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SS > Opthamology > Flashcards

Opthamology Flashcards

(51 cards)

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1
Q

Causes of subjunctival heamorrhage

A

Idiopathic but can be after sneezing or vomiting

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2
Q

Key factors in eyelid injuries

A

Restore anatomy
Close in layers
Retain function
Minimise scar

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3
Q

Muscles in charge of ptosis

A

Levator palpebrae superioris

Superior tarsal muscle

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4
Q

Bones of the orbit

A 
Palantine
Ethmoid
Lacrimal
Maxillary
Zygomatic
Frontal
Sphenoid
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5
Q

What are the extra occular muscles?

A

Superior and inferior obliques
Lateral and medial rectus
Superior and inferior rectus

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6
Q

Innervation of occular muscles

A

Occulomotor-inferior oblique, medial, superior and inferior rectus
Trochlear- superior oblique
Abducens- lateral rectus

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7
Q

Muscles of eyelid

A 
Orbicularis oculi (CN7) closes lid
Levator palpebrae (CN3) opens lid
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8
Q

Anatomy of eyelid

A

Tarsal plate-makes it hard to invert

Conjunctiva-lines inside of lid and outside of eyeball and produces mucins

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9
Q

Tear film

A 
10-12 microlitres of fluid on surface of the eye
allows eyelid to flow over eye
3 layers
Mucins
Aqueous
Oil (stops evaporation)
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10
Q

Main lacrimal gland vs accessory lacrimal gland function

A

Main-reflex watering when something is stuck in your eye

Accessory lacrimal gland produce tear film fluid

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11
Q

Where do tears go?

A

Lacrimal canaliculi which then lead into lacrimal sac then lacrimal duct

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12
Q

Difference between cranial nerve three palsy and horners syndrome?

A

Both have pstosis
CN3 palsy: eye turned out and big pupil
Horner’s Syndrome: narrow pupil

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13
Q

Orbital septum

A

White tough barrier between orbit and lid tissues stretching from tarsus to orbital rim-important to determine if inflammation is behind or in front if this

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14
Q

Orbital blow out fracture mechanism

A

Orbital floor cracks under trauma and the contents fall down into maxillary sinus
Gives black eye (haematoma), infraorbital nerve loss, double vision and downgaze or upgaze

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15
Q

Thyroid eye disease mechanism

A

Enlarged extra ocular (recti) muscles push the eyeball out of the socket so it bulges

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16
Q

length of average eye

A

2.5cm

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17
Q

Myopia(short sighted) vs Hyperopia (longsighted) vs astigmatism

A

Myopia- focuses in front of retina
Hyperopia-light focuses behind the retina
Astigmatism-light focuses in lots of different places

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18
Q

Cornea

A

600 microns (viewed with slit lamp)
Epithelial, stroma and endothelium- has an endothelial pump and barrier to pump water out of stroma to dehydrate it (better for light)
No blood vessels
Massive innervation
2/3 of light bending done at cornea (due to curvature and difference in refractive index between air and water)
Fixed power lens

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19
Q

Diseases which affect cornea

A

Corneal dystrophies, scars, keratoconus (cornea looks like a rugby ball), increased thickness

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20
Q

Imaging cornea

A

IVCm confocal
Anterior OCT
Computerised topography
Biomechanical corvis st (air puff)

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21
Q

Keratoconus

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A

Multifactorial-familial, eye rubbing, down syndrome
“two hit hypothesis”
Most common cause of corneal transplant
Begins at puberty

22
Q

Lens

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A

Variable power lens
Connected to ciliary body by zonules
matrix on outside but mostly cells
Epithelial layer on outside, fibre cells within
Nucleus of lens present at utero-grows cortex during life

23
Q

Cataract

Study These Flashcards
A

precipitation of protein within lens cells
Areas can extend into centre or on edges
Diagnosis-opthalmoscope and slit lamp with reduced visual acuity and lens opacity
usually age related
Treated with phacoemulsification surgery

