KMK (Missing Optics and Pharm) Flashcards
Information is based on my knowledge
Lupus
- Butterly rash (malar rash)
- Dry eye
- High ANA ratio
- 10 to 1 in females
- 20 to 30 years of age
RA
- Morning joint pain
- Scleromalacia perforans (necrotizing scleritis without inflammation)
- Articular cartilage
- Females, ages 40 to 50
- Positive RF Test
JIA
- Females (ages 6 and below)
- Similar findings as RA, but have Uveitis
- A negative RF factor, but positive ANA factor
- Chronic, bilateral, non-granulomatous anterior uveitis
- Low grade fever
Sjogren’s syndrome
- dry mouth, arthritis, dry eye
Sarcoidosis
- African American Female
- Positive ACE test, chest X-ray
- Anterior granulomatous uveitis
- Bell’s palsy
- Vasculitis and Vitritis
- Dacryoadenitis
Ankylosing Spondylitits
- Bamboo spine
- Sacroilititis
- Uveitis
- aortic regurgitation
- Sacroiliac x-ray
- HLA-B27 testing
Reactive Arthritis (Reiter’s Syndrome)
- Can’t See, Can’t Pee, and Can’t Climb a Tree
- Uveitis
- Urethritis
- Arthritis
- Low Grade Fever
- Young males
- HLA - B27
Psoriatic Arthritis
- Joint pain with psoriatic lesions around knees, elbows and scalp
- Anterior Uveitis
- HLA- B27
- TX UV - B light exposure and methotrexate
Behcet’s Disease
- Recurrent Acute Hypopyon
- Recurrent oral aphthous ulcers
HIV and AIDS
- CD4 T cells: lower than 200 = AIDS
- ELISA: Screener
- Western Blot: Confirms ELISA
- CMV
- Pneumocystic Pneumonia
- Mycobacterium TB
- Karposi Sarcoma
Sturge Weber Syndrome
- Facial capillary malformation
- Port Wine Stain
- Glaucoma
- Neurological issues on the affected side of port wine stain
- Vascular issues of the eye
Tuberous Sclerosis
- Benign tumors grow in the brain
- Astrocytic Hamartoms
- Ash leaf spots (hypopigmented macules)
Down Syndrome
- 21st Chromosome
- Mental Retardation
- Epicanthal folds
- Congential Cataracts
- Glaucoma
- Strabismus
- Keratoconus
Von Hippel Lindau Disease
-Retinal Angioma (Can cause a RD, Glaucoma and loss or vision)
Marfan’s syndrome
Ectopic Lentis (Superior Temporal)
Huntington’s Chorea
- 30 to 50 year old
- Abnormal EOM’s
- 15 to 20 year survival rate
Familial Adenomatous Polyposis (FAP)
- Gardner’s Syndrome
- Multiple CHRPE’s
- Polyps on the colon post-puberty
Name 3 AR systemic conditions.
1) Sickle Cell Anemia
2) PKU (Phenylketonuria)
3) Tay Sach’s
Name 2 X-linked genetic disorder’s
1) Fabry’s - lipid deposit in blood vessels
2) Duchenne Muscular Dystrophy
Osteogenesis Imperfecta
- Blue Sclera
- Keratoconus
- Megalocornea
Prenicious Anemia
B12 Deficiency
Hodgkin’s Lymphoma
- Reed Sternberg cells
- Epstein Barr Virus (50% cases are associated)
- If diagnosed early, good prognosis
Non-Hodgkin’s Lymphoma
- Abdominal pain
- Bone marrow biopsy to determine T or B cell types
What type of cells is pre-dominate in Acute Leukemia?
Blast cells
Acute Myeloblastic Leukemia (AML)
- Infants and middle aged or older
- Normal WBC count w/ excessive myeloblasts
- Auer Rods seen within leukemic cells in the blood
Acute Lymphoblastic Leukemia (ALL)
- Peak age is 2 to 10 years
- Normal WBC count with lymphoblasts
Retinal hemorrhage with a white spot
Roth spot
a) Leukemia
b) Endocarditis
Chronic Myelocytic Leukemia (CML)
- 25 to 60 year old
- Poor prognosis 3 year survival
- WBC count 50,000 to 300,000 with increase granulocytes
- Philadelphia chromosome
Chronic Lymphocytic Leukemia (CLL)
- Greater than 50 years of age
- Male
- WBC count of 20,000 to 200,000 mature small lymphocytes
- 5 to 10 year survival rate
What is Virchow’s triad?
Theory of Venous Thromboembolism (VTE)
a) Alteration in blood flow (stasis)
b) Vascular endothelial injury
c) Alterations in the constituents of the blood through an inherited or acquired hypercoaguable state.
Venous thrombosis occurs most commonly in what 3 areas?
- Deep leg veins
- Heart
- Lungs
Arterial Thrombosis occurs most commonly in what 3 areas of the body?
- Brain
- Spleen
- Kidneys
What causes Anaphylactic shock?
Histamine release
What is the suspect of pupil involving CN III palsy?
Aneurysms
What are the lab results tell you with someone with Arthersclerosis?
High LDL
High CRP
Low HDL
What should WNL of total cholesterol?
200
What is the WNL of HDL?
40 or higher
What is the WNL of LDL?
130 or less ; if heart disease then 100
What is the WNL of triglycerides?
150 or less
What medication should be given if a pt has a MI?
325mg of Aspirin
Which eye will be impacted if Cartoid Artery disease is detected?
Ipsilateral.
Symptoms: Amaurosis fugax or complete loss of vision.
Sign: High pitched Bruit over the artery
What are 2 choroid findings associated with HTN?
- Siegrist streaks
- Elschnig spots
What stage do you find Papilledema when associated with HTN?
Stage 4
What happens in Left side heart failure?
Pulmonary edema ; fluids fills into lungs
What is the common cause and symptoms associated with Left CHF?
Ischemic Cardiomyopathy ; shortness of breath
What happens in Right CHF?
Inability to pump into the lungs and causing edema in abdomen and legs.
What is the common cause and symptoms in Right CHF?
Left CHF ; Pulmonary HTN, COPD and Right side MI’s.
What is the culprit for Rheumatic fever and what other 2 systemic conditions is it associated with?
Strep Pyogenes (Hemolytic streptococci) ; Reactive Arthritis and JIA
What does Rheumatic fever do to the heart?
Alter the heart valves ; usually mitral valve
What lab test will give you re-assurance its Rheumatic fever?
ESR testing
What are the signs and symptoms of a Cartoid Artery TIA?
- Contralateral hand.arm weakness
- Sensory loss to face or leg
- Ipsilateral Amaurosis fugax
What are the signs of a Vertebrobasilar TIA?
- Diplopia
- Unilateral or Bilateral visual loss
- Ataxia
- Vertigo
- Dysarthria
What kind of cardiovasulcar issue can spare the macula or involve it?
Stroke
If a stroke has happened, the macula is spared. What brain structure has been impacted?
Occipital lobe ; Middle or Posterior cerebral artery but NOT BOTH!
What type of testing is needed to determine size and location of a stroke?
CT scan
Macula only Homonymous Hemianopsia occurs due to?
Occlusion ; macula cortex blood supply has occurred due to a tumor
Most common type of stroke?
Ischemic ; Usually Embolism of an Arthersclerotic plaque
What is the most common type of hemorrhagic stroke?
Subarachnoid Hemorrhage
What ocular finding is associated with a subarachnoid hemorrhage?
CN III palsy w/ Pupil involvement
What does the Anterior Cerebral artery supply?
Frontal lobe
What does the Middle Cerebral artery supply?
- Frontal lobe
- Lateral surfaces of the Temporal Lobe
- Lateral surfaces of the Parietal lobe
- Occiptal lobe
What does the Posterior Cerebral artery supply?
- Temporal lobe
- Occipital lobe
If the Anterior Cerebral artery impacts the frontal lobe, what is processes are impacted?
- Logical thought
- Personality
- Voluntary movement
If the Middle Cerebral artery impacts the 4 lobes, what processes are impacted?
