ophtha-all Flashcards
Vitreous is also attached to (but less firmly )
Optic disk margin
Macula
Post peripheral surface of lens
Anterior condensation of peripheral vitreous forms
Anterior hyaline membrane
Embryological origin of lens
from ectoderm from lens plate of 2 wk old embryo which becomes lens vesicle
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”)
Vitrectomy Thru pars plana
Closed vitrectomy
At old age.. What metachromatic color has difficulty reaching the retina?
Blue and violet metachromatic
It is due to opaque particles in vitreous
Impairment of vision
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)
Extra capsular method procedure that utilizes probe frozen -20 C
Cryoextraction
Second sight is due to
Lenticular myopia form change of index of refraction
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)
It is due to cast on retina by opacities floating in vitreous
Positive scotoma
Symptom of vitreous opacities
Seeing spots in field of vision to actual diminution of vision of varying degree
Volume of vitreous
4ml
Caused by fine aggregates of vitreous protein due to age or myopia
Musca volitantes
Disparity of image size between 2 eyes
Anisokonia
Hypothyroidism is asso with developmental cataract. What is its essential feature?
Low ration of Ca to P in bld
Management for cataract
Surgical removal
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
In young, surgery should be done ASAP if..
Both eyes have poor vision
Strabismus sets in
How is accommodation in aphakia
Completely lost
Lost of gel-like consistency or conversion of vitreous into liquid
Vitreous liquefaction (syneresis)
As the secondary vitreous increases in vol, the primary vitreous is forced forward to central position, the site of ?
Cloquet’s Canal
Type of senile cataract which tends to become hard and shrunken
Nuclear cataract
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
- Major arterial circle of ciliary body and part of ant choroid
- 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
- Behcet’s disease
- Harada’s disease
- 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
TB
The principles of treatment of uveitis can be resolved into
- Mydriasis
- Anti-inflammation
- 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
- Choroid
- Ciliary body
- 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
- Outer layer of large veins leading to vortex veins (haller)
- Middle layer of medium veins and some arterioles (sattler)
- 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
- 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
- Redness
- Crust formation
- Secretion (watery secretions, discharges)
- Lumps
- Lid disturbances (malformation,malposition)
- 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
- Proptosis, exophthalmos
- Displacement of globe
- Congestion or edema of lids and conjunctiva
- 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
