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Boards Review > Lids/Lashes/Lacrimal > Flashcards

Lids/Lashes/Lacrimal Flashcards

1
Q

How do the tears seen in dry eye compare with those in normal eyes?

A

Higher pH than normal

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2
Q

In dry eye, does the osmolarity of the tears increase or decrease?

A

Increase

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3
Q

What is the tear volume in a normal patient?

A

6.0-8.0 microliters

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4
Q

What is the average drop volume of an ophthalmic drop?

A

25-50 microliters

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5
Q

What is madarosis?

A

Eyelash loss

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6
Q

What is poliosis?

A

Eyelash discoloration due to a decrease or absence in melanin

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7
Q

Contraction of the orbicularis oculi to close the eye aids in movement of tears through the lacrimal canalicul and nasolacrimal drainage system via the action of which section of the muscle?

A

Muscle of Horner

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8
Q

What is the other name of the Muscle of Horner?

A

Pars lacrimalis

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9
Q

The muscle of Horner is part of which portion of the orbicularis?

A

Palpebral

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10
Q

Where do the fibers for the muscle of Horner originate?

A

Lacrimal crest

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11
Q

What is the other name for the muscle of Riolan?

A

Pars ciliaris

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12
Q

Where does the muscle of Riolan lie?

A

Near the lid margin

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13
Q

What is the purpose of the muscle of Riolan?

A

To keep the lids opposed to the globe (also some rolling of the lids)

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14
Q

What is the primary action of the muscle of Mueller?

A

Sympathetic control to widen the palpebral fissure

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15
Q

A common cause of epiphora in infants is caused by a small membrane that covers over what structure?

A

The valve of Hasner

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16
Q

The majority of Valve of Hasner blockages in infants will self-resolve within what time frame?

A

12 months

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17
Q

What Tx may be used to try and unblock the Valve of Hasner in an infant?

A

Massage of the nasolacrimal sac

18
Q

What is the most common cause of trichiasis?

A

Chronic blepharitis

19
Q

A 43 year-old female patient complains of sequential styes, and red, irritated eyes. SLE reveals meibomitis and blepharitis, along with lid telangiectasia, with a 4 second TBUT. She also reports that her cheeks, nose, forehead and chin are easily flushed, especially when exposed to heat or cold. What is your tentative Dx?

A

Rosacea

20
Q

Rhinophyma is common in rosacea. What is rhinophyma?

A

Large, bulbous, red nose

21
Q

Rosacea is seen more frequently in which gender?

A

Female, 2:1

22
Q

What is the best Tx for ocular rosacea?

A

Manage concomitant lid disease

ATs

23
Q

What are the potential ocular implications of rosacea?

A 
Blepharitis
Meibomitis
Telangiectasia
Dry eye syndrome
*SPK
*Pannus
*Neovascularization
* = less common
24
Q

What is a hallmark, common finding of Systemic Lupus Erythematosus?

A

Malar (butterfly) rash on the cheeks and nose

25
Q

What causes a malar rash to worsen in SLE?

A

UV light

26
Q

Your patient is complaining of epiphora. If after administering Jones I test, your cotton swab shows dye. What is the most likely cause of the epiphora?

A

Hypersecretion of tears

27
Q

Reflexive blinking is caused by the stimulation and inhibition of which muscles?

A

Stimulation of orbicularis

Inhibition of levator

28
Q

An abnormally high positioned upper eyelid crease is indicative of which type of eyelid ptosis?

A

Aponeurotic

29
Q

What are the clinical findings associated with an aponeurotic ptosis?

A

Mild to moverate upper eyelid ptosis
Abnormally highly positioned upper eyelid crease
Good levator function

30
Q

What is the typical demographic that is seen with an aponeurotic ptosis?

A

Elderly

31
Q

What causes an aponeurotic ptosis?

A

Stretching of the levator aponeurosis, resulting in elongation of the length of the muscle and resultant ptotic upper eyelid

32
Q

What is the typical measurement from upper lid margin to lid crease in males and females (downgaze)?

A

Males 8mm

Females 10mm

33
Q

What 3 bones make up the floor of the orbit?

A

Maxillary
Palatine
Zygomatic

34
Q

Which bone is the weakest in the orbital floor?

A

Maxillary bone (posteromedial portion)

35
Q

What bones make up the orbital roof?

A

Lesser wing of sphenoid

Frontal (orbital plate)

36
Q

What bones make up the lateral wall of the orbit?

A

Greater wing of sphenoid

Zygomatic

37
Q

What bones make up the medial wall of the orbit?

A

Maxillary
Lacrimal
Ethmoid
Spenoid

38
Q

Which cranial nerve is responsible for opening the eye?

A

CN III - oculomotor

39
Q

Which cranial nerve is responsible for closing the eye?

A

CN VII - facial

40
Q

To open the eye, CN III innervates which muscle?

A

Levator

41
Q

To close the eye, CN VII innervates which muscle?

A

Orbicularis oculi

42
Q

Which CN provides sensory innervation to the eyelids and cornea?

A

CN V - Trigeminal

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