PPO2 Flashcards
(103 cards)
1
Q
what is arcus?
A
form of degeneration around the limbus composed of CHOLESTEROL esters and LDL @ stroma. Usually @ inf. cornea and stroma. There are varying degrees.
2
Q
what does a unilateral arcus possibly indicate? which side is “bad?”
A
vascular occlusion on the side WITHOUT the arcus.
3
Q
what is limbal girdle of vogt? what does it mean?
A
Age-related sub-EPIthelium collagen degeneration @ cornea. There are white crystal appearances @ 3 & 9 o’clock.
**Type1– clear translucid zone due to Ca deposits at the Bowman’s layer, which is at a difference location on the sclera
4
Q
hudson-Stahli line
A
iron deposit along Bowman’s layer that looks brown/yellow @ margins of inf. pupil. More common in dry eye people and frequency is the same with age (20y/o= 20% etc)
5
Q
Descemet’s striae
A
striation in Descemet’s membrane @ cornea. If very very large–> maybe corneal edema.
6
Q
What is Hassal-Henle bodies?when is it a guttata?
A
- peripheral= hassal-Henle bodies=iron deposit @ bowman’s membrane
- central cornea= guttata nodular thickening of Descemet’s membrane composed of collagen and byproduct of ENDO-thelial cells
7
Q
what is grayson’s disease of cornea?
A
deterioration of layer–due to age mostly
- peripheral cornea
- vascularization may be present
8
Q
what is the % of population that has arcus between 40-60 years old? past 70-90 years old?
A
- 60% have arcus
2. 90% have arcus
9
Q
what eye disease is common in Hudson-stahli line?
A
- dry eye or tear flow problems @ pupil margin
- change increases with age
- A NORMAL FINDING
10
Q
what is Descemet’s striae?
A
- Descemet’s membrane striation
- normal finding that’s VERTICAL
- bad if paried with stromal edma**
11
Q
what is the aka of “crocodile shagreen”? what is characterized by this disease?
A
- Mosaic Shagreen
- gray/white opacity that has clear spaces–looks like crocodile!
- mostly peripheral
- due to Bowman’s Layer relaxation
12
Q
what is a risk factor for pt. with guttata (which is normally age related)
A
Fuch’s endothelial dystrophy
- look for corneal stromal edma
- check pachymetry
13
Q
what is corneal farinata?
A
- tiny, dust like flecks @ STROMA–looks like sprinkled flour
- retro illumination
- bilateral w/ no VA change
14
Q
what is band keratopathy?
A
- Ca salts @ inter-palp zone (begins @ basement membrane)
- corneal degeneration where corneal nerves penetrate Bowman’s
- mostly central, but mild cases can be at 3&9 o’clock
- if in KIDS= rheomoetoid arthritis is risk factor and get irididis
- decreased VA
15
Q
where does the Ca salts come from in band keratopathy?
A
- tears that have Ca and Phosphate
- dry eye/evaporative tears increase solute concentration esp. @ INTRA-palp and the balance is affected
16
Q
how do we get Band Keratopathy?
A
- inflammation= uveitis, glauc, corneal edma
- systemic= hyper-parathyroid (immuno), juvenile rheumatoid arthritis, thiazides, vit. D toxicity, renal failure
17
Q
what is treatment of band keratopathy?
A
ONLY IF VA AFFECTED—scraping with a knife + Ca binding agent EDTA
- surgical excimer laser keratectomy to polish cornea
18
Q
what is Salzamann’s Nodular Degernation?
A
- elongated basal epi cell lesions
- plaques @ epi and Bowman’s= opaque color
- has keratocytes, esp. at anterior
19
Q
what is the dimensions of the normal cornea?
A
- 6mm x 10.6mm vertically
- central thickness 0.53 and 0.70
20
Q
list layers of the cornea
A
- epi ( surface with microplicae+microvillie for absorption of mucin= rewetting, 5-7 layers of basal columnar cells attached via hemidesomosomes to BM + wing cells)
- BM
- bowman’s
- stroma (any break after here will scar)
- Descemet’s membrane
- endo
21
Q
does the epithelium scar as a result of inflammation?
A
no, epi has regenerative properties 7-14 days
22
Q
does the BM lesion cause scar?
A
yes/no…takes 6-8weeks to regenerate and disruption can cause corneal erosions
23
Q
does Bowman’s lesions cause scar?
A
YES, doe NOT regenerate—very STRONG though, so if finally break through, then will scar!
