(From outer to inner) 1. Pigment epith 2. Rods and cones 3. External limiting membrane 4. Outer nuclear layer 5. Outer flexiform layer 6. Inner nuclear layer 7. Inner flexiform layer 8. Ganglion cell layer 9. Nerve fiber layer 10. Internal limiting membrane

optha-retina, glaucoma Flashcards by zarieh Novela

Only non transparent portion of retina

Blood columns and pigment epithelium

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Innermost layer of the eye

Retina

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Posteriorly, retina converges towards the ____ to form intra ocular portion of _____

Posteriorly, retina converges towards the OPTIC DISK to form intra ocular portion of OPTIC NERVE

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The anterior or peripheral portion of the retina is marked by ____ where retina is transformed into nonpigmented epith of ciliary body

The anterior or peripheral portion of the retina is marked by ORA SERRATA where retina is transformed into nonpigmented epith of ciliary body

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The retina is firmly attached to 2 portions

Ora serrata

Optic disk

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Layers of retina

(From outer to inner)

Pigment epith
Rods and cones
External limiting membrane
Outer nuclear layer
Outer flexiform layer
Inner nuclear layer
Inner flexiform layer
Ganglion cell layer
Nerve fiber layer
Internal limiting membrane

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Pigment epith is derived from

Outer layer of optic cup

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If pigment epith is derived from outer layer of optic cup, then the rest of the retina Comes from

Inner Layer

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Where does retinal detachment occur?

Between pigment epith and the rest of the retina, which has embryological basis.

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The pigment epith is composed of single layer of ____ cells! with micro villi projecting into the interspace between outer segments of rods and cones.

Polygonal cells

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Layer which is source of metabolic enzymes, as well as vit.A needed by visual cells, which is imp in the phagocytosis of degenerated fragments of outer segments.

Pigment epith

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Rods and cones layer is composed of outer and inner segments. What segment can you find the light-sensitive photo chemicals?

Outer segment
Has transverse disk which contain the visual pigment concerned in photochemistry of visual process converting light energy into chemical energy of nerve impulse.

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Rods and cones layer is composed of outer and inner segments. What segment contains usual cyto and cytoplasmic organelles esp mito which amplifies the weak impulse into a transmitted current?

Inner segment
Which is connected to the outer by a constriction containing the cilia, which thought to transmit electrical impulse to the finely granular inner segment

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Layer of retina which is a fenestrations membrane composed of terminal bars

External limiting membrane

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External limiting membrane is Formed by junctional attachment between..

membranes of Muller cells and the inner segment of photoreceptors

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Layer of retina which is composed of the nuclei of the photoreceptors.

Outer nuclear layer

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Layer of retina which constituted by the axons of photoreceptors and the connecting dendrites of bipolar cells

Outer flexiform layer

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In what region does the bipolar cells and other elements of inner layer of retina are pushed to the sides, where the axons and dendrites in outer plexiform layer take an oblique or tangential course.

In region of fovea

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In region of fovea, the bipolar cells and other elements of inner layer of retina are pushed to the sides, the axons and dendrites in outer plexiform layer take an oblique or tangential course. This unique portion of outer plexiform is called..

Nerve fiber layer of Henle

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Layer of retina which consists if nuclei if several cells, namely bipolar cells, Muller’s cells, horizontal cells, and amacrine cells.

Inner nuclear layer

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Layer of retina which is composed of axons of bipolar cells and dendrites of ganglion cells.

Inner plexiform layer

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Layer of retina in which ganglion cells usually form a monocellular layer throughout most of the retina

Ganglion cell layer

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Layer of retina where the axons of the ganglion cells converge toward posterior pole of the eye to eventually from the optic nerve.

Nerve fiber layer

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Layer of retina which is the cuticular derivative of Muller’s cells and serves to delineate the retina from the overlying vitreous.

Internal limiting membrane

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Bld supply of retina

Central retinal artery and vein which enters the eye thru optic disk

First branch of ophthalmic artery

Central retinal artery

As the retinal artery enters the eye, it loses its ____ , and the medial muscular coat becomes ____.

