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Eye > Part 1 > Flashcards

Part 1 Flashcards

1
Q

Outer membrane of eye

A

Anterior most 1/5th cornea
White 4/5th sclera

Covered w bulbar cunjuctiva with sclera beneath

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2
Q

What is limbus

A

Junction of cornea and sclera

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3
Q

Pupil size? Function

A

2-4mm
Dilate- mydriasis
Contract- miosis

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4
Q

Miosis by?

A

Sphincter pupilae muscle constriction

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5
Q

Mydriasis by?

A

Dilator pupilae muscle

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6
Q

Sphincter pupilae muscle innervated by which nerve?

A

Oculomotor nerve CN3

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7
Q

Dilator pupilae innervated bywhich nerve?

A

Sympathetic nerves

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8
Q

Heterochromia iridum

A

Different colour of Iris in different eyes
One eye brown one eye blue

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9
Q

Heterochromia iridis

A

Different colour in same eye

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10
Q

Patient comes with partial ptosis, miosis, enophthalmos of one eye and anhydrosis on one side of face. There’s loss of cilliospinal reflex
What is Dx?

A

Horner’s syndrome

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11
Q

Horners syndrome

A

Piece MEAL
P- partial ptosis
M - miosis
E - enophthalmos
A - anhydrosis
L - loss of cilliospinal reflex

Occurs due to compression of cervical sympathetic chain.

Partial ptosis caused by Muller’s muscle palsy which is innervated by sympathetic nerve

Miosis caused due to palsy of dilator pupilae muscle nerve, also sympathetic.

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12
Q

Ptosis caused by which nerve palsy?

A

Lavator palpebra superioris

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13
Q

Which lung tumour leads to Horner syndrome?

A

Pancoast tumour

Superior sulcus tumour of the lung causing compression of the cervical sympathetic chain

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14
Q

Eye components

A

Outer fibrous layer- cornea and sclera
Middle layer is vascular - Iris, ciliary body and choroid
Inner layer is neural- retina

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15
Q

Thinnest, anterior most part of retina

A

Orra serrata

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16
Q

Ciliary body components

A

Pars plana
Pars plicata- responsible for aqueous humour production.

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17
Q

Volume of orbit

A

30ml

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18
Q

Volume of eyeball

A

7ml

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19
Q

Volume of posterior segment

A

4ml

Posterior segment is filled by vitreous humour
(Portion posterior to the lens)

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20
Q

Volume of anterior chamber and posterior chamber

A

0.25ml AC
0.06ml PC

Anterior segment is divided into anterior and posterior chambers.

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21
Q

Eye development starts by which week of gestation?

A

3rd week of intrauterine life
(21 days)

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22
Q

Neuroectoderm derivatives

A

VOIR

V- secondary virtuous
O- optic nerve
I - iris
R - retina

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23
Q

Neural crest sells derivatives

A

** C3OST**

C- cornea
C- ciliary ganglion
C- ciliary muscles

O- optic nerve sheath
S- sclera (partly made from mesoderm)
T- trebacular meshwork (drainage of AH)

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24
Q

Normal Axial length?

A

Newborn- 16.5mm
Adult- 24mm

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25
Q

Normal Corneal size?

A

Newborn- 9mm
Adult- 11mm

Takes 2 years to reach adult size

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26
Q

Newborn eye is hypermetropic by how much?

A

+2 to +3 diopters

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27
Q

Lens derives it’s nourishment from?

A

Aqueous humour, more than vitreous humour

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28
Q

Refractive power of eye?

A

+60 diopters

Corneal- +43D
Lens- +17D

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29
Q

Refractive Indices

A

Refractive Index of-

Aqueous = Vitreous = 1.34
Cornea- 1.37
Lens- 1.39
Center of Lens- 1.42 (max)

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30
Q

Lens capsule is made up of?

A

Type 4 collagen

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31
Q

Type 4 collagen also present in?

A

Basement membrane

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32
Q

Lens capsule is thinnest at?

A

Posterior pole

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33
Q

Coloboma

A

Congenital anomaly caused by Inability of hyaloid fissure to close (closes by 7-8 wk of IUL)

Most common type- infronasal

(Pupil dripping down. See picture)

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34
Q

Anterior lenticonus

A

Hereditary condition
Anterior conical protrusion of lens
Seen in Alport syndrome

Triad-
Can’t hear (SNHL)
Can’t see (AL)
Can’t pee (nephritic syn)

35
Q

Most common cause of cataract

A

Old-age
senility

36
Q

Most important drugs that cause cataract

A

Steroids

37
Q

Most common cause of blindness

A

First- cataract
Second- refractive error

38
Q

Most dangerous type of cataract

A

Posterior polar cataract

Characteristic onion peel appearance of opacification of lens

39
Q

What type of cataract is seen in diabetes mellitus?

