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Glaucoma > Ophthoquestions Plastics > Flashcards

Ophthoquestions Plastics Flashcards

1
Q

Patients with recurrent chalazion in same location whose contents are filled with solid materials should be evaluated for

A

Sebaceous gland carcinoma

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2
Q

Stain used for sebaceous gland carcinoma

A

Oil red O

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3
Q

Type a spread exhibited by sebaceous gland carcinoma

A

Pagetoid spread. Perform map biopsy of conjunctiva if biopsy is positive. Can have skip lesions.

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4
Q

How long do lashes take to regrow after epilation

A

3-6 weeks

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5
Q

Lesion that appears at 1-2 months of age, enlarges initially and then stabilizes with spontaneous resolution between 3-5 years of age.

A

Capillary hemangioma

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6
Q

Treatment indications for capillary hemangioma

A

Lesion induces refractive error or lesion causes eyelid to obstruct visual axis (amblyiogenic)

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7
Q

Treatment options Capillary Hemangioma

A

Superficial lesions: topical timolol
Larger/deep lesions: Oral propranolol
Last resort: surgical excision for refractive lesions

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8
Q

Sarcoidosis: common ocular findings

A

anterior or posterior uveitis (30-70%), conjunctival nodules (40%)

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9
Q

Most commonly affected adnexal structure in Sarcoidosis

A

Lacrimal gland

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10
Q

Most common cause of congenital nasolacrimal obstruction

A

Valve of Hasner

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11
Q

What bones constitute the Roof, Medial wall, Floor, and Lateral wall of the orbit?

A

Roof: Front Less (frontal bone, lesser wing of sphenoid)
Medial wall: SMEL (Sphenoid, Maxilla, Ethmoid, Lacrimal)
Floor: MoP Z (Maxilla, Palatine, Zygomatic)
Lateral wall: Great Z (greater wing of sphenoid, zygomatic)

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12
Q

NF1 ocular findings and associations

A

Lisch nodules, optic nerve glioma, Plexiform neuroma (can result in S-shaped upper eyelid deformity)

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13
Q

Compound helps disperse lidocaine

A

hyaluronidase

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14
Q

Most common eyelid cancer

A

Basal cell carcinoma (40x rate of SCC)

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15
Q

Most common site for Basal cell carcinoma

A

lower eyelid (50-60%), Medial canthus (25-30%), upper eyelid (15%), Lateral canthus (5%)

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16
Q

Basal cell carcinoma appearance

A

Pearly nodule sometimes with telangiectasia. Peripheral palisading histologically

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17
Q

Ophthalmic division of CN V primary branches:

A

Lacrimal, nasociliary, and frontal branches
Frontal divides into supratrochlear and supraorbital.
Nasociliary divides into short and long ciliary nerves

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18
Q

Nerve that innervates Cornea

A

Nasociliary branch of V1. Also gives off branches that supply the ethmoid sinus, lateral wall of nose, and tip of nose

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19
Q

Different procedures for

  1. <33% full thickness deficit
  2. Defect between 33-50%
  3. Defect > 50% in lower eyelid
  4. Defect >50% in upper eyelid
A
  1. Direct closure
  2. Lateral canthotomy then semicircular flap (tenzel flap)
  3. Modified Hughes procedure
  4. Cutler-Beard procedure
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20
Q

Structures from punctum to valve of Hasner

A

canaliculi (2 mm vertical then 8-10 mm horizontal to nasolacrimal sac (12-15mm) then nasolacrimal duct (12mm) to valve of hasner

21
Q

Thinnest walls of orbit

A

ethmoid and maxillary

22
Q

Causes involutional entropion (3)

A
  1. Horizontal eyelid laxity -> lateral tarsal strip
  2. Disinsertion of the lower eyelid retractors -> retractor reinsertion.
  3. Overriding preseptal orbicularis -> partial orbicularis myectomy
23
Q

What part of lacrimal gland should be biopsied if needed

A

orbital

24
Q

Systemic conditions to think about with unilateral or unusual presentations of ptosis

A

Myasthenia gravis (anti-acetylcholine receptor antibody in 90%), CN III palsy (large pupil on ptosis side) do angiogram to r/o aneurysm, Horner’s syndrome

25
Q

Functions of anterior and posterior medial canthal tendon

A

Anterior: structural support of eyelid
Posterior: keeping eyelid and punctum apposed to globe

Between the anterior and posterior tendons lays the lacrimal sac

26
Q

GCA biopsy shows breaks in what structure:

A

Internal elastic lamina

27
Q

50% of orbital lymphoproliferative lesions are located in

A

lacrimal gland fossa.

90% of these are non-Hodgkin B-cell lymphoma

28
Q

Rhabdomyosarcoma: most common type, most lethal, and best survival rate.

A

Embryonal (80%) with propensity to superonasal quadrant. Alveolar is awful (most lethal, lower orbit), Pleomorphic please (best survivial)

29
Q

Most likely leukemias to metastasize to orbit

A

ALL and AML

30
Q

Epicanthus TIPS

A

Tarsalis (top), Inversus (inferior), Palpebralis (U=L), and supraciliaris (above eyebrow)

31
Q

Superior orbital fissure structures within annulus of Zinn

A

CN III, CN VI, and nasociliary branch of CN V1

32
Q

Structures within fissure but outside annulus of Zinn

A

LFTs (Lacrimal, Frontal of V1, and Trochlear)

33
Q

Which nerve/actions are not effected by retrobulbar block?

A

Superior oblique innervated by CNIV which 1. incyclotorsion, 2. Depression, 3. Abduction

34
Q

Inferior oblique separates which fat pads?

A

Medial and central fat pads

35
Q

Canaliculitis is most commonly caused by

A

Actinomyces Israelii: filamented gram positive rod

36
Q

Relationship between lateral canthal tendon and medial canthal tendon insertion sites

A

Lateral canthal tendon inserts 2 mm superior to medial canthal tendon

37
Q

Natural path from lacrimal sac to inferior meatus

A

Inferior, posterior, and slightly lateral

38
Q

Main eyelid protractor

A

Orbicularis oculi

39
Q

Location and function of Krause and Wolfring glands

A

Krause and Wolfring produce aqueous component of tears. Krause is in fornicies, Wolfring are at non-marginal tarsal borders

40
Q

NF-1 diagnostic criteria

A 
Six + cafe-au-lait spots
Axillary or inguinal freckles
Two or more typical neurofibromas, or one plexiform neurofibroma
Optic nerve glioma
Two or more iris hamartomas
Sphenoid dysplasia
first degree relative with NF1
41
Q

Optic findings Tuberous sclerosis

A

Retinal astrocytomas

42
Q

Optic findings von Hippel-Lindau

A

Retinal Angiomatosis

43
Q

Optic findings with Wyburn-Mason

A

Racemose Angioma

44
Q

Autoantibody associated with granulomatosis with polyangiitis

A

cANCA

45
Q

Autoantibody for Polyarteritis Nodosa

A

pANCA

46
Q

Autoantibody associated with systemic lupus erythematosus

A

ANA

47
Q

Sjogren’s Syndrome antibody

A

Anti-SSA (anti-Ro)

48
Q

Distance from posterior globe to orbital apex
Length of optic nerve within orbit
Length of optic nerve within optic canal

A

18 mm
25-30mm
10mm

Glaucoma (3 decks)

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