24
Q

Ciliary body

Study These Flashcards
A

Contains ciliary muscle which surrounds eye and is responsible for accommodation
Relaxed-ciliary muscle at biggest diameter
Contracted-makes lens fatter-when looking at close things
Ciliary epithelium produces aqueous humor which fills area between lens and iris (constant into anterior chamber) drains into trabecular meshwork. Damaged trabecular meshwork = increased ocular pressure

25
Retina components
Optic disc with optic nerve and retinal artery | Fovea-centre of visual acuity
26
Retina functions
Absorb photons Turn light into chemical message Turns chemical message into electrical impulse Transmits electrical impulse to the brain via ganglion cells
27
Cell types in retina
Most posterior = photoreceptors (rods and cones) Bipolar linker cells ganglion cells = send impulse to brain
28
Why is the retina back to front
Photoreceptors are highest energy consuming cells in the body so need direct contact with endothelial cells which give nutrients and remove waste
29
Central and peripheral retina differences
Central-more rods and cones | Peripheral-fewer cones but more rods(good for detecting movement)
30
Fovea optimises light entry?
``` Bipolar and ganglion cells moved out of the way so light directly hits photoreceptor Most cones (responsible for visual acuity and colour vision) ```
31
Macula lutea
Pigmented area around fovea containing xanothophyll caratenoids which prevent light damaging foveal cones
32
Optic nerve
No photoreceptors Causes blind spot-covered by binoccular vision Alongside retinal artery and vein
33
Colour absorbancy
Red cone-longest wavelength Green cone Blue cone-shortest wavelength
34
Colour blindness
More common in males | Most commonly green-red
35
Glaucoma
Old age Specific pattern of axonal loss elevated intraocular pressure Visual loss-open angle and closed angle
36
IOP assessment
Normal 11-22mmHg | Linked to glaucoma but some people with it have normal pressure
37
Open angle glaucoma
Most common | 2nd cause of blindness in NZ
38
Closed angle glaucoma
only 5% of glaucoma cases Rapid onset pain and redness vomitting abdo pain Mid dilated pupil
39
Optic nerve cupping
Increased pressure/glaucoma equals cuppingof optic nerve- half has to be gone before any vision loss occurs effects peripheral vision first (tunnel vision)
40
Common retinal disorders
Retinal detachment Diabetic retinopathy Macular degeneration -wet or dry peripheral vision normal but central vision lost
41
How to test visual acuity
Measured at 6 metres Described in angles to remove distance factor 6/24 means measured at 6 metres, able to read line 24 of snellen chart
42
What makes up left visual field in the brain
Temporal hemi field in left eye (90 degrees) | Nasal hemi field in right eye (60 degrees)
43
What makes up right visual field in the brain
Temporal hemi field in right eye | Nasal hemi field left eye
44
Optic nerve in relation to macula
Optic nerve is always NASAL to macula | Blind spot is always temporal on visual field (if dark spot on the left then it is left eye)
45
Pathology in both temporal hemi fields lost
Optic chiasm | Bitemporal hemiopia
46
Pathology in left temporal hemi field and right nasal hemi field loss
Right side-posterior to optic chiasm | Left homonymous hemiopia
47
Pathology in loss of superior part of both left temporal and right nasal
Right optic tract inferior and posterior to chiasm | Left superior homonymous quadratinopia
48
Marcus Gunn pupil
Relative Afferent Pupillary Defect Shine light in normal eye=both pupils constrict Shine light in abnormal eye=both pupils dilate
49
How to reveal a squint (strabismus) with cover up test
Convergent squint: Normal eye covered, squinting eye moves outwards Divergent squint: Normal eye covered, squinting eye moves inwards
50
How to reveal a squint (strabismus) with light reflection test
When shining a light 33cm away, reflexes should be symmetrical in both eyes A reflex displaced outwards=convergent strabismus A reflex displaced inwards= divergent squint
51
5 different types of Ishihara plates (non-diagnostic)
Alternating-see different number if you are colour blind or not Hidden-normal people see no number Invisible-normal people see a number Diagnostic-normal people see 2 numbers, colour blind see 1 Non-verbal plates

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