-aceulluar structure that will undergo hypertrrophy
24
Q
what makes up your stroma?
A
- collagen, fibroblasts with keratocytes etc.
* * DUA’S LAYER: acellular and pre-Descemet’s that separates the LAST row of keratocytes
25
where does the Descemet's layer terminate at? Can descemet's break?
- ends at SWALBE'S line
| - made of lattice collagen fibrils and can easily break from the stroma
26
what are the layers for gonio? What do we see in a closed angle like in glauc?
1. swalbe's = outer (attaches to Descemet's)
2. Trabecular Meshwork
3. Sclera Spur
4. Ciliary Body = inner most.
** will only see swalbe's in a super close angle glaucoma!
27
what does corneal endo do? can it regenerate?
- corneal endo: amitotic hexagonal cells used for PUMPS--maintain corneal aqueous flow!
- decreased with age and DOES NOT REGENERATE--hypertrophy= pachymetry!
28
what is the cornea blood supply from?
- avascular itself
- conjunctival episcleral vessels around the limbus
- O2 and nutrients supplied by atmosphere + tear film @ anterior
- aqueous humor gives nutriens @ posterior
**closed eyes= no oxygen from conjunctival capillaries--wake up with dry eye
29
the limbus contains radial vessel "ridges" aka ___? that do what? what's a disease that starts here?
- AKA Palisades of Vogt's
- has lymphatics + blood for Oxygen--neovascularization starts here @ limbus!
- needed for apithelial regeneration
30
what are the symptoms of corneal edema?
- normally has 78% water, anything 5% and over is edema= light scatter=low VA
- usually starts as stromal edema that leads to corneal edema
- not a "disease" just response to disturbance of the balance in pump function wher ethere's fluid accumulation that affects INTRAocular hydrostatic P
31
what is basis for epithelial healing? (summary)
- adjacent cells cover damaged part
- fibronectin secreted and acts like glue to hold together
- mitotsis in 24hrs and Palisades of Vogt's in chemical burns wher ewhole pithelium is damaged
**epi CANNOT adhere to Bowman's without the BM, so if that's damaged, it'll take 6-8 weeks= need bandage to encourage healing!
32
what does it mean if the cornea is "performated?"
- cornea is penetrated all the way through!
| - use Seidel test to check for leaking aque. fluid= Fluoscein on wound and check for leaking dye (due to pH change
33
what's the difference between abrasion and ulcer?
1. ulcer= superficial loss of corneal tissue that led to necrosis from infection/inflammation
- epi disurption w/ stroma problem--100% beyond Bowman's!!
- not immediately painful, more slow devleoping---red 360 degrees
- cells and flare present
- 2ndary to unattended epi. defect
- **ultimate: enzymatic destruction of MACROMOLEC. that are part of cornea collagen
- can lose sight!! (like CL over wear and pesudomonas growth)
2. Abrasion--trauma and does NOT go beyond Bowman's usually
- small infiltrates and Flue stains do not "leak"--instead has small "halo" around it
- no discharge, only red @ infected area
- treat with antibiotics + cyclo to prevent iritis--NO ANESTHETICS!!
34
what are teh signs of neurotrophic ulcers
- CN5 (trigeminal) paralysis= pt. can't feel it
| - can have hypopoyn with it: white leukocyte build up spot--inflammation @ ant. chamber (iritis, uveitis etc)
35
when do recurrent erosions happen? which type of staining is used to check? how's it look?
- usually in MORNING--eye is dry
- usually due to organic abrasions-current
- antibiotic ointment (ung) @ night, drops @ day for 1 week until healed
**use NEGATIVE staining!
36
how do anterior stormal punctures work? when are they used?
- for recurrent erosions
- needle punctures into Bowman's into stroma (shallow depth)
- promotes epi. binding to underlying tissue (Bowman's )
37
what is Doxycycline (200mg, BID) used for?
- recalcitrant recurrent corneal erosions
- have increased MMA (matrix metalloproteinase enzym) that dissolve BM's fibrils and hemidesomosomes and looses attachment= BAD
**doxycycline= tetracycline antibiotic + corticosteroid DECREASES MMP and prevent future erosions
38
how do we treat foreing body removal
- Alger brush
| - cotton swab "rolling around"
39
what are some diseases that give you Iron lines in the cornea? (ABNORMAL!)
