z ophtho Flashcards by Lech Sedlak

lower lid retractors

inferior tarsal muscle, capsulopalpebral fascia

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signs of disinsertion of lower lid retractors

involutional entropion, deeper fornix, reverse ptosis, minimal involvement of lower lid in downgaze, white subconj line below inferior tarsal border

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the average distance from posterior globe to the optic foramen

18 mm

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most common type of melanoma around eyelid

lentigo maligna 90%, second is nodular

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which medication is contraindicated in carbon dioxide laser skin resurfacing

Isotretinoine (delay epithelial healing –> scarring)

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congenital myogenic ptosis - behavior of lid

levator belly is fatty and fibrous. MRD1 lower in primary. higher in downgaze. lid partially open when tries to close their eyes

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involutional ptosis - behavior of lid

lower in primary and downgaze

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contributes to both voluntary lid closure and spontaneous blinking

pretarsal orbicularis

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bony feature that separates the superior orbital fissure from the optic canal

optic (sphenoid) strut

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cause of bleeding after orbital surgery

transconjunctival approach to the inferior orbit - damage of perforating artery in the inferotemporal quadrant (branch of infraorbital artery)

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monoclonal antibody for TED

TEPROTUMAB - inhibits IGF-IR

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topical cream for cutaneus melanoma in situ and basal cell carcinoma

IMIQUIMOD

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IMIQUIMOD

topical cream for cutaneus melanoma in situ and basal cell carcinoma

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IFN gamma + alpha

injection for BCC and SCC

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injection for BCC and SCC

IFN gamma + alpha

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attach to Whitnall’s tubercule

Lateral canthal tendon 2. Check ligament of the lateral rectus 3. Lateral horn of the levator aponeurosis 4. Lockwood’s ligament

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TRICHOFOLLICULOMA

solitary, very fine blonde hair-like structure at its center or a sebum-secreting pore

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Lateral tarsal strip

preferrred for ECtropion. shortening the lower eyelid and then suturing it to the periosteum. maintains the sharp lateral canthal angle

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PILOMATRIXOMA

reddish-purple calcifies subcutaneus mass

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TRICHOLEMMOMA

resembles verruca/wart

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EPIDERMAL INCLUSION CYST

from pilar duct, central pore, filled with keratin

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APOCRINE HIDROCYSTOMA

smooth, filled with fluid

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by how many mm are the orbits separated

25 mm

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Bick procedure

in ectropion and entropion. removal of full-thickness pentagonal wedge adjacent to lateral canthal angle (causing rounding of angle)

Lateral tarsal strip

shortening the lower eyelid and then suturing it to the periosteum

Medial spindle procedure

for medial ECtropion/punctal ECtropion. removning a diamond shaped piece of conjuctiva and lower lid retractors 4 mm inferior to the inferior canaliculus and then placing inverting sutures

Maxillary nerve - important branches

Zygomatic nerve (zygomaticotemporal nerve, zygomaticofacial nerve), through the Inferior orbital fissure, Infraorbital nerve

Levator excursion (function)

from down to upgaze. 11-20 mm

MRD1

3-5mm

MRD2

4-6mm

increased MRD2

lower lid ectropion or retraction

decreased MRD2

reverse ptosis (Horner's syndrome)

V2 passes through

foramen rotundum

V3 passes through

foramen ovale

absorbable sutures + time

fast gut (7 days), plain gut (7-10 days), Polyglatin 910-Vicryl (21 days)

non-absorbable sutures

Prolene and nylon

Junctional nevus - where

within dermis

nevus - highest malignant potential

Junctional

Compound nevus - where

across dermis and epidermis

internal hordeolum

acute infection of the Meibomian glands

external hordeolum

acute infection of the Zeis glands

decreases the pain on injection of lidocaine

sodium bicarbonate

most common tumor causing optociliary shunts

optic nerve sheath meninigioma (30% have)

epiphora - definition

overflow of tears down the face

cause stenosis within the nasolacirmal drainage system

DOCETAXEL, 5-FU

What % of hyperthyroidic develop TED

30%

What % of TED are hyperthyroidic at some point

90%

The most common disease in TED

Grave's Disease

innervation of rectus belly

at the posterior 1/3 of the muscle

caucasian - where in upper lid does the superior orbital septum fuse with the levator

2-5 mm superior to the upper border of the tarsal plate

% of orbital cellulitis secondary to contiguous spread from sinuses

90%

orbital cellulitis - imaging

maxillofacial CT

Blepharochalasis

rare autoimmune-like condition that occurs in young women that is characterized by repeated bouts of upperlid edema

rule of thumb for dermatochalasis surgery

10 mm from the incision to the eyebrow and 10 mm from the incision to the eyelid margin

Fasanella-Servat procedure

tarsoconjunctival mullerectomy - used to treat mild amounts of ptosis less than 2 mm

hemifacial spasm - most common cause

facial nerve compressed by an ectaticvertebral artery or anterior inferior cerebellar artery

Garcia-Harris Criteria - early drainage of the subperioscteal abscess

9 or older, frontal sinusitis, non-medial location, large, anaerobic, recurrent, chronic sinusitis, optic nerve or retinal compromise, dental origin

Bowen's disease

squamous cell carcinoma in-situ