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Ophthalmology Flashcards

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1
Q

What are Meibomian Glands?

A

Sebaceous glands located within the tarsal plate of the eyelid that secretes a lipid rich substance that keeps the tears over the cornea (lipid component of tear film)

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2
Q

Where does the optic nerve pass through the sclera?

A

The Lamina Cribrosa

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3
Q

Which regions of the sclera are more prone to rupture?

A
  1. Insertion of Optic Nerve

2. Insertion of Extraocular Muscles

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4
Q

Describe the histology of the layers of the sclera

A
  1. Episclera- external, loose CT

2. Sclera Proper- Dense collagen fibers (No Vasculature or Fibroblasts, so poor healing)

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5
Q

What can cause a blue sclera?

A
  1. High IOP
  2. Scleritis
  3. Osteogenesis Imperfecta
  4. Pigmented Congenital Nevus
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6
Q

What is the Limbus?

A

The transition from the clear cornea to the opaque sclera

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7
Q

What makes up the anterior surface of the iris?

A

Fibroblasts and Melanocytes

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8
Q

What controls the Dilator of the Iris?

A

Sympathetics

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9
Q

What controls the Sphincter of the Iris?

A

Parasympathetics

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10
Q

What is Anisocoria?

A

A difference in the sizes of the pupils

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11
Q

What is the layer of the Conjunctiva that covers the inner surface of the eyelid and is attached to the tarsal plate?

A

Palpebral Conjunctiva

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12
Q

Describe the histology of the superior and inferior conjunctival fornices

A
  1. Pseudostratified columnar epithelium
  2. Lots of Goblet Cells
  3. Site of the Lacrimal ductules (which pierce this layer of conjunctiva to –> tears)
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13
Q

Which layer of the conjunctiva covers the eye?

A

Bulbar Conjunctiva

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14
Q

What is the histology of the bulbar conjunctiva?

A
  1. Non-keratinizing Stratified Squamous Epithelium

2. Few Goblet Cells

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15
Q

What makes up the majority of refraction?

A

Cornea + Tear Film

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16
Q

What is Bowman’s Membrane?

A

A basement membrane separating the external epithelium of the cornea from the stroma. This acellular layer protects the spread of malignant cells from the epithelium

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17
Q

Describe the histology of the stroma of the cornea

A

It has aligned collagen fibers (for transparency) and is normally dehydrated

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18
Q

What is the membrane deep to the stroma of the cornea?

A

Descemet Membrane

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19
Q

What is the site of Kayser-Fleischer Ring deposits seen in Wilson’s disease (copper)?

A

Descemet Membrane

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20
Q

An eye that is too long is what?

A

Myopic

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21
Q

An eye that is too short is what?

A

Hyperopic

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22
Q

Describe the flow pattern of Aq Fluid

A
  1. Produced by Ciliary Body
  2. Moves through Posterior Chamber and bathes the lens
  3. Passes through iris into the Anterior Chamber
  4. Drains through the Trabecular Meshwork
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23
Q

What are the consequences of infoliation of the lens?

A
  1. Presbyopia (loss of elasticity with age –> inability to accommodate for near vision)
  2. Cataracts (accumulation of old epithelium and proteins)
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24
Q

What is the Posterior Chamber?

A

Small area anterior to the lens but posterior to the iris

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25
Q

Aq Fluid that becomes trapped in the posterior chamber is a cause of what condition?

A

Acute Angle Closure Glaucoma

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26
Q

What is the Vitreous Humor?

A

Avascular gel that is located between the retina and posterior surface of the lens that contains collagen + Hyaluronic Acid

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27
Q

What occurs to the Vitreous with aging and what are the consequences?

A

The Vitreous undergoes liquefaction and collapse with aging which –> floaters and may cause vitreous detachment from the retina

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28
Q

From what embryological structure are the sensory cells of the retina derived?

A

Diencephalon

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29
Q

What is the function of the Retinal Pigment Epithelial Cell Layer?

A

To absorb light that penetrates all layers of the retina and reduce scattering of light –> increased visual acuity

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30
Q

What are the order/functions of sensory cells of the retina?