A

Snowflake cataract

More common in type 1 than type 2.

Due to accumulation of sorbitol, made by conversion of glucose by aldose reductase enzyme

40
Q

Cataract due to deposition of copper in lens?

A

Sunflower cataract

Seen in Wilsons disease and chalcosis

41
Q

Copper deposition causing brown ring formation around cornea?

A

kayser Fleischer Ring or kf ring
In copper excess conditions
(Wilson’s disease and chalcosis)

Cu deposition in the descemets membrane of cornea.

42
Q

Which type of cataract seen in galactosaemia?

A

Oil drop cataract

due to accumulation of galactitol/ dulcitol

Caused by conversion of galactose by aldose reductase enzyme

43
Q

Only reversible cataract?

A

Oil drop cataract

44
Q

Blunt trauma causes, which type of cataract?

A

Rosette cataract
Rose petal like pattern

45
Q

Most common type of complicated cataract

A

Posterior subcapsular cataract

46
Q

Stages of cataract

A

1- Incipient cataract
2- Immature cataract
3- Intumescent cataract
4- Mature cataract
5- Hypermature cataract
o Calcified
o Morgagnian

47
Q

Complication of morgagnian cataract

A

Phacolytic glaucoma

48
Q

Complication of sclerotic/calcified cataract

A

Phacotopic glaucoma

49
Q

Features of hypermature/morgagnian cataract

A

Bag of milk appearance, due to cortex liquefication
and sunken nucleus

50
Q

Patient with
Gradual painless loss of vision
Glare
Coloured halos
Second sight
Dx?

A

Cataract

Second sight means near vision is getting better, seen mc in nuclear cataract

Senile cataract

51
Q

Rx of cataract

A

1st line- phacoemulsification
Incision is 3.2mm

1- keratome used to make incision in SICS( small incision cataract surgery)
2 ant. chamber is maintained by hydroxypolymethylcellulose
3 capsuporrhexis
4 hydrodissection
5 sculpting of nucleus
6 cracking of nucleus
7 emulsification of each quadrants
8 cortical cleanup and insertion of IOL

52
Q

Cataract surgery also done bye other procedure?

A

FLCS
femtolaser assisted cataract surgery
Is a type of Nd Glass laser
Wavelength of 1053nm

53
Q

Complications of cataract surgery

A

UGH syndrome:

Uveitis
Glaucoma
Hyphaema (blood in ant chamber

Early complications of anterior chamber IOL insertion

54
Q

Intraocular lens

A

Rigid- poly methylmethacrylate
Foldable- best- acrylic.

Ideal site - posterior chamber
(In the bag)

55
Q

Endophthalmitis
Dx
Rx

A

Inflammation of vascular and retinal layer of eye

Can be early or late
Early: staph epidermididis
Late: propionibacterium acne

red sclera
Hazy cornea
Hypopyom- pus in ant chamber
Sudden pain full loss of vision

early complication of cataract surgery

Rx- intravitreal inj. of antibiotics

56
Q

Late complication of cataract surgery

A

Posterior capsular pacification PCO
/Secondary cataract

Can be of 2 types
1- elschnig’s pearls. More common (children) pearly opacities
2- sommering rings

Patient will present after 6 to 8 months of cataract surgery with Gradual painless loss of vision

Rx- Nd yag laser capsulotomy (opening)

57
Q

Nd Yag laser

A

neodymium-doped yttrium aluminium garnet
Wavelength: 1064 nm
Common in posterior capsular opacities (capsulotomy)

58
Q

Subluxation

A

MCC- marfans syndrome- fibrillin 1 gene mutation
MC type- Superotemporal subluxation

Inferonasal subluxation- caused by homocystinuria

59
Q

Congenital cataract

A
  • abnormal white pupillary reflex= leucokoria

-mc type- blue dot 🔵 cataract (universal)
- vision is perfectly normal.

  • zonular cataract (opacification of zonules) / lamellar cataract.
  • can lead to blindness
60
Q

Raccoon eyes

A

Bilateral ecchymosis

Due to anterior cranial fossa fracture

61
Q

Vossius’ Ring

A

Pigmented ring like shape formed by iris coming into contact w cornea due to a concussion injury and leaving some pigment behind

62
Q

Orbital Fracture

A

Most common- floor of orbit fracture
With characteristic tear drop sign.

