ophtha-all Flashcards by zarieh Novela

Vitreous is also attached to (but less firmly )

Optic disk margin
Macula
Post peripheral surface of lens

How well did you know this?

Not at all

Perfectly

Anterior condensation of peripheral vitreous forms

Anterior hyaline membrane

How well did you know this?

Not at all

Perfectly

Embryological origin of lens

from ectoderm from lens plate of 2 wk old embryo which becomes lens vesicle

How well did you know this?

Not at all

Perfectly

Cells of posterior wall of lens vesicle will become

Primary lens fiber (which begins to fill in the cavity of vesicle to constitute the central region “central dark interval”)

How well did you know this?

Not at all

Perfectly

Vitrectomy Thru pars plana

Closed vitrectomy

How well did you know this?

Not at all

Perfectly

At old age.. What metachromatic color has difficulty reaching the retina?

Blue and violet metachromatic

How well did you know this?

Not at all

Perfectly

It is due to opaque particles in vitreous

Impairment of vision

How well did you know this?

Not at all

Perfectly

Factors that contributes to transparency of lens

Regular parallel arrangement of fibers with the nuclei at periphery
Curvature of surfaces
Refractive capsule
Location of geometric center at middle
(And in addition, smooth, gradual blending of refractive indices-capsule,cortex and nucleus)

How well did you know this?

Not at all

Perfectly

Extra capsular method procedure that utilizes probe frozen -20 C

Cryoextraction

How well did you know this?

Not at all

Perfectly

Second sight is due to

Lenticular myopia form change of index of refraction

How well did you know this?

Not at all

Perfectly

Metab changes in lens is due to

Increase in Na and Ca content or
Decrease in K, glutathione ans as orbit acid content
(Which may lead to cataract)

How well did you know this?

Not at all

Perfectly

It is due to cast on retina by opacities floating in vitreous

Positive scotoma

How well did you know this?

Not at all

Perfectly

Symptom of vitreous opacities

Seeing spots in field of vision to actual diminution of vision of varying degree

How well did you know this?

Not at all

Perfectly

Volume of vitreous

4ml

How well did you know this?

Not at all

Perfectly

Caused by fine aggregates of vitreous protein due to age or myopia

Musca volitantes

How well did you know this?

Not at all

Perfectly

Disparity of image size between 2 eyes

Anisokonia

How well did you know this?

Not at all

Perfectly

Hypothyroidism is asso with developmental cataract. What is its essential feature?

Low ration of Ca to P in bld

How well did you know this?

Not at all

Perfectly

Management for cataract

Surgical removal

How well did you know this?

Not at all

Perfectly

How does cataract formed in changes in ciliary body

Catalytic changes in ciliary body which is responsible for increased formation of aqueous with the aid of carbonic anhydrase

How well did you know this?

Not at all

Perfectly

In young, surgery should be done ASAP if..

Both eyes have poor vision

Strabismus sets in

How well did you know this?

Not at all

Perfectly

How is accommodation in aphakia

Completely lost

How well did you know this?

Not at all

Perfectly

Lost of gel-like consistency or conversion of vitreous into liquid

Vitreous liquefaction (syneresis)

How well did you know this?

Not at all

Perfectly

As the secondary vitreous increases in vol, the primary vitreous is forced forward to central position, the site of ?

Cloquet’s Canal

How well did you know this?

Not at all

Perfectly

Type of senile cataract which tends to become hard and shrunken

Nuclear cataract

How well did you know this?

Not at all

Perfectly

Embryological origin of primary vitreous

Protoplasmic processes of the lens vesicles and inner layer of optic cup

Aka linear extraction because of linear corneal incision

Capsulectomy

IFN pa cities are more numerous and extensive, the fundus reflex is

Lost

Any disturbance such as . . . Will cause lens opacities or cataract

Change in curvature Insinuation of water between individual fibers Deposition of substance in capsule

Source of hyaluronic acid and has phagocytic effect

Hyalocytes

Vigorous opacities is caused by

Inflammatory cells (post uveitis, endophthalmitis) RBC (vitreous hemo) Saponified Ca soaps (asteroid hyalitis) Cholesterol crystals (synchisis scintillans) Tumor cells (RB) Foreign bodies ff pentrating injury

Optical system of eye

Lens and cornea

Lens has sparse or numerous cells?

Sparsely cellular

By presbyope so who'd discovered that they can read small fine prints without aid of their old reading glass

"Second sight"

At what age will the zonule become hard to break, or be broken?

Before 40 y/o, zonule fibers are hard to break | After 20 y/o, zonules may be broken with aid of alpha-chemo trypsin

Type of cataract asso with local eye pathology (corneal infection, uveitis, glaucoma, vitreous hemo, retinal detachment, retinitis pigmentosa and tumors)

Complicated cataract

Gel-like conversion of colloidal struc of vitreous (which occur on aged, myopic, in trauma and inflammation)

Vitreous liquefaction (syneresis)

Cells of anterior wall of lens vesicle will become

Sub capsular epithelium

Is vision not threatened in vitreous detachment?

Yes. Unless asso with retinal tears, detachment or vitreous hemorrhage

What can u see in ophthalmoscope when the lens is completely opaque

No fundus reflex

In early nuclear sclerosis in cataract

Iris shadow

Extra capsular method procedure which uses lens capsule forces

Forcep extraction

Dz procedure to determine the nature and position of the opacities in lens

Biomicroscopy

Indication for surgical removal of cataract

Inability to perform usual work with aid of spectacles | Development of secondary glaucoma and uveitis

Lens has no blood vessels, nutrition is from..

Aqueous thru selective osmosis

Vitreous has the firmest attachment to the pars plana and retinal periphery

Vitreous base

Spherical protrusion of ant or post portion of lens producing visual impairment

Lentiglobus

Cataract is caused by

Metab changes Permeability disturbance Changes in aqueous, vitreous and ciliary body (Other: heredity, racia predisposition, malnutrition, light, heat, radiation and endocrine disturbance)

Lentiglobus vision is improved by

Refraction or lens extraction

Diagnosis of aphakia

Presence of deep anterior chamber Tremor of iris (iridodenisis) Absence of purkinje image

Extra capsular method procedure done in young, where ant capsule is removed ASAP and the hard nucleus is expressed out. Bigger corneal wound is made.

Capsulectomy

S&s in lens dislocation

Blurring Iridodenisis Monocular Diplopia (if lens equator is seen at pupil) Glaucoma (if ciliary body us irritated)

Deep form of ectopia lentis is

Congenital

Occurs as asymmetrical defect of zonule so lens is displaced away from the defective zonule fibers (as seen in semi dilated pupil)

Lens dislocation

Congenital absence of lens charac by small eyes (microphthalmic)

Aphakia

Where does the lens nuclei located?

Equator

If lens dislocation is due to trauma, lens is displaces toward...

Inferior (for zonules affected are superior)

Systemic cataract may be due to

DM | Hypothyroidism

Method of cataract extraction where capsule breaks

Extracapsular extraction

Ophthalmic exam of fudge requires the need of high plus lens, approx..

+10 D

Indentation or defect of lens equator asso with absence of zonule fibers

Lens coloboma

A gradual and progressive dse charac by Any opacity of lens with visual impairment

Cataract

Method of cataract extraction where lens is removed with capsule intact

Intra capsular extraction (not possible if pt is <20 y/o)

What can u see in ophthalmoscope in pathological vitreous

Scattered floater or opacities may appear black against red fundus reflex

This occurs when vitreous liquefaction results to separation of surrounding tissue (esp retina)

Vitreous detachment

Crystalline biconvex structure

Lens

Mesenchymal cells enter the region of optic cup to contribute to ..

Primary vitreous

T/f. In Monocular aphakia, wearing spectacles will not restore the binocular vision

True. Because of disparity of image size (anisokonia) between 2 eyes

Seen as floater spots darting ms and out of field of vision (esp when gazes is focused in an illuminated background)

Musca volitantes

Condensation of fibrillation struc of vitreous or actual fibroblastic or glial proliferation from vascular elements. Pigments epith cells is also the source

Vitreous band and membrane

Vitreous band is commonly seen in

Diabetic retinopathy or ff long standing vitreous hemorrhage

Lens begins to lose its transparency with aging process

Senile cataract

Is visual outcome of lens extraction in complicated cataracts can't be predicted?

Yes

Young with cataract are prone to complications

Retinal detachment Uveitis Glaucoma

Lens dislocation is common in

Arachnodactyly or marfan's syndrome | Charac by extreme length and thinned of bones, ms weakness and miosis

What can you see in ophthalmoscope in cataract

At distance may show black spots in fundus reflex against orange-red background

Type of cataract which is generally bilateral, opacity localized in ant or post pole and lamella may be involved

Hereditary type of developmental cataract

In microphakia, when the pupil is dilated, the edge of Lens is seen all around the circumference of pupil = highly myopic

Microphakia is hereditary, recessive

Gel-like subs and constitutes the main bilk of eyeball

Vitreous

How does cataract formed in diabetics

Hyperglycemia increases reduced sugar (sorbitol) in aqueous and by osmosis, it withdraw some water from lens.

If lens dislocation is developmental type, lens is displaced..

Upward

Cells of equator of lens vesicle will become

Secondary fibers (which grows to surround embryonic lens)

Vitreous base extends __ mm anterior to ______ | And from posterior to _____.

2mm anterior to Ora serrata on pars plana | And from posterior to Ora serrata on peripheral retina

Ant capsule of lens is cut crosswise. The small knife is passed thru small puncture of cornea.

Discission

Part of lens

Central hard nucleus | Peripheral soft cortex enclosed by a capsule

Most common complaint in cataract

Cloudiness of vision

Lens has passive/active metabolism

Active metabolism as shown by its high protein

It is due to much traction and/or prsessure in retina by partially detached vitreous body

Photopsia

What are the conenzymes found in glycolysis during anaerobic condi

ATP | DPN diphosphoridine nucleotide

Lens is held in position by

Zonular fibers (from ciliary body that fused with capsule at region of equator)

Potential space between Lens and anterior hyaloid

Space of Berger

Formed by 9th wk by activity of vitreous and retinal cells

Secondary vitreous

Extra capsular method procedure where special app is that can be introduced anterior and post to lens with their rotating sharp edge slowly tearing the lens capsule and subs into small bits then aspired out

Lensectomy

Extra capsular method procedure which uses metal suction tip

Phakoeresis

In complicated cataract, the opacities begins..

Beneath the capsule (as a result of changes in capsular permeability)

Type of senile cataract where in opacity involves outer layers

Cortical cataract

"After-cataract" "membranous cataract"

Secondary cataract

When ciliary ms relaxes, zonules become tense, lens thinner = focused beyond retina = HYPEROPIA

When ciliary ms contract, zonules loosen, lens thicker = focused beyond retina = MYOPIA

Extra capsular method procedure where ant capsule is ruptured. Lens subs is stirred by the same point instru used in penetrating cornea

Needling

Forms bulk of postnatal vitreous

Secondary vitreous

Produce by margin of growing optic cup which later becomes suspension ligament of lens

Tertiary vitreous

Type of senile cataract where in the oldest fibers in center of lens lose their transparency

Nuclear (sclerotic type)

The cortical or outer layer of vitreous contains Small no of cells called..

