Eyes Flashcards

Question

What are the attachments of the inferior oblique?

Answer 1

Medial part of orbit floor | Sclera posteriorly

Answer 2

Muscles attached along orbital axis, not optical so pull eyeball at an angle - each muscle will have more than one movement Oblique muscles attached to posterior part of sclera, so pull anterior part in opposite direction

Answer 3

``` Third >Drooping eyelid >Eye can move only laterally (and slightly down) Fourth >Eye moving up when adducted Sixth >Eye being adducted >Unable to abduct ```

Answer 4

Misalignment of the eyes | Leads to two different images in brain

Answer 5

Esotropia - manifest convergent squint | Exotropia - manifest divergent squint

Answer 6

Amblyopia (lazy eye) - brain supresses images from one eye leading to poor vision in that eye without any pathology. Treat by stimulating "lazy" eye to work with eye patch in younger years Diplopia (double vision) - normally squint due to palsies

Answer 7

All fibres from eye pass through optic chiasma. The Temporal view (fibres near nasal) cross over to other side of the brain Therefore two optic tracts formed, one from right, one from left visual fields, and are on opposite side of brain to their field These fibres synapse at the lateral geniculate body of thalamus Form optic radiation, passes behind internal capsule to reach primary visual cortex in occipital lobe Thus the Right visual cortex sees the left half of the visual field and vice versa.

Answer 8

Blindness in one eye

Answer 9

Both lateral view lost (bitemportal hemianopia)

Answer 10

contralateral homonymous hemianopia | Blindness in both the right or the left field of visions in both eyes

Answer 11

Start in dimly lit room Pen torch in one eye, check that both pupils constrict Swing light to other side, both should remain constricted

Answer 12

Ciliaris muscle in ciliary body Constrictor pupillae in iris at pupillary border Above innervated by parasympathetic CN III Dilator pupillae radially running muscle in iris Sympathetic innervation

Answer 13

Impulses travel along optic nerve - optic chiasma - tract when light hits retina Some fibres do not enter the lateral geniculate body of thalmus Instead enter midbrain (where CN III is situated) Part of the IIIn nucleus is the edinger-westphal nucleus for these parasympathetic They go to the EWN on both sides, thus initiating response on each side

Answer 14

Preganglionic parasympathetic fibres from EWN pass through IIIn into orbit Go to synapse in ciliary ganglion Postganglionic fibres go through short ciliary nerves to constrictor pupillae Constriction of both sides

Answer 15

Different sizes - anisocoria | Pupils may react abnormally to light

Answer 16

Anisocoria due to damage to the sympathetic innervation to the pupil. You might also see ptosis (drooping of the eyelid) on the affected side Other signs – anhidrosis (loss of sweating on the affected side) Horner’s syndrome can occur due to disruption of sympathetic fibres at any point. An example would be Pancoast’s tumour of the lungs!

Answer 17

Any abnormality of the afferent/efferent limb/ centre of reflex Diseases of the retina – > detachment/ degenerations or dystrophies Diseases of the optic nerve – such as in optic neuritis (frequently seen in MS) Diseases of the III cranial nerve (efferent limb)

Answer 18

Lens opacification ~30% >65 Initially looks like spokes, then just becomes white

Answer 19

UV rays enter eye, lens absorbs to stop harm to retina Lens damaged in process Older fibres never shed/regenerated Damaged lens fibres go opaque, cause cataract

Answer 20

Surgery only way Small insicion + lens capsule opened Cataractous lens removed by emulsification (pharmacoemulsification) Plastic lens placed in its stead Lens implant after cataract surgery – PCIOL = Posterior Chamber Intra Ocular Lens

Answer 21

Raised intraocular pressure 2nd most common cuase of blindness Most commonly seen form of primary glaucoma is Primary Open Angle Glaucoma (POAG) ~1% population aged 40 – 89 Bilateral Patient can be asymptomatic for a long period of time Picked up on routine eye exams

Answer 22

Pressure on nerve fibres cause them to die out and results in reduced visual field Optic disc appears pale, unhealthy and cupped Ultimately results in blindness

Answer 23

``` Eye drops to reduced IOP Beta blockers Carbonic anhydrase inhibitors Prostaglandin analogues Laser trabeculopasty Trabeculectomy surgery ```

Answer 24

``` Sudden onset and painful, with vision loss/blurring + headaches On examination >Red eye, cornea often o paque >Pupil mid-dilated >IOP severely raised ```

Answer 25

1 Functional block in the small eye - lens enlargement 2 mid dilated pupil - periphery of iris crowds around angle and outflow is obstructed 3 iris sticks to pupillary border prevents reaching anterior chamber. Leads to iris ballooning anteriorly and obstructing angle

Answer 26

Decrease IOP >IV infusion w/ or w/o oral therapy - carbonic anhydrase inhibitors Analgesic Constricor eye drops Steroid eye drops Iridotomy (laser) both eyes to bypass blockage

Answer 27

In open angle the drainage through the tracbecular meshwork is blocked Which leads to GRADUAL increase in IOP Closed angle is where iris blocks angle so AH cannot drain Which leads to SUDDEN increase in IOP Red eye + pain Emergency

Answer 28

Infectious - needs aggressive management to prevent spread/scarring Viral, bacterial, fungal Non-infectious - uclers due to trauma, corneal degeneration or dystropy

Answer 29