Weakest wall- medial wall of orbit

Palsy-
1- infraorbital nerve
2- inferior rectus muscle

63
Q

D shaped pupil

A

Iridodialysis

Separation of iris form it’s base

64
Q

Pt. Complains
Redness
Watering
Discharge

A

Conjunctivitis

65
Q

Most common type of conjunctivitis?

A

Viral

adenovirus

66
Q

Most common bacteria, causing conjunctivitis?

A

Staphylococcus aureus

67
Q

Angular conjunctivitis MCC

A

MCC- morexella axenfeld

Temporal side of the conjunctiva/lateral canthus maceration

68
Q

Subconjunctival haemorrhage

A

PACE

Haemorrhagic conjunctivitis, more commonly seen in viral

P- picorna virus
A- adenovirus
C- coxsakie
E- entero virus/ echo

MCC- Accu haemorrhagic conjunctivitis- Apollo virus.

69
Q

Trachoma

A

-Chronic inflammation of cornea and conjunctiva
Corneal opacity- pannus
-Also known as- Egyptian ophthalmia
- cause- clamydia trachomatus (a- c serotypes)
- SAFE strategy
Surgery
Antibiotics
Facial cleanliness
Environmental sanitation
- DOC- azithromycin
- prophylactic- 1% tetracycline ointment

70
Q

Trachoma features

A

-Follicles give sago grain appearance
-Papillae give velvety appearance
-Arlt’s line - conjunctival scarring in the upper lid
-Herber’t pits- depresses scar follicles on the upper limbus (pathognomic feature)

HAPPy For Trachoma

71
Q

Opthalmia neonatorum

A

-Infection in first 28 days of life
-MCC- clamydia trachomatis(D to K)
-Most severe- gonococcal (1-3 days)

Hsv if after a week

72
Q

Vernal keratocunjunctivitis VKC

A

Also called spring cataract
Type 1 hypersensitivity to exogenous allergens
More common in young boys

Olopatadine -DOC

  • HORNER TRANTA SPOTS eosinophilic accumulation at the upper limbus
  • cobblestone pppilae over the palpebral conjunctiva.
  • shield ulcer
    -Thick ropey discharge maxwell Lyon sign
  • pseudo garantoxon

Rx-
Preventive - Avoid allergens, Dry hot climate, rubbing eyes,
Lid hygiene, sun glasses, cold compression.
Antihistmamines (Topical/Oral)
Mast cell stabilisers
NSAIDs - Ketotifen
Topical or Oral Steroids
Acetylcysteine drops
Topical Cyclosporin
Supratarsal injection of steroids

73
Q

Arcus senilis/ gerontoxon

A

Arch like deposition of lipids in corneal periphery

74
Q

Phlyctenular conjunctivitis

A

-Type 4 hypersensitivity reaction
-By endogenous allergens
-Most common- staph aureus + tuberculin protein
Common in tb

75
Q

Pterygium

A
  • Wing shaped flap of conjunctiva seen encroaching the cornea
  • cause- UV B Rays causing elasticity degeneration
  • more common on nasal side
  • surgery indications- cosmesis (don’t look nice)
  • stocker’s line (iron deposits)
  • Types: progressive, regressive, stationary.
76
Q

Ptregium rx

A
  1. Tear substitute
  2. Topical steroids
  3. Sunglasses and then simple/conjunctival flap excision
  4. Bare sclera/conjunctival autograft/flap surgery for excision

To prevent recurrence after excision all of the following Conjunctival autograft:
6. Amniotic membrane transplantation
7. Mitomycin C with excision to prevent recurrence
8. Radiation
9. Argon Laser
10. Peripheral lamellar keratoplaty.

77
Q

Bitot spots

A

White frothy toothpaste like spots on sclera
Feature of - xerophthalmia
vit. A deficiency
First feature- night blindness
First sign- conjunctival dryness

(X1a- conjunctival xerosis
X1b- bitot spots
X2- corneal xerosis
X3a- corneal ulceration
X3b- keratomalacia
XN- night blindness
XF- xerophthalmia fundus)

78
Q

Thickest layer of cornea

A

Stroma

79
Q

Normal cell count of endothelium layer of cornea

A

2500 cells/cubic meter
Checked by specular microscope
Fall below 500 leads to corneal opacity

80
Q

Corneal ulcer

A

MCC- bacterial

Signs-
hazy cornea
Hypopyon- mobile and sterile

81
Q

Most common corneal dystrophy

A

Epithelial

82
Q

Most common stromal corneal dystrophy

A

Lettice

83
Q

Interstitial keratitis

A

Involves the stroma of cornea

Feature of congenital syphilis

Hutchinsons triad-
Hutchinson teeth
Interstitial keratitis
Sensorineural hearing loss

Eye (3 decks)

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