Ophthalmology: Eyelids Flashcards
What do the following pre/suffixs mean?
1. -Blephar-
2. -Cor-
3. -Cycl-
4. -Dacro-
5. -Hyal-
6. -Kerat-
7. -Papilla-
8. -Phak-
- Lid
- Pupil
- Ciliary body
- Tears
- Vitreous
- Cornea
- Optic disc
- Lens
What do the following terms mean?
1. Aniscoria
2. Blephrospasm
3. Bupthalmos
4. Chemosis
5. Ectropion
6. Entropion
7. Endophthalmitis
8. Enopthalmos
9. Epiphora
10. Equator
- Unequal pupils
- Sustained closing or excess blinking of the eye- usually pain
- ‘Ox eye’- enlarged eye from sustained glaucoma
- Oedema of conjunctiva
- Outward displacement of lid
- Inward displacment of lid
- Inflammation of all the interior of eye
- Abnormally deep position of the eye in the orbit
- Poor tear drainage leading to overflow
- Roughly over the ciliary body- oriented vertically, not horizontally
What are the following terms?
1. Exophthalmos
2. Hyphaema
3. Hypopyon
4. Lagophthalmos
5. Microphthalmia
6. Miosis
7. Mydriasis
8. Panophthalmitis
9. Phthisis bulbi
- Abnormal protrusion of the eye- acquired or congenital
- Blood in the anterior chamber
- Pus in the anterior chamber
- Rabbit eye- abnormally prominent eye
- An abnormally small eye
- Constriction of the pupil
- Dilation of the pupil
- Inflammation of all parts of the eye
- Sunken soft ‘end stage’ eye due to severe irreversible damage
What do the following terms mean?
1. Ptosis
2. Staphyloma
3. Synechiae
4. Trichiasis
- Abnormally low carriage of the upper lid
- Defect in the coat of the eye- becomes lined with uveal tissue
- Adhesion of the iris to adjacent tissues following inflammation
- Skin hairs in contact with the eye
Generally what is the method of administration of opthalmic drugs?
- Topical always has higher conc on ocular surface an anterior chamber
- Oral if inflammation or infection in the posterior segment
What antibiotics can be used for opthalmic drugs?
- Chloramphenicol- broad spectrum- not recommended for corneal ulcers
- Fusidic acid- non-specific conjunctivitis- narrow spec- not suitable for corneal ulcers
- Gentamycin- broad spec, includes pseudomonas
- Ciprofloxacin/Ofloxacin- broad spec- expensive
What is the function of anti-collagenase drugs?
- Acetylcysteine- anti-metling agents for melting corneal ulcers
What corticosteroids can be used optically?
- Dexamethasone
- Prednisolone acetate
Never on corneal ulcers
What optical anti-inflammatories are used?
- Cyclosporin- also stimulated tears (dry eye)
- Tacrolimus-
- Acular
- What are mydriatics?
- What drugs can be used?
- Dilate the pupil for treament of uveitis and lens/fundus examination
- Atropine- long lasting, not for examination
Tropicamide- short acting
What are the different anti-glaucoma medications and what are there actions?
- Dorzolamide/Brinzolamide- topical carbonic anhydrase inhibitors
- Latanoprost/Travoprast- prostaglandin analogues
- Timoptol- beta-blocker- often in combination of above
What is the indication ofr eye lubricants?
What are the different ones?
Treatment of dry eye
* Lubithral
* * Lacrilube
* Artelac night time gel
* Anhypro, Hylo Forte, Hyabak
Non prescription
- What muscle closes the eye?
- What nerve innervates it?
- What muscle opens the eye?
- What nerve innervates it?
- Orbicularis oculi
- VII- facial
- Levator palpebrae superioris, muller’s muscle
- Levator- III- occulomotor
Muller’s- smooth muscle/sympathetic
- Where are tarsal/meibomian glands found?
- What is their function?
- Run at right angles along the lind margin
- Release lipid on to pre-corneal tear film
How are the eyelids stabilised and attached to bony orbit
Y-shaped ligmaments
How should the skin be prepared for surgery of the following procedures?
1. Enucleation
2. Eyelid surgery
3. Corneal, conjunctival, third eyelid
What is used for an antiseptic
- Full surgical clip
- Clip field only
- No clipping
Non-lathering aqeuous povidone-iodine
What are the principles of eyelid surgey?
- Knots must never touch the eye
- Hairs must never touch the eye
- Cornea must be protected without exposure problems such as inability to blink
- What is distichiasis?
- How is it diagnosed?
- How is it treated?
- Hairs grow from the tarsal gland openings and irritate the cornea
- Watery eyes, visible corneal damage (rare)
- Some none, if do none ideal
- What is ectopic/conjunctival cilia
- How it it treated?
- Hairs that emerge from the conjuntival surface
- Excise a deep wedge- no suturing
How is entropion treated?
Skin-muscle operation
* Dog conscious- decide on excision
* Incise skin and suture together
* Imagine pinching with pliers but pinched skin is removed
What different entropion surgeries may be required?
- Shar Peis- skin muslce of all four lids, when young- tacking sutures
- St. bernards, bloodhounds- diamond eye- specialist
- Lateral canthus- ligament section
- Medial entropion- pugs
- Upper lid trichiasis/entropion- english cocker spaniels
- What is the most common eyelid tumour?
- How are they treated?
- Sebaceous epithelioma/adenoma
- Excision usually curative
What surgeries can be used to prevent chronic sequential ulcers in brachycephalics?
- Facial fold removal
- Medial entropion
- Shortening at palpebral apature
Describe the anatomy of the nicitiating membrane?
- Fold in the conjunctiva
- Supported by a T-shaped cartilagenous frame
- Gland- 1/3 aqueois of tears
- Lymphoid follicles
How can nicitating membanes be examined?
- Gentle pressure of the globe through the upper lid
What are common differentials for third eyelid?
Usual complaint- prominence
* Congenital lack of pigment
* Prolapse
* Folding/kinkage of cartilage
* Plasma cell infiltrations- GSDs
* Retrobulbar swellings
* Horners
Can be carcnoma, lymphoma or histiocytosis
How is third eyelid prolapse treated?
- Traditionally excised
- Pocket technique- enclose in a fold of conjunctiva
What can be used in the treatment of plasma cell infiltration of third eye lid in german shepherds?
- Cyclosporin
What are the features of horner’s syndrome?
- Ptosis- low upper lid
- Enopthalmos- deep eye
- Miosis- pupil dilation
- Protrusion of nicitating membrane
