Lacrimal System Flashcards

1
Q

Tear flow

A
  1. Secretion by the lacrimal gland onto the ocular surface
  2. Channeled medially by the orbicularis pump mechanism
  3. Drainage into the nasolacrimal system via the upper and lower puncta
  4. Flow through the upper and lower canaliculi into the common canaliculus
  5. Common canaliculus → Nasolacrimal sac → Nasolacrimal duct → inferior nasal meatus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thinnest and most superficial layer of the tear film

A

lipid layer
prevents evaporation of the tear film
produced by meibomian gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

thickest layer of the tear film

A

aqueous layer
Produced by lacrimal gland
has an immune function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Deepest layer of the tear film

A

Mucin layer
Produced by conjunctival goblet cells
Spreads film evenly and keeps it stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lacrimal gland innervation

A

Sensory innervation → lacrimal nerve (branch of CNV1)
Lacrimation (secretomotor) → Parasympathetic (CN7)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

accessory lacrimal glands

A

krause and wolfring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Krause glands

A

found at the conjunctival fornices and are more abundant in the upper fornix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Wolfring glands

A

less numerous but bigger. They are found at the tarsal plate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Eyelash associated glands

A

The glands of Moll and Zeis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Moll galnds

A

apocrine (modified sweat glands)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Zeis glands

A

holocrine (sebaceous)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Schrimers test description

A

Filter paper placed under the lower lid. Amount of moisture measured after 5 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

TBUT test description

A

Eye is stained with fluorescein dye and the time taken for the first dry spot to appear on the cornea is measured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Jones test description

A

Jones 1 -
Dye squirted onto the conjunctiva and cotton bud placed in the inferior meatus.
Jones 2 -
Dye syringed into the nasolacrimal system and cotton bud placed in the inferior meatus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dacryocystography

A

Radiological evaluation using injected fluorescent contrast to evaluate the nasolacrimal system morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dacryoscintigraphy

A

Radiological evaluation of nasolacrimal system drainage using radiopharmaceutical eyedrops

17
Q

schirmer test interpretation

A

> 10mm → normal (Schirmer negative)
<5mm → tear deficiency (Schirmer positive)

18
Q

TBUT test interpretation

A

<5 seconds → abnormal tear film
10-30 seconds → normal

19
Q

Treatment ladder of dry eye

A
  1. Lubrication and artificial tears
  2. Topical steroids and pilocarpine
  3. Punctal plugs
  4. Autologous serum drops
  5. Bandage contact lenses
  6. Tarsorrhaphy (sewing the lids shut, this is typically a temporary measure)
20
Q

pathology of Sjogren’s syndrome

A

associated with rheumatoid arthritis and SLE
anti-ro and anti-la autoantibodies

21
Q

triad of sjogren’s

A

dry eye, dry mouth and parotid gland swelling

22
Q
A