``` Group of disesases that are >Bilateral, opacifying, non-inflammatory >Mostly genetic >Sometimes accumulation of substances Present in first-fourth decade Decreased vision One layer of cornea - spread to others ```

Answer 30

Lattice (stromal) Autosomal dominant Depositation of amyloid material in corneal stroma Patient presents with eye irritation, pain, blurred vision Examination shows bilateral criss-crossing opacities in corneal stroma Treat by managing symptoms, corneal transplant

Answer 31

Asymmetrical bilateral progressive odema of cornea Elderly Destruction/death of epithelium cells Eventually opacification Initially symptomatic, later corneal transplant

Answer 32

Anterior Intermediate Posterior

Answer 33

iris inflammed - w/ or w/o ciliary body Leaks plasma and white blood cells into aqueous humour Seen in slit lamp examination as hazy anterior chamber + cells deposited in back of cornea Red, painful eye w/ vision loss

Answer 34

cilliary body inflammed Ciliary body inflammed leaks cells + proteins Leads to hazy vitreous humour Floaters/hazy vision

Answer 35

choroid inflammed | Frequently spreads to retina, causing blurred vision

Answer 36

Isolated illness Non-infections auroimmune disease Infectious causes Systemic disease

Answer 37

Self limiting bacterial/viral infection of conjunctiva Red, watery eyes, increased discharge No loss of vision as long as infection does not spread to cornea Treat with antibiotic eye drops if bacterial

Answer 38

To test if blood vessels getting enough blood flow Can point to macular degeneration or diabetic retinopathy Eye drops to dilate eyes Take pictures of inner eye Then inject fluorescein dye into vein in arm Take pictures as fluroescein moves through eye

Answer 39

Non-invasive imaging test using light waves to take cross sections of retina

Answer 40

``` Central retinal vein occlusion Central retinal artery occlusion Ischaemic optic neuropathy Stroke Vitreous haemorrhage Retinal detachment Sudden discovery of pre-exisiting unilateral LoV ```

Answer 41

Hypertension Glaucoma Hyperviscosity Inflammation

Answer 42

Embolis | Inflammation

Answer 43

``` Pain on eye movements Reduced vision Red desaturation Central scotoma Relative afferent pupil defect Swollen optic disc ```

Answer 44

``` Cataract Refractive error Age-related macular degeneration Open angle glaucoma Diabetic retinopathy Hypertensive retinopathy Inherited retinal dystrophies Drug-induced retinopathy ```

Answer 45

``` Common (10% >65, 30% >75) Progressive loss of central vision Risk factors >Age >Smoking >Poor diet ```

Answer 46

Cotton wool spots + exudates visible on retina Vascular abnormalities Maculopathy

Answer 47

Inheritance Sporadic (90%) Dominant, X-linked recessive Photopic ERG reduced, scotopic normal

Answer 48

Anti-malarials Phenothiazines Tamoxifen

Answer 49

Series of inherited conditions affecting photoreceptor functions leading to progressive loss of vision

Answer 50

Treat infection if present Topical anti inflammatory Systemic steroid Systemic immunosuppresants

Answer 51

``` Pain, redness, lid swelling Systemically unwell Double vision/limitation in EOEM Conjunctivitis/chemosis Exophthalmos Blurred vision ```

Answer 52

Sinusitis / dental infections | Haematological spread

Answer 53

Eyelid tumours Lacrimal drainage tumours Orbital tumours

Answer 54

Pedunculated or sessile (broad-based) | Characteristic ‘raspberry’ texture

Answer 55

``` = Seborrhoeic keratosis Greasy, brown, flat, round/oval Similar texture to squamous cell papilloma ‘Stuck on’ appearance Unrelated to sun exposure ```

Answer 56

Composed of atypical melanocytes | Location of these melanocytes influences clinical appearance and potential for malignant transformation

Answer 57

Fast growing, highly vascularised granuloma May follow surgery, infection, trauma Erythematous pedunculated mass Rx Excision

Answer 58

``` Features suggestive of BCC Slow, inexorable growth over months Usually non-pigmented, elevated, ulcerated Pearly, rolled, irregular border Telangiectasia Lack of tenderness ```

Answer 59

``` Sun damaged skin and pre-existing AK Scaly surface over a thick plaque Growth over weeks rather than months Metastatic risk of 3-10% Rx Excision ```

Eyes Flashcards

(83 cards)