As the retinal artery enters the eye, it loses its INTERNAL ELASTIC LAMINA and the medial muscular coat becomes INCOMPLETE.

How many capillary networks are there in the retina? Where is It located?

Two. One in nerve fiber layer and one in inner nuclear layer. They are closely interconnected.

Retinal capillaries contains ___ that are located in the basement membrane.

Mural cells

The artery and vein have a common adventitial sheath at their crossings, an important factor in the production of AV crossing changes in what diseases?

Arteriosclerotic and hypertensive retinopathies

Photoreceptors which func at low level of illumination or night vision (scotopic vision).

Rods

Photoreceptors which func at high level of illumination or daytime vision (photopic vision).

Cones

Photoreceptors for color vision

Cones

Center of acute vision

Fovea centralis

Rods/cones are concentrated in Fovea centralis

Cones

Main cells in retinal periphery

Rods

Photoreceptors concerned with peripheral vision

Rods

The retina is dependent on a continuous supply of ___ for its metabolism.

Glucose

Cells the serves as the storehouse of glucose in the form of glycogen

Muller's cells

The retina gets its bld supply from 2 sources

choriocapillaries supply the outer layer | Retinal arteries supply the inner layer

Principal symptom of retinal patho

Visual disturbance

Visual disturbance may be manifested as..

``` Visual blurring Photopsia Sector visual field defect Disturbance of image shape or size Nyctalopia ```

Visual loss or impairment may involve (central/peripheral vision) if macula is involved.

Central vision

Visual loss or impairment may involve (central/peripheral vision) if extra macular area (esp rods) is involved.

Peripheral vision

Seeing flashes of light

Photopsia

It is caused by any stimulus on the eye which results in only one retinal response, and that is seeing light.

Photopsia

Photopsia may be experienced in ___ where the retina is mechanically stimulated as it floats or moves in the vitreous.

Retinal detachment

Photopsia may be experienced in ___ which causes traction in the retina (Moore's lightning streaks).

Vitreous detachment

Actual loss of a part of the field of vision or a sensation of a curtain or a fog covering the involved portions of the field of vision

Sector visual field defect

Some retinal condi which can produces sector visual field defect

Partial retinal detachment Large retinal hemorrhage Branch occlusion of retinal vessels

Caused by disturbance in the alignments and position of the visual cells, esp macular area as in macular edema, central serous retinopathy or flat retinal detachment

Disturbance of image shape or size

Distorted image

Metamorphopsia

Large image

Macropsia

Small image

Micropsia

Refers to impairment of vision at night or in dim illumination and is present mainly in disturbances of rod func as in pigmentary degeneration of retina and vit A deficiency

Nyctalopia

Usual loos of arterial obstruction

Emboli from a cardiac thrombus

``` Retina artery is very much constricted Optic disc is pale Rest of eye ground is white (due to coag necrosis) Cherry red spot Box car appearance ```

Crao

Treatment for crao

Dilators - paracenthesis, inhalation of co2 (carbogen) | Drugs - amyl nitrate inhalation, retrobulbar acetylcholine, prescoline

Common cause of CRVO in elder

Endothelial proliferation

Common cause of CRVO in young

Phlebitis

Venous engorgement Retinal hemorrhage Hyperemic disk with blurring of margin Hotdog catsup appearance

CRVO

Common complication of CRVO

Glaucoma (3 mos after onset) has rubeosis iridis

Retinal edema in hypertensive retinopathy is seen as shining reflex from the retinal surface not unlike a wet surface and is called

Retinal sheen

Grading in hypertensive retinopathy

1. Narrowing of arteries to 3/4 to 1/2 of corres vein with occasional focal constriction of terminal arterioles 2. Narrowing of arteries to 1/2 to 1/3 of corres vein with several focal constriction of terminal arterioles 3. Grade 2 + cotton wool exudates with flame shaped hemo 4. Grade 3 + mild to mod edema of disk

In arteriosclerotic retinopathy, a Whitish plaque of lipid seen in the wall of retinal artery

Atherosclerosis

Lipoidal infiltration of white streak at side of blood column is seen and called

Pipe stem sheathing (vascular sheathing)

In arteriosclerosis, when the median streak completely covers the entire bld column, the artery is called

Copper wire artery

In arteriosclerosis, when the sclerosis reaches the advance stage abs reflects back all the light falling on its surface, the artery is called

Silver wire artery

This is an early stage of silver wire artery where the artery is seen as a solid white cord with no bld column showing through.

