Osler Flashcards
Rx for canaliculotis
Curratage of the canaliculus
Ptosis ddx
Neurogenic
Aponuerotic
Cicatricial
Mechanical
Ptosis repair
Levator advancement
Fasanella servat
Mullerectomy
Canaliculitis risks
Pilocarpine
Ho punctal plugs
Previous radioactive iodine
Chemo agents
Normal lf how many mm
12-15mm
Normal mrd1
4 mm
How to correct mild 2 mm ptosis
Mullerectomy
How to correct moderate ptosis lf 4-8mm
Levator resection
How to correct involutional/aponeurtic ptosis
Levator advancement
What to do if lf
Sling
Sebhorric keratosis how to treat
Cut it off
Whats the important thing to do w thyroid
Stop smoking!!!!!
Ss w hyphema what do u have to do?
Admit give oxygen and iv fluid
What nerves do u worry about w a cn7 palsy?
6 or 8
Tearing case w kid what not to forget
Congenital glaucoma
Ptosis ddx
Pseudoptosis (dermatochalasis or brow ptosis)
Neurogenic
Involutional
What visual field for ptosis?
Taped and untaped superior 64
Bilateral ptosis what do younhave to consider?
That its brow ptosis- do brow lift prior to any bleph
Retrobulbar heme ddx
Varix
Reyrobulbar heme (canthotony cantholysis)
Lymphangioma
Ccf
Ectropion repair options
Ointments
Tape lids
Lateral tarsal strip
May need full thickness skin graft if too tight
Kid w ptosis eating
Jaw winking
Squamous cell more or less agressive than bcc?
More aggressive
Can met perineurally or hemeatogenouy
How do you treat floppy eyelid syndrome?
Horizontal lid toghtening procedure
Tarsal wedge for the upper lid
Look for lash ptosis
Risk factors for floppy eyelid
Obesity
Sleep apnea
How to treat symblepharon?
Agg lubrication
Symbleph ring
Red skin ddx?
Rosacea
Doxy risks
Gi upset
Sun sensitivities
Tooth discoloration
Eccymosis in a kid whats ddx?
Trauma abuse orbital fx
Neuroblastoma- bilateral racoon eyes in young kid
How do you cut out lid melanoma?
Wide excision w 5 mm margins bc melanoma stain takes overnight to get path back
Then you repair the defect the nexr day
Where does upper eyelid drain
Lower eyelid drain?
Upper- pre auricular
Lower sub mandibular
Ocp what to look for on biopsy?
Immunoflourescent stain of bm
Squamous cell wu
Need sentinal node biopsy and met wu
Can spread perineural spread
What type of bcc is likely to met to orbit?
Medial canthus
Rx of entropion
Cl Lubricate Quicket suture Wedge resection and clsore Lat tarsal strip
Why would postlasik have halos at night?
1) Ho high refractive pwr
2) small ablation zone and when pupil dilates at night causes halos
Whats the abby value?
Related to the preoperty of a lens. Used to classify glass by amount of chromatic abberation it produces. High abby value means less chromatic abberation
Someone w induced astigmatism what can u check?
Topo- could be forme fruste kcn irreg astig
Fit w hcl or rgp
What type of lens can u use if pt co colors or chorm abberation?
Doublet lens
Myopic surprise sp ceiol ddx
Ovd in back of bag
Iol forward
Iol calc off
Pco
Favorable lenticular astigmatism what to do?
Scl or glasses bc hcl would unmask lenticular astig
High plus lenses what type of scotoma might they have?
Roving ring scotoma or jack in the box phenomenon
What does the snr mean?
Signal to noise ratio.
If low then a length could be off
Optical principle of titmus testing
Polarization each eye in glasses is polarized 90 degrees away from each other forms 2 distinct images on retina this is how 3D movies work
If has so in eye what type of iol to choose?
Not silicone
Convex-plano iol
A length could be falsely long could put in too weak power- gives hyperopic surprise
Talk to retina if can do combined sor i
Whats the best tint for sunrise sunset and whats best tint for midday?
Sunrise- brown
Midday- smoke gray
Etdrs chart based on what principle?
Visual angle- 3 lines diff = doubling of acuity each line 0.1 log change
Letters are sen serifed
Whats an occupational bifocal?
Ex mechanic put bifocal portion on top