- Primary motor of the face
- Primary sensory of the face
- Throat
- Hand and arm
- Speech
- Vision
What are the signs, when the posterior Cerebral artery is impacted?
- Contralateral hemiplegia
- Hemianopsia
- Color Blindness
- Verbal Dyslexia
- Opposite visual field defects
What are the signs associated with a Cluster headache?
- Red eyes
- Nasal stuffiness
- Transient or Permanent Ipsilateral Horner’s Syndrome
What is the classic triad for Meningitis?
Fever
Headache
Neck stiffness
What is the most common primary malignant brain tumor?
Glioblastoma Multiforme
What is the most common benign brain tumor?
Meningioma
Which is the most common type of a functional pituitary adenoma?
Prolactin Secreting tumor
What type of visual field defect is common with a Pituitary Adenoma?
Bitemporal Hemianopsia
What are the ocular findings associated with Guilliam Barre?
- Adie’s Tonic
- Diplopia
- Facial Diplegia
- Papilledema
What type of tumor is associated with MG?
Thymoma (Thymic tumor)
What type of deposits are associated with Alzheimer’s?
Amyloid
What is the classical triad for Parkinson’s?
TRAP Tremor at rest Rigidity Akinensia Postural Instability
Which artery is impacted when a Epidural Hematoma occurs due to trauma?
Middle meningeal artery
What is the triad for Horner’s syndrome?
- Ptosis
- Miosis
- Anhydrosis ; absence of sweating on involved side
Which type of cells are destroyed in DM I?
Beta cells
What is lacking in Diabetes Insipidus?
ADH
What are the lab findings associated with Hypothyroidism?
- Increased TSH
- Decreased T3 and T4
What are the 2 main findings in Graves Ophthalmopathy?
1) Proptosis
2) Upper lid retraction
Hyperparathyroidism is marked by ________?
Hypercalcemia
What are the 3 ocular findings associated with Hypothyroidism?
- Cataracts
- Uveitis
- Blurry vision
What is the triad for Cushings?
- Moon face
- Buffalo hump
- Obesity
What is occurs in Acute Renal Failure?
Decreased GFR
Increase BUN
Increased Creatinine
What systemic condition is commonly associated with Chronic Renal Failure?
Diabetes
Nephrotic syndrome is associated with what product in the urine?
3.5 grams of protein
What is the ocular presentation in Chlamydia?
Inferior palpebral follicles
What do you treat Chlamydia with?
Azithromycin or Doxycyline
What does an ocular infection of Gonorrhea present?
Severe, Hyperacute and purulent discharge
What type of test confirms Herpes Simplex and which type of cells?
Wright-Giemsa stain and Multinucleated giant cells
What is the culprit in Syphilis?
Treponema Pallidum (Spirochete)
At what stage may the eye become involved in regards to Syhphillis?
Secondary
At what stage of Syphillis does the pupil become involved, what is the name of condition and signs?
Tertiary ; Argyll Robertson ; Bilateral CONSTRICTED pupils, with good response to accommodation.
What are three tests you could do for Syphillis?
a) Rapid Plasma Reagin (RPR)
b) Venereal disease research laboratory (VDRL)
c) Enzyme immunoassay (EIA)
What are 3 good diagnostic tests for syphillis?
a) FTA-ABS
b) TPPA
c) MHA - TP
RPR-VDRL is negative but FTA-ABS is positive what does that mean?
FTA-ABS - pt had syphillis at one point in life.
RPR and VRDL - displays that if it is active or not.
Which medication causes floopy iris due to BPH?
Tamsulosin (Flomax)
What test indicates prostate cancer?
PSA
What 2 ocular conditions are associated with Wilson’s Disease?
- Sunflower cataract
- Kayser-Fleischer Ring
What is the medication used in Wilson’s Disease?
Cuprimine (Penicillamine)
What are the 3 major ocular side effects of Cuprimine?
- Ocular MG
- Ocular Pemphigoid
- Optic Neuritis
How is Hepatitis A acquired?
Fecal oral route
How is Hepatitis B acquired?
Blood, IV drugs and Sex
What is the Triad for Cholecystitis (Gall bladder inflammation)?
- Pain in right upper quadrant after meals
- Overweight females of child bearing age
- Murphy’s sign (Palpation hypersensitivity)
What is the leading cause of COPD?
Smoking
Pink puffers are for?
Emphysema
Blue bloaters are for?
Chronic Bronchitis
What is retinal finding in regards to TB?
CME
Carcinomas arise from what type of cells?
Epithelial cells
Sarcoma’s arise from what type of tissue?
Mesenchymal
What is the optic neuropathy sign for Alcoholism?
Toxic optic neuropathy = Bilateral temporal optic nerve pallor
Most common Alkali solution?
Sodium Hydroxide
What ocular findings are we worried about with someone who had a chest compression injury?
Purtscher’s Retinopathy
- Cotton Wool spots
- Exudates
- Diffuse Retinal Hemorrhages
Which sinus is commonly associated with Orbital Cellulitis?
Ethmoid
Most common agent in ADULT Orbital Cellulitis?
Staph Aureus
Most common agent in CHILD Orbital Cellulitis?
H. Influenza
What signals a Orbital Cellulitis vs. Preseptal Cellulitis?
Orbital will have: Decrease vision Pain on eye movement EOM restricition Proptosis
What is the strongest correlation of Thyroid ocular conditions?
Cigarettes
What are not impacted in Thyroid disease when evaluating EOM’s?
Tendon’s
Note: Psuedotumor - Involves EOM’s
What is the triad for Cartoid Cavernous Fistula?
Chemosis
Pulsatile Proptosis
Ocular Bruit
What is the most common cause of Steven Johnson Syndrome?
Medication - typically Sulfonamides
What is Meige’s syndrome?
BEB and lower facial abnormalities
Which muscle is impacted during Myokymia?
Orbicularis Oculi
What are the signs of Basal Cell Carcinoma?
- UV exposure
- Occasionally bleeds and won’t heal
- Fair skin
- Increased sun expsosure
- Central ulceration
- Shiny, Firm pearly nodule with superficial telangiectasia
Which carcinoma is more common?
BCC (40 times more)
Which carcinoma is more aggressive?
SCC
What is the biggest way to differentiate between SCC and BCC
BCC will have surface vascularization while, SCC does not
What is the classical presentation of Acute Dacryoadenitis?
S-shaped ptosis
Which race tends to be predominant with Conjunctival Melanoma’s?
Caucasian
What organ is the most common metastasis from, in regards to Conjunctival melanoma?
Liver
CIN is associated with what type of carcinoma?
Squamous Cell Carcinoma
What are 2 signs that are NOT associated with Bacterial Conjunctivitis?
Corneal signs
Lymphadenopathy
What type of testing diagnosis is needed for Gonoccal Conjunctivits?
Thayer-Martin agar
What is the triad for PCF?
- Low Grade Fever
- Follicular Conjunctivitis
- Phyrangitis
Note: Swimming is usually associated with PCF
Important findings associated with EKC?
- Pain
- Corneal involvement
If a contact lens rides to high, what does that usually mean?
CTL Warpage
What is the NaFl staining pattern when the CTL’s rides too low?
3 to 9 o’clock staining
Superior Arcuate Epithelial Lesion (SEAL) is due to what CTL issue?
Tight fitting Hydrogel CTL
What is the most common culprit for Phylectenular Keratoconjunctivitis?
Blepharitis
Note: Most common in female teenager
Which layer of the conjunctiva is impacted in a pterygium/pinguecula?
Conjunctival stroma
Which layer is disrupted in a pterygium?
Bowman’s
What medication is used to determine episcleritis vs. scleritis?
Phenylephrine
What is the early sign in Keratoconus?
Fleicher’s ring
Where is the initial break in Keratoconus?
Bowman’s
Which layer do Vogt straie reside?
Stroma
Corneal hydrops occur in which layer?
Descemet
Haab Straie occurs in which layer?