1. Ferry line= line around a bleb in post-op gluacoma
2. stocker's line= tip of ptyergium
3. Fleischer's ring= ring of keratokonus
4. Coat's ring= once you remove a ring, it's what's left
40
What are the 3 most common Grayson's disease of cornea? what are hallmarks' of Grayson's?
1. Kerotokonus 2. Fush's dystrophy 3 Epi, BM disorder
- bilateral, hereditary disease affecting central cornea
- avascular and begins early
- unrelated to other diseases
41
what are some hallmarks of keratoconus?
- central and paracentral cornea
- stromal thinning
- apical protrusion
- irregular mires
* *NON inflammatory
- 80% bilateral
- hereditary= 8% relatives || associated with other CT disorders (Raynaud's/syndactylyl/Down's syndrome/Marfan's/Ehlers-Danlos
**associated with Fleischer's Ring & corneal thinning
42
what did the CLEK study find regarding kerotokonus?
- collab longitudinal eval of keratoconus
- 13.5% have blood rel. w/ disease
- 50% eye rubbing
- pt. have poor ability to process and eliminate oxy&nitrogen= oxidative damage
- changes protein/DNA and lipid functions
- more apoptosis @ ant. stromal keratocytes
43
what are some hypothesis of how keratoconus happens?
- collagen cross linking issues around puberty and stays that way for 10-20years= MAIN theory
- proteoglycan abnormalities
- fibrillation of Bowman's layer that causes breaks + fibrous growth @ break points
44
what is Munson's sign? what disease is it in?
- keratokonus late stage
- shape of the cone shows convex of lower lid @ DOWN gaze
- apex thinning + stria @ post. stroma
45
what happens in later stage kerotoconus as cone developes?
- reticular scaring @ bowman's
- can't get 20/20 VA
- Fleischer ring w/ Fe depositions @ epi (use colbalt blue)
- stromal thinning + scarring= lamellae decrease
* *may have Descemet's membrane= stroma edema with decrease in VA + Pain!--resolves in a few months
- treat w/ cyclo + hypertonic solution to lower Pressures
46
what are the classifications of Keratoconus?
1. mild= less than 48D
- oblique astig + high myopia, but difficult to tell from externals
2. moderate= 48-54D
- 1+ corneal signs with corneal nerves present
- 40%= Vogt's striae
- 50%Fleischer's ring
- 20% corneal scarring
3. severe= greater than 54D
- vogt's striae 60%
- 70% Fleischer's ring + scaring
- acute corneal hydrops (edema)--MMA is in stroma and "broke out"
47
how is collagen cross linking surgery performed for kerotoconus?
- removing corneal epi (epi-off) and adding riboflavin (vit. B2)
- UV-A the whole eye and produce rxn oxygen molecules that cause chemical bonds--> strengthn collagen fibrils
**stops keroto progression**
48
what is Fush's epi-endo dystrophy?
- slow, progressive decline in endo. cell pumps/function= stromal epithelial edema
- BILATERAL and has decreased vision + pain
- females 50-60 y/o +
- autosomal DOMINANT
- cell density drops, pumps don't work as well and cell density can be below 500 cells= dry eye + "subepi "bullae"= painful!
**use specular reflection
49
what are early signs of Fuch's? how does this disrupt eye?
- endo acts as barrier to movement of salt& metabolites @ stroma
- pumps bicarbonate ions OUT of stroma & into aque. humor
- get GUTTATA 1st= endo layer impairment and decrease pump action
- edema arises due to compromised stroma=get irregular epi. surface= bullous keratopathy+ corneal scarring
**use specular microscope to measure end. cell density--may need to strip Descemet's membrane and put in a DONOR if below 500 cells
50
what is the best way to view Fush's dystrophy? what disease are Fuch's pt. higher chance of?
- sclerotic scatter--limbus light up
| - more likely to get glaucoma because problems and the endothelium= problems at Trabec meshwork too
51
what is Epi-basement dystrophy/disordered? what are the 5 signs to look for?
- BM disruption causes (can see with (-) staining)--thicken and interferes with anchoring of epi to stroma
1. dots (map-dot)--gray white intra-epi opacities= microcyst that have nuclear debri & lipids that can discharge randomly to corneal surface and produce erosion as it "disappears"
2. maps= irregular geographic shaped and seen w/ dots usually.
