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Head and Neck > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What are the layers of the eyeball?

A

Fibrous coat
Vascular coat
Sensory coat

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2
Q

What are the components of the fibrous coat?

A

Sclera
Cornea

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3
Q

What are the components of the vascular coat?

A

Iris
Ciliary body
Choroid

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4
Q

What are the components of the sensory coat?

A

Retina

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5
Q

What is the lens?

A

A biconvex transparent crystalline lens
Suspended by suspensory ligaments from the ciliary body

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6
Q

Where is the anterior segment and what does it contain?

A

Infront of the lens
Aqueous humour

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7
Q

Where is the posterior segment and what does it contain?

A

Behind the lens
Vitreous humour

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8
Q

What is the anterior segment divided into?

A

Anterior chamber- in front of iris
Posterior chamber- behind iris but in front of lens

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9
Q

Where is the angle of the anterior chamber?

A

End of sclera but start of cornea

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10
Q

What is the path of aqueous humour?

A

Reabsorbed via Schlemm’s canal into systemic circulation
Constantly produced and reabsorbed by ciliary body
Trabecular meshwork help aqueous humour drain into Schlemm’s canal

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11
Q

What is the purpose of aqueous humour?

A

Maintain intraocular pressure

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12
Q

What are the orbital foramen?

A

Optic foramen
Superior orbital fissure
Inferior orbital fissure

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13
Q

What is the conjunctiva?

A

Thin vascular membrane that covers the inner surface of the eyelids and loops back over the sclera
Does not cover cornea

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14
Q

What are the different parts of the conjunctiva?

A

Superior fornix
Ocular conjunctiva
Palpebral conjunctiva
Fornical conjunctiva
Inferior fornix

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15
Q

What is the lacrimal apparatus?

A

Lacrimal gland ducts open into conjunctival sac.
Tears drain through punctae into lacrimal sac.
Sac drains through nasolacrimal duct into inferior meatus of nasal cavity

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16
Q

What are the intrinsic muscles of the eye?

A

Parasympathetic (III): Ciliaris, Constrictor pupillae
Sympathetic: Dilator pupillae

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17
Q

What are the causes of pupil abnormalities?

A

Disease of retina
Disease of optic nerve
Disease of III cranial nerve

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18
Q

What are the extrinsic muscles of the eye and their innervation?

A

Medial rectus- III (oculomotor)
Lateral rectus- VI (Abducent)
Inferior rectus- III (oculomotor)
Superior rectus- III (oculomotor)
Superior oblique- IV (trochlear)
Inferior oblique- III (oculomotor)
Levator Palpabrae Superiorus (LPS)- III (oculomotor)

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19
Q

What is the primary action of the extrinsic eye muscles?

A

Medial rectus- adduction
Lateral rectus- abduction
Inferior rectus- depression
Superior rectus- elevation
Superior oblique- intorsion
Inferior oblique- extorsion

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20
Q

What is the origin and insertion of recti muscles?

A

Origin: tendinous ring
Insertion: sclera anteriorly

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21
Q

What is the origin and insertion of the superior oblique muscle?

A

Origin: lesser wing of sphenoid
Insertion: sclera posteriorly

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22
Q

What is the origin and insertion of the inferior oblique muscle?

A

Origin: medial part of orbit floor
Insertion: sclera posteriorly

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23
Q

What is the origin and insertion of the LPS muscle?

A

Origin: roof of orbit
Insertion: upper eyelid

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24
Q

What is strabismus?

A

Squint- misalignment of the eyes
- Esotropia: convergent
- Exotropia: divergent

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25
Q

What cranial nerves are in the orbit?

A

Optic (II)
Oculomotor (III)
Trochlear (IV)
Abducens (VI)

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26
Q

What is the arterial supply of the orbit?

A

Ophthalmic artery (branch of ICA)
- Central retinal artery
- Short posterior ciliary arteries
- Long posterior ciliary arteries
- Anterior and posterior ethmoidal arteries
- Muscular arteries

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27
Q

What is the venous drainage of the orbit?

A

Superior and Inferior ophthalmic veins which drain into the cavernous sinus

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28
Q

What are the histological layers of the cornea?

A
  1. Epithelium- non keratinised stratified squamous
  2. Bowman’s membrane- basement membrane of corneal epithelium
  3. Stroma- regularly arranged collagen, no blood vessels
  4. Descemet’s layer
  5. Endothelium- single layer
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29
Q

Why is the cornea transparent?

A

Regular arrangement of collagen in stroma
No blood vessels
Endothelium cell layer has a pump that actively keep aqueous humour out

30
Q

Why is the cornea an immune privileged site?

A

Avascularity means foreign antigens from a corneal graft won’t be recognised

31
Q

What does a gonioscope visualise?

A

The angle of the anterior chamber

32
Q

What is the blood supply of the outer retina?