A
  1. Photoreceptors (Rods and Cones, perception of light)
  2. Bipolar Cells (Lateral Inhibition to increase contrast)
  3. Ganglion Cells (transmit to brain)
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31
Q

What is the center of the retina where visual acuity is the sharpest?

A

The Macula (especially Fovea)

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32
Q

What is the choroid?

A

The vascular layer between the retina and the sclera

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33
Q

What is the innermost layer of the Choroid that serves as the basal lamina?

A

Bruch’s Membrane

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34
Q

What structures make up the Uveal Tract?

A

Ciliary Body + Iris + Choroid

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35
Q

The Optic Nerve is surrounded by meninges posterior to the globe; what are the connection sites of the (1) Dura and (2) Leptomeninges?

A
  1. Sclera

2. Choroid

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36
Q

What are the Glands of Zeis?

A

Sebaceous glands located at the margin of the eyelid that produce an oily substance onto the hair follicles

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37
Q

What are the Glands of Moll?

A

Apocrine Sweat glands located at the margin of the eyelid

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38
Q

What is the function of eye lashes?

A
  1. Protect the eye from debris

2. Early warning sign of something approaching the eye (causes reflexive closing)

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39
Q

Inflammation of what gland results in a Chalazion?

A

Meibomian Gland

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40
Q

What is the lacrimal gland?

A

An eccrine gland that produces the Aqueous layer of the tear film

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41
Q

What condition causes swelling of regional lymph nodes?

A

Viral Conjunctivitis

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42
Q

What lymph nodes drain the lateral conjunctiva?

A

Preauricular

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43
Q

What lymph nodes drain the medial conjunctiva?

A

Submandibular

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44
Q

What provides the superficial mucous layer of the tear film?

A

Goblet Cells within the Conjunctiva

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45
Q

What are the layers of the tear film?

A
  1. Superficial Oil/Lipid (prevents evaporation)
  2. Aqueous Layer
  3. Mucous Layer (Holds tear film to eye)
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46
Q

What is the function of the tear film?

A
  1. Lubrication
  2. Smooth Optical Surface
  3. Oxygen and Nutrient Delivery
  4. Contains Lysozymes and immunoglobulins
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47
Q

What is the embryologic origin of the anterior surface of the Cornea?

A

Ectoderm

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48
Q

What attaches the basal Columnar cell layer of the cornea to its basement membrane?

A

Hemidesmosomes

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49
Q

What makes up the stroma of the Cornea?

A
  1. Parallel rows of Collagen

2. Ground Substance (mucoprotein and glycoprotein)

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50
Q

What is the function of Corneal Endothelium?

A

It is a single layer of hexagonal cells that actively pump fluid from the stroma

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51
Q

What is the punctum?

A

A small opening at the medial aspect of each eyelid that works to capture tears and funnel them into the nasolacrimal system

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52
Q

Describe the Nasolacrimal/Canalicular System’s path

A

Punctum –> Superior and Inferior Canaliculus –> Common Canaliculus –> Lacrimal Sac –> Nasolacrimal Duct –> Inferior Turbinate of the Nasopharynx

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53
Q

What causes Acute Angle Closure Glaucoma?

A

Blockage of Aq outflow due to closure of the angle by the peripheral iris

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54
Q

What are some clinical features of Acute Angle Closure Glaucoma?

A
  1. Red Eye
  2. Pain
  3. Nausea
  4. Cloudy Cornea
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55
Q

What are treatment options for Acute Angle Closure Glaucoma?

A
  1. Peripheral Iridotomy

2. Diuretics (acetazolamide and mannitol)

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56
Q

What is Iritis/Iridocyclititis?

A

Inflammation of the iris/iris + ciliary body

*Called Anterior Uveitis

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57
Q

What condition causes a ciliary flush and hypopyon?

A

Iritis

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58
Q

What are symptoms of iritis?

A
  1. Redness
  2. Pain worse with light
  3. Ciliary Flush
  4. Decreased vision
  5. Lacrimation
  6. Cellular Depositis
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59
Q

What is the treatment for iritis?