- related to laminar thickening of BM with aberrant membrane extending to epithelium
- fibrillogranular material 2-6mm in thickness
3. cysts
4. fingerprints--BM projecting and trapping the ant. migrating cells (cluster of concentric lines)--view via retroillumination
5. blebs--bubble like, fibrillogranular proteins @ api BM that inden basal epithelium
* *prone to recurrent erosions
52
are there any major symptoms wioth epi layer dystrophy. How do we look for signs?
nothing major, usually dry eye and recurrent erosions that have foreign body sensation and pain + photophobia
**usually dry eye worse in morning due to low pumping @ night
- we use slit lamp + Fl staining or (-) staining and look for disruption
53
what's treatment for epi layer dystrophy?
- lubrication for dry eye
- ointnment + hyperosmotic for recurrent erosions
- NO CL wear!
54
what are some affects of drug deposition on the cornea?
1. thiazides--antipsychotics
- block Da= yellow brown deposits @ stroma @ ant. lens, UV triggers
- retinapathy
2. plaquenil--microdeposits
3. amidarone (heart)--microdeposits (whorl kertopathy
4. rheumatoid arthritis
- yellow depotis @ post. stroma & descement's
5. retinoids-acutane--vit A related treatment for sporiasis---gives fine round sub epi opacitiy @ cornea
55
what is the grey line on the adnexa?
-diving landmark on lid margin that separates lids into anterior/posterior
56
what is the orbital septum? what's it do?
-around the rim and creates barrier for th elids
-prevents pre-septal celluitis
-surgically important for IDing eye
fibrous sheath from the orbital rim
57
what do 1. glands of Moll 2. gland of Zeiss 3. meibomian glands 4. Gland of Krause&wolfing do?
1. Moll= secretes fatty material + sweat into hair follicles
2. Zeiss= lipid material into hair follicles
3. meibomian glands= sebaceous glands
4. Krause and Wilfing= accessory lamcrimal
58
Lid Colomboma
- gaps & notes @ lids= incomplate lid formation--incompletely development (NOT hereditary)
- get dry eye and eye disccation
59
epicanthal folds
- lid formation mainly in ASIANS
- autosomal dominant + bilateral
- redundant folds of skin from upper lid to inner canthus
- can get pseudostrabismus (ESOTROPE fake)
**can be w/ down syndrome
60
Distichiasis
- rare + auto. DOMINANT
- meibomian glands replaced by abnormal row of lashes (cilia!)
- results: 2ndary dry eye + hyperemia (red eye) due to increased injection
- Fl stain: damages the epi cells will stain more
- create SPK: due to inflammation
**to treat: bandage CL +epilation (tweezer to pull out) + electrolysis (destroy actual hair follicles so it falls out) +cryotherapy (liquid nitrogen to destroy lashes)
61
Blepharimosis
- auto. dominant due to FETAL ALCOHOL SYNDROME!
- flatter bridge and nose area with BILATERAL ptosis of upper lids and picanthal folds
- leator muscle can be affect
62
ectropian
lids NOT appositional, actually flipped out
- excessive tearing and hyperemia due to exposure and SPK
- treat w/ art. tears 4-6x/day or use gel lubrication (supportive treatment)
-cause: congenital (rate), involution due to age (common!)= loose muscles, Bell's CN7--ectropian on SAME side as paralysis
63
entropian
- inward turning life/lashes and irritates cornea
- excessive tearing,
- conj irritate
- foreign body sensation
- Trochoma= bacterial conjunctivitis @ upper life w/ red eye
64
dermatochalasis
- older, middle aged pt. common
- loosen/redundant skin on eyelid
- pseudoptosis
- bilateral + asymmetric appearance
- decreased VA, VF (frontalis affected)
- trichiasis
65
what are the 2 types of papilloma?
1. pedunculated: sticking out at you, still benign
| 2. sessile: FLAT, nothing is coming out
66
what is the difference between pseudoriferous cyst and sebaceous cyst?
- pseudoriferous cyst= clear fluid due to plugged gland of MOLL--like a blister
- sebaceous scyst= yellowy fluid due to plugged sebacous gland ("lance"/cut it off)
67
what are the ABC's to check for malignant lid tumors?
```
A= asymmetry
-non uniform or fast growing changes
B= bleeding
-bleeding or sloughing of skin or hair growth change
C= Color
-change from original color
```
68
what is the difference between Nodular form and ulcerative form and sclerosing form of malignant tumors
1. Nodular: common + raised + 5-10mm with pearl/translucent edges + teangietatic vessles
2. ulcerative= raised w/ LESS fine edges + umbilication+ eorsions for an ulcerative center
- causes mechanical ectropion
3. Sclerosing= rare + pale yellow + indistinct borders
69
what are clinical signs of ACUTE staph. Blepharitis vs. CHRONIC?