Hyalocytes

Light flashes esp on movement of eyeball

Photopsia

Small lens with tendency to be spherical (spherophakia)

Microphakia

Some contraceptive drug have been found to induce cataract formation, such drug as ..

Thalidomide

In old age with change in color perception, the Blue color becomes ___

Green

Color of lens

Pale yellow | Darkens with old age

Sole source of energy of lens

Carbohydrates

Binocular vision is attained only with aid of contraindication tact lens or intra ocular lens

Unilateral cataract

The gel-like consistency, of oddity and viscosity of vitreous is due to

Due to a double fibrillation network system of collagen-like protein and hyaluronic acid which is suspended in large amt of water

Type of cataract with opaque membrane due to incomplete absorption of lens ff trauma or incomplete surgical removal of lens

Secondary cataract

Type of senile cataract tends to swell and liquefy

Cortical cataract

Principal objective sign in cataract

Lens opacity

Post peripheral surface of lens is called

Hyaloidocapsular ligament of Weigert

Thru corneal incision and aphakic pupil

Open vitrectomy

Partial or complete failure of embryonic hyaloid vascular system to regress which produces white pupil in small eye

Persisted hyperplastic primary vitreous

Most common symptom in vitreous detachment

Photopsia or floater

Most common type of hereditary type of developmental cataract

Ant axial embryonal cataract (appearing S&s multiplr fine opacities surrounded by faint halo)

In rubella cataract, surgery is done

After 3 yrs

Microphakia is asso with

Ectopia lentis | Congenital weakness of zonules

It affects pregnant mothers during first trimester (maternal illness during fetal life)

Rubella (lens is isolated for 3 yrs after birth)

Lens used to focus rays of light in retina

Aphakia bifocal lens

Flashing spots in field of vision

Positive scotoma

3 main symptom on pathology of vitreous

Positive scotoma Photopsia Impairment of vision

Change in color perception is due to

Accum of metabolizes of aa, tryptophan

Corneal and scleral scar, coloboma of iris and eccentric or irreg pupil may be present

Aphakia

Extra capsular method procedure where it uses special type of app used to dislocate anteriorly, fragments it by ultra vibration and finally aspirated the resulting small particles out

Phacoemulsification

Most common microorganism in bacterial purulent inflammation

Staph aureus P. Aeruginosa Proteus Coli form bacillus

Type of uveitis caused by live microorganism invading the eye

Granulomatous uveitis

Non-granulomatous/granulomatous uveitis. | Posterior synechiae

NG. Very thin | G. Heavy and hard to break

Choroid is supplied by

10-20 short ciliary a. (A branch of ophthalmic a)

COLOBOMA is located inferiorly/superiorly

Inferiorly

Beneficial effects of mydriasis

``` Breaks post synechiae (which is responsible for 75% of complications that end up in blindness) Reduces volume of iris, consequently decongesting the iris mechanically (which diminishes the vascular exudation of inflammatory cells) Reduces pain (cycloplegic effects) ```

Portions of iris, ciliary body, choroid or whole uvea is affected. It is charac by failure of optic cup to close completely during fetal life

COLOBOMA

Bilat post uveitis with retinal detachment in young

Harada's disease

Endophthalmitis may end up into phthisis

Yes

Purulent or non purulent inflammation: caused by bacteria or fungus

Purulent inflammation

Signs seen in uveitis with the aid of magnifying loupe or bio microscope (slit lamp)

Keratic precipitate Deposition of cells on post surface of cornea Aqueous flare or trnaslucency caused by increased albumin, aqueous cells, Koeppe's and Bussaca's pseudonodules Iris true nodule and stromal granuloma Post synechiae or adhesion between iris and cataract cells

It provides nourishment for pigment epith and outer layer of retina

Choroid

Usual known cause of endogenous uveitis. Nematode

Hookworm | Ascaris

First sign in fungus purulent inflammation

Hypopyon

Mydriasis solutions

Soln of atropine 1% Phenylephrine 10% Scopolamine 1% For 1-3 times/d

Usual complaint in Aniridia

Photophobia

TB uveitis affects both ant and post uvea?

Yes

The blood vessels layers are limited by 2 membranes, externally by ____ and internally by ____

Externally by suprachoroid | Internally by Bruch's membrane

Non-granulomatous/granulomatous uveitis. | Choroidal exudates

NG. None | G. Large

Type of uveitis caused by introduction of inert substances, the composition of living organism, or whole dead organism into the eye

Non granulomatous uveitis

Panophthalmitis is characterized by

Proptosis Chemosis Limitation of ocular movement

Treatment for leprosy

Sulfone drugs (promin, promizole)

Non-granulomatous/granulomatous uveitis. | Pigmentation

NG. None | G. Prominent at borders of chordal exudates

Does TB uveitis has tendency for recurrence?

Yes

Common cause of larvae migran syndrome

Larval hookworm and ascaris in dogs and cats

Anterior uvea

Iris and ciliary body

Charac by acute ant uveitis with greasy kp, and pseudo or true iris nodule or circumscribed irreg choroidal exudates

TB uveitis

Special type of uveitis with mild ant or post granulomatous uveitis and violent post uveitis with endophthalmitis

Larvae migran syndrome

Gout attack lasts for ____ leaving come residual post synechiae, pupillary membrane and and later in bans keratopathy

4-10 d

Anterior uvea has 2 circumferential arterial network

1. Major arterial circle of ciliary body and part of ant choroid 2. Minor arterial circle of iris

Difference in color of iridis of 2 eyes

Heterochromia

Usual known cause of endogenous uveitis. Viral

``` Herpes simplex Herpes zoster Measles Mumps Lymphogranuloma venerum Cytomegalic inclusion bodies ```

Pigment proliferation depends on amt of pigment. What has least pigmentation and greatest pigmentation?

Iris has least pigmentation. Ciliary body more. Choroid most.

More severe inflammatory reaction

Ciliary body. | Hs greater number of blood vessels and cells

Non-granulomatous/granulomatous uveitis. | Ciliary injection

NG. Severe | G. Mild

Special type of uveitis charac by small peripheral exudates with hemorrhage that ends up as sharply demarcated punched-out scars

Histoplasmosis

Most common org causing foci of infection

B-streptococcus hemolyticus

Secretes aqueous humor and controls accommodation

Ciliary body

When there is pain in purulent inflammation which occurs during the first week in endogenous type and much later in exogenous type

Glaucoma

In acquired type of heterochromia. the light/dark colored type is abnormal.

Darker eye because of pigment proliferation. | It usually follows uveal inflammation

Special type of uveitis confined to ant segment as granulomatous uveitis with whitish nodule in surface of iris

Leprosy

3 types of uveitis believed to be viral in etiology

1. Behcet's disease 2. Harada's disease 3. Vogt-Koyanagi disease

Least severe inflammatory reaction

Iris. | Has limited bld supply and few stromal cells

Non-granulomatous/granulomatous uveitis. | Aqueous

NG. Cells plenty | G. Cells few

Mydriasis is done within ____ otherwise synechiae will remain permanent

Done within first 7-10 d

When infection extends to sclera and orbital struc producing proptosis, chemosis and limitation of ocular movement

Panophthalmitis

Behcet's disease

Appearance of ant uveitis Hypopyon Aphthous ulcer on mouth, tongue and genitalia

T/f. Uveitis is a recurring condition

True

To destroy cyst containing trophozoites which when released are responsible for recurrence

Photo coagulation

Cause of uveitis common in Asia and Eastern Europe

The principles of treatment of uveitis can be resolved into

1. Mydriasis 2. Anti-inflammation 3. Specific therapy

Virus that cause ant non-granulomatous type

Herpes simplex Herpes zoster Mumps Lymphogranuloma venerum

Usual known cause of endogenous uveitis. Fungal

``` Blastomyces Monilia Coccidiodomyces Cryptococcus Histoplasma ```

Usual known cause of endogenous uveitis. Protozoan

Amoeba | Toxoplasma

Non-granulomatous/granulomatous uveitis. | Vitreous opacities

NG. Thin with few cells | G. Heavy with plenty cells

Most severe inflammatory reaction

Choroid. | Has marked vascularity

In Aniridia, what is present behind the limbus

Iris tag

Non-granulomatous/granulomatous uveitis. | Course

Non granulomatous. Self-limiting (1-2wks) | Granulomatous. Protracted with remission

If there is consistent and prolonged Mydriasis, give

Sub conjunctival injection 0.5mL

Most common microorganism in fungal purulent inflammation

``` Aspergillus Candida Sporotrichium Cephalosporum Cryptococcus Actinomyces ```

Regulates size of pupil

Iris

Adhesion between iris and cataract cells

Synechiae

Absence of iris

Aniridia

In glaucoma, there is pain in purulent inflammation which occurs during ___ endogenous type and____ in exogenous type

In glaucoma, there is pain in purulent inflammation which occurs during 1st wk in endogenous type and much later in exogenous type

Specific type of uveitis that has protean manifestation.

TB uveitis

Pigmented vascular middle coat of the eye extending from optic disc to pupil

Uvea

Specific type of uveitis with acute ant uveitis with greasy kp, and post granulomatous uveitis

Lens-induced uveitis

Virus that cause posterior -granulomatous type

Cytomegalic inclusion body

Embryological origin of ciliary body and iris

Have Neuro ectodermal components

In heterochromia, when aging, these 3 appears

Glaucoma Uveitis Cataract

Choroidal absence which may be partial or total where only macula is left. With bight blindness but central vision is retained.

Choroideremia

Cause of uveitis common in Middle East and japan

Viruses

In hereditary type of heterochromia. the light/dark colored type is abnormal.

Light colored eye because if thinning of iris stroma

Accompanied by adjacent notching of lens and Astigmatic refractive errors

Ciliary body coloboma

Cause of uveitis common in central US

Histoplasmosis

Embryological origin of uvea

Mesodermal in origin from tissues surrounding primary optic vesicle

Posterior uvea

Choroid

If condition in purulent inflammation does not improve in 4 days...