A

Topical Steroids or systemic anti-inflammatory treatment if severe

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60
Q

Which condition that causes red eye is associated with a dendritic ulcer of the cornea?

A

Herpes Simplex Keratitis

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61
Q

What is a Pseudodendrite?

A

A corneal abrasion that has healed similar to the shape of the dendritic ulcer seen with HSV

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62
Q

What agents are the common cause of Bacterial Keratitis?

A
  1. Staph aureus

2. Strep pneumo

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63
Q

What is the common clinical finding of bacterial keratitis?

A

An oval white/yellow dense lesion in the cornea

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64
Q

What is typically necessary to get a bacterial infection of the cornea?

A

Contact wear or corneal trauma

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65
Q

What is the treatment for Bacterial Keratitis?

A

Topical Antibiotics (Tobramycin and Cefuroxime)

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66
Q

What is bacterial keratitis?

A

Bacterial infection of the cornea

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67
Q

What are the types of Conjunctivitis?

A
  1. Bacterial
  2. Viral
  3. Allergic
  4. Neonatal
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68
Q

What is conjunctivitis?

A

Inflammation of the conjunctiva

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69
Q

What organisms cause Bacterial Conjunctivitis?

A
  1. Staph epidermidis
  2. Staph aureus
  3. Strep pneumo
  4. H. influenza
  5. Moraxella
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70
Q

What condition presents with acute redness, gritty itchy eyes, burning and discharge that makes it difficult to open eyes upon waking?

A

Bacterial Conjunctivitis

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71
Q

What is the treatment for bacterial conjunctivitis?

A
  1. Broad Spectrum Antibiotics

2. Antibiotic Ointment at night

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72
Q

What is the common cause of viral conjunctivitis?

A

Adenovirus

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73
Q

How is viral conjunctivitis spread?

A
  1. Respiratory or ocular secretions

2. Contaminated towels, pillowcases ect

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74
Q

What is the incubation period of viral conjunctivitis?

A

4-10 days

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75
Q

What is the treatment for viral conjunctivitis?

A

Supportive and Symptomatic treatment

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76
Q

Which type of conjunctivitis presents with itchy, watery red eyes, sneezing, mild edema and milky pink conjunctiva?

A

Allergic Conjunctivitis

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77
Q

What is the treatment for allergic conjunctivitis?

A

Topical Antihistamines

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78
Q

Which causative agent of neonatal conjunctivitis presents 5-19 days after birth?

A

Chlamydial Conjunctivitis

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79
Q

Chlamydial Conjunctivitis in neonates can be associated with what other diseases?

A
  1. Otitis
  2. Rhinitis
  3. Pneumonitis
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80
Q

What is the treatment for Chlamydial Conjunctivits?

A

Topical Tetracycline and Erythromycin

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81
Q

Which causative agent of neonatal conjunctivitis presents 1-3 days after birth?

A

Gonococcal Conjunctivitis (Neisseria gonorrhoeae)

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82
Q

What is the treatment for Gonococcal Conjunctivitis?

A

Topical and Systemic Penicillin

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83
Q

What condition presents as unilateral discomfort, redness, tenderness and watering of the eye?

A

Episcleritis

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84
Q

What is the treatment for Episcleritis?

A
  1. Topical Steroids (Loteprednol)
  2. Topical NSAIDs
  3. Systemic NSAIDs
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85
Q

What is Scleritis?

A

A granulomatous inflammation of the sclera that ranges for mild severity to a severe necrotizing process that leads to loss of vision

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86
Q

What disease is associated with Scleritis?

A

Rheumatoid Arthritis

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87
Q

What is the treatment of Scleritis?

A
  1. Oral NSAIDs and Steroids

2. Immunosuppressive drug like Cyclosporine (for necrotizing type)

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88
Q

What are Adnexal Diseases?

A

Inflammatory diseases of structures adjacent to the eye

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89
Q

What is Blepharitis?

