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Opthalmo > Lid & Lacrimal > Flashcards

Lid & Lacrimal Flashcards

1
Q

What are the 3 muscles of the eyelid?

A

1) Orbicularis oculi muscle
2) Levator palpebrae superior muscle
3) Superior tarsal muscle (Muller muscle)

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2
Q

Levator palpebrae superior muscle function?

A

Main elevator of the upper lid

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3
Q

Levator palpebrae superior muscle supplied by?

A

3rd CN (Oculomotor)

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4
Q

Muller’s muscle function?

A

Weaker elevator of the upper lid

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5
Q

Muller’s muscle supplied by?

A

Sympathetic system

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6
Q

Orbicularis oculi muscle function?

A

Lid closure

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7
Q

Orbicularis oculi muscle supplied by?

A

7th CN (Facial)

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8
Q

The conjunctiva can be divided into:

A

1) The palpebral conjunctiva (covering the eyelids)
2) The bulbar conjunctiva (covering the globe with its sclera)
3) The conjunctival fornix

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9
Q

What are the causes of ptosis?

A

1) Mechanical (anything preventing full eyelid opening)
2) Disinsertion of the aponeurosis of the levator muscle from its insertion on tarsus
3) Neurological
4) Myogenic

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10
Q

What is the most common cause of acquired ptosis?

A

Disinsertion of the aponeurosis of the levator muscle from its insertion on tarsus

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11
Q

What is the most common cause of congenital ptosis?

A

Malformation of the levator
palpebrae superioris muscle

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12
Q

Ptosis signs?

A

1) Palpebral aperture size reduction
2) Lid creases are absent or in abnormal position.
3) Horner’s syndrome signs (small pupil, anhydrosis )
4) 3rd CN palsy (large pupil, Diplopia)
5) Myasthenia Gravis (fatigue after repeated movements)

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13
Q

What is Involutional Entropion?

A

When the preseptal part of the orbicularis muscle overrides the pretarsal muscle

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14
Q

Management of entropion?

A

1) Taping of the lower lid and Lubrication
2) Botulinum toxin into the orbicularis muscle (palpebral part)
3) Surgery

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15
Q

Causes of ectropion?

A

1) Age related orbicularis laxity
2) 7th CN palsy
3) scarring of the periorbital skin

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16
Q

What is a Chalazion?

A

Lipo-Granuloma within the tarsal plate due to meibomian gland obstruction

17
Q

Molluscum Contagiosum is caused by:

A

DNA Poxvirus

18
Q

What is the cyst of Moll?

A

Translucent cyst due to sweat gland obstruction

19
Q

What is the Cyst of Zeis?

A

Opaque cyst due to obstructed accessory sebaceous gland

20
Q

90% of eyelid tumors
are __.

A

Basal Cell Carcinoma

21
Q

Basal cell carcinoma has a ___ (good/bad) prognosis.

A

Good

22
Q

What is Trichiasis?

A

Eyelashes are directed towards the globe and the lid margin is normal

23
Q

What causes Trichiasis?

A

Chlamydia trachomatis

24
Q

Tears drains into (in order):

A

Upper and lower puncta -> Upper and lower canaliculi -> Common canaliculus -> Lacrimal sac -> Nasolacrimal duct -> Nose

25
Q

The tear film comprises three layers:

A

1) A thin mucin layer in contact with the ocular surface
2) Aqueous layer
3) A surface oil layer

26
Q

The thin mucin layer of the tear film is produced by:

A

Conjunctival goblet cells

27
Q

The Aqueous layer of the tear film is produced by:

A

Lacrimal gland

28
Q

The surface oil layer of the tear film is produced by __ and delivered to __.

A

The tarsal meibomian glands; the lid margins

29
Q

Sjogren’s syndrome’s dry eyes is mainly caused by a deficit in which layer of the tear film?

A

Aqueous layer, due to deficient Lacrimal gland secretions

30
Q

Aqueous layer deficiency signs on fluorescein stain:

A

1) Early break up of the tear film after 5 seconds of blink suppression

2) Punctate staining will show small dots of fluorescein over the exposed corneal or conjunctival surface

3) Filamentary keratitis (tags of abnormal mucus)

31
Q

Evaporative dry eye can be caused by:

A

1) Inadequate Meibomian oil delivery (MGD)
2) Malposition of the globe or lid Margin

32
Q

Watery eyes will result from failure of __.

A

The distal end of the nasolacrimal duct to canalize

33
Q

Obstructed canaliculi may result in ___ or ___.

A

Mucocele; Dacryocystitis

34
Q

In infantile drainage obstruction, the conjunctiva __ (is/is not) inflamed

A

Is not

35
Q

Causes of adult drainage
obstruction?

A

1) Infections
2) Direct Trauma, Fractures
3) Topically applied drugs

Opthalmo (10 decks)

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