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Kanski > Oculoplastics > Flashcards

Oculoplastics Flashcards

1
Q

The most common cause of lacrimal drainage failure

A

Punctal abnormality

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2
Q

Fluroscein dissappearance test (BKZ)

A

High meniscus >= 0️⃣.6️⃣ mm

N= 0️⃣.2️⃣-0️⃣.4️⃣ mm

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3
Q

The most common causes of primary punctal stenosis

A

Chronic blepharitis

Idiopathic stenosis

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4
Q

Ptosis measurements

A

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

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5
Q

Surgery in ptosis

A

LF is good=>10➡️KJM
LF is fair=>5➡️levator advancement
LF is poor=<4➡️frontalis suspension

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6
Q

Entubation in canalicular obstruction

A

Left in situ for 6weeks to 6 months

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7
Q

FOS

A

Cranium➡️orbita
Superior: CN5(1): lacrimal, frontal; CN4, VOS
Inferior: CN3, CN6, n.nasociliaris, sympathic fibers from the cavernous plx

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8
Q

FOI

A

Orbit➡️pterygopalatine and infratemporal fossa

CN5(2), branches of the pterygopalatine ganglion, VOI

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9
Q

Hertel

A

> 20 mm ➡️ proptosis
(Upper limit for white men:22)
Difference of >2-3 mm btw the eyes is suspicious

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10
Q

Thyroid eye disease-clinical activity score

A

Treatment if >3️⃣/7️⃣

  1. Spontaneous orbital pain
  2. Gaze evoked orbital pain
  3. Eyelid swelling
  4. Eyelid erythema
  5. Conjunctival redness
  6. Chemosis
  7. Inflammation of caruncule
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11
Q

Thyroid eye disease treatment

A

IV metilprednisolone
500mg once weekly - 6 weeks
250mg once weekly - 6 weeks

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12
Q

Preseptal cellulitis and Bacterial orbital cellulitis-patogens and treatment

A

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

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13
Q

BCC

A

Most common: LOWER eyelid

Differentiation from SCC: surface vascularization, slowly growing

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14
Q

Blepharitis-anterior vs posterior

A

Anterior: staph or seborrheic
Posterior: MGD

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15
Q

Chalazion vs Ext.Hordoleum

A

Chalazion: Meibomian,retained sebasous secretions

Ext.hordoleum: Zeis, staph

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16
Q

Angular blepharitis-cause and treatment

A 
Moraxella lacunata/S.aureus
⬇️
Topical chloramphenicol(gemysetin)
bacitracin
erythromicin
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17
Q

Where is the nasolacrimal duct obstruction in congenital obstruction?

A

Valve of Hasner

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18
Q

Chronic canaliculitis-cause

A

Actinomyces Israelii

*sulfur granules

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19
Q

Thyroid eye disease-signs

A

Dalrymple:lid retraction in primary gaze
Kocher:frightened appearence in attentive fixation
The von Graefe:retarded decent of the upper lid in downgaze

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20
Q

Thyroid eye disease-Orbital myositis diff diagnosis

A

TED: always tendon sparing
OM: with or without involvement of the tendons

21
Q

Acute dacryocystitis vs Acute dacryoadenitis

A

Cystitis: staph/strep➡️oral flucloxacilin/co-amoxiclav

Adenitis: EBV/rarely bacterial➡️treatment not required in many cases (or according to the cause)
⭐️S-shaped ptosis

22
Q

Congenital causes of watering eye-diff diagnosis

A 
Nasolacrimal duct obstruction 
Punctal atresia
Congenital glaucoma
Chronic conjunctivitis (chlamydia)
Keratitis
Uveitis
23
Q

Carotid-cavernous fistula-triad

A

1️⃣pulsatile proptosis(with bruit)
2️⃣conjunctival chemosis
3️⃣whooshing noise in the head

24
Q

Carotid-cavernous fistula-the most frequently affected CN

A

CN 6 (due to its free-floating location within the cavernous sinus)

25
Carotid-cavernous fistula-investigation
CT/MR: prominence of the VOS
26
Varices and Lymphangioma-the most frequent site
Upper nasal ⭐️Lymphangioma:bluish
27
The most common tumour of the orbit and periorbital area in childhood
Capillary haemangioma
28
Capillary haemangioma-visceral involvement
Can lead to serious complications: thrombocytopenia(Kasabach-Merritt syndrome), high-output cardiac failure ⚠️systemic investigation should be considered
29
Capillary haemangioma-treatment
Rapid growth 3-6months after diagnosis Slower phase of natural resolution 30% resolve by age 3 75% resolve by age 7
30
The most common orbital tumor in the adults
Cavernous haemangioma
31
Cavernous haemangioma-treatment
Asymptomatic: observation alone Symptomatic: surgical excision (well encapsulated and relatively easy to remove unlike capillary h.)
32
The most common epithelial tumour of the lacrimal gland
Pleomorphic adenoma=benign mixed tumour ✳️No pain ✳️Treatment:surgical excision ❗️NO BIOPSY prior to surgery in order to prevent seeding
33
The most common peripheral neural tumour of the orbit
Plexiform neurofibroma
34
NF-1
``` Iris hamartomas=Lisch nodules Optic nerve glioma Plexiform neurofibroma Encephalocoele Glaucoma ```
35
NF-2
Optic nerve sheath menengioma
36
The most common soft tissue sarcoma of childhood | The most common primary orbital malignancy in children
Rabdomyosarcoma
37
Evisceration
Sclera and extraocular muscles remain intact ❗️if malignancy➡️do enucleation
38
Evisceration
Sclera and extraocular muscles remain intact ❗️if malignancy➡️do enucleation
39
The most common cause of both unilateral and bilateral proptosis in adults
Thyroid eye disease
40
The most common cause of unilateral proptosis in children
Orbital cellulitis
41
Orbital walls-the strongest and the weakest
Strongest: lateral Weakest: medial
42
The volume of the average human orbit
30 mL
43
MR-T1 and T2
T1: fat brighter T2: vitreous brighter
44
Optic nerve glioma-radiography
⭐️pathognomonic: Kinking of the optic nerve
45
The most common malignant neoplasm of the lacrimal gland
Adenoid cystic carcinoma ✳️perineural invasion➡️pain ✳️Biopsy is necessary for histological diagnosis
46
Wolfring and Krause
10% of production (basal tear secretion) (lacrimal➡️reflex tear secretion) Wolfring: in tarsus Krause: in the conjunctival fornices
47
Upper and lower eyelid-analogs
Levator aponeurosis↔️capsulopalpebral fascia Whitnall’s ligament(condensation of levator muscle sheath)↔️Lockwood’s suspensory ligament(condensation of capsulopalpebral fascia) Müller muscle↔️inferior tarsal muscle
48
Meibomian, Zeiss, Moll
``` Meibomian: within tarsus ➡️chalazion Zeis: near lid margin ➡️external hordeolum Moll: near lid margin ```

Kanski (7 decks)

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