A

A bilateral inflammation of the eyelid margin that results in burning, grittiness, mild photophobia and redness/crusting of the lid margin

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90
Q

What conditions are associated with Blepharitis?

A
  1. Staph infections

2. Rosacea

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91
Q

What are the treatment options for Blepharitis?

A
  1. Lid hygiene
  2. Antibiotic and Steroid Drops
  3. Tetracyclines for chronic use
  4. Fish Oil
  5. Warm Compresses
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92
Q

Which condition causes exophthalmos?

A

Thyroid Eye Disease

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93
Q

How does Thyroid Eye Disease cause exophthalmos?

A
  • Changes due autoimmune process involving IgG
    1. Hypertrophy of Extraocular Muscles due to increase in glycosaminoglycans
    2. Compression of Optic Nerve
    3. Proliferation of Orbital Fat, CT and Lacrimal glands
    4. Retention of Fluid
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94
Q

What condition describes an infection of the lacrimal sac?

A

Dacryocystitis

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95
Q

What are the treatment options for Dacryocystitis?

A
  1. Broad Spectrum Antibiotics
  2. Warm Compresses
  3. Incision and Drainage
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96
Q

What is a Hordeolum?

A

A small abscess caused by Staph infection of the Meibomian glands or lash follicles that results in a tender, inflamed swelling in the eyelid that points anteriorly

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97
Q

What are the treatment options for a Hordeolum?

A
  1. Warm Compresses
  2. Epilation
  3. Oral Antibiotics
  4. Incision and Drainage
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98
Q

What is a Chalazion?

A

A chronic lipogranulomatous inflammatory lesion caused by blockage of a Meibomian gland or stagnant secretions

99
Q

What condition increases the risk of developing a Chalazion?

A

Acne Rosacea

100
Q

What is the presentation of a Chalazion?

A

A painless nodule that may blur vision due to compression of the cornea

101
Q

What are the treatments for a Chalazion?

A
  1. Topical Steroid
  2. Warm Compress
  3. Incision and Drainage
  4. Tetracycline for recurrent cases
102
Q

Which condition results from a ruptured episcleral blood vessel?

A

A subconjunctival hemorrhage

103
Q

What is a Pterygium/Pingueculum?

A

A fibrovascular sheet that grows over the cornea (Pingueculum does not cross the limbus)

104
Q

What is the cause of a Pterygium/Pingueculum?

A

It is a response to hot climates, chronic dryness and exposure to the sun

105
Q

What is the treatment for a Pterygium?

A

Surgical excision

106
Q

What is the term for dry eye caused by Aq tear deficiency?

A

Keratoconjunctivitis sicca

107
Q

What are symptoms of Keratoconjunctivitis sicca?

A
  1. Irritation
  2. Sensation of a foreign body in the eye
  3. Burning
  4. Stringy mucus discharge
108
Q

What is the function of Cyclosporine in treating Keratoconjunctivitis Sicca?

A

Decreases mononuclear cell function

109
Q

Why is there more corneal exposure in patients with Balle Palsy?

A

Because it causes lagophthalmos and the patient cannot close their eye completely

110
Q

What is entropion?

A

A painful condition where the eyelids (usually lower) are turned inward due to laxity of the lower lid and an over riding orbicularis muscle

111
Q

What is the treatment for entropion?

A

Surgery

112
Q

What is ectropion?

A

A condition where the lower eyelid is turned away from the eye

113
Q

What is epiphora?

A

Condition when tears run down the cheeks (often seen with ectropion)

114
Q

Surgical reattachment of the lateral canthal tendon to the orbital wall is used to treat what condition?

A

Ectropion

115
Q

What is blood in the anterior chamber from trauma called?

A

A hyphema

116
Q

What is the first step in treatment of a chemical injury to the eye?

A

Copious irrigation of the eye

117
Q

What is the function of the zonules?

A

They suspend the lens and allow it to change shape in response to changes in the ciliary body, resulting in a new focal point

118
Q

Eyestrain, difficulty seeing in dim light and problems focusing are early signs of what condition?