Descemet
Culturing a fungus should be done with what test?
Sabourds Agar
What type of hypersensitivity is Staph Marginal Keratitis?
Type III
Salzmann plaques are derived of?
Hyaline
Band Keratopathy deposit is located?
Bowman’s (Anterior portion)
Which refractive surgery is known to create a hyperopic shift?
RK
What are the golden refractile particles in Synchisis Scintillians?
Cholesterol crystals
Where do BRVO’s occur the most?
Superior temporal
What is 90 day glaucoma?
Neo occuring in the angle after 90 days of the incident of CRVO
Which retinal vessels are autoregulated?
Arteries
What is the most common retinal atropy?
Retinitis Pigmentosa
Glaucomflecken causes what type of cataract?
ASC
What is the greatest threat during Acute Angle Closure?
CRAO
What signs occurs during Uveitic Glaucoma?
Iris Bombe
What type of bond is between the cornea and glycocalx?
Covalent
Where is the rRNA produced?
Nucleolus
Which cells in the body are multinuclear?
Osteocytes and Skeletal muscle cells
What is the most abundant protein in the blood stream?
Albumin
What are the most to least common WBC’s?
Neutrophils Leukocytes Monocytes Eosinophils Basophils
Never Let Monkey’s Eat Banana’s
What is the hepatic triad?
Hepatic Artery
Portal Vein
Bile Duct
What does the Frontal lobe give personality?
Speech
Broca’s area (Frontal lobe); if impacted what will happen?
Speech issues
What happens when Wernicke’s is impacted? (Temporal lobe)
Word’s wont make sense
MLF and coordination of the VOR is done where?
Upper medulla
Where is respiration and sleep coordinated?
PONS
Where is the red nucleus located in the brain?
Upper midbrain
What gives rise to the diencephalon and cerebral hemispheres?
Forebrain
Sleeping behaviour, eating and body temperature is conducted by?
Hypothalamus
Which papillitis condition is considered reversible ischemia?
Diabetic Papillopathy
Syphillis can cause what pupillary condition?
Argyll Robertson
Neuroretinitis is most commonly associated with?
Cat Scratch Disease
What is the pathophysiology of an INO?
Defect in MLF
What is the sign of a INO?
Lack of adduction on the affected side and a nystagmus on the contralateral side
Most common intrinsic tumor of the ON?
Optic Nerve Glioma
Where is the most common area of impact with Orbital Cavernous Hemangioma?
Muscle cone posterior to the globe
What happens to the visual acuity in Papilledema?
Enlarged Blind spot
What is malignant HTN?
200/120
Which CN is impacted in IIH?
CN 6 ; causing an eso deviation
What type of VF defect is seen in Toxic neuropathy?
Centrocecal or central ; you’ll see temporal pallor
3 types of orthograde degeneration?
- PRP
- CRAO
- RP
What is the classical example of a retrograde degeneration?
Pituitary tumor
What is the VF defects (2) from a pituitary tumor?
Bitemporal Hemianopsia and Junctional scotoma
Where is the lesion in Foster Kennedy symdrome?
Frontal lobe
In a horner’s syndrome patient, if cocaine was instilled into the affected eye, what will happen?
No response.
Normal pupil will have a dilation occur
What would Hydroxyamphetamine do in a Horner’s patient?
Preganglionic: Pupil dilation
Postganglionic: No dilation
What are the 3 conditions associated with Argyll Robertson?
- Neurosyphillis
- Diabetes
- Alcoholism
What are the signs of Argyll Robertson?
- Miotic pupil
- Light-near dissociation (Light won’t constrict pupils but will with convergence and accommodation)
If you notice a CN3 palsy, without pupil impact, what is the follow up time frame?
1 week
What other symptom is associated with Adie’s Tonic?
Diminished deep reflex tendon
What Rx is need to diagnosis Adie’s Tonic?
0.125% Pilocarpine
Dilated pupil but with 0.125% Pilocarpine is constricts….what is the condition?
Adie’s Tonic
Dilated pupil and does nothing with 0.125% Pilocarpine. 1% pilocarpine causes constriction…what is the condition?
CN 3 Palsy
Dilated pupil and does not react to 0.125% and 1% pilocarpine… what is the condition?
Iris sphincter tear or pharmacologic dilation
What are the parasympathetic innervated items associated with the inferior division of CN3?
- Iris Sphincter
- Ciliary muscle
Pt comes in with CN4 palsy and a head tilt to the left. Which side is the lesion?
Right CN 4 Palsy
Lesion is on the opposite side away from the head tilt
A pt has a Thymoma, which condition is associated?
Myasthenia Gravis
Superior Tarsal AKA Muscle of Mueller is innervated by which system?
Alpha 2 - Sympathetic
Which layer of the conjunctiva has IgA and Lymphoid tissue?
Stroma
Which facial muscle is associated with showing aggression?
Procerus
Pulls the eyebrow muscles together
Which ganglion does the lacrimal gland recieve innervation from?
Pterygopalatine ganglion
What keeps the puncta open?
Lacrimal papilla
The nasolacrimal duct is adjacent to which structure?
Maxillary sinus
Which 2 EOM’s create the Ligament of Lockwood?
IO and IR
Where does the superior oblique originate?
Lesser wing of the Sphenoid and CTR
The superior lateral branch of the Ophthalmic artery supplies what EOM’s?
SR, SO and LR
The inferior lateral branch of the Ophthalmic artery supplies what EOM’s?
MR, IO and IR
Which Vein and 3 nerves travel through the SOF but above the CTR?
Superior Ophthalmic Vein
- Lacrimal Nerve
- Frontal Nerve
- Trochlear Nerve
What passes through the inferior orbital fissure and CTR is?
Inferior Ophthalmic Vein
The facial artery comes off the external carotid artery. What are the 3 terminal branches of the facial artery?
- Superficial temporal artery
- Maxillary artery
- Angular artery
What branch of the facial artery supplies the medical canthus?
Angular artery
What branch of the external carotid, gives way to another branch which supplies the IR and IO?
Maxillary Artery –> Infraorbital branch –> IOF –> IR and IO
What does the Infraorbital branch of the maxillary artery supply, name 4.
- IR
- IO
- Lower eye lid
- Lacrimal sac
What are the 2 vascular supply for MACI?
Long Posterior Ciliary Artery (LPCA)
Anterior Ciliary Artery (ACA)
What do the SPCA’s supply?
Macula and Choroid
What provides blood to the ON?
Circle of Zinn
What do the LPCA’s supply?
Anterior Choroid
Iris
Ciliary Body
What terminal branch of the OA supplies the Lacrimal Sac?
Dorsal Nasal Artery
What are the 4 structures where the Anterior Ciliary Vein takes blood away from?
- Iris
- Ciliary Body
- Conjunctiva
- Schlem’s Canal
Where does the blood supply from the CRV go to?
ONLY Superior Ophthalmic Vein
Where does the inferior branch of the inferior ophthalmic vein drain into?
Pterygoid Plexus
Where does the superior branch of the inferior ophthalmic vein drain into?
Cavernous Sinus
Which is the only layer of the cornea that has zonula occludens?
Superficial layer
What layer of the cornea increases with age?
Bowmans
What 3 conditions are associated with limbal stem cell deficiency?
- Aniridia
- SJS
- Alkali corneal burn
What type of collagen resides in Bowman’s?
Type 1
What type of collagen resides in the Stroma?
Type 1
Where does the orbital vein drain in to?
Middle temporal vein
Where does the common facial vein drain into?
Internal jugular vein
What has he strongest impact on corneal diopter?
air/tear film medium
What are the 3 H’s that occur in Descemet’s?
- Hassall Henle Bodies
- Haab’s Straie
- Hydrops
When the eyelids are closed, where does the cornea get its oxygen from?
Conjunctival vessels
What does the superficial conjunctiva carry, name 3.
- Microvilli
- Goblet cells
- Melanin Granules
Where are the Goblet cells densest?
Furthest away from the limbus
What is the thickest Basement membrane in the body?