Pipe stem sheathing

Grading of severity in arteriosclerosis

1. Slight widening of median reflex with slight compression 2. More widening , with more marks of compression 3. Copper wire artery 4. Silver wire artery

Edema of macular region

Central serous retinopathy

Retinal detachment that is always asso with break in retina

Primary retinal detachment

Retinal detachment due to disease process of retina or the vitreous and choroid

Secondary retinal detachment

Most common symptom of retinal detachment

Photopsia

Elevated retina Grayish retina Retinal vessels appear constricted and darker

Retinal detachment

Most common intraocular tumor

Retinoblastoma

Cats eye reflex

Leucocoria

Stage of retinoblastoma with soapy white mass in retina

Intraocular stage

Stage of retinoblastoma with increased iop, ocular congestion nod corneal edema and vitreous filled with tumor mass

Glaucomatous stage

Stage of retinoblastoma with tumor extending out of eyes into orbit via ocular emissaria or thru optic nerve

Extra ocular stage

Retinoblastoma metastasize to __ via

Long bone via hematogenous spread

In Glaucomatous stage of retinoblastoma, what is the only resor it save the life of the pt

Enucleation

Glaucoma produces irreversible blindness

True

Iop regarded as suspect for glaucoma

21mmHg

Regulation of IOP by

Anterior segment of eye

Increased iop in glaucoma is due to

Abnormal aqueous outflow Rarely due to over production Most rarel py due to nice venous back pressure

Effect of iop is ultimately manifested in

Optic disk

Disturbance to floe of protoplasm contributes to glaucoma

True

2 sources of symptoms of glaucoma

Increased iop | Disturbance of optic nerve func

Acute or chronic glaucoma: Severe ocular pain, sudden diminution if vision, seeing haloes around light, ciliary injection, Lacrimation, pupillary dilation

Acute glaucoma

Acute/chronic glaucoma: | Gradual closure of angle and gradual increase in iop, symptoms may be absent

Chronic glaucoma

Iop increased because aqueous could not flow to trabecular mesh work due to apposition of iris to the anterior chamber angle

Primary angle closure glaucoma

This disease arises because if an inherited a atomic defect that causes a shallow anterior chamber

Primary angle closure glaucoma

Treatment of choice for primary angle closure glaucoma

Surgery

Principle of management of primary angle closure glaucoma

Lower iop Analgesic Referral to ophthalmologist

Closure of angle brought about by condi in eye that causes the iris to move towards the mesh work. (Eg exaggeration of pupillary block such as uveitis, lens dislocation, bulging hyaloid face)

Secondary angle closure glaucoma

The treatment of Secondary angle closure glaucoma is directed to ocular condition that gives rise to it

Principle of therapy is the same as primary angle closure type

Aqueous has access to the anterior chamber angle all the time because there is no ore existing ocular or systemic disease that can be tagged as causative agent. It is symptom-free chronic, slowly progressive condi.

Primary open angle glaucoma

Treatment of primary open angle glaucoma

Medical

Drugs used in primary open angle glaucoma

1. Miotics - increase outflow 2. Carbonic anhydrase inhibitors - decrease aqueous production 3. Epinephrine - enhance exit of aqueous

Treatment of infantile glaucoma

Surgical (goniotomy)

S&s of infantile glaucoma

``` Lacrimation Blepharospasm Photophobia Corneal enlargement Glaucomatous cuppping ```

Glaucoma asso with hereditary or familial disease are not always present at birth

True

Glaucoma asso with hereditary disease, a syndrome of arachnodectyly, cardiac anomalies, lens subluxation

Marfan's syndrome

Glaucoma asso with hereditary disease, a syndrome of corneal Arcus (post embryotoxon), ectopia, polycoria, hypoplasia of anterior iris.

Axenfeld syndrome