A

Prebyopia

119
Q

Increased glare from point light sources, such as car headlights at night, is an early sign of what condition?

A

Cataracts

120
Q

Loss of a normal red reflex may indicate what?

A

Advanced cataracts

121
Q

Dark spots in the red reflex may indicate what?

A

Moderate nuclear cataract

122
Q

What condition may result in bilaterally displaced lenses due to compromised zonules?

A

Marfan Syndrome

123
Q

What gene is mutated in Marfan Syndrome?

A

Fibrillin Gene

124
Q

What is phacoemulsification?

A

Use of ultrasound to break up the existing lens in an artificial intraocular lens transplant

125
Q

Describe the pathway of visual transmission

A

Retina –> Optic Nerve –> Chiasm –> Optic Tract –> Optic Striations –> Occipital Lobe

126
Q

Where is the first place in visual transmission that has input from both eyes>

A

The optic tract

127
Q

What innervates sensation to the cornea and eyelids?

A

Trigeminal Nerve

128
Q

What nerve innervates the orbicular is oculi for lid closure?

A

Facial Nerve

129
Q

Pupil dilation is controlled by what?

A

Sympathetics

130
Q

What is the syndrome which affects sympathetics?

A

Horners

131
Q

Pupil constriction is controlled by what?

A

Parasympathetics

132
Q

What can cause a disruption of the parasympathetics (and CNIII) to the eye?

A

Aneurysm of the Circle of Willis (Posterior Communicating Artery)

133
Q

What is the pathway of the Pupillary Light Reflex?

A
  1. Retina –> Pretectal Nucleus (decussate)
  2. Pretectal Nucleus –> Edinger Westphal Nucleus
  3. Edinger Westphal Nucleus –> Ciliary Ganglion
  4. Ciliary Ganglion –> Constrictor of the Pupil
134
Q

What does a unilaterally dilated pupil indicate?

A

Third Nerve Palsy

135
Q

What do bilaterally dilated pupils indicate?

A

Drug use

136
Q

What is Adie’s Tonic Pupil?

A

A unilateral, large and regular pupil with an absent light reflex that is caused by denervation of the postganglionic supply to the sphincter pupillage and ciliary muscle caused by a viral illness

137
Q

In addition to the large pupil, what else may be seen with Adie’s Tonic Pupil?

A
  1. Diminished deep tendon reflexes

2. Autonomic Nerve Dysfunction

138
Q

What is a relative afferent pupillary defect?

A

Condition where the optic nerves conduct in an asymmetric fashion - likely caused by problem of one of the optic nerves

139
Q

How do you detect a relative afferent pupillary defect?

A

Swinging flashlight Test

140
Q

What would a unilateral small pupil indicate?

A

Horner’s Syndrome

141
Q

What is the triad of Horner’s Syndrome?

A
  1. Miosis (lack of innervation to Dilator Muscle)
  2. Ptosis (Meuller Muscle)
  3. Anhydrosis
142
Q

Does a Horner’s Eye respond to light and accommodation?

A

Yes

143
Q

Where could the deficit be for Horner’s?

A
  1. Hypothalamospinal Tract above T1
  2. Preganglionic Neurons going to the Superior Cervical Ganglia
  3. Postganglionic Neurons projecting from the Superior Cervical Ganglia
144
Q

What are potential causes of Horner’s?

A
  1. Vertebrobasilar Artery Infarction
  2. Tumors
  3. MS
  4. Internal Carotid Dissection
  5. Pancoast Tumor
145
Q

The parasympathetic fibers riding with CNIII go to what?

A

Pupillary Sphincter

146
Q

What is the triad of a Third Nerve Palsy?

A
  1. Misalignment
  2. Ptosis
  3. Mydriasis
147
Q

If the pupil is NOT involved in a Third Nerve Palsy what is the cause?

A

Vasopathic (Diabetes)

148
Q

If the pupil is involved in a Third Nerve Palsy what is the cause?

A

Aneurysm of the Posterior Communicating Artery or some other cause of compression- Urgent

149
Q

Which nerve/extraocular muscle is most sensitive to increased ICP?

