Oculoplastics Flashcards
The most common cause of lacrimal drainage failure
Punctal abnormality
Fluroscein dissappearance test (BKZ)
High meniscus >= 0️⃣.6️⃣ mm
N= 0️⃣.2️⃣-0️⃣.4️⃣ mm
The most common causes of primary punctal stenosis
Chronic blepharitis
Idiopathic stenosis
Ptosis measurements
KRM=4-5 mm
KA= 🚺8-12 mm, 🚹7-10 mm
LF= >15 mm; good:12-14, fair:5-11, poor:>5mm
Kapak cizgisi= 🚺10 mm, 🚹8 mm
Surgery in ptosis
LF is good=>10➡️KJM
LF is fair=>5➡️levator advancement
LF is poor=<4➡️frontalis suspension
Entubation in canalicular obstruction
Left in situ for 6weeks to 6 months
FOS
Cranium➡️orbita
Superior: CN5(1): lacrimal, frontal; CN4, VOS
Inferior: CN3, CN6, n.nasociliaris, sympathic fibers from the cavernous plx
FOI
Orbit➡️pterygopalatine and infratemporal fossa
CN5(2), branches of the pterygopalatine ganglion, VOI
Hertel
> 20 mm ➡️ proptosis
(Upper limit for white men:22)
Difference of >2-3 mm btw the eyes is suspicious
Thyroid eye disease-clinical activity score
Treatment if >3️⃣/7️⃣
- Spontaneous orbital pain
- Gaze evoked orbital pain
- Eyelid swelling
- Eyelid erythema
- Conjunctival redness
- Chemosis
- Inflammation of caruncule
Thyroid eye disease treatment
IV metilprednisolone
500mg once weekly - 6 weeks
250mg once weekly - 6 weeks
Preseptal cellulitis and Bacterial orbital cellulitis-patogens and treatment
Preseptal: S.aureus, S.pyogenes ➡️ ORAL co-amoxiclav
Orbital:➕S.pneumoniae, H.influenza [ethmoid sinus]
➡️ IV ceftazidime, metronidazol—continue till the patient has been apyrexial for 4 days, followed by 1-3 weeks of oral treatment
BCC
Most common: LOWER eyelid
Differentiation from SCC: surface vascularization, slowly growing
Blepharitis-anterior vs posterior
Anterior: staph or seborrheic
Posterior: MGD
Chalazion vs Ext.Hordoleum
Chalazion: Meibomian,retained sebasous secretions
Ext.hordoleum: Zeis, staph
Angular blepharitis-cause and treatment
Moraxella lacunata/S.aureus ⬇️ Topical chloramphenicol(gemysetin) bacitracin erythromicin
Where is the nasolacrimal duct obstruction in congenital obstruction?
Valve of Hasner
Chronic canaliculitis-cause
Actinomyces Israelii
*sulfur granules
Thyroid eye disease-signs
Dalrymple:lid retraction in primary gaze
Kocher:frightened appearence in attentive fixation
The von Graefe:retarded decent of the upper lid in downgaze