A

Fenestrated blood vessels of the choroid

33
Q

What is the blood supply of the inner retina?

A

Branches of central retinal artery

34
Q

What is the fovea centralis?

A

Area of maximum visual acuity
Packed with cones, no rods

35
Q

What are the layers of a tear film?

A

Layer 1- mucinous layer
Layer 2- aqueous layer
Layer 3- oily layer

36
Q

What is refraction?

A

Bending of light when it passes from one optical medium to another

37
Q

How does a sharp image form on the retina?

A

Light waves from an object bend at the cornea and bends more at the lens
Therefore, forms an inverted image of the object sharply focused at the retina

38
Q

What rays reach the eyes for distant objects?

A

Parallel

39
Q

What rays reach the eyes for close up objects?

A

Divergent
Need to be bent a lot more than parallel rays to bring them to focus on the retina

40
Q

What is accommodation?

A

Capacity of our eyes to change focus from distant objects to close objects
- Lens changes shape
- Pupils constrict
- Eyes converge

41
Q

What does a thicker lens allow?

A

More powerful so able to focus on close objects

42
Q

What is myopia?

A

Short sighted
Rays focused in front of retina
Bending power of cornea and lens is too much for that eyeball

43
Q

What is hyperopia?

A

Long sighted
Rays focused behind retina
Using accommodative power all the time for far off things, so no power left to see close objects

44
Q

What is astigmatism?

A

Close and distant objects appear hazy
Multiple focal points

45
Q

What is presbyopia?

A

With age the lens gets less mobile/elastic
Seeing near objects becomes difficult

46
Q

What is phototransduction?

A

Conversion of light energy to an electrochemical response by photoreceptors (rods and cones)

47
Q

Where is visual pigment?

A

In the outer segment of rods and cones
Outer segment contains stacks of lamella which are made up of cell membrane.
Integrated into cell membrane is visual pigment

48
Q

What is the visual pigment in rods?

A

Rhodopsin

49
Q

What is the visual pigment in cones?

A

Cone opsins S, M and L
- Blue, Green, Red

50
Q

What is visual pigment regeneration?

A

Activated pigment compounds need converted back to normal
Done by vitamin A

51
Q

What is your visual field?

A

Everything you see with one eye (including periphery)

52
Q

What is the visual pathway?

A

Optic nerve → crosses over at chiasma → optic tract → synapses at LGB → optic radiation reaches occipital lobe (Primary visual cortex)

53
Q

What are the 2 parts of the retina in the visual pathway?

A

Nasal retina
Temporal retina

54
Q

What is amblyopia?

A

Lazy eye

55
Q

What is diplopia?

A

Double vission

56
Q

What is Horner’s syndrome

A

Anisocoria due to damage to sympathetic innervation to pupil

57
Q

What is anisocaria?

A

Different pupil sizes

58
Q

What is ptosis?

A

Drooping of eyelids on affected side

59
Q

What is anhidrosis?

A

Loss of sweating on affected side

60
Q

What are common orbit disorders?

A

Blow out fracture
Proptosis- eyeball protruding out
Infection spread through emissary veins

61
Q

What are common eye movement disorders?

A

CN VI palsy
CNIII palsy
CN IV palsy

62
Q

What are common lids and conjunctivae disorders?

A

External stye (hordeolum externum)
Internal stye (hordeolum internum)
Conjunctivitis
Corneal ulcers
Corneal dystrophies

63
Q

What are cataracts?

A

Lens opacification

64
Q

What causes cataracts to develop?

A
  • Embryological fibres never shed and get compacted in the middle.
  • No blood supply to lens
  • Absorb harmful UV rays
  • Damaged lens fibres
65
Q

What is the treatment for cataracts?

A

Surgery

66
Q

What is glaucoma?

A

Intraocular pressure raised above 21mm of mercury
Eyes optic nerve damaged due to raised intraocular pressure

67
Q

What is the triad of signs for glaucoma?

A
  • Raised IOP
  • Visual field defects
  • Optic disc changes on ophthalmoscopy
68
Q

What is the treatment for glaucoma?

A

Eye drops to decrease IOP
Laser trabeculoplasty
Trabeculectomy

69
Q

What is angle closure glaucoma?

A

Acute, painful onset
IOP severly raised
Anterior chamber (AC) shallow and angle is closed

70
Q

What are methods for lowering IOP?

A
  • IV infusion with or without oral therapy- carbonic anhydrase inhibitors
  • Analgesics, antiemetics
  • Constrictor eye drops- pilocarpine
  • If no contraindication beta blocker drops
  • Steroid eye drops (dexamethasone)
71
Q

What is uveitis?

A

Inflammation of uvea (vascular layer of eye)

72
Q

What are the types of uveitis?

A

Anterior- iris
Intermediate- ciliary body
Posterior- choroid

Head and Neck (8 decks)

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