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Kanski > Oculoplastics > Flashcards

Oculoplastics Flashcards

1
Q

The most common cause of lacrimal drainage failure

A

Punctal abnormality

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2
Q

Fluroscein dissappearance test (BKZ)

A

High meniscus >= 0️⃣.6️⃣ mm

N= 0️⃣.2️⃣-0️⃣.4️⃣ mm

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3
Q

The most common causes of primary punctal stenosis

A

Chronic blepharitis

Idiopathic stenosis

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4
Q

Ptosis measurements

A

KRM=4-5 mm
KA= 🚺8-12 mm, 🚹7-10 mm
LF= >15 mm; good:12-14, fair:5-11, poor:>5mm
Kapak cizgisi= 🚺10 mm, 🚹8 mm

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5
Q

Surgery in ptosis

A

LF is good=>10➡️KJM
LF is fair=>5➡️levator advancement
LF is poor=<4➡️frontalis suspension

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6
Q

Entubation in canalicular obstruction

A

Left in situ for 6weeks to 6 months

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7
Q

FOS

A

Cranium➡️orbita
Superior: CN5(1): lacrimal, frontal; CN4, VOS
Inferior: CN3, CN6, n.nasociliaris, sympathic fibers from the cavernous plx

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8
Q

FOI

A

Orbit➡️pterygopalatine and infratemporal fossa

CN5(2), branches of the pterygopalatine ganglion, VOI

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9
Q

Hertel

A

> 20 mm ➡️ proptosis
(Upper limit for white men:22)
Difference of >2-3 mm btw the eyes is suspicious

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10
Q

Thyroid eye disease-clinical activity score

A

Treatment if >3️⃣/7️⃣

  1. Spontaneous orbital pain
  2. Gaze evoked orbital pain
  3. Eyelid swelling
  4. Eyelid erythema
  5. Conjunctival redness
  6. Chemosis
  7. Inflammation of caruncule
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11
Q

Thyroid eye disease treatment

A

IV metilprednisolone
500mg once weekly - 6 weeks
250mg once weekly - 6 weeks

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12
Q

Preseptal cellulitis and Bacterial orbital cellulitis-patogens and treatment

A

Preseptal: S.aureus, S.pyogenes ➡️ ORAL co-amoxiclav

Orbital:➕S.pneumoniae, H.influenza [ethmoid sinus]
➡️ IV ceftazidime, metronidazol—continue till the patient has been apyrexial for 4 days, followed by 1-3 weeks of oral treatment

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13
Q

BCC

A

Most common: LOWER eyelid

Differentiation from SCC: surface vascularization, slowly growing

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14
Q

Blepharitis-anterior vs posterior

A

Anterior: staph or seborrheic
Posterior: MGD

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15
Q

Chalazion vs Ext.Hordoleum

A

Chalazion: Meibomian,retained sebasous secretions

Ext.hordoleum: Zeis, staph

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16
Q

Angular blepharitis-cause and treatment

A 
Moraxella lacunata/S.aureus
⬇️
Topical chloramphenicol(gemysetin)
bacitracin
erythromicin
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17
Q

Where is the nasolacrimal duct obstruction in congenital obstruction?

A

Valve of Hasner

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18
Q

Chronic canaliculitis-cause

A

Actinomyces Israelii

*sulfur granules

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19
Q

Thyroid eye disease-signs

A

Dalrymple:lid retraction in primary gaze
Kocher:frightened appearence in attentive fixation
The von Graefe:retarded decent of the upper lid in downgaze

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20
Q

Thyroid eye disease-Orbital myositis diff diagnosis

A

TED: always tendon sparing
OM: with or without involvement of the tendons

21
Q

Acute dacryocystitis vs Acute dacryoadenitis

A

Cystitis: staph/strep➡️oral flucloxacilin/co-amoxiclav

Adenitis: EBV/rarely bacterial➡️treatment not required in many cases (or according to the cause)
⭐️S-shaped ptosis