A

VI- Lateral Rectus

150
Q

Which nerve/extraocular muscle is frequently affected by microvascular disease?

A

IV- Superior Oblique

151
Q

Diplopia that worsens as the day goes on is a sign of what condition?

A

Myasthenia Gravis

152
Q

What is Nystagmus?

A

Repetitive, involuntary oscillation of the eyes

153
Q

What are 4 conditions that cause opted disc elevation?

A
  1. Disc Drusen
  2. Papilledema
  3. Optic Neuritis
  4. Ischemic Optic Neuropathy
154
Q

What is Disc Drusen?

A

Deposits that make the optic nerve look bumpy

155
Q

What can differentiate optic neuritis from papilledema?

A

Optic Neuritis is typically unilateral

156
Q

What is a common cause of optic neuritis?

A

Multiple Sclerosis

157
Q

What are the two types of Ischemic Optic Neuropathy?

A
  1. Arteritic (Giant Cell Arteritis- Temporal Artery Biopsy))

2. Non-Arteritic (HTN, -Aspirin Therapy)

158
Q

What is Amaurosis Fugax?

A

A transient loss of vision in one eye (TIA of optic nerve)

159
Q

What is a Scotoma?

A

An area of the visual field where vision is either absent or diminished

160
Q

Where would the lesion be for a Homonoymous Hemianopia (knock out of one side of vision)?

A

Behind the Chiasm

161
Q

Where would the lesion be for bitermporal hemianopia (tunnel vision)?

A

The chiasm

162
Q

Where is the Vitreous located?

A

Between the retina and lens

163
Q

How can you distinguish vessels on ophthalmoscopic exam?

A

Arterioles- smaller and in front

Venules- larger and deep

164
Q

What is the Retinal Pigment Epithelium?

A

Pigmented cell layer beneath the neurosensory retina that provides nutrients to the retinal visual cells; it is attached to the Choroid

165
Q

What is the pigmented yellow spot near the center of the retina?

A

the Macula

166
Q

What is the fovea?

A

A small pit in the center of the macula that has the largest concentration of cone cells for high resolution vision

167
Q

Floaters and Flashes are symptoms that suggest what?

A

Vitreoretinal Disorders

168
Q

What is the first sign of a retinal detachment?

A

Flashes

169
Q

What is the underlying cause of blurring or distorted vision?

A

Subretinal Fluid

170
Q

What is the cause of minimalization?

A

Edema that is stretching out the photoreceptors

171
Q

What causes abrupt progressive dimming of vision in one eye?

A
  1. Retinal Detachment

2. Vitreous Hemorrhage

172
Q

What causes an abrupt loss of peripheral visual field?

A

Peripheral Retinal Detachment

173
Q

Cataracts, Retinoblastoma and Retinal Detachment can all result in what finding?

A

Loss of the normal red reflex

174
Q

Hemorrhage and Cataracts can result in what?

A

Dark spots on the red reflex

175
Q

What is the cause and pathology of Non-proliferative Diabetic Retinopathy?

A

Microvascular Occlusion results in loss of Pericytes which allow leakage from the capillaries –> Edema, dot/blot hemorrhages and hard lipid exudates which all –> retinal ischemia

176
Q

What is the treatment option for non-proliferative diabetic retinopathy?

A

Focal Laser Therapy

177
Q

What is Proliferative Diabetic Retinopathy?

A

Proliferation of abnormal vessels in response to chronic ischemia –> profound vision loss

178
Q

What is the treatment for Proliferative Diabetic Retinopathy?

A

Pan-retinal Photocoagulation

179
Q

Which systemic diseases have important findings on fundoscopic exam?

A
  1. Diabetes
  2. Systemic HTN
  3. Embolic CV Disease
  4. HIV
  5. Metastatic Cancer
180
Q

What is Sclerotic Retinopathy?

A

Narrowing of the arterioles (HTN)

181
Q

Central (or Branch) Retinal Vein Occlusion is caused by what?

