Ophthalmic Disease

Question 1

What is entropion

Answer 1

When the eye lid rolls inward
Hairs and eyelashes rub the cornea
Commonly breed or genetic associated

Question 2

What kind of secondary changes can entropic occur from

Answer 2

Dehydration
Eyelid trauma
Neurologic changes

Question 3

What can entropion cause

Answer 3

Corneal injury and ulceration, epiphora (excessive tearing), blepharospasms which is squinting, and photobia which is light sensitivity

Question 4

How can you treat or avoid entropion

Answer 4

Protect cornea with hydration products
Tears any secondary infection
Check for corneal injury or staining
Surgery needed for correction with modified hotz Celsus procedure

Question 5

What is cherry eye

Answer 5

Also considered a prolapsed nictitans which is weak tissue fibers that fail to hold the gland of the third eyelid in place

Question 6

What does protrusion of the gland in cherry eyes lead to

Answer 6

Poor blood flow and swelling of the gland
This can lead to altered tear production

Question 7

What does the gland of the nictitans produce and what should you never do to the gland

Answer 7

50 percent of the eyes tear
You should never remove the gland as it can lead to dry eye

Question 8

What is a pocket imbrication surgery

Answer 8

Replaces the gland back into position
The incision should not be fully closed as tears need to be able to escape to lubricate the eye

Question 9

What is the cornea

Answer 9

Clear tissue due to hydration from production of tears

Question 10

What is the outer layer of the cornea

Answer 10

Epithelium

Question 11

What is the inner layer of the cornea and what is the layer that lays over this layer called

Answer 11

The inner most layer is the endothelium
The layer that cover the endothelium is the descemet’s membrane

Question 12

What is the layer between the epthelium and endothelium called

Answer 12

The stroma

Question 13

What kind of tissue is the cornea and how does it receive nutrients

Answer 13

Avascular tissue that received nutrients from the aqueous humor and tear film
Vessels begin to form when injury occurs

Question 14

What is the most common cause of corneal ulcers

Answer 14

Trauma
Can also be due to drying of the cornea

Question 15

What do patients usually present with in regards to corneal ulcers

Answer 15

Ocular pain, epiphora, corneal edema, corneal vascularization

Question 16

Where is the nerve supply in the cornea

Answer 16

Outer 1/3 of the cornea

Question 17

What can corneal ulcers lead to and how do you fix it

Answer 17

Can lead to descemetocele
Can fix with surgery

Question 18

How do you diagnose a corneal ulcer

Answer 18

Fluorescent stain
The epithelium and endothelium of the cornea are hydrophobic and doesn’t take up a stain
The stroma of the cornea allows for a stain uptake with reveals the ulcer

Question 19

How can toy treat corneal ulcers

Answer 19

Medically managed with topical ophthalmic medications
DONT use steroids as they make the ulcer worse
Ulcers should be healed in a week but in severe cases conjunctival pedicle grafts are performed

Question 20

What is an indolent ulcer

Answer 20

Failure of the leading edge of the ulcer to heal to the deep stroma
Also known as boxer ulcers

Question 21

How do you treat indolent corneal ulcers

Answer 21

Debridement of the flap and performing a keratectomy which creates micro abrasions into the corneal stroma which allows for epithelial tissue to track into

Question 22

What is keratoconjunctivitis sicca

Answer 22

Also known as dry eye
Commonly caused by autoimmune disease against tear glands
Could also be due to secondary ocular conditions
Sulfa containing antibiotics are also known to cause this

Question 23

How does water production of the tear find relate to keratoconjunctivitus

Answer 23

Decreased production leaves an oil and mucus component behind causing a common mucus discharge
Corneal pigmentation is also seen in chronic cases

Question 24

How can you diagnose keratoconjunctivitis

Answer 24

Schirmer tear test
Over 15 mm of tears should be produced in one minute

Question 25

How can you treat keratoconjunctivitis

Answer 25

Use an immunosuppressive eye medication for auto immune cases
Surgery for correction of structural conditions
Support hydration to the cornea with artificial tear products
Plastic surgery to relocate salivary duct to eye for hydration

Question 26

What is pannus

Answer 26

Also considered chronic superficial keratitis
Immune mediate disease affecting the cornea
Raised pink mass on the cornea usually toward the lateral edge of the eye
Usually bilateral and lesions will spread across cornea leading to blindness is not treated

Question 27

What can exacerbate pannus

Answer 27

Uv light or high altitude conditions

Question 28

How to treat pannus

Answer 28

Steroids or immunosuppressives
Treat any secondary infection with topical ointment
Doggies for control of uv light

Question 29

What is uveitis

Answer 29

Inflammation of the uvea which involves the iris, ciliary body, and choroid
Can be anterior or posterior involvement as well as all uveal tissue

Question 30

What can anterior uveitis cause

Answer 30

Red eye or ocular pain with mitotic pupils, blepharospasms or photobia

Question 31

Would you have a low or high intraocular pressure with uveitis

Answer 31

Low

Question 32

How do you treat uveitis

Answer 32

Anti inflammatories or steroids
You want to treat underlying cause
Can cause blindness or secondary glaucoma if not addressed

Question 33

What is a glaucoma

Answer 33

Disease of increased intraocular pressure
Usually failure to remove aqueous humor rather than producing too much

Question 34

What does glaucoma cause

Answer 34

Ocular pain
Buphthalmia or enlargement of the eye
Mydriasis or dilation of the pupil
Sever cases can cause blindness or eye rupture

Question 35

How to diagnose glaucoma

Answer 35

Measuring eye pressure

Question 36

How do you treat glaucoma

Answer 36

Topical eye medication and or surgery
Can restore vision but not always
In non responsive patients, enucleation is needed