Ophthalmology Flashcards
Which of the orbital walls is most likely to undergo a blow-out fracture?
Inferior and medial
Which structure is responsible for closing the eyelids tightly?
orbicularis oculi orbital part muscle, Innervated by CNVII
What is the motor innervation of the superior tarsal (Mueller’s) muscle?
sympathetic innervation (not somatic motor innervation like skeletal muscles).
The sympathetic fibers originate from the superior cervical ganglion and travel along the carotid plexus and then through the ophthalmic division of the trigeminal nerve (CN V1) to reach the muscle.
The lacrimal gland is found in which part of each orbit?
Superior lateral
The tendon of which of the following muscles passes through the trochlea?
Superior oblique innervated by trochlear nerve
Where does the inferior oblique muscle originate from?
orbital margin of the maxilla, lateral to the lacrimal sac.
What is the somatic motor innervation of the lateral rectus muscle
Abducens nerve
What is the action of the levator palpebrae superioris?
Elevate the upper eyelid
Between which vertebral levels do presynaptic sympathetic fibres leave the spinal cord?
between the T1 and L2 vertebral levels.
In which ganglion do
sympathetic fibres travelling to the head and neck synapse?
Superior cervical ganglion
Postsynaptic sympathetic fibres reach the orbit by travelling on the surface of which of the following arteries?
Internal carotide artery
External supply head, neck and scalp
Which of the following parasympathetic ganglia are associated with the eyeball
Ciliary ganglion
What are the pterygopalatine ganglion, submandibular ganglion, otic ganglion
lacrimal gland, salivary glands
Partial gland
The ciliary ganglion is associated with which cranial nerve?
Oculomotor nerve
Which crinal nerve innervate the dura mater
CNV
which meningeal layer adheres closely to the brain ?
Pia
at which vertebral level does the subarachoid space end
S2
identify the location of 3rd 4th and lateral ventrucles
which structre produce CSF
Choroid plexus
How to identify which eye you looking at
make the C in your hand if its with your right hand is right eye if its with your kleft hand its left eye
A 32-year-old man presents with blurred vision and pain in his left eye. He reports a history of a penetrating injury to his right eye 1year ago, which was surgically repaired. On examination, there is granulomatous anterior uveitis in both eyes, with mutton-fat keratic precipitates and vitritis. Fundoscopy reveals Dalen-Fuchs nodules in the posterior pole.
What is the most likely diagnosis?
A. Endophthalmitis
B. Vogt-Koyanagi-Harada syndrome
C. Sympathetic ophthalmia
D. Sarcoidosis
E. Behçet’s disease
C. Sympathetic ophthalmia
Explanation:
Sympathetic ophthalmia is a bilateral granulomatous panuveitis that occurs after penetrating trauma or surgery to one eye. Key features include:
History of penetrating injury or surgery to one eye (the exciting eye).
Onset of symptoms in the contralateral eye (the sympathizing eye) weeks to months after the initial injury.
Granulomatous inflammation in both eyes, including:
Mutton-fat keratic precipitates.
Vitritis.
Dalen-Fuchs nodules (yellow-white lesions at the level of the retinal pigment epithelium).
Choroidal thickening on imaging.
Blood and thunder
Diabetic Eye Disease
Retinal Artery Occlusion
Retinal detachment
Branch Retinal Artery Occlusion
Macular degeneration
Classify the diabetic retinopathy
Severe NPDR
How would you treat this patient (VA 6/9)
Describe the Vein Occlusion
RE Inferotemporal BRVO
What Are three symptoms associated with with this
What are the three clinical symptoms present
ptosis , frontal baldness, EXOTROPIA Bilateral facial wasting with hollow cheeks
Ask to shake there hand cause they will not be able to let go
How many bones make up the orbit?
Frontal
Lacrimal
Ethmoid
Zygomatic
Maxillary
Palatine
Sphenoid
What is this and what is the causative organism
Dendritic ulcer
Viral keratitis
What treatment should be avoided in viral keratitis and why
Steroids worsen the dendritic ulcer causing geographic ulcer and increase the risk of fungal infection.
3a. On examination you find a right eye to be positioned down and out, with a drooping lid and dilated pupil. What is the most likely pathology
What pathology are you most worried about in this situation??
What investigation is most appropriate
3rd never palsy
Posterior Communicating Artery
Aneurysm
MRI angiogram
Terms ‘Papilloedema’ and ‘cupping’ are sometimes confused. What causes ‘cupping’?
Glaucoma
OCT test stands for Optical Coherence Tomography
What is OCT most useful in evaluating
Age related macular degeneration
CRAC cherry-red spot because the retina become so pale that The choroidal blood vessels beneath the FOVAS become more visible, giving the fovea its characteristic red appearance.
Hypopyon
Hyphaema
The lateral rectus is supplied by which cranial nerve and is responsible of what movement of the eye?
Question 2Select one:
CN III / oculomotor nerve and abduction
CN III / oculomotor nerve and adduction
CN VI / abducent nerve and adduction
CN VI / abducent nerve and abduction
When assessing visual function, there are some test which focus on assessing pupil reflexes. Which of the following explanations best describes how to perform the assessment for a RAPD (relative afferent pupillary defect)?
Question 4Select one:
Move the pen torch swiftly between the pupils
Give the patient something to focus on, e.g. your finger, and move it closer to them.
Shine a light into the pupil and observe the contralateral pupil.
Shine a light into the pupil and observe constriction of that pupil
The oculomotor motor (CN III) nerve supplies which muscles of the eye?
Question 7Select one:
Inferior rectus, medical rectus, lateral rectus
Inferior oblique, superior oblique, lateral rectus
Inferior rectus, medial rectus, inferior oblique
Inferior oblique, superior oblique, inferior rectus