A

Increased pressure in the artery compresses the vein, leading to diffuse hemorrhaging and vision loss

182
Q

What condition appears as unilateral diabetic retinopathy, and what test should be done?

A

Ocular Ischemia (Carotid Disease); do a Carotid Study

183
Q

Central Retinal Artery Occlusions are caused by what type of occlusion?

A

Thromboembolic

184
Q

What occurs as a result of retinal artery occlusion?

A

Severe rapid vision loss

185
Q

Branch Retinal Artery Occlusions are caused by what type of occlusion?

A

Embolic

186
Q

What virus causes severe retinopathy in HIV patients with low CD4 counts?

A

CMV

187
Q

Where in the eye are cancers likely to metastasize and why?

A

The choroid because it is highly vascular

188
Q

What disease is associated with a white pupil (leukocoria)?

A

Retinoblastoma

189
Q

In addition to leukocoria, what finding may be present in Retinoblastoma patients?

A

Non-paralytic strabismus

190
Q

Which type of Rb increases the risk of bilateral Rb?

A

Hereditary

191
Q

What is the gene that results in the abnormal tumor suppressor seen in Rb?

A

13q14

192
Q

What is the inheritance of Rb?

A

Autosomal Dominant

193
Q

Why is sporadic Rb rare?

A

Because it would require 2 somatic mutations

194
Q

What is non-paralytic strabismus?

A

When the eyes cannot focus on the same point simultaneously (not due to muscle paralysis, seen in Rb)

195
Q

What is rhegmatogenous Retinal Detachment?

A

Occurs when there is a break in the retina and fluid has entered the sub retinal space

196
Q

What is the treatment for retinal detachment

A

Urgent Surgery

197
Q

What is a virectomy?

A

Removal of Vitreous Material

198
Q

Why could you see an altered red reflex in retinal detachment?

A

Because fluid has entered the potential space

199
Q

What two structures work to remove Aq Fluid from the eyes?

A
  1. Trabecular Meshwork

2. Venous Outflow from the Uveoscleral Tract

200
Q

What condition is an optic neuropathy caused by elevated IOP?

A

Glaucoma

201
Q

Where are axons commonly injured in glaucoma?

A

The Lamina Cribrosa

202
Q

An elevated cup/disc ration indicates what?

A

Glaucoma

203
Q

What vision is typically lost first in glaucoma?

A

Peripheral

204
Q

What are the risk factors for Open Angle Glaucoma?

A
  1. IOP > 21
  2. African or Caribbean
  3. Age
  4. Family Hx
205
Q

What are the risk factors for Angle Closure Glaucoma?

A
  1. Narrow Anterior Chamber
  2. Hyperopia
  3. Dilation of pupil
  4. Age
  5. Asians
206
Q

What condition presents with red eye, pain and nausea?

A

Angle Closure Glaucoma

207
Q

What are the two general mechanisms for treating open angle glaucoma?

A
  1. Increasing Aq outflow

2. Decreasing Aq production

208
Q

What drugs increases Aq outflow for Open Angle Glaucoma and how do they work?

A
  1. Parasympathomimetics (by constricting the pupil and pulling the ciliary muscle they open the trabecular meshwork)
  2. Prostaglandins (increase outflow through the uveoscleral tract)
209
Q

Which drugs may cause redness and lash growth?

A

Prostglandins

210
Q

What drugs are used to decrease Aq production for Open Angle Glaucoma and how do they work?

A
  1. Topical Beta Blockers (decrease production by ciliary body)
  2. Carbonic Anhydrase Inhibitors (inhibit enzyme)
  3. Alpha 2 Agonists (decrease Aq production and increase uveoscleral outflow)
  4. Adrenergic Agonists (increase Aq outflow - due to Beta Agonist effects)
211
Q

What are the surgical options for Acute Angle Closure Glaucoma?

A
  1. Peripheral Iridectomy

2. Laser Peripheral iridotomy

212
Q

What are the surgical options for Open Angle Glaucoma?