Lens Capsule
What are the 2 main products the lens capsule is made of ?
GAG’s
Type 4 collagen
Where are the water crystallins located in the lens?
Lens Cortex
Note: Alpha, Gamma and Beta
What are the 2 areas of the sclera that hold elastin?
Scleral spur and Lamina Cribrosa
Anteriorly displaced Shwalbe’s line is considered what condition?
Posterior Embryotoxin
What Iris layer provides the definitive color to the Iris?
Anterior border layer
Vortex veins are located in what layer of the Choroid?
Haller’s
What is the vitreous composed of?
Hyaluronic acid
Type 2 collagen
The vitreous has what predominat type of cell and which layer are they located in?
Hyalocytes ; Vitreous Cortex
Which portion of the PR has mitochondria?
Ellipsoid
Which portion of the PR displays protein synthesis?
Myoid
At what wavelength does rhodopsin absorb light?
507 nm
Where does the first synapse in the visual system occur?
OPL
Note: OPL is the only layer that has a dual blood supply and is also the Henle’s layer
Lateral inhibition occurs with what retinal cell?
Horizontal cell
Which types, rods or cones, are not in the foveola. Pick 2.
Rods and Blue cones
The boundary between the fovea and parafovea is called?
Clivus
Cranial 10 palsy, Vagus nerve (Uvula), will deviate which side?
AWAY from the side of the lesion
Cranial 12 palsy, Hypogloassal (tongue) will deviate towards which side?
SAME side of the lesion
Left CN 3 palsy will lead to defect to which SR?
Right ; note it is contralaterally displaced
What is the sensory and motor innervation of the lacrimal gland?
Sensory: Lacrimal nerve V1
Motor: Zygomatic branch of the CN 7
A CN6 palsy, will display what type of sign?
Head towards the lesion
Which branch of CN 7 innervates the Orbicularis Oculi
Zygomatic
Removal of an acoustic neuroma, will result in the paralysis of?
The Parotid gland
Other than the Retina autoregulting its blood, what other structure does the same?
ON
A macula only VF defect is usually caused by?
a tumor
When does accommodation mature?
3 months
When does the vergence system mature?
2 months
When does stereopsis mature?
6 months
Grating acuity matures when?
3 to 4 years
Vernier acuity matures when?
6 to 8 years
Other than accommodation, vergence, and stereopsis, when do the visual attributes mature?
4 months
What is the most common type of color defect in the elderly?
Blue Yellow defects
What is the most difficult movement in the elderly?
upgaze
Where does glycolosis occur in the cell?
cytosol
What are the 2 processes that occur in the mitochondira?
Kreb’s cycle and Oxidative Phosphorylation
What is the medication to treat CMV?
Vitravene
Corneal ulcers and pediatric bacterial conj, is caused by?
Strep Pneumoniae
Corneal ulcer due to CTL wear is usually what rod?
Pseudomonas Aeruginosa
Otitis media which is often seen in conjunction with conjunctivitis?
H. Influenza
Ophthalmia neonatrum is associated with what STD?
Chlamydia
What is the triad for Ricketts?
Fever
Headache
Rash
What type of interferon is used to treat MS?
Beta Interferon
How do you treat chronic granulomatous ? Interferon?
Gamma
What are the first antibodies that reach the antigen’s?
IgG and IgM
Systolic pressure is based on?
Contraction of the ventricle
Based on QT on EKG
Diastolic pressure is based on?
Relaxation of the ventricles
Based on TR on EKG
What is the most potent vasoconstrictor in the body?
Aniotensin II
Which hormone regulates water retention?
ADH (Vasopressin)
Which CAI works on the PCT and possibly cause metabolic acidosis?
Acetazolamide
What is the only thing that leaves the DCT?
Water
What does not leave the ALOH?
Water
Which area of the Kidney does Furosemide work on?
Ascending loop
Where does HCTZ work on the kidney?
DCT
Which pitutary gland hormone has a diabeticogenic effect?
Growth Hormone
What is the main function of ADH?
Blood volume regulation
Which hormone regulates milk ejection?
Oxytocin
Which hormone is related to Diabetes Insipidus?
ADH deficiency
Where is the highest concentration of calcium intracellular and extracellular?
Intracellular: Mitochondria
Extracellular: Bones
What are 2 glucocortico steroids?
Cortisol and Corticosteroid
What are 2 mineral corticosteroid?
Aldosterone and Deoxycorticosterone
What GI organ is associated with second pass metabolism?
Rectum
What is the term for regular blinking, in the aid for tear film?
Spontaneous blinking
Auditory reaction is done by which CN and what type of blink?
CN 8 ; reflex
Which CN is impacted during a reflex blink, when something touches the cornea?
CN 5 ; Nasociliary of the Ophthalmic branch of the Trigeminal
Which portion of the Orbicularis is responsible for reflex?
Palpebral
What type of secretion is meibomian gland lipid release?
Holocrine
Which layer of the tearfilm is moved laterally by the upper eyelid??
Mucin layer
Through what system do the tears follow into the puncta?
Capillary attraction
What is the thickness of the tearfilm?
3um
What is the function of lyzozyme in the tear film?
Cleaves peptidoglycan of bacteria
What is the function of lactoferrin in the tear film?
Cheleats Fe2+ ; which is essential for bacteria
What is the function of Beta lysin in the tear film?
destroys bacterial membrane
Which aqueous producing items, assist in maintainence tears?
Krause and Wolfring
What is a higher concentration in the tears vs. blood plasma?
Potassium
Angular VOR movements are conducted at?
Semi-circular canals
The saccula and utricle are located in the Vestibulea. What are their functions?
Saccule: Verticle linear movement
Utricle: Horizontal linear movement
Saccades are controlled by the _______?
CONTRALATERAL Frontal eye field
Pursuits are controlled by________?
IPSILATERAL Parietal lobe
Where is vergence controlled?
Brainstem
Which wavelength is 99% transmitted through the cornea?
400nm
Which UV causes welder’s flash?
UV-C
Movement of what ion into the Aqueous, will result in Cl- going to the tear film?
K+
What is the minimum partial required for the cornea?
15 to 20 mmHg ; the atmosphere O2 PP is approx 150 hhmg and when sleeping it goes down to 55mmHg
Which layer of the cornea stores glycogen the most?
Epithelium
Which 2 layers of the cornea can not regenerate?
Endothelium and Bowman’s
What happens to the IOP when accommodatin kicks in?
Decreases
What is the primary oxidative protector in the lens?
Glutathione
What type of abberations are reduced based on a smaller pupil?
Chromatic and Spherical Abberations
Which layer of the Choroid increases with age?
Bruch’s membrane
What are the 3 graded potential cells in the retina?
Bipolar cells
Photoreceptors
Horizontal cell
Which types of retinal cells have lateral inhibition?
Horizontal cells
Binocular processing occurs?
V1
What is the EOG for abnormal finding?
lower than 1.80
What is a normal VEP response?
<90msec
Which pathway is an anisocoria impacted?
Efferent
How long does it take for the entire Aquoues to be replaced?
100 minutes
What is the object location formula?
l = n1/L
Note: n1 = index of medium in which light travels before striking the optical system.
What is the image location formula?
l’=n2/L’
What is the primary focal length formula of an SSRi?
f= (-)n1/F
What is the secondary focal length formula of an SSRI?
f’= n2/F
What is the apparent depth formula?
n1/l = n2/l’
What is the Equivalent Power formula?
Fe = F1+F2 - (t/n2)F1F2
Note: This formula is used when comparing a thin lens to a thick lens
What is the formula for back vertex power?
Fv= (F2) + (F1/1-(t/n2)F1)
What is an aperture stop?
Limits the amount of light passing into an optical system when viewing an object
What is a field stop?
Limits the SIZE of the object that can be imagined by the system
What is an entrance pupil?
Image of the aperture stop formed by lenses in FRONT of it.
What is an exit pupil?
Image of the aperture stop formed by lenses BEHIND it.
