Part 3

Question 1

Extraocular muscles of eye

Answer 1

7 total
- 4 recti- sup inf medial and lateral
- 2 obliques- superior and inf
- 1 Lavator palpebra superioris

• Originate from annulus of Zinn. **Except **for inferior oblique that originates form the lacrimal bone
  -Inserted behind equator of eye ball.
  -sup. Oblique takes turn at the trochlea
  -thinnest and longest muscle- sup oblique
• innervation by CN3 for all muscles EXCEPT SO4 and LR6

Question 2

Intraoccular muscles of eye

Answer 2

3 total

• sphincter pupilae _ innervated by 3CN
• dilator pupilae _ innervated by sympathetic nerves
• cilliary muscles.

Question 3

Esotropia

Answer 3

• median deviation/ adduction of eye
• Type of strabismus/ squint

Question 4

Exotropia

Answer 4

-lateral deviation/ abduction of eye

Question 5

Myopia

Answer 5

Far vision

Question 6

Hypermetropia

Answer 6

Near vision

Question 7

Agre related refractive error called?

Answer 7

Presbyopia

Question 8

Test to asses squint

Answer 8

Hirschberg test
Light reflex

1 mm deviation - 15 diopters
2 mm deviation - 30 diopters

Question 9

3 CN palsy

Answer 9

• ptosis
• down and out eye

LPS - ptosis
SR + IO - for downward eye
medial rectus - for outward eye

Question 10

Muscles responsible for elevation of eye

Answer 10

SR and INF. OBLIQUE

Question 11

Function of external muscles

Answer 11

SIN- all superiors are introters
All inferiors are extroters

RAD- all recti are adductors
All obliques are abductors

SO- ABID- sup. Oblique=
Abduction - intorsion - depression

Question 12

6CN palsy

Answer 12

• lateral rectus muscle
• primary gaze normal
• eye will not move laterally in affected side
• Diplopia
• head turn toward same side

Question 13

4CN palsy

Answer 13

• diplopia on down gaze
• head turn towards opposite side
• sup. Oplique
• eye will be down only.

Question 14

Ambyopia RX

Answer 14

• Lazy eye
• Occlusion/ patching of the normal eye
• anblyogenic period- 7-8 years
• can be treated till 14 years

Question 15

Papilledema

Answer 15

• Reactionary disc edema
• 8 times enlarged size
• Angry sun appearance
• Venous tortuousity
• Increased intracranial pressure
• increased size of blind spot in perimetry
• pupil and vision is normal

Question 16

Most common cause of optic neuritis?

Answer 16

Multiple Sclerosis

Question 17

Optic neuritis

Answer 17

1- papillitis
involvement of optic Disc
- size 2x enlarged OD
-RAPD (Marcus Gunn pupil)

2- neuroretinitis
** involvement of optic nerve + OD + macula**
- cystoid macular edema causing macular star appearance

Question 18

Primary optic atrophy

Answer 18

Death of ganglionic cells

• Primary- trauma toxins tumours
• Chalky white appearance of OD
• Secondary- after papillitis or neuroretinitis
• grey white OD

Question 19

1st order neurons of visual pathway?

Answer 19

Rods and cones

Question 20

Visual pathway

Answer 20

• optic nerve
  Cross innervation (nasal side responsible for temporal vision and vv)
• optic chiasma
  Only nasal fibres cross at optic chiasma
• optic tract
• terminate in lateral geniculate body
• optic radiation
• visual cortex (occipital lobe)

Question 21

Anopsia

Answer 21

• complete loss of vision of whole eye
• damage of optic nerve
• will affect same side

Question 22

Bitemporal hemianopia

Answer 22

• damage of optic chiasma nasal fibres
• compression of chiasma by tumours prolactinoma and craniopharyngioma
• will affect opposite side
• nasal fibres damage will cause temporal side vision loss

Question 23

Homonymous hemianopia

Answer 23

• same side vision loss
  Either right sided or left sided
• always CONTRA LATERAL
• damage to optic tract
• same side ka vision loss, opposite side ka lesion

Question 24

All lesions below the optic chiasma will cause?

Answer 24

Homonymous hemianopia

Question 25

All lesions below optic chiasma will affect which side

Answer 25

Contra lateral side

Question 26

Color blindness

Answer 26

**X linked recessive** (Only affect males, females will be carriers) - Most common- **Deuteranopia** green color - PuRe- protanopia for red - TB - tritanopia for blue color **ishihara chart** to check red and green

Question 27

Uvea composed of?

Answer 27

Iris Cilliary body Choroid

Question 28

Uveitis types

Answer 28

1- anterior 2- intermediate 3- posterior uveitis Anterior- iritis, iridocyclitis Intermediate- pars planitis Posterior- choroiditis All parts- pan uveitis

Question 29

Uveitis (ant)

Answer 29

- cells (inflammatory) seen in ant. chamber- - if cells attach behind cornea - **keratin precipitates** KPs - **mutton fat KPs** in granulomatous - **thin fine KPs** in non granulomatous - KPs arranged in triangle pattern- **Arlt’s triangle** ant uve - **irregular pupil** due to adhesions - 360• adhesions = iris bombe - Irregular dilated pupil - **festooned pupil** anterior uve - associated with alkalising spondylitis - koeppe’s nodules at pupillary margins - busacco’s nodules on surface of iris — due to aggregation of epitheloid and mononuclear cells Slit lamp microscope to check anterior chamber

Question 30

DOC for ant uveitis? DOC for **Acute attack** of ant uveitis?

Answer 30

1- Steroids 2- cycloplegics (for pain relief since it’s acute condition) Atropine used

Question 31

Longest acting cycloplegic

Answer 31

Atropine- used in children

Question 32

Shortest acting cycloplegic

Answer 32

Tropicamide - used in adults

Question 33

Intermediate uveitis

Answer 33

- candle wax dripping sign - snowball/ snow banking sign -DOC- steroids

Question 34

Posterior uveitis

Answer 34

- choroiditis In active form - **headlight in the fog appearance-** hazy posterior segment + bright optic disc - MCC - toxoplasmosis

Question 35

Bilateral granulomatous Panuveitis

Answer 35

Sympathetic opthalmitis MCC- penetrating injury at the cilliary body Treatment of choice- enucleation