1. ACUTE: sudden onset
- unilateral that becomes bilateral within 24/48hrs
- inflammed lid margins + colarettes @ lash base + conj. hyperemia
- tylosis
- CHRONIC: NEED ANTIBIOTICS!!
- long period of time + other lid problems developing like..
- madarosis + trichiasis +2ndary dary eye
**Both will have NORMAL EOM/VA/Pupils!
70
what are some signs of Staph Belpharitis?
- rossettes= dilated vessels
- colarettes= stuff at base of lashes
- hordeolum= acute focal infections @ gland of ZEISS
- Chalazion=granulomous, non-inflammatory infection of the oil gland (Meibomian)--a bump
71
what is the difference between staph. blepharitis and SEBORRHEIC bleph?
- seborrheic= involves scalp + face+ brow
- infection/stress/nutrion play a role
- foreign body sensation/ burning/BILATERAL
- NO ulcers, tyolysis or other abnormality
72
what is the underly part of angular blepharitis?
- usually related to alcoholics
- red/itchy path of skin @ temporal lid by fornix (corner of eye
- treat with antibiotics + zinc if due to moraxella for 7-10 days
73
what is the difference between internal hordeolum (stye) vs. chalazion?
1. hordeolum is just infection of lid margin area, @ oil gland (ZEISS gland)
- will be RED, tender to touch, warm
2. chalazion= deep within meibomian gland is clogged with high lipid deposits--NOT an infection
- will not have same redness/not painful
74
what is demodex? where does it appear on eye? (life cycle approx 14 days)
- 8 legged mites in all age groups @ the bilateral hair follicles (like lashes)
1. dem Folliculorum-- @ hair follicle
- larger, abdomen is rounder
- eggs are 0.1mm (big) and arrow shaped)
2. Dem Brevis @ sebaceous gland and smaller
-has oval eggs that's 0.06mm (smaller)
-
75
what disease is phthiriasis palpebrarum due to? what to check if it's in kids?
- pediculus parasite which is same as 8 legged thing that cause sexual crabs
- mus tonctact child services if see in young children--due o sex. abuse or poverty
76
what is molluscum contagiosum? what are findings?
- transmitted via contact and around 2-10mm
- cheesy center + multiple lesions
- causes collicular conjunctivitis
77
what causes varruca?
- HPV virus
| - looks like a small caulliflower on the lid region
78
what are some normal findings of how the lacrimal system should look/work?
- want patency betewen puncta and lacrimal sac
- appositional of puncta to the globe (puncta adhering to globe)
- Jone's Test: put dye in eye and blow it out to see lacrimal duct drainage (one uses anesthetics+ keretometer)
79
what are the layers of the tear film and what do each do?
1. meibomian + Zeiss= lipid layer for stabilizing tear film--most outter layer
- damage due to Cl wear or Bell's palsy or other lid closure problems= dry eye, or osmolarity changes
2. aqueous layer (largest!)= lacrimal gland _ accessory lacrimal (Krause _ Wolfring)
- salts, proteins, glucose, lactate
3. Mucin= inner most and has goblet cells + crypts of Henle, Gland of Manz
- vit A deficient, LASIK, trachoma can all affect here
- trochoma= destroy goblet cells
- glycocalyx normally binds mucin to cornea surface here
80
what is Sjogren's syndrome and how do it affect the eye?
- autoimmune disease w/ TRIAD
| 1. dry eye 2. dry mouth 3. rheumatoid arthritis!
81
where is the Line of Marks?
-lid margin, near interpalp zone
82
what can "filaments" along the cornea mean? what are filaments? What stain do we use?
- in SEVERE dry eye
- loss of epi cells where the dead cells cling" onto the corneal surface and looks like "String" vertically
- use Rose Bengal to check
83
which layer will the punctal plugs help maintain? (out of superficial lipid, aque, mucin layer)
--aqueous layer!!
**meibomian gland deficiency will not use this as that's a mucin/goblet cell disorder
84
what is the measurement of the nasolacrimalgland?
- veritcal= 2mm
- horizontal= 8mm
**the actual nasolacrimal duct is about 17mm vertically long to the nose
85
how long to collagen plugs stay for? how are they used?