Vitrectomy (evacuation of vitreous)

Suppuration in uvea, retina and vitreous setting up

Endophthalmitis

Non-granulomatous/granulomatous uveitis. | Nodules

NG. None | G. Frequent

Endo or exogenous type of purulent inflammation: | Initially hypopyon

Exogenous type

T/f: choroid has tendency to be isolated as well as macula

True. Because of segmental arrangement of choriocapillaries

Non-granulomatous/granulomatous uveitis. | Pain

NG. Present | G. None

Special type of uveitis with post choroidal exudate

Toxoplasmosis

Non-granulomatous/granulomatous uveitis. | Onset

Non Granulomatous: acute | Granulomatous. Chronic

3 parts of uvea

1. Choroid 2. Ciliary body 3. Iris

Usual form of foci of infection

Ant uveitis with fine kp and cells and post synechiae

Reflex pupillary dilation

Mydriasis

Non-granulomatous/granulomatous uveitis. | Keratin precipitates

NG. Small, pin-point | G. Big and greasy

Non-granulomatous/granulomatous uveitis. | Retinal edema

NG. Generalized | G. Localized over choroid all exudates

Anti-inflammation by locally applied steroid utilized in anterior uveitis. Local suspension, ointments , subconj, succinate ans subconj acetate is given every ... To obtain adequate therapeutic level in aqueous.

Local suspension. 1-3 hrs Ointment. 6-8 hrs Subconj succinate. 3 d Subconj acetate. 2 wks

Similar with harada's disease but ends up with an ant granulomatous uveitis with accompanying vitiligo, poliosis, alopecia, dysacusia

Vogt-kayanagi disease

Specific type of uveitis charac by acute ant uveitis with fibrin in anterior chamber I. Young asso with collagen disease

Rheumatoid disease

Endo or exogenous type of purulent inflammation: | Initially vitreous opacities

Endogenous type

T/f: uveitis by itself does not cause blindness

True

Most common org causing foci of infection in Philippines

Alpha strep

Non purulent inflammation

Uveitis

Specific type of uveitis charac with spontaneous or traumatic rupture of lens capsule

Lens-induced uveitis

Special type of uveitis wc is an autoimmune disease with bilateral granulomatous uveitis which follows a perforating ocular injury affecting ciliary body in one eye.

Sympathetic ophthalmia.

Special type of uveitis as acute ant granulomatous uveitis with gelatinous exudate and crystals in ant chamber

Gout

Cause of uveitis common in Western Europe and America

Toxoplasmosis

In Aniridia, the structure behind the cornea is

Black

Anterior uvea is supplied by

2 long ciliary a (branch of ophthalmic a)

Usual known cause of endogenous uveitis. Bacterial

``` TB Leprosy Syphilis Strep and staph Klebsiella Meningococcus Gonococcus Coliform bacilli ```

Special type of uveitis with ant granulomatous uveitis ans appears as macular edema

Amoeba

Non-granulomatous/granulomatous uveitis. | Residual damage

NG. None or very slightly | G. Always and marked

Choroid layers of blood vessels

1. Outer layer of large veins leading to vortex veins (haller) 2. Middle layer of medium veins and some arterioles (sattler) 3. Inner layer of choriocapillaries

Accumulation of leukocytes in anterior chamber

Hypopyon

S&s of uveitis

``` Ciliary injection Fibrin in anterior chamber Small irreg pupil Pupillary membrane Vitreous opacities Choroids exudation ```

Any black area seen on the reflex in ophthalmoscope means ...

Opacity in ocular media

Green vision

Chloropsia

If the iris is pushed backward, the anterior chamber is ...

Deep

Sudden/gradual onset of blindness is charac of crao, vitreous hemo, retinal detachment and optic nerve trauma

Sudden onset

The portion in space wherein objects can be seen when gazing at a certain fixed direction.

Visual field

Subjective signs

1. Pain (orbital pain, headache) | 2. Disturbances of vision

Rainbow colored halo

Glaucoma | Incipient cataract

The peripheral vision is determined by measuring

Visual fields | Dark adaptation

Ophthalmoscope studies the...

Retina Choroid Optic disk

Presence of a fast component denotes a labyrinthine etiology. It is caused by poor central vision.

Ocular nystagmus

The smallest print can be read by normal individual at a distance of __cm

25cm (13in)

Temporal to the disc is the

Macula

Headaches that are localized in___ regions are ocular in nature.

Frontal and temporal

Foreign body sensation or sharp pain in the eye occurs when

When lid moves

Soreness or tenderness is elicited by.

Pressing the eyeball

Xanthopsia is due to

Jaundice and carbon monoxide poisoning

White vision is due to

Digitalis poisoning

If the headache is bilateral, it is asso with.

Uncorrected refractive errors or ms imbalances

Caused by dilatation of superficial conjunctival blood vessels

Conjunctival congestion

Red vision

Erythropsia

Visual pigment of rods

Rhodopsin

The most practical way for one to measure the accommodation of a patient is to test his vision for near by what Test?

Jaeger test cards

Defects In the 2 eyes that are not equal in size and shape are termed congruous/incongruous.

Incongruous

The human eye as a sense organ is stimulated adequately by light alone and it sees that portion of energy spectrum whose wavelengths range from..

400-800 millimicra (mu)

Minute irregular curvature of cornea can be detected only by ..

Placido disk or keratometer

Pain sensation in the eye can be tested by looking for ..

By looking for Ciliary tenderness and by checking for corneal sensitivity.

Sudden/gradual onset of blindness is charac of corneal opacities, cataract, optic atrophy and chronic intraocular inflammation.

Gradual progressive blindness

The highest limit of the normal value in applanation tonometer

20mmHg

Redness localized in lateral aspect

Inflammation of lacrimal gland

Violet vision

Ianthenopsia

Temporary dimness sensation is vestibular/ocular in origin and are elicited by turning of eyes vertically or horizontally.

Ocular

The cones/rods are anatomically more separated and 2-4 cones/rods is connected to one ganglion cell.

Rods

Seeing double with only one eye noted when 2 diff retinal areas of an aye subserve 2 diff images

Monocular diplopia

Visual pigment of cones

Iodopsin

The second most frequent abnormal neurologic finding in cerebellopontine angle tumor

Diminution of sensation of eyes

An island of vision surrounded by a sea of blindness.

Visual field

Both eyes may have partial blindness at the same time.

True

Whirling and swaying sensation is vestibular/ocular in origin and are elicited by a sudden movement of the head.

Vestibular

The cones/rods are anatomically closely packed together and each cones/rods is connected to one ganglion cell.

cones

What do u call the reflex when the light is directed to the pupil of one eye, that the pupil will constrict

Direct light reflex

Any gray or bluish area seen on the reflex in ophthalmoscope means ...

Retinal lesion

The highest limit of the normal value in indentation or schiotz tonometer.

25mmHg or 5 scales reading

Superior palpebral folds are generally present in the upper lid ___mm above margin

10mm

Generally, upper lid margin is ___mm below upper limbus, while the lower lid margin is just at level of lower limbus.

2mm

Filipinos at age __ have difficulty reading fine prints at a distance of __cm.

37yrs old | 28-30cm

Colored vision

Chromatopsia

Central vision is determined by measuring

Visual acuity | Color perception

Erythropsia is due to

Vitreous hemorrhage | Aphakia

It is tested by touching the cornea with a wisp of cotton

Corneal sensitivity

Objective signs

1. Redness 2. Crust formation 3. Secretion (watery secretions, discharges) 4. Lumps 5. Lid disturbances (malformation,malposition) 6. Eyeball disturbance (abn size, malposition, maldirection, malfixation)

Chloropsia and ianthenopsia is due to

Chorio-retinal pathology

Normally a person will start not seeing the colored objects within __sec.

40s. More than this period is abnormal.

It is felt after excessive use of the eyes or when the patient tends to rub the eyes

Itching, smarting or burning sensation

At the peripheral part of the chamber, the iris should be adherent to the cornea

False

What do u call the reflex when the light is directed to the pupil of one eye, that the pupil will constrict and simultaneously the pupil of other eye will also constrict.

Consensual light reflex

Yellow vision

Xanthopsia

Poor near vision

Presbyopia

Redness localized nasally is due to

Inflammation of lacrimal sac

Caused by dilatation of deeper blood vessels of anterior ciliary artery

Ciliary injection

Among Asians the superior PAlpebral fold can be located lower or lost because

Of the absence of cutaneous insertions of elevator palpebral ms

This soln should be placed on the eyes after the examination to avoid an acute attack of glaucoma

Pilocarpine 1%

Cyanopsia is due to

Initial cataract extraction

Blue vision

Cyanopsia

The term hypotropia is not used.

Yes. If right eye is lower, it is recorded as left hypertropia.

The ophthalmoscope is put on. The lens is set at zero. The examiner directs the light at the patient's eye from a distance of __cm.

5ocm

If the headache is unilateral, it is due to ..

Inflam of orbit, lids or eye and glaucoma

What color has the longer wavelength?

Red

Measured by checking the minimum size of a letter that the eye can recognized at a certain distance under daylight illumination.

Visual acuity

Whitish foamy secretion can be present in

Vit A deficiency

What color has the shorter wavelength?

Violet

The distance between that point and the eye has an equivalent power of accommodation expressed in

Diopter

The presence of the lens can be verified by the appearance of at least 2 light reflexes in the pupillary area (purkinje images). One reflex coming from,, and the other from...

Anterior lens capsule and posterior lens capsule

If the iris is pushed forward, the anterior chamber is ...

Shallow

Absence of a reflex occurs when the opacity in the ocular media is

So dense as not to allow the light to penetrate inside

Defects In the 2 eyes that are equal in size and shape are termed congruous/incongruous.

Congruous

The veins are larger in size than arteries. The veins may show pulsation but not the arteries.

True

Hemangioma of Irreg blue red patch of variable size formed by diffuse telangiectasis of mature vessel of dermis

Nevus flammeus

Acute staph infection of asso gland of lids charac with circumscribed red, swollen and tender mass

Hordeolum

Skin deposition of lipid materials in inner part of upper and lower lid. Lesion is yellowish and slightly elevated plaque with sharply demarcated margins

Xanthelasma

What IOM is involved in ptosis

Superior rectus ms

Most common malignant tumor of eyelid

BCC

Small cylindrical benign growth in eyelid

Cutaneous horn

In ulcerative blepharitis, chronically, lid margins hypertrophies and thickens which cause upper lid to droop down giving ruse to sleepy appearance called

Tylosis

Endocrine exophthalmos is a pituitary disfunc wherein an ____ is released initiating cellular filtration of tissue within the orbit

EPS

Hemangioma of soft red lesions which disappears spontaneously

Capillary hemangioma

Retrodisplacement of globe is seen in..

Horner's syndrome

Local inflam which affects skin of lid

Contact dermatitis

OO has 2 parts. What part is responsible in invol blinking?

