lecture 10 opthalmic dyes and evaluation of the lacrimal system

Question 1

name the 2 accessory glands that contribute to the aqueous layer of the tear film

Answer 1

wolfring and krause

Question 2

what is the primary source of oxygen for the cornea

Answer 2

the tears

Question 3

what percentage of your tears exits the nasolacrimal system?

Answer 3

75%, (25% is lost thru evaporation)

Question 4

reflex tears afferent pathway is _____ and the efferent pathway is _____

Answer 4

CN5, CN7

Question 5

what are the 3 components of the corneal reflex?

Answer 5

lacrimation, miosis, and blinking

Question 6

what does the “tear prism” refer to?

Answer 6

the tear meniscus

Question 7

What are the 3 components of the tear system?

Answer 7

production, distribution, and drainage

Question 8

the accesory glands contribute _____ _____ while the main lacrimal gland is for _____ _____

Answer 8

basic secretion, reflex stimulation

Question 9

which is the stimulation for lacrimation and secretion of tears?

A) afferent
B) efferent

Answer 9

B) efferent.

Question 10

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

Answer 10

B) overflow of tears. caused by either hypersecretion of tears or outflow obstruction (punctal or nasolacrimal duct).

Question 11

Normal tear meniscus height is _____.

Answer 11

0.2mm (less than this indicates dry eye due to poor H2O tear component)

Question 12

soapy tears is an indication of what?

Answer 12

increased fatty acids in tears caused by Meibomium Gland Dysfunction

Question 13

dry eye symptoms are consistent with:

A) more viscous tears
B) less viscous tears

Answer 13

A) more viscous tears. (the lower the viscosity, the smoother the flow of tears)

Question 14

Schirmer 1 measures the tear production of both ____ and ____ , while the Basic tear secretion test measures only _____ and Schirmer 2 measures only _____

Answer 14

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

Question 15

which 2 uses anesthetic:

A) schirmers 1
B) schirmers 2
C) basic tear secretion test

Answer 15

B) schirmers 2 C) basic tear secretion test

Question 16

Which test would you use a q-tip to irritate the nasal mucosa?

A) Schirmers 1
B) Schirmers 2
C) Basic tear secretion test

Answer 16

B) Schirmers 2

Question 17

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

Answer 17

1) 5 min
2) 2 min
3) 5 min

Question 18

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 _____

Answer 18

1) greater than 15mm
2) greater than 15mm
3) greater than 10mm

Question 19

What are the mild, moderate, severe measurements for the schirmer’s 1 test interpretations

Answer 19

mild reduction=10-15mm, moderate =5-10mm, severe=5mm or less

Question 20

The jones dye tests 1 and 2 are used to check for…..

Answer 20

blockage of the nasal-lacrimal system

Question 21

What s the major difference between Jones 1 and 2?

Answer 21

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

Question 22

What is the main patient complaint that would warrant the jones tests?

Answer 22

epiphora

Question 23

diffuse SPK is indicitive of…

A) viral, medicamentosa
B) dry eyes
C) bacterial infection
D) superior limbic keratitis

Answer 23

A) viral, medicamentosa

Question 24

interpalpebral SPK is indicitive of…

A) viral, medicamentosa
B) dry eyes
C) bacterial infection
D) superior limbic keratitis

Answer 24

B) dry eyes

Question 25

inferior SPK is indicitive of…

A) viral, medicamentosa
B) dry eyes
C) bacterial infection, blepharitis, lagopthalmos, dry eye
D) superior limbic keratitis

Answer 25

C) bacterial infection, blepharitis, lagopthalmos, dry eye

Question 26

superior SPK is indicitive of…

A) viral, medicamentosa
B) dry eyes
C) bacterial infection
D) superior limbic keratitis

Answer 26

D) superior limbic keratitis

Question 27

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

Answer 27

A) loss of epithelial cells

Question 28

What is medicamentosa?

Answer 28

toxic response to topical mediactions

Question 29

what is lagopthalmos?

Answer 29

incomplete closure of lids, sometimes can happen to patients at night while they sleep

Question 30

what does rose begnal do?

Answer 30

it does NOT accumulate in epithelial defects, it stains devitalized tissue, also stains mucous. also stains where mucous isn’t covering.

Question 31

how is lissamine green different from rose bengal?

Answer 31

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

Question 32

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

Answer 32

A) CN5

Question 33

Ocular conditions associated with reduced sensitivity include:

Answer 33

HSV, neurotrophic keratitis, diabetes, HZV, post K surgery, MS

Question 34

You place fluorescien dye in your pt’s eye and check for a “waterfall” pattern on the cornea. What is this test called?

Answer 34

Seidel test.