Where is the exit pupil located in a Galilean telescope?
Inside
Where is the exit pupil located in a Kaplerian telescope?
Outside
What is an entrance port?
Image of the Field stop formed in front of it
What is an exit port?
Image of the field stop formed by lenses behind it.
Which acuity aid do we use when assessing depth of focus when the issue is refractive?
Pinhole.
Pantoscopic tilt of minus lens occurs at what axis?
180
Note: plus lens are opposite
Faceform tild of a minus lens occur at what axis?
90
Note: plus lens are opposite degree
Formula to calculate the power of a mirror?
F=2n/r
What is the Munnerlyn’s equation for ablation depth per diopter?
I=(d^2)/3
d = ablation in mm
Malus law for incident light on a polarizer?
I=Intensity of the incident light / 2
Lensometer formula?
x = f^2 x Fv
Hand neutrilzation of a minus lens will display what type of motion?
With motion
Keratometer formula?
337.5/r
Lens clock formula?
F = (Lens - 1 / Lensclock -1) Power on the lens clock
Sag depth formula
((F1+F2)h^2) / 2n-1
Minimum Blank size formula?
M= ED + 2d +2mm
d= decentration per lens
Distortion can be minimized by what type of combination lens?
Orthoscopic Doublet
Prism Apex Angle formula
d=A(n-1)
Prism Power and thickness formula
Prism = (100g(n-1))/l
Shape factor formula?
1 / 1-(t/n)F1
Power factor
1/1-hFv
Transmittance formula?
Reflected= (n2-n1)^2 / (n2+n1)^2
Transmittance = 1-Reflected
Javals Rule
Arx = 1.25 x Astigmatism + (-0.50D x 090)
Usually the BC is changed, but if you increased the OZD by 1.2mm, how much should the BC changed?
Flatten by 0.75D
Note: Every 0.4mm in OZD change, 0.25D should be flattened of the BC.
When should a Bitoric design be recommended?
> 2.50 astigmatism and NOT equaling 1.5D corneal astigmatism
What is the best fit for ATR GP fit?
Saddle fit
When is a Back surface toric CTL used?
> 2.50 corneal astigmatism and equals 1.5 x corneal astigmatism
What is the function of prism ballasting?
Minimize CTL rotation during blinking
High water content, low silicone hydrogel = low permeability is what type of CTL?
SiHy
High water content = high permeability, what type of CTL?
Hydrogel
Which type of ametropia requires more accommodation with CTL’s on?
Myope
Which type of ametropia requires spectacle magnication while wearing CTL’s?
Myope
Which ametropia require more convergence with CTL’s?
Myope
What is the formula for magnifcation of a stand magnifer?
M=F/1 +1
Formula for telecope magnification?
M= -Ocular/Objective
What is the maximum magnification of a Galilean telescope?
4x
To get rid of accommodation in a telescope what should be put in front of the ocular lens?
Reading cap
What is legal blindness in the USA?
20/100 in the better seeing eye or 20 degree or less of of visual field diameter in the better seeing eye.
What are the 3 types of Duane’s retraction syndrome?
Type 1: aBduction
Type 2: aDduction
Type 3: Both
AC/A Ratio formula
AC/A = PD + NFD (Phoria at near - Phoria at distance)
PD: pupillary distance in CM
NFD: near fixation distance in METERS
Exo = +
Eso = -
Gradient AC/A
AC/A = (P1 - P2)/(S1-S2)
P1 and 2 = Phoria under 1st and 2nd condition
S1 and 2 = accommodative stimulus under condition 1 and 2
Sheards criterion formula
S=(2/3)D - (1/3)R
D= phoria demand R= reserve
BI = Exo BO = Eso
Percival’s criterion
P = (1/3)G - (2/3)L
G = Greater of the 2 ranges L = Lesser of the 2 ranges
Note: If (-) or zero; no prism is needed.
What is the most common type of Anisometroic Amblyopia?
Hyperopic Anisometropia
Which test is good for microstrabismus?
4 BO prism
During visuoscopy, you notice the center of the grid to be temporal to the FLR. What type of eccentric fixation?
Temporal eccentric fixation
Bagolini lens test reveals “/”. What does this mean?
OS supression
Bagolini lens test reveals “X”, what does this mean?
NRC if covertest shows no tropia
Bagolini lens test reveals “V”. What does this mean?
Esotropia with NRC or UARC
A strict criteria will have what type of threshold?
Higher than expected.
Which color defect is usually acquired?
Tritanope (Blue yellow defect)
What are the 2 monocular depth cues?
Pictorial depth cues and Motion parallax
Which of the 4 purkinje images is real and inverted?
4
Only one created by a concave surface
Sulfonamides
MOA: Inhibit dihyroPTEROATE (First step of folic acid)
Bacteriostatic
Gram + and -
Ocular: Blepharitis and Conjunctivitis
Ocular side effects: Contact Dermatitis, burning, stining, suburn around eyelids
Systemic: Pyri/Sulfa = treat Toxo ; Sulfa-Meth/Trimeth = Bactrim
Systemic side effects: Myopic refractive changes, SJS (conjunctival lesions), Kernicterus
Trimethoprim
MOA: Inhibit dihydroFOLATE reductase (second step of folic acid)
Gram + and - ; BUT BAD AGAINST PSUEDOMONAS
Combined with Polymixin B (Good against -) = PolyTrim
Systemic: Oral treatment of ocular Toxoplasmosis
TMP = Treats marrow poorly ; causes aplastic anemia, granulocytopenia and leukopenia
Bacitracin
- MOA: Stops Bacterial cell wall synthesis
- Bacterialcidal
- Gram + ONLY
- Blepharitis
- Ointment only
Penicillin
MOA: Transpeptidase inhibitor
Gram + and Gram -
Amoxicillin + Clacvulanic Acid = Augmentin
Dicloxacillin = Good against MSSA but not against MRSA
Sideeffects:Hypersensitvity reactions
SJSJ is associated with Amoxicillin
Birth Control Pills are ineffective when using Penicillins
Cephalosporin
MOA: Transpeptidase inhibitor -Gram + and - First gen (+) 2nd gen (+) and small (-) 3rd gen (+) and (-)
Cephalexin: Dacryoadenitis, Preseptal Cellulitis
-Never for MRSA
Ceftriaxone: IM for gonorrhea and Gonococcal conjunctivitis
Sideeffects: Hypersensitivity, thinning of blood
Fluoroquinolones
MOA: Inhibit DNA gyrase and Topoisomerase 4
Ocular: Corneal ulcer, corneal abrasion and bacterial conjunctivitis
Systemic: Cipro ; gram (-) urinary and GI infections. Moxi ; pneumonia, sinusitis, intra abdominal and skin infections
What is the major side effect of an ORAL FLQ?
Tendinitis
If a FLQ is unavailable for a sight threatening corneal ulcer, which ocular med is next in line?
Cefazolin
What is a major side effect of an Aminoglycoside?
SPK
Pt with renal failure, requires an antibiotic. Which one would you consider?
Doxycycline
Name 4 bacteriostatic agents?
- Tetracyclines
- Erythromycin
- Sodium Sulfacetamide
- Trimethoprim
Extended usage of Chloramphenicol can lead to ?
- Aplastic Anemia
- Optic Neuritis
Treatment for Chlamydial infections?
Azithromycin
What are the 3 recommended treating agents for MRSA?
- Bactrim
- Clindamycin
- Doxycycline
What are the 2 side effects of Rifampin?
- Orange tears or urine
- Exudative conjunctivitis
Side effect of Isoniazid?
Optic neuritis ; possibly due to neurotoxicity
Whic TB drug causes bilateral Retrobulbar Optic Neuritis?
Ethambutol
What are 2 ocular side effects found with Zidovudine (Retrovir)?
CME
Amblyopia
Which 2 Hep C medications display conjunctivitis as the most common side effect but retinopathy and retinal occlusions occur as well?
Ribavirin and Interferon
Which intraocular implant is used for CMV Retinitis?