- lasts 4-6weeks and will dissolve on its own?
- diagnostic+prognostic indicator--like using a trial before doing it for real
- those with Sjogren's can try this out to see if there's improvement before using permanent ones
**watch for epiphora= excessive tearing due to lack of drainage
-blocks 80% (@ lower puncta, 60% @ upper puncta) of tears from draining!
86
what are teh 3 signs of "dry eye" defintion?
1. inflammation of the ocular surface
2. VA drop
3. ocular surface damage
**can cause discomfot, low VA, tear film instability, increased osmolarity of eye
87
what are signs of dry eye and what are the associated symptoms?
1. corneal/conj staining--sandy/gritty/foregin body sensation
2. MGD--burning
3. reduced TBUT (les than 10sec) + reduced Schirmir's (less than 1010mm/5mins)--tearing
88
there are 2 types of dry eye, what are they and which one is the popular one? what % has this?
- evaporative= MGD deficient= lipid deficient--when tears evaporate too fast
* *POPULAR=86% have evap!**
-aque. deficient= decrease in lac. gland production= eyes does not stay moist
89
wher eis the lid wiper vs. the line of marx? Is it same as the gray line?
1. Lid wiper= more on the inner part of kessing's space
- part of the parakeratinized cells located near surface of muoco junction of eyelid and cornea, TOUCHES the ocular surface and can have that "scratchy" feeling
2. line of Marx= never touches ocular surfaces, more on the "flat" part of the lid margin
- where the epi of the palp conjunctiva abuts against the epi of the eyelid.
**NOT THE GRAY LINE!!**
90
if the patient says they feel every blink and it hurts to blink, what is linkely prblem?
lid wiper epitheliopathy
| -touches ocular surfaces and stains with FL due to lack of lipid lubrication
91
what is the Korb-blackie light test? what does it check?
- use transilluminator and shine on closed lids
- check for leaks of light @ the lid margins to see if pt. completely closes their eyes
- checks dry eyes
92
what is the chemical compounds BAK? what drops is it in and what does i t do to eye?
-BAK is in Visine for dry eyes--benzo chloride
-damages corneal epi
reduces nerve fiber density + reduce aqu. tear production
-nerve degeneration
-increased inflammatory cell infiltration
93
what 2 classes of drugs help with antiinflammatory?
- NSAIDS + corticosteroids
1. corticosteroids= inhibits phosolipids conversion to arachdonic acid
2. NSAID (non-steroids responding drugs)= inhibits COX2 to convert for clotting TxA2
-anti inflammatory properties and can increase tear production and decrease immune response
94
what 2 muscles govern blink and oil production during blink?
1. muscle obicularis
2. muscle of Riolan--encircle terminal ends of the meibomian glands--the gray line
-exert pressure on meibomian glands
95
is FCC an objective or subjective test?
- assessing lead/lag
- SUBJECTIVE test
**watch out for accommodators and can change their CLC--not good for young pt**
96
what are the age group for presbyope ADDs?
* 45= +1.00D
* 55= +2.00D
* everything else is between this
97
if you decrease the cyl power of an Rx by -1.00, how does that change the over all Rx? how do you fix it?
**must keep SE, so decrease in -1.00 is a drop in -0.50 in SE sphere power so much increase the (-) power by -0.50D to compensate for the drop in cyl
98
patients with anisometropia can experience anisoPHORIA when reading...what can this create and how to fix it?
- can experience vertical imbalance due to the difference prism affects when they look through peripheral vision (not @ optical center)
**switch to CL, get 2 pairs of glasses or raising the seg height/dropping optical centers, slab off glasses
99
what pupil related disease comes with anisocoria?
1. physiological
2. parasymp= dilated
- Adie's, pharmacologic, CN3 palsy/Bell's
3. symp= constricted
- horner's--ptosis, miosis, anhydrosis
4. L-N dissociation
- argyll- Robertson
- dorsal midbrain syndrome
100
what is virulence mean?
exhibit pathogenity when present in small numbers
101
what will a smear show in primarily bacterial conjunctivitis? what about viral conj?
1. BACTERIAL--neutrophils
| 2. VIRAL--lymphocytes
102
what are signs of basic conjunctivitis?
- hyperemial= redness
- chemosis- swelling of lid/eye
- discharge--mucous? watery?
- papillae
- follicles
103
vernal allergy conjunctivitis=?
seasonal+ giant papillary conj + men> women + children