Central orbital part of OO

Thyrotoxic exophthalmos is charac by

Slight exophthalmos Lid retraction Lid lag

Blinking is a protective mechanism, it involves the contraction of tarsal part of OO lasting

0.3 s every 5s

The orbit extends anterior to the tarsus and can thank ligaments forming

Orbital septum

Passive forward displacement or protrusion of eyeball from its normal place

Proptosis

Symptomatology of orbital pathology

1. Proptosis, exophthalmos 2. Displacement of globe 3. Congestion or edema of lids and conjunctiva 4. Bruit and pulsation

Swelling of this hordeolum is at lid margin

External hordeolum

Contains orbital fat that serves as cushion for the eyeball

Peripheral surgical space

BCC of lid spreads by

Hematogenous spread

Thermal burns, lid injuries and skin infection may result in

Ectropion

In ulcerative blepharitis, lashes may be lost due to destruction of hair follicles called

Madarosis

Inability of lids to close due to paralysis of CN7

Lagophthalmos

Swelling of this hordeolum is away from lid margin

Internal hordeolum

In lid, Incision of grayline splits into

Posterior part- tarsal plate and conjunctiva | Anterior part- orbicualris oculi, skin and hair follicles

Rare type in which the affected eyelid elevates when the pt opens his mouth while chewing or laterally moves his jaw. Ptosis reappears when mouth is closed.

Marcus-Gunn or jaw-winking phenomenon

Infection of lids by crab louse (pediculosis pubis or capitis)

Phthiriasis palpebrarum

A difference of __mm between eyes in exophthalmometry is abnormal

>2mm

Orbital edema has no muscle paralysis.

Yes

Space Between periorbita and bone

Subperiosteal space

True exophthalmos is less frequent than proptosis

True

SCC of lid is common in m/f, lower/upper lid

M, upper lid

Form of verruca that is filiform

Verucca digitala

SCC of lid spreads by

Lymphatic spread

Infection of gasserian ganglion charac by unilateral vesicular eruption along distribution of 1st and 2nd division of CN5

Herpes zoster ophthalmicus

In orbital vein obstruction, what can u find in ophthalmoscope

Venous stasis | Optic atrophy

Notching of defect in continuity if lid margin

Coloboma

Solid tumors ans endocrine exophthalmos do not yield any degree of compressibility.

True

Innervating of eyelid

Upper lid and lateral portion of lower lid - C5-1 (ophthalmic n) The rest is form maxillary div thru infraorbital n.

Ulcerative blepharitis is caused by what organism

Staph aureus

Hordeolum involving meibomian gland

Internal hordeolum

Loss of elasticity of skin of lids in aging

Blepharochalasis

Each tarsus contains parallel rows of this gland which provides airtight closure of lids and provides rapid evaporation of tears.

Meibomian gland

Red inflamed margins with yellow crust which may become adherent to base of lashes

Ulcerative blepharitis

Abnormal drooping of upper lid due to absence or weakness of levator palpebral ms or lesion to CN3

Congenital Ptosis or blepharoptosis

Chronic inflammation of meibomian gland which is usually bilateral and preceded or asso with blepharitis

Meibomianitis

Lymphatic drainage of eyelid

Medial 2/3 of lower lid and medial 1/3 of upper lid - submaxillary lymph vessel Lateral 1/3 of lower lid and lateral 2/3 if upper lid - pre-auricular lymph vessel

Exaggerated contraction of orbital part of OO. A marked reflex of blinking.

Blepharoclonus

Result of accidental inoculation or localization of virus in a ore-existing break in skin during period of view is (2-6d ff vaccination)

Lid vaccinia

Ms of eyelid

Orbicularis oculi Levator palpebral superiosis Palpebral smooth ms of muller

Decreased compressibility in orbitonometry indicates

Infiltrative or neoplastic lesion

Dehiscence of orbital septum giving ties to localized swelling in lid when orbital fat prolapsed

Baggy eyelid

Entire orbital cavity is lined with periosteum called the

Periorbita

Forcible closure of lids which is usually bilateral caused by marked contraction of OO and corneal lesion

Blepharospasm

OO has 2 parts. What part squeezes the eyelid shut?

Peripheral orbital part of OO

Chronic/acute contact dermatitis with weeping eczema

Acute local dermatitis

Reduced length and width of palpebral fissure

Blepharophimosis

Blinking is absent in infant

True

Form of verruca that is round

Verruca vulgaris

Viral wart of lid that is slow growing and with mild infectivity

Verruca

Orbital hemorrhage is characterized by

Axial proptosis w. Limitation of eye movement | Ecchymosis

Hemangioma wherein the lesion is composed of simple endothelial line spaces larger than capillary hemangioma

Cavernous hemangioma

Marked invol twitching of eyelid caused by eye strain, nervous tension and weakend body resistance

Myokymia

Increased compressibility in orbitonometry indicates

Vascular tumor

Func of eyelids

1. Protect the globe for external injury and excessive light 2. Distribute tears uniformly over anterior surface of face.

Vertical fold of skin from inner eyebrow to root of nose

Epicanthus

BCC/SCC starts as warty growth with keratotic covering gradually eroding until ulcer develops

SCC

Chalazion can cause glaucoma

True

BCC of lid is common in m/f, lower/upper lid

M, lower lid

Bld supply of eyelids

Lacrimal and ophthalmic arteries | Branch form external carotid artery thru facial, superficial, temporal and infra orbital a.

Central surgical space

Ms cone

Embryological origin of eyelid

From fronto-nasal processes

Hordeolum involving gland of zeiss and moll

External hordeolum

BCC/SCC starts as elevated nodule with central dimple and pearly borders

BCC

Form of verruca that is flat

Verucca plana

Another row of eyelashes, usually towards the cornea

Distichiasis

Chronic granulomatous inflammation of meibomian gland, charac by painless swelling of g without inflammatory signs

Chalazion

Assessment of compressibility of orbital contents

Orbitonometry

Redness limited to lid margins, aggravated by smoke, chemical fumes, and smog, and produce greasy scaling of skin

Squamous blepharitis

Active forward displacement or protrusion of eyeball from its normal place

Exophthalmos

Venous return of eyelid

Cavernous sinus or | Into IJV via SOV and IOV

Blepharitis that is usually secondary to seborrheic dermatitis of scalp and eyebrows

Squamous blepharitis

4 compartments

1. Subperiosteal space 2. Ms cone 3. Peripheral surgical space 4. Episcleral space

Lid coloboma usually occurs in

Inner and middle 1/3 of upper lid | Outer and middle 1/3 of lower

Intermittent proptosis, more prominent when bending the head down, blowing nose and during physical exertion

Orbital varices

Small vesicles with clear content due to sweat gland obstruction

Sweat gland cyst

Port wine stain

Nevus flammeus

Yellowish white tumor on tarsal portion of lid. Mistaken for and asso with Chalazion

Meibomian gland Ca

Chronic/acute contact dermatitis with dry skin, indurated and itchy

Chronic local dermatitis

Provides passive ab against vaccinia organism

VIG vaccinia immunoglobulin

Embryological origin of lower lid

Maxillary process

Part of palpebral conj is adherent to bulbar conjunctiva

Symblepharon

Inflammatory condi of lid charac by formation of nodules with umbilicated craters (with waxy materials)

Molluscum contagiosum

Inflam sequela wherein eyelashes are misdirected to cornea

Trichiasis

When upper and lower old are fused after inflammation subsides

Ankyloblepharon

Form of verruca that is threadlike

Verucca filiformis

Small pinhead sized yellowish white elevation due to sebaceous gland retention

Milium

Space formed by recti ms and their intermuscular mem with tenon's capsule

Ms cone

Bruit/pulsation is seen earlier in aneurysm, while Bruit/pulsation is a later sign.

Bruit is seen earlier in aneurysm, while pulsation is a later sign.

Orbit is pathway of cranial nerves..

CN 2-6

Inflammation of lid margin

Blepharitis

Space between periorbita and ms cone

Peripheral surgical space

Infection of lid characterized by vesicle formation along lash line, edema tours lid margin and dermatitis may appear

Herpes febrilis

Management if blepharitis, hordeolum and Meibomianitis

Warm moist compress

Space between sclera and tenon's capsule

Episcleral space

Orbital edema is characterized by

Axial proptosis Venous congestion Restriction of ocular movements

Scarring of conj and lid margin cause by inflammation, injuries and operation is ff by

Entropion

Entire orbital contents are completely enclosed except

At palpebral fissure

Blinking is diminished in what condition

Hyperthyroidism and Parkinson's disease

Characterized by pulsationg exophthalmos of rapid onset ff a basal fracture

Carotico-cavernous fistula

Conjunctival growth covering the corneal marginal ulcer. Can grow from any direction besides nasal and temporal region.

Pseudo-pterygium

Lymphomatous tumor of lacrimal, parotid and submaxillary gland

Mikulic's disease

Viral conjunctivitis caused by adenopharyngoconjunctival virus (APC8)

Epidemic conjunctivitis

Flat diffused conjunctival pigmentation that occurs after age of 40. Sometimes asymptomatic

Melanosis

Non developmental of conj from surface ectoderm. Gland appears as congenital cystic mass which extends posterior to orbital apex.

Cryptophthalmos

A keratoconjunctivitis but only can affect bulbar conj

Phlyctenular conjunctivitis

Bacteria that predominates in conj pathology

Strep Diphtheria Staph

Fungus infection of Canaliculi

Actinomycosis

Bacteria that increase in cadaver

``` Beta hemolytic strep E.coli Klebsiella pneumonia Pseudomonas aeroginosa Flavo bacterium ```

Dilatation of superficial conjunctival blood vessels.

Conjunctival injection

Other virus that cause viral conjunctivitis

Exenthematous virus (.small pox, chicken pox, measles, German measles) Herpes virus Myxovirus (mumps, influenza and new castle disease)

Conjunctivitis commonly found on malnourished children and pulmonary TB

Phlyctenular conjunctivitis

Onward transmission of tears down the duct is due to

Forces of gravity and pumping of sac caused by elastic recoil of its wall after act of blinking

Palpebral and bulbar conjunctiva is separated by

Fornix

Viral conjunctivitis accompanied by marked febrile symptoms

Pharyngoconjunctival fever

Obstruction of upper puncta does not cause epiphora

True

Localized whitish nodule with necrotic excavated center surrounded by conj infection

Phlyctenular conjunctivitis

Negative/positive pressure exists in lacrimal sac when one blinks

Negative pressure

3 mucin secretors

Conjunctival goblet cells Crypts of Henle Gland of Manz

Reduces intensity of symptoms and duration of condition by enhancing the immune response even if after onset

Oral Methisoprinol

Most common neoplasm of lacrimal gland

Mixed tumor

Dryness of eye does not occur even if lacrimal glands are removed.

True. As long as basic secretors are normal

Trachoma is common in palpebral/bulbar conj

Palpebral conj

Bilateral enlargement of lacrimal gland with chronic inflammatory lesion of uveal tract that occurs in asso with bilateral inflammatory swelling with facial palsy (heerfordt's syndrome)

Uveo-parotitis

Dacryo-adenitis may occur as complication of..

Mumps, measles, influenza, thyroid fever

Lymphatic drainage of conjunctiva

Lateral: pre-auricular or superficial parotid lymph node Medial: submaxillary lymph node

Test for patent drainage

Dropping of saccharine or chloramphenicol soln on conj cul-de-sac. If pt experience bitter taste after 5-15min, passage is open

Viral conjunctivitis that has conjunctival hemorrhage in upper bulBar conjunctiva

Acute hemorrhagic conjunctivitis

Single clue signifying pathology of conj

Foreign body sensation

Reflex secretors

Main lacrimal gland in upper temporal portion of orbit | Adjacent accessory palpebral gland

3 oil secretors

Meibomian gland (25 in upper tarsus; 20 in lower) Gland of zeiss - at palpebral margin of each eyelid Gland of molls - at roots of eyelashes

Viral conjunctivitis caused by coxsackie 24 or EV70

Acute hemorrhage conjunctivitis

Basic secretors has no afferent nerve supply

True

Test to determine adequate lacrimal secretion

"Schirmer's filter paper test" A filter paper (5x35mm) bent around 5mm at one end and is anchored by hanging over the lower eyelid margin covering the lower puncta. After 5 min, 10mm should be wet.

Lacrimal app is responsible in formation of pre-corneal film which is formed by

Deep mucoid Middle watery Superficial oily

Only superficial tissue of body where blood vessels can be seen

Conjunctiva

Always involved primarily on true hypersecretion

Reflex secretors

Other symptoms of conjunctival pathology

``` Conjunctival injection Lacrimation or discharge Formation of papilla or follicle Hemorrhage Ulceration Growth ```

Allergic conjunctivitis most produce ____ and this cells are found in discharge

Most produce chemosis | Eosinophils found in discharge

Bld supply of conjunctiva

Palpebral branch of nasal and lacrimal artery at lids | Anterior ciliary artery at limbus

If secondary dacryocystitis is due to infection of adjacent bone, what is the management?