Ganciclovir
If Ganciclovir fails for CMV, what is given next?
IV Foscarnet
What ocular condition is worsesome when a antifungal is ineffective?
Endophthalmitis
Risk of retinopathy for exceeding the usage of Plaquenil is at what amount?
400mg/day or 6.5mg/kg of body weight/day
What type of cataract forms from steroid usage?
PSC
Which NSAID causes Reye’s syndrome?
Aspirin
Which cold medication is “cautioned” to patients with high IOP?
Psuedophedrine
Which NSAID is useful, when a pt has gastric issues?
Celecoxib
Which second generation H1 blocker has a side effect of ocular gyric syndrome?
Cetrizine (zyrtec)
What is the most common peptic ulcer cause?
H. Pylori
Which H2 blocker causes gynocomastia and loss of libido?
Cimetidine
Which short acting B2 agonist are to be used in caution with IOP?
Metaproteronol
Albuterol
Levalbuterol
Terbutaline
Which type of bronicodilator is a cause of concern in narrow angle glaucoma patients?
Muscarinic Antagonist ; Ipratopium
Which immunosuppressant is a cause of concern for Opportunisitic infections and lymphomas?
Methotrexate
Which drug has the potential of causing crystalline retinopathy and whorl keratopathy?
Tamoxifen
Non-opoid analgesic that is an Agonist MU receptor?
Tramadol
Sumitriptan can cause what vasoconstrictive condition?
NAION
What are the 3 pigmentary affects do anti-psychotics cause?
- pigment on corneal endothelium
- anterior stellate cataract
- hyperpigmentation of the RPE
Side effect of Bromocriptine?
Pitutary Adenoma - Prolactin
What is an ocular side effect of Donepizil?
IOP lowering
Name 1 SSRI?
Fluoxitine (Prozac)
Which type of medication do you not give to suicical pts?
TCA’s (Amitriptyline, Imipramine)
MAOI’s and what grocery products can cause a lethal hypertensive crisis?
- Dried Meats
- Wine
- Cheese
Which medication causes choroidal swelling?
Topiramate
Why is metformin a first line oral med for diabetes?
It prevents hypoglycemia
What is the side effect of metformin?
Lactic acidosis
Which diabetic med is a cause of ocular concern?
Pioglitazone : can cause Macular Edema
Which medications cause cyanopsia or NAION?
Sildenafil
Which alpha 1 blocked is profoundly known to cause floppy iris syndrome?
Tamsulosin (Flomax)
Medications, such as Lisinopril, can cause what type of side effect?
Cough
Which cardiac medication is beneficial in patients with low tension glaucoma?
Calcium Channel blocker
Which drug work on the ascending LOH?
Furosemide
Which drug works on the early DCT?
HCTZ
What are 2 unusual side effects of HCTZ?
- Transient Acute Myopia
- Acute angle closure glaucoma
What works on the late DCT?
Spirnolactone ; also works on the collecting duct
What are the 3 ocular side effects of Digoxin?
- B/Y defect
- Retrobulbar optic neuritis
- Entoptic phenomenom
3 ocular findings associated with Amiodarone
- Whorl keratopathy
- NAION
- ASC lens deposit
Name the 7 side effects of Accutane?
- Dry eyes
- Blepharoconjunctivitis
- Pseudotumor cerebri
- lid edema
- color vision loss
- nyctolopia
- cataracts
What are the main side effects of Pilocarpine?
Browache, headaches and myopic shift
Which syndrome is associated with Atropine use?
Down syndrome
Fast onset and shortest duration for cycloplegia?
Cyclopentolate
Fast onset and shortest duration for mydriatic?
Tropicamide
What is a major side effect of Visine?
Fixed dilated pupil
What is the function of an alpha 2 agonist?
Increase uveoscleral outflow and decrease aqueous out flow
Names: Briminodine and Apraclonidine
Brimonidine is known to cause follicular conjunctivits, however which preservative decreased these signs?
Purite ; Alphagan-P
Major side effect of alpha 2 agonist (Brimonidine and Apraclonidine)?
Dry mouth
Which type of glaucoma medication that has a crossover effect?
Beta blocker
Which systemic conditions, pick 2, can be masked by Timolol?
Diabetes and Hyperthyroidism
Which beta blocker is good for pulmonary pts?
Betaxolol
Which macular condition is associated with PG’s?
CME
Ocular anesthetics are amide or ester based?
Ester
What is the most common affect from an initial instillation of an NSAID?
Stinging
Note: Good for seasonal allergies without any corneal involvement
Parent derived steroids, are what type?
Steroid (Lipid soluble)
Norepi and epi are what type of steroid?
Amine based
What are the 3 peptide hormones?
ADH, Oxytocin and TRH
What are 3 granulocytes?
Basophils
Eosinophils
Neutrophils
Triglycerides moved from the intestines to the liver are carried out by?
Chylomicrons
Michealis menten formula
Vm (s) / Km + s = V
Which bacterial agent is associated in warmer climates?
H. Influenza
Rocky mountain fever, is associated with what agent?
Rickettesia - Gram -
Chocolate agar and Bacitraicin together well allow to allocate which bacterial agent?
Haemphilus
20/30 spatial acuity will display what CPD of spatial frequency?
20 CPD
600/30 = 20
Connective tissue mnemonic for Keratoconus
T-DOME
Which three (2 corneal layers) have type 1 collagen?
Bowman’s
Sclera
Bones
Which layer of the cornea is impacted in Dellen?
Stroma (Dehydration)
What is the fulcrum of the levator?
Whitnall’s
What is the mnemonic for secondary and tertiary function?
SIN RAD
Recti - Adduction
Superior’s - Intortion
Note: Adduction or Abduction is a tertiaryor a primary action only
SPE
Residual/OR: <0.75 CT: >1.50
Spherical GP
Residual/OR: <0.75 CT: <2.50
Toric BC
Residual/OR: >0.75 CT: >1.50
Front Toric
Residual/OR: >1.00 CT: <1.00
CPE
Residual/OR: >0.75 CT: >1.50
Reduced Thickness
x = t/n
Real object and Negative lens
Virtual, Upright, Smaller image
Real Object, Between first focal point and Plus lens
Virtual, Upright, Enlarged
Lens power and Mirror combo
2D1 + P (n’)
Ophthalmic Artery Branches
CRA Lacrimal Muscular SPCA LPCA Supra Ethmoid
Virtual Object; placed between focal point and minus lens
Real, Upright and Larger
Special Viseral Afferent CN?
CN 1, 2 and 8
Sympathetic and Parasympathetic are what system?
Visceral (Autonomic)
What controls balance and muscle movement?
Cerebellum
CSF travels through which layer?
Subarchnoid
Which layer of the Scalp is considered the danger area?
Loose Areolar Tissue
- Black eye
- Danger area of scalp (lead to dural sinuses)
Toughest bone in the skull
Zygomatic
Kreb’s cycle
2 ATP
Aerobic
Matrix of Mitochondria
Glycolysis
Cytoplasm 2 ATP Anaerobic Can go to lactic acid fermentation Glucose to Pyruvate
Electron Transport chain
34 ATP
Aerobic
Inner membrane of Mitochondria
What is the most potent ocular steroid?
Durezol
Which class of drugs decrease bronchoconstriction?
Lukast drugs
Why do steroid increase IOP?
Decrease the outflow through corneosclero outflow
What are the most common side effects of steroids?
Hyperglycemia HTN Peptic ulcers Weaker bones Decrease collagen (fibroblast)
Which NSAID is known for corneal melting?
Diclofenac
What NSAID causes a lot of bleeding in the and around the eye?
Indomethacin
Which 3 drugs are known for pigmentary retinopathy?
Thioridizine
Indomethacin
Chlorprimizine
MOA of FLQ?
DNA Gyrase and Topoisomerase 4
Which drugs are involved in delayed corneal healing and which layers are impacted?
Aminoglycosides (Tobramycin and Gentamycin) ; Epithelial and Bowmans
Which 4 drugs can cause Psuedotumor cerebri?