22
Q

Congenital causes of watering eye-diff diagnosis

A 
Nasolacrimal duct obstruction 
Punctal atresia
Congenital glaucoma
Chronic conjunctivitis (chlamydia)
Keratitis
Uveitis
23
Q

Carotid-cavernous fistula-triad

A

1️⃣pulsatile proptosis(with bruit)
2️⃣conjunctival chemosis
3️⃣whooshing noise in the head

24
Q

Carotid-cavernous fistula-the most frequently affected CN

A

CN 6 (due to its free-floating location within the cavernous sinus)

25
Q

Carotid-cavernous fistula-investigation

A

CT/MR: prominence of the VOS

26
Q

Varices and Lymphangioma-the most frequent site

A

Upper nasal

⭐️Lymphangioma:bluish

27
Q

The most common tumour of the orbit and periorbital area in childhood

A

Capillary haemangioma

28
Q

Capillary haemangioma-visceral involvement

A

Can lead to serious complications: thrombocytopenia(Kasabach-Merritt syndrome), high-output cardiac failure
⚠️systemic investigation should be considered

29
Q

Capillary haemangioma-treatment

A

Rapid growth 3-6months after diagnosis
Slower phase of natural resolution
30% resolve by age 3
75% resolve by age 7

30
Q

The most common orbital tumor in the adults

A

Cavernous haemangioma

31
Q

Cavernous haemangioma-treatment

A

Asymptomatic: observation alone
Symptomatic: surgical excision (well encapsulated and relatively easy to remove unlike capillary h.)

32
Q

The most common epithelial tumour of the lacrimal gland

A

Pleomorphic adenoma=benign mixed tumour

✳️No pain

✳️Treatment:surgical excision
❗️NO BIOPSY prior to surgery in order to prevent seeding

33
Q

The most common peripheral neural tumour of the orbit

A

Plexiform neurofibroma

34
Q

NF-1

A 
Iris hamartomas=Lisch nodules
Optic nerve glioma
Plexiform neurofibroma
Encephalocoele
Glaucoma
35
Q

NF-2

A

Optic nerve sheath menengioma

36
Q

The most common soft tissue sarcoma of childhood

The most common primary orbital malignancy in children

A

Rabdomyosarcoma

37
Q

Evisceration

A

Sclera and extraocular muscles remain intact

❗️if malignancy➡️do enucleation

38
Q

Evisceration

A

Sclera and extraocular muscles remain intact

❗️if malignancy➡️do enucleation

39
Q

The most common cause of both unilateral and bilateral proptosis in adults

A

Thyroid eye disease

40
Q

The most common cause of unilateral proptosis in children

A

Orbital cellulitis

41
Q

Orbital walls-the strongest and the weakest

A

Strongest: lateral
Weakest: medial

42
Q

The volume of the average human orbit

A

30 mL

43
Q

MR-T1 and T2

A

T1: fat brighter

T2: vitreous brighter

44
Q

Optic nerve glioma-radiography

A

⭐️pathognomonic: Kinking of the optic nerve

45
Q

The most common malignant neoplasm of the lacrimal gland

A

Adenoid cystic carcinoma

✳️perineural invasion➡️pain

✳️Biopsy is necessary for histological diagnosis

46
Q

Wolfring and Krause

A

10% of production (basal tear secretion) (lacrimal➡️reflex tear secretion)

Wolfring: in tarsus
Krause: in the conjunctival fornices

47
Q

Upper and lower eyelid-analogs

A

Levator aponeurosis↔️capsulopalpebral fascia
Whitnall’s ligament(condensation of levator muscle sheath)↔️Lockwood’s suspensory ligament(condensation of capsulopalpebral fascia)
Müller muscle↔️inferior tarsal muscle

48
Q

Meibomian, Zeiss, Moll

A 
Meibomian: within tarsus
      ➡️chalazion
Zeis: near lid margin
      ➡️external hordeolum
Moll: near lid margin

Kanski (7 decks)

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