L4

Question 1

How mydriasis can be achieved

Answer 1

stimulation of dilator muscle

paralysis of sphincter muscle

Question 2

what is the name of stimulation of dilator

and its example

Answer 2

adrenergic agonist and sympathomimetric

phenylephrine

Question 3

what is the ocular side effect of phenylephrine

Answer 3

1. widening of palpebral aperture
2. blanching of conjunctiva blood vessel

due to present of alpha receptor

Question 4

what are the other clinical uses of phenylephrine

Answer 4

1. breaking posterior synechiae
2. diagnostic test for horners syndrome

Question 5

what are the precaution of systemic disease in phenylephrine usage

Answer 5

cardiac disease
hypertension
artheriosclerosis
hyperthyroidism

Question 6

what is another name for paralysis of sphincter

Answer 6

cholinergic antagonist

parasympatholytic

antimuscarinic

Question 7

what is an example of paralysis of sphincter

Answer 7

tropicamide

Question 8

what is the precaution in systemic disease in usage of tropicamide

Answer 8

down syndrome

brain disorder

Question 9

what is the 4 clinical routine prior dilation

Answer 9

1. check anterior chamber angle
2. measure eye pressure before and after dilation
3. take a good history ; ensure no history of angle closure, drug allergy, not using any miotic for glaucoma, no systemic drug and disease health condition
4. have a miotic available

Question 10

what is the ssx of aacg

Answer 10

elevated iop,

blurry vision

nausea, vomitting

ciliary flush

fixed semi dilated pupil

corneal oedema

Question 11

what is the contraindication of mydriasis

Answer 11

anterior chamber iol

history of angle closure glaucoma

subluxated iol/ lens

narrow or closed angle

Question 12

what is cycloplegics

Answer 12

cycloplegics is the paralysis of ciliary muscle resulting in loss of accommodation

cyclopegics block the postsynapstic muscarinic receptor in iris and ciliary body

Question 13

signs of atropine poisioning

Answer 13

relaxed accommodation,

inhibite sweat gland,

dilated blood vessel,

hallucination and confusion.

Question 14

what are the indicaiton of cycloplegics

Answer 14

when accommodation are not relaxed sufficiently. - bv anomalies, latent hyperopia, less than 6 yo

treatment of myopia, amblyopia, uveitis (relax spasm and prevent posterior synechiae)

Question 15

how can miosis achieve by

Answer 15

stimulation of spincter

paralysis of dilation

Question 16

whatt are the uses of miotics

Answer 16

reversal od mydriasis

anti-glaucoma medication

diasgnostic agent in adie pupil

Question 17

what are the pupil disorder characterized by anisocoria

Answer 17

physiologic anisocoria

horner’s syndrome

adies pupil

cn3 palsy

argyll robrtson pupil

Question 18

what are the common characteristic of pupil disorder

Answer 18

only 1 pupil is invovled

affected pupil either cant dilate or constrict

Question 19

what is physioloic anisocoria

Answer 19

good light reaction in both eyes

tend to be equal anisocoria in bright and dim

pupillary size difference usually less than 1mm

no dilation lag

Question 20

what is horner syndrome

Answer 20

damage @ any point along the sympathetic pathway

damage can occur in form of trauma, tumour involvement, infarction, middle ear infection, disease of eye itself

Question 21

feature of horner’s syndrome

Answer 21

ptosis, miosis
anhidrosis
hererochromia iridis , dilation lag

Question 22

what is adies tonic pupil

Answer 22

caused by post ganglionic parasympathetic lesion

• pupils and accommodation are affected
• sluggish and segmental constriction to light

Question 23

Pharmacologic evaluation of Adies Tonic pupil

Answer 23

The sphincter shows cholinergic hypersensitivity.

Larger pupil is supersensitive to 0.125% pilocarpine (cholinergic agonist ).