CANT Contraceptives Accutane Naldixic Acid Tetracycline
What is a major ocular side effect of Minocycline?
Blue sclera
Note: Scleritis can cause a blue sclera
Which ocular drug is known to cause conjunctival cysts?
Tetracycline
Doxycycline is used for which 2 ocular condition?
Dry Eye
Chlymadia
Which ocular drug use to cause Aplastic Anemia, now is discontinued in the USA?
Chloramphenicol
Which 2 drugs are used for Gonnrhea Neonatrum?
Erythromycin and Silver Nitrate
What drug is used for systemic Gonnarhea?
Ceftriaxone
MOA of Rifampin?
RNA Polymerase
Which fungal mediation work on Microtubles?
Griseofulvin
Which one is the only H1 Blocker Antihistamine?
Emedastine
Which 4 drugs cause a depolarization of Ca+2 in a Basophil or Mast cell?
Cromlom, Ala, Alo and Alo
Which systemic allergic medication is known to cause pigmentary issues?
Promethazine
Which drug works on the MAO portion to inhibit the postganglionic adernergic portion?
Phenylzaline
What is the major SE of MG?
Diplopia
What are the 5 topical Cholenergic Antagonist?
ASHCT
Which respiratory drugs can cause an increase Aqueous prodction?
Beta 2
Minus Lens and Real Object?
ALWAYS, Virtual, Upright and Minified
Plus lens and Object at Infinity?
Real, Inverted and Smaller
Plus lens and Object at 2f?
Real, Inverted and Same size
Plus lens and Object between 2f and f?
Real Inverted and Larger
Plus lens and Object at f?
No image
Plus lens and Object between lens and f?
Virtual, Upright and Enlarged
Corrected refractive hyperope vs. Corrected refractive myope ; Which has a larger retinal image?
Corrected Refractive Hyperopia
For tight fitting CTL, when will the pt see better?
After blinking
Lateral magnification
m=hi/ho = l’/l
Relative Distance
DON
D=Original Distance/New Distance
Relative Size
SNO
S=New Size/Original Size
Hand Held Magnifer
F/4
Which magnifier requires more accommodation?
Stand ; No accommodation needed
Stand magnifer
F/4+1
What does it mean 5x45 telescope?
M=Ent/Exit
5=45/exit
How much prism do you want to give to your +10.00 pt?
12PD
10+2 = 12
0.4m/1.0M is what in snellen?
20/50
Where is the far point of a myope?
In front of the eye
Far point of a hyperope?
Behind the eye (Virtual)
What does Absolute Hyperopia mean?
Accommodation that cannot overcome hyperopia
Resolution acuity is what type?
Teller card
What type is recognition acuity?
Snellen acuity
Minimal detectable acuity vs. Snellen?
Minimal detactabke is better than Sneller
What is hyperacuity?
Vernier
Exo deviation will display which way, in regards to cover test?
Same as the paddle
How do you treat Eso pt’s?
Plus lens
What mneumonic work when prescribing lenses or prism?
BIM BOP
What is the age for Anamolous Correspondance to occur?
Age 5
What coordinates the vestibular system?
Endolymph in the Semi-circular canalas
What is measured in the vestibular system?
Speed
Which system allow to monitor for constant motion?
OKN
Saccades have a______ velocity and _______ latency.
Fast Velocity
Slow Latency
Vergence: Eye at rest?
Tonic
Vergence; Awareness of something is close?
Proximal
Vergence; Retinal Disparity
Fusional
Vergence; Retinal blur
Accommodative
Which law is disrupted in Duane’s and Brown’s?
Sherrington’s
What is another issue with the globe in regards to Duane’s?
Globe retraction
What is the major problem with Brown’s?
Limited elevation in Adduction
Note: this is due to the SO not relaxing
Most plentiful antigen marker?
IgG
Made first antigen?
IgM
Mneumonic for a heart attack treatment?
MONA
Morphine
Oxygen
Nitro
Aspiring
BPH Meds like Terazosin or Tamsulosin can cause floppy iris syndrome. What is the MOA? What systemic condition can be caused?
Alpha 1 Antagonist ; Orthostatic Hypotension
Which condition is associated with Gluten?
Celiac Disease
Best way to differentiate between TMJ and GCA?
Jaw pain on movement in TMJ.
What 3 systemic conditions can cause Optic Neuritis?
MS, Sarcoid and Lupus
Phlyctenules are associated with what condition?
TB
What are the 3 main cell’s associated with chronic inflammation?
Macrophages, Lymphocytes and Plasma cells
What major systemic condition is associated with decrease blood supply?
Diabetes
What Ion causes cell tissues death?
Na+
Coagulative necrosis occurs where?
Heart
Liquefactive Necrosis occurs where and is caused by?
Lungs ; Fungal
Caseous necorsis is?
Cheesy in lungs ; occurs due to TB
2 systemic conditions associated with Interstitial Keratitis?
Herpes and Syphillis
3 ocular conditions associated with syphillis?
Salt and Pepper fundus
Intersitial Keratitis
Uvities
Note: Neuroshyphillis could have been added too
2 conditionsthat cause infant cataract?
Rubella and Galactosemia
Skip lesions and Cobblestone are associated with which condition?
Crohn’s
What is Meniere’s triad?
Vertigo, Hearing loss and Tinnitus
ETDRS CSME classification
1) Thickening of the retina at or within 500 um
2) Hard exudate at or within 500 um with associated retinal thickening
3) Zone of 1 DD or retinal thickening, that is withing 1DD of the macula
HTN Retinopathy stages
Grade 0: No changes
Grade 1: Barely detectable arterial narrowing
Grade 2: Obvious arterial narrowing with focal irregularities
Grade 3: Grade 2 plus retinal hemorrhages, exudates, cotton wool spots, or retinal edema
Grade 4: Grade 3 plus papilledema
Chronic Arteriosclerotic HTN stages by Schieie
Stage 1: Widening of the arteriole reflex
Stage 2: Arteriovenous crossing sign
Stage 3: Copper-wire arteries (copper colored arteriole light reflex)
Stage 4: Silver-wire arteries (silver colored arteriole light reflex)
What is considered early NPDR?
Atleast 1 microanuerysm
Whats is Moderate NPDR?
Multiple heme’s; cotton wool spots and venous beading
What is Severe NPDR?
4-2-1 rule
4 quadrants of hemes
2 quadrants of venous beading
1 quadrant of IRMA
Cholinergic agonist should be caution in?
Asthma pt’s
Epipherine reveral occurs when epinephrine is given to a patient taking?
a1 blockers
Which drug is known to increase the metabolism of Warfarin?
Phenobarbital
Toxicity of heparin can be reversed by using?
Protamine
Which ligament is located anteriorly to the orbital septum?
Medial palpebral ligament
Which EOM is the only one that has its anatomic orgin anterior to the globe?
Inferior Oblique
Which two nerves form to make the Frontal nerve?
Supratrochlear and Supraorbital
Layers of the conjunctiva to the sclera.
Conjunctival Epi > Conjunctival Stroma > Tenon’s Capsule > Episclera > Sclera
Which corneal layer cannot regenerate?
Bowman’s
Definition of anterior boundary of the limbus?
Line from the Schwalbe line to the termination of Bowman’s
What is the transition of Schwalbe’s line?
Descemet’s
Where is MACI located?
Ciliary body
Where is the minor arterial circle of the iris located?
Iris stroma
Anterior iris epithelium is composed of what special type of epithelium?
Myoepithelium
Where is the insertion of the longitudinal muscles of the ciliary muscle?
Anterior Choroid
Where is the orgin of the longitudinal muscles of the ciliary muscle?
Scleral Spur
The posterior choroid is supplied by the ?
Short Ciliary Arteries
Which layer of the retina provides the blood retinal barrier?
RPE
Optic radiations terminate ?
