute, self-limiting mucocutaneous disorder usually caused by drugs, infection or malignancy
Erythema multiforme
41
What are the 4 types of lacrimal obstruction?
1. Trachoma 2. Cicatricial Pemphigoid 3. Erythema Multiforme 4. Chemical/Thermal Burns
42
What are the 4 things that can cause inflammatory lacrimal infiltration/damage?
1. Sarcoidosis 2. Lymphoma 3. AIDs 4. Graft vs. Host Disease
43
WIT: May present initially as dacryoadenitis; infiltration of lacrimal gland by sarcoid granulomata?
Sarcoidosis
44
Sjogren's patients are at an increased risk of developing what disease?
Lymphoma
45
What 4 categories of systemic drugs can cause ADDE?
1. Anticholinergics 2. Adrenergic Agonist 3. Diuretics 4. Anti-hypertensive
46
What 3 things can cause a reflex sensory block for making aqueous/tears?
1. Infective (HSV) 2. Corneal Surgery 3. Neutrophic Keratitis 4. Diabetes 5. CL wear
47
The severing of what 2 corneal nerves can cause sensory denervation?
LPCN & SPCN
48
Neurotrophic Keratitis is due to what type of injury?
CN V nerve or ganglion injury
49
What are the intrinsic causes of EDE?
1. MGD 2. Disorders of Lid 3. Low Blink Rate
50
Increased ocular surface exposure leads to an increase in evaporatation and resultant ___ ____?
Tear hyperosmolarity
51
What are some disorders leading to increased ocular surface exposure?
1. High myopia 2. Exophthalmos 3. Nocturnal lagophthalmos
52
Low blink rate is found in what disease?
Parkinson
53
What are the extrinsic causes of EDE?
Environments with increased air flow or low humidity | - increases tear osmolarity
54
What additional factors can lead to tear film instability?
1. Vitamin A def. 2. Topical drugs/preservatives 3. Allergic Conjunctivitis 4. Anterior Blepharitis
55
Why does Vit A. deficiency cause DED?
Vitamin A is needed for the development of goblet cells and expression of the glycocalyx mucin
56
What is a Bitot's spot?
Build up of keratin on the conjunctiva due to Vitamin A deficiency

Anterior Segment 2 (14 decks)

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