Excision of inflamed sac

Inclusion blenorrhea is common in palpebral/bulbar conj

Lower palpebral conj

Streptothrix infection in upper canaliculus with dilatation of canaliculus with purulent discharge that oozes from puncta

Actinomycosis

Innervation of conjunctiva

Sensory - nasociliary, lacrimal, frontal, infraorbital, ciliary nerve Sympa- ophthalmic a.

Fleshy mass in bulbar conj that invades the cornea at horizontal meridian

Pterygium

3 organisms producing ophthalmia neonatorum

Chlamydia oculogenitalia Staph aureus Neisseria gonorrheae

Viral conjunctivitis is self limiting for how many weeks

1-2wks

Filipino are known to be immune in trachoma and are affected that ends with what stage?

Follicular stage

Conjunctiva has no lymph nodes

Yes. But have lymph vessels.

Tears enter the lacrimal sac partly by..

Capillary attraction and suction

Lower puncta comes forward and away from marginal strip of tear fluid and epiphora results

EVersion of lower puncta

Purulent discharge in conjunctiva is produced by

Neisseria gonorrhea | B-streptococcus

Fibers of OO which surrounding the lacrimal sac

Horner's ms

Discharge of blenorrhea

Mucopurulent discharge

Dilatation of deeper ciliary blood vessels near the limbus.

Ciliary injection

Chlamydia conjunctivitis

Trachoma | Inclusion blenorrhea

Only this secretors are present during sleep.

Basic secretors

Inclusion blenorrhea is caused by

Chlamydia oculogenitalia

Triangular yellowish mass at bulbar conjunctiva with base towards the limbus. Aggravated by exposure to wind, dust, and sun.

Pinguecula

Reflex efferent pathway for sympa

CN7

Eversion of lower puncta is due to

Senile laxity of lids Chronic blepharitis Ectropion

Lacrimal passages

Lacrimal puncta Canaliculi - upper and lower empties in lateral wall of sac Lacrimal sac Lacrimonasal duct

Bacteria that increase in debilitated persons

Pseudomonas aeroginosa | Enterobacter sp

Can arise from chronic dacryocystitis if infection extends beyond the limits of sac and give rise to abscess.

Acute primary dacryocystitis

Fundamental part of secretory system of lacrimal app

Basic secretors

Hereditary form in chronic primary dacryocystitis is common

True

Epiphora is due to

Hyper secretion - due to emotional influence, local irritants in eyes, nose Drainage interference - due to displacement of lower puncta, obstruction of lower puncta, Canaliculi, sac or duct

Depression between follicles in upper .1/3 of upper palpebral conj and lower 1/3 of lower palpebral conj

Crypts of Henle

Excessive tearing

Epiphora

In chronic primary dacryocystitis, infection may spread into tissues around the lacrimal sac

Peridacryocystitis

3 basic secretors

Mucin secretors Lacrimal secretors Oil secretors

Viral conjunctivitis that produces pseudo-membrane in lower and upper palpebral conj

Epidemic conjunctivitis

Inflammation of lacrimal sac

Dacryocystitis

Fold of mucosa which guards the ostium

Hasner's valve

Reflex afferent pathway

CN5

Chronic primary Dacryocystitis is common in male

Female

3 lacrimal secretors

Microscopic acinotubular gland of Krause (40-50 in upper; 6-8 in lower) Wolfring gland (3 in upper tarsus; 1 in lower tarsus) Occasional gland in plica semilunaris or caruncle

In addition to purulent discharge, may produce membranous material

Strep conjunctivitis

Pterygium: bulbar/palpebral conj?

Bulbar conj

Phlyctenular conjunctivitis has immunologic reaction to

Tuberculoprotein

Nevi: bulbar/palpebral conj

Bulbar conj

Drainage of tears is assisted by

Pars marginalis of OO or ciliary bundle of riolan

Venous drainage of conjunctiva

Drains thru post tarsal venous plexuses of eyelid

Dacryocystitis in infant is due to

Incomplete canalizations of lower part of lacrimal duct and/or Differentiation of valve of hasner in inferior meatal area of nose

Mucopurulent discharge

``` Hemophilus aegyptius h. Influenza Staph aureus p. Aeroginosa E. Coli Proteus mabilis ```

Pinguecula: bulbar/palpebral?

Bulbar conj

Acute conjunctivitis with marked chemosis ans watery discharge on exposure to certain grasses, plants and trees

Atopic conjunctivitis

Mucoid discharge is common in (canthus)

Lateral canthus (thus called angular conjunctivitis)

Mucoid discharge is produced by

Moxarella-axenfeld diplobacillus

Discharge of Vernal conjunctivitis

Thick syrupy discharge

Tear secretion

98. 2% water | 0. 8% solid

Pigmented elevated tumor located at bulbar conj

Nevi

4 stages of trachoma (mcCallan)

1. Formation of follicles 2. Presence of papillary hypertrophy and transformation of follicles into "sago grain" struc 3. Beginning of scarring 4. Period of cicatricization when all inflammatory activity end

Infection of lacrimal g due to pyogenic organisms which may lead to Suppuration

Dacryo-adentitis

Mucous gland is found on epithelium of..

Bulbar and tarsal portion of palpebral conj

Lymphatic reaction with neoformation of lymphoid tissue with peripheral vascularization

Follicle

Recurrent condi affecting upper palpebral conj of both eyes during summer

Vernal conjunctivitis

The internal common puncta may be preceded by dilation

Sinus of maier

Vascular reaction charac by neoformation of blood vessels at the center surrounded by lymphoid infiltration

Papilla

Clinical condi with dryness of eye

Xerophthalmia Sjögren's syndrome (keratoconjunctivitis sicca) Steven-Johnson syndrome - erythema multiforme Riley-day syndrome

Most common org producing mucopurulent discharge

Hemophilus aegyptius

Has big papillae arranged on cobblestone appearance

Vernal conjunctivitis

Due to disease or injury in the neighborhood of lacrimal sac and duct producing interference of tear passage

Secondary dacryocystitis

Trachoma is caused by what organism

Chlamydia trachoma

Acquired from venereal contact and swimming in nonchlorinated pool

Inclusion blenorrhea

If secondary dacryocystitis is duet to trauma of duct, as in fracture, what is the management?

Dacrycystorhinostomy

Chronic primary dacryocystitis is caused by

Streptococci | Pneumococci

Bacterial growth can be prevented by

Low temp Antibacterial action of lysozyme in tears Mechanical effect of blinking Production of antibiotics by some bacteria present in conj Flushing action of Tear flow

Indications for keratoplasty

Improvement if visual func of opaque or diseased cornea Correction of severe altered struc Replacement of active diseased cornea Improvement if cosmetic appearance of cornea

Multiple minute epith erosion which stains with Fluoroscein

SPK

Corneal staphyloma has no recoverable vision and is painful

True

Softening of cornea

Keratomalacia

Viral keratitis is most common due to what virus

Herpes simplex

If Hassan Henle bodies changes centrally

So renal gluttata

Tunic coat mainly for protection, covered by tenons capsule and conjunctiva

Sclera

Embryological origin of stroma and endothelium

Para-axial mesoderm

Opaque ring within cornea scleral junction charac by lipid deposits demonstrating fat stain

Arcus senilis

Classif, of corneal scared as to density: | Large enough to be seen as gray spot

Macula

Lower lid bulges when pt looks down

Munson's sign

With history of trauma with vegeteble matter

Fungal keratitis

Characterized with presence of vesicles or bless accompanied by foreign body sensation and pain

Bullous keratopathy

Bilateral, begins as endothelial degeneration ff by stromal and epithelial edema and appearance of bulbar.

Endothelial (fuch's) dystrophy

Most common agent in bacterial corneal ulcer abroad

Pneumococcus (most common) Poor axels P. Aeruginosa

Microcornea

<10mm

Treatment for band keratopathy

O.4-1.8% Ethylene diamine tetra acetic acid (EDTA) as cheating agent ff by scrapping of Ca deposits

Small excrescences in periphery of descemet's mem.

Hassan Henle bodies

Most common malnutrition blindness in India

Kereatomalacia

Superficial punctuate keratitis (SPK) is caused by what virus

