Ocular Adnexal Evaluation (M3) Flashcards
About how many meibomian glands are in the upper eyelid? 1. Lower eyelid? 2
- 25-30
2. about 20
What are contraindications for punctal plug insertion?
- allergy to collagen or silicone
- active conjunctival infection
- dacryocystitis
- eyelid inflammation
What is the procedure in which an eyelash is mechanically removed called?
epilation
What is the anesthetic procedure preparation of lacrimal sac dilation and irrigation?
instill two drops of proparacaine and place anesthetic soaked Q-tip over punctum for a few minutes
When performing the Jones 1 testing, does the lack of of fluorescein mean (+) or (-) result? 1. What does this indicate? 2. What should be done? 3
- negative
- functional blockage
- massage lacrimal sac and blow nose then repeat. Then if still positive, do Jones 2
When performing the Jones 2 testing, does the lack of of fluorescein mean (+) or (-) result? 1. What does this indicate? 2
- negative
2. functional blockage exists nearer to canaliculus and punctum
What is the distance from lid margin to skin fold in primary gaze?
pre-tarsal show
When performing the Jones 2 testing, does the presence of fluorescein mean (+) or (-) result? 1. What does this indicate? 2
- positive
2. functional blockage likely in nasolacrimal duct
What is the margin-reflex distance? 1. What is normal? 2
- distance from upper lid margin to corneal reflection of penlight
- 4-4.5 mm
What is the diameter range of silicone punctal plugs?
0.3-0.8mm
What are the lid margin descriptor terms?
- scalloped/notched
- erythematous
- telangiectatic
What are the contraindications for meibomian gland expression?
- acute internal/external hordeolae
2. preseptal cellulitis
What is the measurement of the anterior projection of the cornea relative to the lateral orbital rim called? 1. What tools are used? 2. What are the indications of these results? 3
- exophthalmometry
- Hertal or Luedde
- proptosis or enophthalmos
What is the distance of lid margin excursion from downgaze to upgaze called? 1. What is normal? 2. What is good? 3. What is fair? 4. What is poor? 5
- levator function
- over 15mm
- 12-14mm
- 5-11mm
- 4mm or less
What are the grading scale terms used to describe meibum?
- clear
- cloudy
- granular
- toothpaste
When performing the Jones 1 testing, does the presence of fluorescein mean (+) or (-) result? 1. What does this indicate? 2
- positive
2. nasolacrimal drainage system is functioning
Is proparacaine used for punctal plug insertion?
yes
What ocular indication does lymph node palpation have?
differential diagnosis of red eye (viral conjunctivitis usually PAN+)
Which eyelid procedures require anesthetic?
- double eyelid eversion
2. meibomian gland expression
What are possible causes of obstruction along the nasolacrimal drainage system?
- debris
- infection of surround tissue
- infection of lacrimal sac
- tumor
During lacrimal sac palpation and punctal regurgitation, what indicates an obstruction, infection or inflammation of the lacrimal sac?
pus or mucus discharge
What is the visible difference between acute and chronic dacryocystitis?
acute is warm and red with pain (both have mucopurulent discharge)
What does the examiner need to beware of when performing double lid eyelid eversion?
Bell’s reflex
What does meibomian gland expression have the possibility of becoming if lid hygiene isn’t addressed right away?
acute internal hordeolum