A
  1. Laser Trabeculoplasty (enlarging meshwork)
  2. Filtering Surgery (cut sclera for new outflow)
  3. Tube
  4. Cyclodestruction (decreasing amount of functional ciliary body)
213
Q

Which muscles receive their blood supply from the lateral branch of the ophthalmic artery?

A
  1. Lateral Rectus
  2. Superior Rectus
  3. Superior Rectus
  4. LPS
214
Q

Which muscles receive their blood supply from the medial branch of the ophthalmic artery?

A
  1. Medial Rectus (also from lacrimal artery)
  2. Inferior Rectus (also infraorbital artery)
  3. Inferior Oblique (also infraorbital artery)
215
Q

What is Amblyopia?

A

Potentially permanent loss of vision due to asymmetric visual input or from vision deprivation

216
Q

What is Strabismic Amblyopia?

A

Where input from the deviating eye is suppressed (#1 cause of unilateral decreased vision in kids)

217
Q

What is refractive amblyopia?

A

Where the input from the eye with the poorer refractive power is ignored

218
Q

What is Form/Occlusion Amblyopia?

A

Depravation of visual stimuli due to cataracts or eye lid mass/ptosis

219
Q

What type of strabismus is it if the size of the deviation does not vary with the direction of the gaze?

A

Concomitant

220
Q

What type of strabismus is it if the direction of gaze does affect the size of the deviation?

A

Incomitant

221
Q

Which type of strabismus is caused by neuro/mechanical/myogenic problems with the extra ocular eye muscles?

A

Incomitant

222
Q

What is esotropia?

A

Cross eyed

223
Q

What is exotropia?

A

Wall eyed

224
Q

What is hypertropia?

A

Eyes pointed upward

225
Q

What is hypotropia?

A

Eyes pointing downward

226
Q

What is the most common cause of childhood blindness?

A

Cortical Blindness

227
Q

What is the initial blood supply to the eye?

A

Hyaloid Artery (reabsorbed in 34 weeks)

228
Q

When do vessels appear in the retina?

A

15-18 weeks (nasal first, temporal last)

229
Q

What is retinopathy of prematurity?

A

Second leading cause of childhood blindness- hypoxia, hypotension and free radicals damage new vessels –> edema and hemorrhage –> traction on retina –> retinal detachment

230
Q

What is the treatment for retinopathy of prematurity?

A

Ablation of the Peripheral Avascular Retina via photocoagulation

231
Q

Other than Rb what else may present with leukocorea?

A

Cataract

232
Q

What is contained in the Anterior Lamellae of the eyelid?

A
  1. Skin
  2. Eye Lash Follicles
  3. Orbicularis Muscle
  4. Levator Aponeurosis
233
Q

What is contained in the Posterior Lamellae of the eyelid?

A
  1. Tarsal Plate
  2. Mueller’s Muscle
  3. Meibomian Gland orifices
  4. Palpebral Conjunctiva
234
Q

What supplies sensation to the eyelid?

A

V1 and V2

235
Q

What is the motor supply of the eyelid?

A

CNIII (LPS), CNVII (Orbicularis Oculi) and Sympathetics (Muellers)

236
Q

What is Blepharoptosis?

A

Low position of the upper eyelid

237
Q

What is Ptosis?

A

Eyelid drooping

238
Q

What are the causes of Ptosis?

A
  1. Third Nerve Palsy
  2. Horner’s
  3. Myogenic (Myasthenia Gravis or Dystrophy)
  4. Aponeurotic (stretching of LPS aponeurosis)
  5. Mechanical (due to lesions, ex-hemangioma)
239
Q

What is dermatochalasis?

A

Excess skin of the upper eyelid

240
Q

A Hutchinson’s Sign if frequently seen with what condition?

A

Herpes Zoster Ophthalmicus

241
Q

What are Xanthalasma?

A

Cholesterol Deposits due to hyperlipidemia

242
Q

Which skin lesion has a “pearl like” shape?

A

Basal Cell Carcinoma

243
Q

Which skin lesion appears more ulcerative?

A

Squamous Cell Carcinoma

Neuro/Psych Exam (12 decks)

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