Clinical Anatomy of Ophthalmology

Question 1

What is ptosis?

Answer 1

Top eyelid drooping

Question 2

What may ptosis cause in children left untreated?

Answer 2

1. Amblyopia (lazy eye)
2. Permanently reduced vision due to inability to properly develop

Question 3

What is the name of the glands embedded in the tarsal plates of the tarsus?

Answer 3

Meibomian glands

(20-25 in total)

Question 4

What do Meibomian glands secrete?

Answer 4

Oily substance

Question 5

Which muscles are involved in opening the eyelid?

Answer 5

1. Levator palpebrae superioris
2. Muller’s muscle (superior tarsal muscle)

Question 6

Which nerve is responsbile for providing motor innervation to the following muscles?

a) Levator palpebrae superioris
b) Superior tarsal muscle

Answer 6

a) Oculomotor (CN III)
b) Sympathetic control

Question 7

Which muscle is involved in closing the eye and which nerve is it controlled by?

Answer 7

Orbicularis oculi

CN VII (facial nerve)

Question 8

Horner’s syndrome is a triad of which three things?

Answer 8

1. Anhydrosis
2. Miosis
3. Ptosis

Question 9

Orbital cellulitis is often bilateral

True or false?

Answer 9

False

It is much more often unilateral

Question 10

What does orbital cellulitis look like superficially?

Answer 10

1. Unilateral erythema
2. Defined orbital redness
3. Difficult eye movements
4. Pupil problems

Question 11

Why is dry eyes a common problem in autoimmune conditions?

Answer 11

Lacrimal gland ducts can easily scar

Question 12

Why may watery eyes be treated with lubricant?

Answer 12

Watery eyes may be caused by dry eyes which become watery due to overcompensation

Question 13

What are the 3 layers of the tear film?

Answer 13

1. Lipid phase
2. Aqueous phase
3. Mucus phase

(all sit above epithelium)

Question 14

Which nerve is responsible for inducing the reflex for tear production?

Answer 14

Trigeminal nerve

Question 15

Which nerve senses dry eyes and signals for tear production?

Answer 15

Trigeminal nerve

Question 16

Which nerve causes tear production?

Answer 16

Facial nerve parasympathetic nerve fibres

Question 17

Which type of conjunctiva lines

a) Inner eyelids
b) Eyeball

Answer 17

a) Palpebrae
b) Bulbar

Question 18

What is special about the tissues forming the conjunctiva?

Answer 18

They are excellent at healing

Question 19

How can the cornea be oxygenated anteriorly?

Answer 19

1. Oxygen from air
2. Palpebral conjunctiva is highly vascularised and allows oxygenation when eyes are closed

Question 20

How does viral conjunctivitis present?

Answer 20

1. Pinkish-red eyes
2. Watery eyes/syrupy secretion
3. Round bumps (rice grain) on lower fornix

Question 21

In viral conjunctivitis, what does it suggest if the round bumps (rice grain) on lower fornix are

a) Bilateral
b) Unilateral

Answer 21

a) Adenoviral cause
b) Chlamydial cause

Question 22

What are the three main layers of the cornea?

Answer 22

1. Epithelium
2. Stroma
3. Endothelium

Question 23

How quiickly does the corneal epithelium turnover?

Answer 23

48hrs

Question 24

The endothelium of the cornea is _______ replaced

Answer 24

The endothelium of the cornea is never replaced

Question 25

Why is the cornea transparent?

Answer 25

Collagen fibres are well organised and regularly spaced

Question 26

Why is the development of cataracts at the back of the lens worse than at the front?

Answer 26

This is where light is focussed

Question 27

How is the lens attached to the ciliary body?

Answer 27

Zonules

Question 28

Why does the ability to focus between far and near objects reduce with age?

Answer 28

Lens fibres have poor regenerating

Question 29

What are the two different aspects of the lens called?

Answer 29

1. Outer part - Cortex 2. Inner part - Nucleus

Question 30

What comrpises the uvea?

Answer 30

1. Iris 2. Ciliary body 3. Choroid

Question 31

What are the main roles of the uvea?

Answer 31

1. Absorbing reflected light into the eye 2. Providing nutritional support to eye structures

Question 32

Where does aqueous humour drain?

Answer 32

Scleral venous sinus | (Canal of Schlemm)

Question 33

Where is aqueous humour secreted?

Answer 33

Ciliary processes

Question 34

What are two key signs on a slit lamp view of the eye for uveitis?

Answer 34

1. Floating cells (like dust particles) 2. Flare (like smoke)

Question 35

How will the eye be positioned in a complete third nerve palsy?

Answer 35

Down and out with ptosis

Question 36

Why is the trochlear nerve unique?

Answer 36

Arises from dorsal aspet of brainstem and crosses over

Question 37

Where does the trochlear nerve enter the orbit?

Answer 37

Superior orbital fissue

Question 38

What does the abducens nerve supply?

Answer 38

Motor innervation to the lateral rectus

Question 39

Where does the abducens nerve pass into the orbit?

Answer 39

Middle of the cavernous sinus

Question 40

When may an abducens nerve palsy occur?

Answer 40

Raised ICP

Question 41

Where does the abducens nerve originate?

Answer 41

Pons

Question 42

Why does optic neuritis cause pain on eye movements?

Answer 42

Optic nerve sheath is attached to the common tendinous ring

Question 43

Typically, a blow-out fracture will entrap which muscle?

Answer 43

Inferior rectus

Question 44

Where are cone cells found in their highest density?

Answer 44

Fovea

Question 45

The retina has which type of epithelium?

Answer 45

Cuboidal

Question 46

By how mnay degrees is the blind spot located temporally in the visual field?

Answer 46

15

Question 47

How may a patient describe a retinal detachment?

Answer 47

1. Flashes of light 2. Curtainscoming down 3. Floaters 4. Painless