``` Adenovirus Inclusion Cytomegalic virus Measles Mumps Trachoma ```

Cornea is rich in _____ this pain is the most common symptom

Sensory nerve supply

Non inflammatory protrusion if center of cornea due to gradual thinning of apex

Keratoclonus

``` Inflammation of deeper portion of sclera Bluish red in color Most common symptom: severe pain Recurrence ipsi common Young adults ```

Scleritis

Coin like corneal opacities common in farmers and agricultural workers

Padi keratitis

Megalocornea

>13.5

Classif, of corneal scared as to density: | Faint cloud like seen with oblique illum

Nebula

Classif, of corneal scared as to density: | Dense and white scar

Leukoma

When iris become S attached to scar tissue resulting to visual disturbance becoz of diffusion if light and irreg refraction esp located within optical centre of cornea

Adherent leukoma

Org that cause diffused inflammation of cornea

Adenovirus Vaccinia Chlamydia

Cornea is a vascular thus dependent on ___ for nutrition

Air, tears and aqueous humor

Clear transparent ocular medium of the eye which is anterior portion of external coat of eye

Cornea

Central corneal opacity which gradually tapers towards periphery. Opacity starts Posteriorly and drags ally involve more anterior layers. Asso with consumption of black rice.

Mindoro corneal opacity

Superficial inflammation of sclera Lesion appears as flat or raised hard immovable nodule surrounded by far red or purple congestion Usually at temporal side Young adults

Episcleritis

Most freq predisposing cause

Sign of active corneal inflammation

Cellular infiltration of stroma Edema Neovascularization Necrosis

Final outcome of severe inflammation in corneal opacity asso with measles

Blindness

Corneal ulcer may end up

Heal without scarring Penetrate into stroma Penetrate deeply to expose descemet's mem Perforate - Panophthalmitis

Replacement of partial or full thickness of diseased cornea with donor tissue

Keratoplasty

Progressive disease of cornea starting at periphery and progresses centrally

Mooren's ulcer

Derived from endothelium

Descement's capsule

Most common agent in bacterial corneal ulcer in Philippines

P. Aeruginosa (most common) Staph aureus D. Pneumonia

Derived from corneal subs appearing at end of 5th month

Bowman's capsule

Hereditary bilateral corneal lesion showing hyaline like deposits in stroma

Familia dystrophy

Calcific degeneration of bowman's mem. A sequela. Of uveitis, keratitis and long standing glaucoma

Band keratopathy

Appears as white or gray-white elevated hard ulcer with dot like satellite opacities

Fungal keratitis

5 layers of cornea

1. Epith - 5 cells thick 2. Bowman' mem 3. Stroma / substantia propria - 90% collagen; 5% cells and mucopolysaccharide 4. Descemet's mem 5. Endothelium - for corneal hydration

Charac by bulging cicatricix of cornea as a result of perforation and iris becomes adherent to back surface if cornea

Corneal staphyloma

The scarring process on corneal opacities is due to

Collagen formation (which contracts as it matures)

Org that cause fungal keratitis

Fusarium Aspergillus Mycelia sterila

Embryological origin of corneal epithelium

Surface ectoderm

Unfavorable factor in keratoplasty

Presence of vascularization

Thinning of apex

Corneal hydrops

Gives rise to superficial ulcer forming branch-like extension (dendritic ulcer) when stained with Fluoroscein

Viral keratitis

Marginal opacification of some superficial peripheral vascularization ff by loss of corneal subs

Senile marginal degeneration (terrien ulcer, gutter degeneration)

Organisms that cause focal central inflammation of cornea

Herpes simplex Hypes zoster Bacteria Fungi

Padi keratitis is caused by

Virus

2 ocular media

Cornea and lens

Refractive power of cornea

43 D (38-47)

Deviation of eye in presence of epicanthis or presence of drooping upper eyelid laterally

Pseudo-strabismus or false squint

Branch of cn7 that supplies the lower portion of OO

Zygomatic branch

Shatter proof lenses. Ordinary lenses given to patient are made of

Crown glass

Objective method if refraction that catches the rays of light reflected at the pt's retina whose source comes from a mirror near the examiner's eye

Retinoscope

Deviation that can be corrected by fusion mechanism. Elicited when fusion is partly interrupted.

Heterochromia

Cn3 palsy | Cerebellar ataxia

Nothnagel's syndrome

Various nuclei are connected cn 6 to higher center responsible for various eye movements thru medial longitudinal fasciculus: For invol conjugate movement

Vestibular nucleus

An extreme condi of myopia with hyper pigmentation

Myopic crescent

Astigmatism is hereditary

True

Develops due to any interruption of development of binocular vision

Strabismus

Management for astigmatism

Cylindrical lense

Measurement for corneal astigmatism

Keratometry

Para/sympa system: affects the pupil and iop

Sympathetic system

Cn6&7 palsied | Contralat hemiplegia

Muller-gambler syndrome

Concomitant pulling effect that may happen becoz of change of position of eyeball from primary position

Secondary action

Esotropia with high hyperopia (great degree of convergence) and deviation greater when fixing at near than far.

Accommodative esotropia

Astigmatism due to corneal scar or faulty surgical incision

Irreg astigmatism

Additional protection can be given by ___ them which is made possible thru additional heating if ordinary lens ff by cooling

Hardening

Measurement of refraction

Diopter

Cn that closes the lids

Cn7

Intraocular lens is removed after ___ to avoid complication

15 yrs

Method of refraction that administers drugs that paralyze accom

Cycloplegic refraction

Process by which the media alters the course of light

Refraction

Too long eyeball or too strong RP

Myopia

2 images coming from each eye are perceived by brain as one

Fusion

Lesion that involves corticobulbar pathways and upper facial ms is spared

UMN lesion

Lesion that involves the nucleus or facial nerve and the entire half of face is paralyzed.

LMN lesion

Stimulation of nuclei turns the eye to opposite direction (slow component of nystagmus). But cortex sensing this abnormal condi rights them by making he eyes move back to other direction (quick)

Cn8

Inflammation of optic nerve (optic neuritis) localized in optic disc ( sudden blurring if 1 eye)

Pappilitis

Due to too short or too weak RP

Hyperopia

Swollen disc due to some interference of optic nerve circulation

Papilledema or choked disc

Cn6 palsy | Contralat hemiplegia

Raymond's syndrome

Inflammation of optic nerve (optic neuritis) localized beyond the globe (no ophthalmoscopic finding)

Retrobulbar neuritis

Optic nerves don't have neurolemal sheath (Schwann)

True

Ametropia is hereditary

True

Management for hyperopia

Convex

Convergent squint Ant chamber is shallow Pupil is smaller Disc is smaller

Hyperopia

Divergent squint Ant chamber is deep Wider pupil Bigger optic disc

Myopia

Used by persons exposed to excessive UV or infra-red rays

Colored lens

Ophthalmic branch

Frontal branch - supra orbital, supratrochlear n Lacrimal branch Nasociliary branch - infra torchbearer

Chiasmal lesions are commonly caused by

Pituitary tumors ans craniopharyngioma

Primary position

Straight forward

Oculomotor paralysis Contralat hemiplegia Paralysis of tongue and lower part of face

Weber's syndrome

Mos that fix at an obj for 1-2min

6 mos

Cn that Elevates upper lid, constricts pupil and incites accommodation

CN3

Normal ms balance, when either eye show no deviation when fusion is partly or completely suspended.

Orthophoria

In papilledema, there is visual disturbance and visual field is abnormal

False

Regular/irreg astigmatism: most common, there are only 2 focal lines produced

Regular

Amt that the lenses can help correct When accom is active, it is the diff between latent and total ametropia

Manifest ametropia

Visual acuity at 1year

6/30

Deviation manifested where in the fusion mechanism can not keep the eyes in parallel alignment.

Heterotropia

Hyperemic disc with blurred margin Dilated blood vessels Elevated disc Macular star

Optic neuritis

Semilunar ganglion of cn5 receives 3 main branches

Ophthalmic branch Maxillary branch - infra orbital n Mandible branch

Cn5 receives fibers from ___ located outside brain

Gasserian ganglion

Management for myopia

Concave lens

Mos that hold obj

3 mos

Refractive power of lens

17 D (12-22)

Branch ophthalmic common in lesion

Frontal branch

In optic atrophy, when nerve fibers are destroyed , they are replaced by ___ and the finer blood vessels ___

Neuro glial tissue and blood vessels closes

Cn3&4 paralysis Contralat hemianesthesia Hemiataxia

Claude's syndrome

Also caused by centicular sclerosis as in incipient cataract.

Myopia

Deviation due to excessive ms tone or excessive accom

Comitant heterotropia

Lower/Upper portion of optic radiation is involved in temporal lobe tumors and otitis abscess

Lower

CN that do not decussate

CN 6

Exotropia with high myopia (minimal degree of convergence) and deviation greater when fixing at far than near.

Accommodative exotropia

Most common strabismus

Comitant esotropia

Mos that follow large obj

2 mos

Various nuclei are connected cn 6 to higher center responsible for various eye movements thru medial longitudinal fasciculus: For lateral gaze

Pons

Exotropia due to excessive ms tones of LR. | Either recessed LR or Resected MR

Non accommodative exotropia

Various nuclei are connected cn 6 to higher center responsible for various eye movements thru medial longitudinal fasciculus: For ff movement of eye

Occipital lobe

Scleral lens whose edges arrest beyond the cornea. Corrects cornea not higher than 1D More comfortable to wear and tolerable longer Hard to sterilize becoz of too many pores

Soft lens

Convergence present at what month

6 mos

Visual cortex

Bowmann's area 17

Light rays are not focused at a pt but at 2 planes. One or both if which are not at same level as plane of retina.

Astigmatism

Drugs to be uses for cycloplegic refraction for persons >38 y/o

Holm atropine Cyclopenyolate Topicamide

Deviation due to paresis or paralysis of one or more EOM

Non-Comitant or paralytic heterotropia

Visual acuity at birth

6/180

Lower/Upper portion of optic radiation is involved in CV accident

Upper

Total refractive power

60 D

Tests for cn 5

Corneal reflex Blinking reflected Sensation of touch, pain and temp in lids

Another way is to use ___ which do not break and are of light weight but appears thicker and scratch easily

Plastic lens

Test for cn 3,4,6

``` Levator function test Duction test Vergence test Pupillary reaction Accom test Diplopia test ```

It's vestibular division has connection to medial longitudinal fasciculus for control of conjugate eye movement in relation to movement of head

Cn8

Drugs to be uses for cycloplegic refraction for children <6 y/o

Atropine

Branch of cn7 that supplies the upper potion of OO

Frontal branch

Corneal lens becoz it is smaller than the diameter of cornea. Corrects corneal astigmatism. Cheaper and easier to clean Needs build up period for tolerance

Hard lens

Decreased or loss of power of accom

Presbyopia

Measures angle do deviation in strabismus, 2 dissimilar targets are placed at end of 2 tubes and can be observed separately by 2eyes thru corresponding eyepiece

Amblyoscope

Astigmatism with no accompanying spherical correction

Simple astigmatism

Most common symptom of ametropia which is bilateral situated in frontal or temporal area, and most common in people with small RE.

Headache

Useful in decreasing illum becoz half of light rays are diverted under wards. Consists of 2 laminated lenses.

Polarizing lenses (Polaroid)

Indiv with ametropia complain of blurred vision which is improved with

Pinhole

Esotropia that occurs in 1 y/o, MR is recessed (weakened) or LR is Resected (strengthened)

Non-accommodative esotropia

Stimulation of sympathetic system induces pupillary dilation/constriction

Pupillary dilation

Binocular vision is not present at birth

True

Refractive error of ___ are physiologic variation

<5 D

Various nuclei are connected cn 6 to higher center responsible for various eye movements thru medial longitudinal fasciculus: For vol conjugate movement

2nd frontal gurus

Visual acuity at 3 yr

6/6

Hard lens is worn only for

8-12hrs with comfort

Amt that accom can help

Latent ametropia

Where optic nerve fuse

Optic chiasm

Total amt of disparity between the length of eye and RO of eye if accom is suspended

Total ametropia

It is due to optical fatigue rather than excessive lighting

Glare

Corresponds to plane of pull of that particular ms

Primary action

One eye can not move in any direction without concomitant movement if the other. In order for both eyes to move in same direction, it will involve the action of at least one ms in each eye.

