lecture 10 opthalmic dyes and evaluation of the lacrimal system Flashcards
name the 2 accessory glands that contribute to the aqueous layer of the tear film
wolfring and krause
what is the primary source of oxygen for the cornea
the tears
what percentage of your tears exits the nasolacrimal system?
75%, (25% is lost thru evaporation)
reflex tears afferent pathway is _____ and the efferent pathway is _____
CN5, CN7
what are the 3 components of the corneal reflex?
lacrimation, miosis, and blinking
what does the “tear prism” refer to?
the tear meniscus
What are the 3 components of the tear system?
production, distribution, and drainage
the accesory glands contribute _____ _____ while the main lacrimal gland is for _____ _____
basic secretion, reflex stimulation
which is the stimulation for lacrimation and secretion of tears?
A) afferent
B) efferent
B) efferent.
epiphora is:
A) small protuding bumps found primarily on lower lids
B) overflow of tears
C) lack of tearing
D) where lacrimation is redirected through different channels
B) overflow of tears. caused by either hypersecretion of tears or outflow obstruction (punctal or nasolacrimal duct).
Normal tear meniscus height is _____.
0.2mm (less than this indicates dry eye due to poor H2O tear component)
soapy tears is an indication of what?
increased fatty acids in tears caused by Meibomium Gland Dysfunction
dry eye symptoms are consistent with:
A) more viscous tears
B) less viscous tears
A) more viscous tears. (the lower the viscosity, the smoother the flow of tears)
Schirmer 1 measures the tear production of both ____ and ____ , while the Basic tear secretion test measures only _____ and Schirmer 2 measures only _____
basic and reflex, basic, reflex…..
schirmer 1=basic and reflex (no anesthetic), Basic uses anesthetic to check basic only. schirmer 2=uses anesthetic to check for reflex only
which 2 uses anesthetic:
A) schirmers 1
B) schirmers 2
C) basic tear secretion test
B) schirmers 2 C) basic tear secretion test
Which test would you use a q-tip to irritate the nasal mucosa?
A) Schirmers 1
B) Schirmers 2
C) Basic tear secretion test
B) Schirmers 2
1) For Schirmers 1 leave strips in for ____ minutes
2) For Schirmers 2 leave strips in for ____ minutes
3) For Basic tear secretion test leave strips in for ____ minutes
1) 5 min
2) 2 min
3) 5 min
1) For Schirmers 1 a normal reading is _____
2) For Schirmers 2 a normal reading is _____
3) For Basic tear secretion test a normal reading is _____
1) greater than 15mm
2) greater than 15mm
3) greater than 10mm
What are the mild, moderate, severe measurements for the schirmer’s 1 test interpretations
mild reduction=10-15mm, moderate =5-10mm, severe=5mm or less
The jones dye tests 1 and 2 are used to check for…..
blockage of the nasal-lacrimal system
What s the major difference between Jones 1 and 2?
Jones 1=use generous amounts of dye in eye to see if punctum is closed by having pt blow nose or insert q-tip in nose to check for dye. Jones 2=irrigate nasolacrimal system with saline solution thru inferior punctum
What is the main patient complaint that would warrant the jones tests?
epiphora
diffuse SPK is indicitive of…
A) viral, medicamentosa
B) dry eyes
C) bacterial infection
D) superior limbic keratitis
A) viral, medicamentosa
interpalpebral SPK is indicitive of…
A) viral, medicamentosa
B) dry eyes
C) bacterial infection
D) superior limbic keratitis
B) dry eyes
inferior SPK is indicitive of…
A) viral, medicamentosa
B) dry eyes
C) bacterial infection, blepharitis, lagopthalmos, dry eye
D) superior limbic keratitis
C) bacterial infection, blepharitis, lagopthalmos, dry eye
superior SPK is indicitive of…
A) viral, medicamentosa
B) dry eyes
C) bacterial infection
D) superior limbic keratitis
D) superior limbic keratitis
You put fluorescien in your pt’s eyes, you see patches of green glow. this is an indicator of….
A) loss of epithelial cells
B) raised patches of epithelial cells
A) loss of epithelial cells
What is medicamentosa?
toxic response to topical mediactions
what is lagopthalmos?
incomplete closure of lids, sometimes can happen to patients at night while they sleep
what does rose begnal do?
it does NOT accumulate in epithelial defects, it stains devitalized tissue, also stains mucous. also stains where mucous isn’t covering.
how is lissamine green different from rose bengal?
they are both effective at staining devitalized tissue on cornea and conj, however, lissamine green doesnt sting as much, doesnt last as long, and is less toxic to the cells
You can test corneal sensitivity loss with a cotton wisp. Loss of corneal sensitivity is often the first sign of damage to:
A) CN5
B) CN7
C) CN3
D) CN2
A) CN5
Ocular conditions associated with reduced sensitivity include:
HSV, neurotrophic keratitis, diabetes, HZV, post K surgery, MS
You place fluorescien dye in your pt’s eye and check for a “waterfall” pattern on the cornea. What is this test called?
Seidel test.
