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Ophthalmology > kk > Flashcards

kk Flashcards

1
Q

What is the definition of ptosis?

A

Drooping of the upper eyelid to cover more than 2mm (1/6) of the cornea while the patient is looking forward.

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2
Q

What are the different causes of acquired ptosis?

A

Aponeurotic (most common acquired cause)

Neurogenic (Horner’s syndrome and 3rd nerve palsy)

Myogenic (myasthenia gravis)

Mechanical (large chalazion)

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3
Q

How is the degree of ptosis assessed?

A

Judged by the lid margin-corneal distance (MRD), which decreases in ptosis. Normal MRD is 4-5mm.

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4
Q

What are the different types of ptosis and their respective causes?

A

-Congenital (simple): Due to dystrophy of the levator muscle, poor levator contraction, and poor relaxation. Associated with anomalies such as weak superior rectus muscle and Marcus Gunn phenomenon.

-Neurogenic: Associated with 3rd nerve palsy and Horner’s syndrome.

-Myogenic: Associated with myasthenia gravis.

-Trauma can cause aponeurotic, myogenic, or neurogenic ptosis.

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5
Q

What are the suitable surgical procedures for ptosis with good and poor levator action?

A
  • Good levator action: Resection
  • Poor levator action: Frontalis sling
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6
Q

What are the complications of unilateral severe ptosis?

A

Amblyopia and squint

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7
Q

Why can mild bilateral ptosis be managed conservatively until the age of school?

A

Full development of muscles can lead to spontaneous improvement.

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8
Q

How can trauma cause ptosis?

A

Trauma can cause aponeurotic, myogenic, or neurogenic ptosis.

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9
Q

What type of ptosis can be mistaken with myogenic (myasthenia gravis) ptosis?

A

Involutional (senile) ptosis, which worsens at the end of the day due to fatigue of Muller’s muscle.

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10
Q

What is the most important extraocular muscle to be examined during EOMs examination and why?

A

Superior rectus, because it shares a common embryological origin with the levator, they both share the same common sheath, and have the same nerve supply.

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11
Q

What is squamous blepharitis?

A

Chronic inflammation of the lid margin characterized by scales

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12
Q

What is ulcerative blepharitis?

A

Chronic inflammation of the lid margin characterized by ulcers.

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13
Q

Etiology

A

The cause or set of causes of a disease or condition.

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14
Q

Organism

A

The specific microorganism responsible for causing a disease.

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15
Q

Predisposing factors

A

Factors that make an individual more susceptible to a disease or condition.

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16
Q

Symptoms

A

Subjective evidence of a disease or condition as perceived by the patient

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17
Q

Signs

A

Objective evidence of a disease or condition as observed by a healthcare professional.

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18
Q

Complications

A

Additional medical conditions or adverse effects that arise from a primary disease or condition.

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19
Q

Why should we rub antibiotic ointment well into the lid margin?

A

Because the organism is hidden in the lash root.

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20
Q

Entropion

A

Rolling in of the lid margin

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21
Q

Ectropion

A

Rolling out of the lid margin

22
Q

Which lid is more affected by all types of entropion & ectropion?

A

Lower eye lid

23
Q

Congenital, Cicatricial (conjunctival fibrosis)

A

Causes of entropion

24
Q

Causes of ectropion

A

Congenital
Cicatricial (fibrosis of skin)

25
Q

Types of Cicatricial causes for entropion

A

Trachoma (most common)
Post-operative
Chemical injuries
Ocular cicatricial pemphigoid

26
Q

Types of cicatricial causes for ectropion

A

Burns, Post-operative (blepharoplasty)

27
Q

Causes of Involutional (senile) entropion

A

Horizontal laxity of lid tissue, vertical laxity

28
Q

Causes of Involutional (senile) ectropion

A

Horizontal laxity of lid tissue

29
Q

Causes of Mechanical ectropion

A

Large chalazion

30
Q

Causes of 7th nerve palsy leading to ectropion

A

Paralysis of orbicularis oculi

31
Q

Symptoms of entropion and ectropion

A

Foreign body sensation
Lacrimation
Photophobia
Blepharospasm
Disfigurement

32
Q

Complications of entropion and ectropion in conjunctiva

A

Ulceration
Keratinization
Chronic conjunctivitis

33
Q

Complications of entropion and ectropion in cornea

A

Corneal ulceration (most dangerous)

Vascularization and opacification

Conjunctival exposure

Corneal exposure&raquo_space; ulceration in lower 1/3

34
Q

Treatment for Cicatricial entropion

A

Replacing the shortened conjunctiva by a mucus membrane graft

35
Q

Treatment for Cicatricial ectropion

A

Replacing the shortened skin by skin graft from behind the ear

36
Q

What is a Hordeolum extremum?

A

A style

37
Q

What is a Hordeolum Internum?

A

An infected chalazion

38
Q

Hordeolum extremum def

A

Acute suppurative infection of zies gland

39
Q

Hordeolum Internum def

A

Acute suppurative infection of meibomian gland

40
Q

Complications of chalazion

A

Infection (hordeolum Internum)

ptosis (if large chalazion on upper lid)

ectropion (if large chalazion on lower lid)

astigmatism (if pressing on globe),

malignant transformation

41
Q

Hordeolum

A

Acute suppurative infection of hair follicle or zies gland (extremum or style)

42
Q

Chalazion

A

Chronic lipo-granulomatous infection of meibomian gland

43
Q

Symptoms of Chalazion

A

Painful, red swelling at lid (for chalazion)

painless lid swelling (painful if infected),

cosmetic disfigurement

44
Q

Treatment of Chalazion

A

Rarely surgical drainage is needed, oral and systemic antibiotics + hot foments, control of diabetes, rarely spontaneous resolution, incision and cottage from conjunctival side (vertical)

45
Q

What are the predisposing factors for Hordeolum?

A

Malnutrition & hypo-vitaminosis
old age
diabetes mellitus

46
Q

What are the local predisposing factors for Hordeolum?

A

Eye strain due to uncorrected errors of refraction, lack of sleep

47
Q

What are the general treatment options for Hordeolum?

A

Systemic antibiotic
topical antibiotics
horizontal incision

48
Q

What is the related organism to lash root?

A

Staph aureus

49
Q

What are the signs of Chalazion?

A

Localized lid swelling, not tender, not attached to skin (firm, well defined)

50
Q

What is the extra information about Chalazion?

A

Chalazion is better palpated than seen, less attached to skin, firm and well defined

51
Q

What are the complications of Hordeolum?

A

Madarosis (loss of eyebrows or eyelashes)

cavernous sinus thrombosis

orbital cellulitis

Ophthalmology (3 decks)

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