Yoke ms

Pis lateral oculomotor paralysis | Contralat intention tremors

Benedik's syndrome

First branch of ophthalmic artery

Central retinal artery

Venous engorgement Retinal hemorrhage Hyperemic disk with blurring of margin Hotdog catsup appearance

CRVO

Common cause of CRVO in young

Phlebitis

Posteriorly, retina converges towards the ____ to form intra ocular portion of _____

Posteriorly, retina converges towards the OPTIC DISK to form intra ocular portion of OPTIC NERVE

Photoreceptors which func at low level of illumination or night vision (scotopic vision).

Rods

Layer of retina where the axons of the ganglion cells converge toward posterior pole of the eye to eventually from the optic nerve.

Nerve fiber layer

Lipoidal infiltration of white streak at side of blood column is seen and called

Pipe stem sheathing (vascular sheathing)

Center of acute vision

Fovea centralis

Seeing flashes of light

Photopsia

Where does retinal detachment occur?

Between pigment epith and the rest of the retina, which has embryological basis.

In region of fovea, the bipolar cells and other elements of inner layer of retina are pushed to the sides, the axons and dendrites in outer plexiform layer take an oblique or tangential course. This unique portion of outer plexiform is called..

Nerve fiber layer of Henle

In arteriosclerosis, when the median streak completely covers the entire bld column, the artery is called

Copper wire artery

Rods and cones layer is composed of outer and inner segments. What segment can you find the light-sensitive photo chemicals?

Outer segment Has transverse disk which contain the visual pigment concerned in photochemistry of visual process converting light energy into chemical energy of nerve impulse.

How many capillary networks are there in the retina? Where is It located?

Two. One in nerve fiber layer and one in inner nuclear layer. They are closely interconnected.

Principal symptom of retinal patho

Visual disturbance

Layer of retina in which ganglion cells usually form a monocellular layer throughout most of the retina

Ganglion cell layer

Most common intraocular tumor

Retinoblastoma

As the retinal artery enters the eye, it loses its ____ , and the medial muscular coat becomes ____.

As the retinal artery enters the eye, it loses its INTERNAL ELASTIC LAMINA and the medial muscular coat becomes INCOMPLETE.

The retina gets its bld supply from 2 sources

choriocapillaries supply the outer layer | Retinal arteries supply the inner layer

Effect of iop is ultimately manifested in

Optic disk

Aqueous has access to the anterior chamber angle all the time because there is no ore existing ocular or systemic disease that can be tagged as causative agent. It is symptom-free chronic, slowly progressive condi.

Primary open angle glaucoma

The artery and vein have a common adventitial sheath at their crossings, an important factor in the production of AV crossing changes in what diseases?

Arteriosclerotic and hypertensive retinopathies

Cats eye reflex

Leucocoria

Retinal detachment due to disease process of retina or the vitreous and choroid

Secondary retinal detachment

In arteriosclerotic retinopathy, a Whitish plaque of lipid seen in the wall of retinal artery

Atherosclerosis

Stage of retinoblastoma with soapy white mass in retina

Intraocular stage

``` Retina artery is very much constricted Optic disc is pale Rest of eye ground is white (due to coag necrosis) Cherry red spot Box car appearance ```

Crao

In Glaucomatous stage of retinoblastoma, what is the only resor it save the life of the pt

Enucleation

Stage of retinoblastoma with tumor extending out of eyes into orbit via ocular emissaria or thru optic nerve

Extra ocular stage

Glaucoma asso with hereditary or familial disease are not always present at birth

True

The anterior or peripheral portion of the retina is marked by ____ where retina is transformed into nonpigmented epith of ciliary body

The anterior or peripheral portion of the retina is marked by ORA SERRATA where retina is transformed into nonpigmented epith of ciliary body

In what region does the bipolar cells and other elements of inner layer of retina are pushed to the sides, where the axons and dendrites in outer plexiform layer take an oblique or tangential course.

In region of fovea

Photoreceptors which func at high level of illumination or daytime vision (photopic vision).

Cones

Edema of macular region

Central serous retinopathy

Retinal capillaries contains ___ that are located in the basement membrane.

Mural cells

If pigment epith is derived from outer layer of optic cup, then the rest of the retina Comes from

Inner Layer

Glaucoma asso with hereditary disease, a syndrome of arachnodectyly, cardiac anomalies, lens subluxation

Marfan's syndrome

Layer of retina which is composed of axons of bipolar cells and dendrites of ganglion cells.

Inner plexiform layer

The treatment of Secondary angle closure glaucoma is directed to ocular condition that gives rise to it

Principle of therapy is the same as primary angle closure type

Treatment of primary open angle glaucoma

Medical

Retinoblastoma metastasize to __ via

Long bone via hematogenous spread

Photopsia may be experienced in ___ which causes traction in the retina (Moore's lightning streaks).

Vitreous detachment

Acute/chronic glaucoma: | Gradual closure of angle and gradual increase in iop, symptoms may be absent

Chronic glaucoma

Photopsia may be experienced in ___ where the retina is mechanically stimulated as it floats or moves in the vitreous.

Retinal detachment

The retina is firmly attached to 2 portions

Ora serrata | Optic disk

Large image

Macropsia

Treatment of infantile glaucoma

Surgical (goniotomy)

Disturbance to floe of protoplasm contributes to glaucoma

True

Rods/cones are concentrated in Fovea centralis

Cones

Photoreceptors for color vision

Cones

Increased iop in glaucoma is due to

Abnormal aqueous outflow Rarely due to over production Most rarel py due to nice venous back pressure

External limiting membrane is Formed by junctional attachment between..

membranes of Muller cells and the inner segment of photoreceptors

This is an early stage of silver wire artery where the artery is seen as a solid white cord with no bld column showing through.

Pipe stem sheathing

Layer of retina which constituted by the axons of photoreceptors and the connecting dendrites of bipolar cells

Outer flexiform layer

Elevated retina Grayish retina Retinal vessels appear constricted and darker

Retinal detachment

Retinal edema in hypertensive retinopathy is seen as shining reflex from the retinal surface not unlike a wet surface and is called

Retinal sheen

Innermost layer of the eye

Retina

Principle of management of primary angle closure glaucoma

Lower iop Analgesic Referral to ophthalmologist

Main cells in retinal periphery

Rods

Drugs used in primary open angle glaucoma

1. Miotics - increase outflow 2. Carbonic anhydrase inhibitors - decrease aqueous production 3. Epinephrine - enhance exit of aqueous

This disease arises because if an inherited a atomic defect that causes a shallow anterior chamber

Primary angle closure glaucoma

Acute or chronic glaucoma: Severe ocular pain, sudden diminution if vision, seeing haloes around light, ciliary injection, Lacrimation, pupillary dilation

Acute glaucoma

The pigment epith is composed of single layer of ____ cells! with micro villi projecting into the interspace between outer segments of rods and cones.

Polygonal cells

Most common symptom of retinal detachment

Photopsia

Distorted image

Metamorphopsia

Caused by disturbance in the alignments and position of the visual cells, esp macular area as in macular edema, central serous retinopathy or flat retinal detachment

Disturbance of image shape or size

Rods and cones layer is composed of outer and inner segments. What segment contains usual cyto and cytoplasmic organelles esp mito which amplifies the weak impulse into a transmitted current?

Inner segment Which is connected to the outer by a constriction containing the cilia, which thought to transmit electrical impulse to the finely granular inner segment

Refers to impairment of vision at night or in dim illumination and is present mainly in disturbances of rod func as in pigmentary degeneration of retina and vit A deficiency

Nyctalopia

Glaucoma produces irreversible blindness

True

Common complication of CRVO

Glaucoma (3 mos after onset) has rubeosis iridis

Photoreceptors concerned with peripheral vision

Rods

Pigment epith is derived from

Outer layer of optic cup

Grading of severity in arteriosclerosis

1. Slight widening of median reflex with slight compression 2. More widening , with more marks of compression 3. Copper wire artery 4. Silver wire artery

Common cause of CRVO in elder

Endothelial proliferation

Treatment for crao

Dilators - paracenthesis, inhalation of co2 (carbogen) | Drugs - amyl nitrate inhalation, retrobulbar acetylcholine, prescoline

S&s of infantile glaucoma

``` Lacrimation Blepharospasm Photophobia Corneal enlargement Glaucomatous cuppping ```

Iop regarded as suspect for glaucoma

21mmHg

It is caused by any stimulus on the eye which results in only one retinal response, and that is seeing light.

Photopsia

Layer of retina which is a fenestrations membrane composed of terminal bars

External limiting membrane

Layer which is source of metabolic enzymes, as well as vit.A needed by visual cells, which is imp in the phagocytosis of degenerated fragments of outer segments.

Pigment epith

Closure of angle brought about by condi in eye that causes the iris to move towards the mesh work. (Eg exaggeration of pupillary block such as uveitis, lens dislocation, bulging hyaloid face)

Secondary angle closure glaucoma

Bld supply of retina

Central retinal artery and vein which enters the eye thru optic disk

In arteriosclerosis, when the sclerosis reaches the advance stage abs reflects back all the light falling on its surface, the artery is called

Silver wire artery

Layer of retina which is composed of the nuclei of the photoreceptors.