Visual cortex
Where does the lens placode develop?
surface ectoderm
Iris sphincter is derived from what developmental pathway?
neural ectoderm
Which germ layer produces the nasolacrimal drainage structures?
surface ectoderm
Neuroglial tissues of the optic nerve comes from which germ layer?
neural ectoderm
Most muscles and bones of ocular structure are derived from?
Mesenchyme
What is a good blood-aqueous-barrier in the iris?
Non fenestrated iris capillaries
Which ion is a higher concentration in the tears than plasma?
Cl-
Lactoferin is secereted by?
Lacrimal gland
What is the cause of lowered IOP during accommodation?
Decreased in outflow resistance
What are the 3 conditions Ceftriaxone is used for?
Gonerrhea, Syhillis and Lyme Disease
Which anesthetic is an amide based?
Lidocaine
Best topical medication for dendritic form of herpes simplex?
Trifluoridine
Which beta blocking agent is associated with causing granulomatous iridocyclitis?
Metipranolol
Which color testing is good to do for an acquired color deficiency?
Fransworth Munsell 100 Hue
What is static perimertry?
Bright light against a background
What is weber’s law?
Constant porportion between Increment threshold = background luminance
Which type of cone does not play a role in luminosity?
S-cones
Dark adaption is related to the curve in what aspect?
If the field becomes larger = larger second portion of the curve. This is due to the fact more rods are used
Which condition shows no dark adaption after pre adapting light is turned off?
Oguchi’s disease
Small variation in panum’s fusional are called?
fixation disparities
Law that states afterimage is perceived as larger than onto a distant surface?
Emmert
Apparent luminance of an intermittent light stimulus when an alternation frequency above the CFF is which law?
Talbot-Plateau law
Brucke Bartley is associatted with what phenomenom?
Brightness
Resolving grating patterns, like black and white bars is what type of acuity?
Resolution
Name 3 static monocular cue’s?
Interposition, Linear perspective and Texture Gradient
VOR latency is approx?
16 msec - very quick
What would happen to the VOR gain from distance to near?
Increase
What is the purpose of the VOR
Stablize vision during head movement
What is saccadic latency?
200 m/sec
What is supressed during a saccade?
Vision
Which type of PR decreased as we age?
Rods
Hardest type of virus to disinfect?
Non-enveloped
Major side effect of Benadryl?
Narrow angle closure
Ciliary muscle is what type of muscle?
Smooth muscle
Over correction of myopia will display what type of phoria?
Increased esophoria
What is generally absent in Latent hyperopia?
diplopia
What is the sequence of signal conduction in cardiac cycle?
SA>AV> purkinje fibers
Which phase of mitosis do chromosomes line up at the equator?
Metaphase
Sequence of pre natal development
Zygote>Morula>Blastocyst>Embryo>Fetus
What is the term when no punctum is present?
Punctal Atresia
Once fertilization of the egg has occurred what hormone is released to inhibit menstration?
HCG secreted by the blastocyst
Center thickness of GP lens formula
0.023 x CTL power +0.19mm
Myopes, do the accommodate more with glasses or CTL’s?
CTL’s ; this is due to the fact there is a mild BI in Specs, whereas CTL’s don’t.
Which hormone, secreted by the hypothalamus, decreases the productionof TSH?
Somatostatin
2 major side effects of Topamax (Anti convulsant)
Myopic shift
Angle closure
LAX criterion will display what with the threshold and sensitivity?
Low threshold
High sensitivity
Trolands are units for ?
Illuminance
Luminous power is measured as?
Lumens
Spatial summation will display?
High sensitivity and Poor resolution
Which product was added to decrease the chances of anemia in AREDS?
Copper ; this was due to the fact that zinc causes anemia and was added as a key ingredient into AREDS
What is the key for using potassium sparing diuertics?
- Help control edema
2. Used for hyperaldoteroism
What is the terminal electron acceptor in the Electron Transport Chain?
Oxygen
How do you neutralize Esophoria?
BO prism
What is the common unit for radiant power?
Watt
For small angle to be reflected at a small angle. What is the name of this angle and how much of an angle degree is the threshold?
Paraxial ; 15 degrees
Least effective POAG med for IOP increase at night?
Timolol
Damage to the Efferent pathway will cause what type of pupil issue?
Anisocoria
Damage to the Afferent pathway will cause what type of pupil issue?
APD
Pons and cerebellum are located?
Metencephalon
Where is the midbrain located?
Mesencephalon
Where is the thalmus and hypothalamus located?
Dienchephalon
Where is the medulla located?
Myelencephalon
Which type of cell surround the ventricle of the CNS but also are part of the epithelial cells of the choroid plexus?
Ependymal
What type of junctions are present with Endothelial cells?
Macula Occludens, Zona Adherens, and Macula Adherens
What gives rise in development to Endothelium, Descemet’s and Stroma?
Neural Crest
MBS formula
Ed + Total Decentration + 2mm
Impetigo occurs due to what two infectants?
Strep Pyogenes and Staph Aur
Where are the action potentials in the ear start?
Hairs of the organ of corti
Most frequent assocation with Normal Tension glaucoma?
Raynaud’s phenomenom
Most common etiology of a CRAO?
Artherosclerosis related thrombus formation
Diffuse SPK is indicative of?
Viral or Toxic
Intrapalpebral SPK staining will be indicative of?
Lagophthalmos
Inferior third of SPK will be indicative of?
Bacterial
Which beta blocker is cardioselective?
Betaxolol
Which beta blocker is non-cardioselective?
Cartelol
Hepatitis C is contracted primarily?
Intervenous drugs
For a myopic patient, what will decrease on ERG?
B wave
Note: This is due to chorioretinal degeneration
Which product in AREDS helps with night blindness?
Zinc
Your using the lens and read 170 as an axis. What changes in the axis, when you flip the glasses around?
010 axis.
What consumes more oxygen, brain or Retina?
Retina
Which phenomenon is associated with seeing lighting streaks due to acceleration of the head?
Moore’s lightening streak
How many months does it take for microcysts to form on a low Dk extended wear CTL?
2 months
If diastolic perfusion pressure decreases, what happens to the prevalence to POAG?
Increases
The most common type of excretory gland in which secretory products are excreted via exocytosis into a duct is known as?
Merocrine
Which group of hydrogel CTL’s are known for high amounts of protein?
Group 4
Which vitamin is forbidden in AREDS for pt’s who smoked before?
Vitamin A
Formula for AREDS 2
Copper Zinc Vitamin C Vitamin E Lutein Zeaxanthin Omega 3 Fatty Acids
Visual Aura without a headache?
Acephalgic Migraine
Denial of vision loss in a pt with blindness is known as?
Anton’s Syndrome
Psuedochromatic plates are hard to detect which type of color deficiency?
Blue and yellow defect
Retinal colobomas are due to ?
Incomplete closure of the optic fissure
Diabetes and Smoking have been known to be protective factors against what corneal condition?
Keratoconus
When does Seasonal Allergic Conjunctivitis get exacberated?
Summer and Spring time
Emotions are regulated by which brain structure?
Amygdala
Which telescope system has a real exit pupil?
Kaplerian
Majority of aqueous is taken away by which system?
Episcleral venous plexus
How does the addition of a competitive inhibitor change the Lineweaver-Burk plot of an enzyme?
Increase the slope
Which histamine receptor plays a role in ocular allergies?
H1
What lens material has the highest Abbe value, thus the lowest chromatic abberation?
Crown Glass - 59
CR 39 - 58
Trivex - 45
Polycarbonate - 30
Painless, ulcerative canchre sores are associated with which condition?
Syhphillis
Which organism is associated with Lyme disease?
Borrelia Burgdorferi
High NRA and low PRA mean?
Over minused
When does steropsis become adult like?
5 to 7 years of age but starts at 3 to 5 months
Cones vs. Rods; which displays better summation?
Rods. It is known that Cones are better with resolution, Contrast sensitivity
Keratometry utilizes what type of acuity system?
Vernier
What is true regarding mirrors?
The angle of incidence is equal to the angle of reflection
What type of cells in the retina display auto regulation?
Pericytes