Outer nuclear layer

Retinal detachment that is always asso with break in retina

Primary retinal detachment

Visual disturbance may be manifested as..

``` Visual blurring Photopsia Sector visual field defect Disturbance of image shape or size Nyctalopia ```

2 sources of symptoms of glaucoma

Increased iop | Disturbance of optic nerve func

Layer of retina which consists if nuclei if several cells, namely bipolar cells, Muller's cells, horizontal cells, and amacrine cells.

Inner nuclear layer

Layer of retina which is the cuticular derivative of Muller's cells and serves to delineate the retina from the overlying vitreous.

Internal limiting membrane

Cells the serves as the storehouse of glucose in the form of glycogen

Muller's cells

The retina is dependent on a continuous supply of ___ for its metabolism.

Glucose

Grading in hypertensive retinopathy

1. Narrowing of arteries to 3/4 to 1/2 of corres vein with occasional focal constriction of terminal arterioles 2. Narrowing of arteries to 1/2 to 1/3 of corres vein with several focal constriction of terminal arterioles 3. Grade 2 + cotton wool exudates with flame shaped hemo 4. Grade 3 + mild to mod edema of disk

Visual loss or impairment may involve (central/peripheral vision) if extra macular area (esp rods) is involved.

Peripheral vision

Visual loss or impairment may involve (central/peripheral vision) if macula is involved.

Central vision

Regulation of IOP by

Anterior segment of eye

Usual loos of arterial obstruction

Emboli from a cardiac thrombus

Stage of retinoblastoma with increased iop, ocular congestion nod corneal edema and vitreous filled with tumor mass

Glaucomatous stage

Glaucoma asso with hereditary disease, a syndrome of corneal Arcus (post embryotoxon), ectopia, polycoria, hypoplasia of anterior iris.

Axenfeld syndrome

Only non transparent portion of retina

Blood columns and pigment epithelium

Iop increased because aqueous could not flow to trabecular mesh work due to apposition of iris to the anterior chamber angle

Primary angle closure glaucoma

Layers of retina

(From outer to inner) 1. Pigment epith 2. Rods and cones 3. External limiting membrane 4. Outer nuclear layer 5. Outer flexiform layer 6. Inner nuclear layer 7. Inner flexiform layer 8. Ganglion cell layer 9. Nerve fiber layer 10. Internal limiting membrane

Some retinal condi which can produces sector visual field defect

Partial retinal detachment Large retinal hemorrhage Branch occlusion of retinal vessels

Actual loss of a part of the field of vision or a sensation of a curtain or a fog covering the involved portions of the field of vision

Sector visual field defect

Treatment of choice for primary angle closure glaucoma

Surgery

Small image

Micropsia

Endophthalmitis causative agent

Meningococcal neisseria

In management of contusion, hyphema is left alone

True. Unless glaucoma sets in

Adenovirus type responsible for pharyngoconjunctival fever

Adenovirus 3,4,7

In iris and ciliary body, the contusion results in

Hyphema

Anti inflammatory drug that Inhibit action of fibrinolysin

Salicylate

Used to treat corneal edema and bullous keratopathy

Dehydrating agents

Anticholinesterase cholinergic drugs

``` Physostigmine Neostigmine Diisopropyl fluorophosphate (DFP) Alkyl-phosphate Demercarium bromide ```

Dilute/concentrated acids produces coagulation necrosis

Concentrated acid

When blood sugar is highe, there is the tendency to be myopic/hyperopic

Myopic

Parasympathetic cholinergic drugs that dilates the retinal artery during CRAO

Acetylcholine

Hypersensitivity reaction to drugs like salicylates and is charac by generalized maculopapular rash, severe stomatitis, ans purulent conjunctivitis

EM, Steven Johnson syndrome

Common source of chemical injuries in the eye

Insecticide and aerosol spray

CONTRAINDICATION to intraocular surgery

Beta hemolytic strep

New formed blood vessels that extends to vitreous, fibrous tissue appears

Retinitis proliferans

Ophthalmia neonatorum, purulent discharge in adult and nongranulomatous uveitis causative agent

GONOCOCCAL neisseria

Foreign body in conj is removed by

Wiping it out with wet cotton pledget

Anti cholinergic or prasympatholytic drug use to treat Mydriasis without cycloplegia

Eucatropine

Dilute/concentrated acids produces slight pain, conj congestion and edema of lids, conj and cornea.

Dilute acids

Anti cholinergic or prasympatholytic drug substitute for atropine, has shorter duration

Scopolamine.

Treatment for measles

Vaccination

Drugs used in treatment of contusion which dilates the pupil with aim of removing the pupillary block

Atropine

Foreign body embedded in cornea is removed by

Spud or long hypodermic needle

The effects of radiation to eye parts according to their order of frequency

``` Lens Conj Cornea Uvea Retina Optic nerve ```

Contagious venereal disease which appears as vesicle or ulcer in the genitals. It has regional adenitis. May lead to parinauds ocular syndrome.

Lymphogranuloma venerum

Produces pallor of conj, pale fundus and pale tortuous retinal blood vessels

Anemia

Parasympathetic cholinergic drugs

Acetylcholine 1:1000 Metacholine 10-20% Carbachol Pilocarpine

Sympatomimetic adrenergic drug used to treat glaucoma in combi with pilocarpine

Epinephrine

Sympatomimetic adrenergic drug of choice for pupillary dilatation

Phenylephrine

Endocrine exophthalmos is not affected by many medical therapy and appears after thyroid surgery

True

Hordeolum/stye causative agent

Staph aureus

Vitreous hemorrhage are removed by

Vitrectomy

Parasympathetic cholinergic drug demonstration the hypersensitivity of the pupil to this drug in Adie's syndrome

Metacholine

Adult type of chronic inflam and degenerative changes in the joints. The findings of subcutaneous nodules are characteristic and may appear similar to miliary TB

Rheumatoid arthritis

Retinal hemorrhage are left alone

True.

The early ocular changes due to diabetics are the results of

Osmotic changes

In primary lesion of hopes simplex , what is absolutely COntraindicated?

Steroids

Sub conjunctival hemorrhage should be diff with the hemorrhage by skull fracture. Which has bright red in color and anteriorly located?

Subconjunctival hemorrhage

Lid wounds are repaired ASAP to avoid contraction of ms and necrosis of skin at wound edged

Vertical wounds should be sutured eve in they are small for they cause traction and notching of lid. Horizontal wounds are repaired if they are >1mm.

What is the effect of contusion in the eye if the eyelids are struck first

Ecchymoses or black eye

Anti cholinergic or prasympatholytic drugs

``` Atropine Scopolamine Homatropine Eucatropine Cyclopentolate Tropicamide ```

First sign of Lupus erythematosus

Lid edema Then hyperkeratosis, seborrhea Finally atrophy of skin

It produces dilation of conj and uveal arterioles, miosis and increased permeability of blood aqueous barrier

Parasympathetic cholinergic drugs

Para/sympa drugs only limited to glaucoma

Parasympathetic cholinergic drugs

Osmotic agent that is safe for diabetic pt

Isosorbide

Adenovirus type responsible for epidemic conjunctivitis

Adenovirus type 8

First step in management of foreign body

Locating the foreign body

Washing agents

Water Normal saline solution (0.9%) Boric acid (2-4%)

Drugs applied in conjunctival sac penetrate mainly thru the cornea by selective diffusion

Drugs having Low surface tension, high lipoid solubility ans rapid degree of electrolyte dissociation penetrate more.

Steroids should not be used for a long time

True. For they can suppress immunologic host response and may produce glaucoma

Adrenergic system acts on sympathetic nerve ending or destroys what enzyme

Amine oxidase

Steroids are not given in cases of intraocular viral or fungal infection

True

Vitamin that keeps the itergrity of epithelium of skin and mucous membrane.

Vit A

Dyes are used to stain the breaks in the continuity of epith of cornea and conjunctiva.

Sodium fluorescein 2% - green Rose Bengal 1% Methylene blue 2-5%

In acute stage of measles, there is non purulent type of conjunctivitis with red dots surrounding by white areas called

Koplic's spot

``` Color identification of ophthalmic drugs: Antimicrobial Steroids Anesthetic Miotic Mydriatic ```

``` Antimicrobial-blue Steroids -white Anesthetic-yellow Miotic-green Mydriasis-red ``` Bam, yanes, ws, gremi, remy

Drugs used in treatment of contusion which constricts the pupil thus opening the anterior chamber

Pilocarpine

Steroid of choice

Methyl prednisolone

Stimulation and blockage of cholinergic system

Stimulation - miosis and increase accom | Blockage - Mydriasis and cycloplegia

Anti cholinergic or prasympatholytic drug used to treat post synechiae and cycloplegic refraction

Atropine

Pseudomem type of conjunctivitis causative agent

Beta-hemolytic strep

Parasympathetic cholinergic drug needed if there is pilocarpine tolerance

Carbachol

Treatment of choice for primary lesion of herpes simplex

Iododioxyuridine (IDU)

Used to treat open angle and aphakic glaucoma

Anticholinesterase cholinergic drugs

Management of chemical injuries

Neutralization

Virus that produces self limited conjunctivitis. The danger occurs if it attacks pregnant women during her first trimester.

Rubella

Produces vesicular Exenthema in eyelid, conj and cornea

Varicella -chicken pox

The most significant ocular manifestation of graves disease

Exophthalmos

In foreign body injury, the eye has to be patched for __ hrs to immobilize the lids so that the regeneration of epithelial defect will not be hindered by blinking

24hrs

Anticholinesterase cholinergic drug for myasthenia gravis that elevates the upper lid temporarily

Neostigmine

The type of toxoplasmosis disease accom by CNS involvement including calcification.

Congenital type

Utilized to lower the iOp in glaucoma tours eyes by decreasing the aqueous formation in ciliary body

Carbonic anhydrase inhibitors

Stimulation and blockage of adrenergic system

Stimulation - Mydriasis | Blockage - miosis

Importanct cause of corneal blindness in underdeveloped countries.

Rubeola (measles )

Osmotic agents

Urea Mannitol Glycerol Isosorbide

New formed blood vessels on retina

Rubeosis iridis

Most frequent form of mechanical injury of the eye

Foreign bodies of the eye

Earliest sign of vit A deficiency

Bight blindness and prolonged dark adaptation

Systemic effects of parasympathetic cholinergic drugs

Hypotension Vasodilation Bronchospasm Increase tone of GI and urinary ms

Contusion may cause deposition of pigment on the surface of anterior lens capsule appearing as a bron ring called

Vossius ring

Use to neutralize histamine or inhibit effects of inflammation

Corticosteroids

In contusion in retina, a milky white area appears at the macula and around the optic disc called

Berlin's edema

Addison's syndrome has no effect on vision.. Only hyper pigmentation of skin of lids, conj and uvea

True

Sympatomimetic adrenergic drugs

Epinephrine | Phenylephrine

Parasympathetic cholinergic drug used to treat accommodative esotropia

Pilocarpine

can inhibit vascularization, decrease capillary permeability and prevent immunological reactions

Steroids

Viruses that attacks the nerves tend to produce

Optic neuritis and EOM palsies

Sub conjunctival hemorrhage should be diff with the hemorrhage by skull fracture. Which has purplish in color and Posteriorly located?

Hemorrhage caused by skull fracture

Helpful in preventive vascularization of cornea

EDTA

Daily requirement of vitamin A

5000 IU

Cholinergic system acts on parasympathetic nerve ending or destroys what enzyme?

Cholinesterase

Anti cholinergic or prasympatholytic drug exclusively used to treat refraction

Cyclopentolate | L

The general color of fundus on polycythemia is

Dusky red or cyanotic

Treatment for endocrine exophthalmos

Orbital decompression

New formed blood vessels which later circle the macula

Retinitis circinata

Severe dehydration, sunken eyeball, bluish appearance of lids causative agent

Cholera vibrio

Viruses producing petechiae hemorrhage may manifest with

Subconj hemo and ecchymoses

The sign and symptoms are marked when the foreign body is on

Cornea because of rich nerve supply

An early indication of vit A deficient is the formation go greasy yellowish plaque in temporal conjunctiva called

Bitot's spot

Parasympathetic cholinergic drug that is widely used for glaucoma. Produces incd permeability of trabecular mesh work and miosis.

Pilocarpine

Chronic vit A deficient sign

Dry mucous mem and tear secretion stops