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Ophtha > Refractive Errors > Flashcards

Refractive Errors Flashcards

(36 cards)

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1
Q

Refractive power of eyeball

A

+60(58.6)

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2
Q

What is near reflex or accommodation triad?

A
  1. Convergence of eyeballs by medial rectus
  2. Miosis by sphincter pupillae
  3. Accomodation by ciliary muscles-increase in Anterior curvature of lens.
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3
Q

Types of Myopia

A
  1. Axial-Path,Buphth,post staph
  2. Index-nuclear cataract
  3. Positional-ant dislocation/subluxation nd Weil march
  4. Curvatural-corneal or lens
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4
Q

Symptoms of myopia

A
  1. Defective far vision/near sightedness

2. Floaters(muscae volitantes)

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5
Q

Signs of eye in myopia

A
  1. Large eyeball-blue thin sclera
  2. Cornea-large
  3. AC-deep
  4. Exophoria
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6
Q

What is fundus?

A

View of all structures in the post segment 1.vitreous nd retina transparent 2.Choroid(red)

*viewed with ophthalmoscope.

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7
Q

Fundus signs in myopia

A
  1. Myopic temporal crescent around optic disc
  2. Optic disc tilted
  3. Lacquer cracks
  4. Foster fuch’s spots
  5. Posterior staphyloma
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8
Q

Overall appearance of fundus in myopia

A

Tessellated or Tigroid appearance d/t diffuse alterations in RPE

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9
Q

Other retinal findings in myopia

A
  1. Lattice degeneration
  2. Rhegmatogenous RD
  3. Retinal tears
  4. Vitreous deatchment - Seen as WEISS rings
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10
Q

Complications of path myopia

A
  1. RD
  2. Complicated cataract-post subcapsular
  3. Vitreous hmg nd choroid also hmg
  4. PAOG- more like an association
  5. Strabismus fixes convergence
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11
Q

Fundus signs nd complications are absent in?

A

Simple or developmental myopia

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12
Q

What are the zones of chorioretinal atrophy

A

2 zones:

  1. Alpha-always seen in glaucoma
  2. Beta-TMC
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13
Q

Laser surgeries in myopia

A
  • Corneal based
    1. Radial keratotomy
    2. PRK with excimer laser
    3. LASIK with excimer or femto(upto -8₹
    4. Smile(upto -10D)
  • Lens based
    1. Clear lens extraction-Fucala sx (for >-12D)
    2. ICL
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14
Q

Types of Hypermetropia

A
  1. Axial-Newborn,micro,nano
  2. Index-cortical sclerosis
  3. Positional-post dislocation
  4. Curvatural-cornea plana
  5. Aphakia
  6. Overcorrected Myopia in refractive Sx or Undercorrected IOL in cataract Sx
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15
Q

Symptoms of Hmt

A
  1. Defective near vision

2. Asthenopic symptoms(over active near reflex)

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16
Q

Signs of Hmt

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A
  1. Small eyeball
  2. AC shallow
  3. ESOTROPIA
17
Q

Fundus signs in Hmt

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A
  1. Pseudopapillitis

2. Shot silk fundus

18
Q

Complications of Hmt

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A
  1. Recurrent styles,chalazia
  2. Accomodation convergent squint
  3. Amblyopia
  4. PACG- prevent mydriatic use in elderly hypermetropes
19
Q

Management of Hmt

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A
  1. Convex(+) sphere spectacles
  2. Contact lens-U/L Hmt
  3. Surgery-1.Cond keratoplasty-radiofreq,upto 3D
    2. Thermal keratoplasty=THC-YAG laser
    3. Hyperopic laser-upto +4D
  4. Lens based-1.ICL upto +4D
    2. Refractive lens exchange-mainly in presbyopes
20
Q

What is astigmatism?

Study These Flashcards
A

A cylindrical refractive error in which both the horizontal nd vertical meridians have different refractory power.

21
Q

Types of regular astigmatism?

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A
  1. Simple myopic
  2. Simple Hypermetropic
  3. Compound myopic
  4. Compound Hypermetropic
  5. Mixed
  6. With the rule
  7. Against the rule
  8. Oblique
22
Q

Causes of astigmatism?

Study These Flashcards
A
  1. Corneal
  2. Lenticular
  3. Retinal/Macular
23
Q

Symptoms nd signs nd investigationsof regular astigmatism

Study These Flashcards
A
  1. Asthenopia
  2. Elongation of objects
  3. Reading close to eyes
  4. Half closure of lids
  5. Head tilt

Ix

  1. Retinoscopy-2 diff refr powers in 2diff axes
  2. Keratometry-diff corneal curvatures in 2 principal meridians
  3. Astigmatic fan test
  4. Jackson cylinder test
24
Q

Management of regular astigmatism

Study These Flashcards
A
  1. Spectacles cylinder convex/concave
  2. Contact lens-rigid/soft/Toric
  3. Surgical-1.Astigmatic keratectomy(AK)
    2. Limbal relaxing incisions(LRI)-upto +2D
    3. Corneal “ “ (CRI)- “
    4. PARK-photoastigmatic refractive keratotomy
    5. Astigmatic LASIK-upto +5D
    6. smile
25
Lens used in astigmatism
Convex-plus-steep axis | Concave= - =flat axis
27
Mx of post keratoplasty astigmatism
1. Selective removal of sutures in steep meridians-1st performed 2. Arcuate relaxing incisions along steep meridians-upto 4-6D 3. Relaxing incisions comb with compression - upto 10D 4. Corneal wedge resection with suture closure of wound in flat meridian. - > 10D 5. LASIK
28
Symptoms nd signs of irregular astigmatism
1. Defective vision 2. Distortion of objects 3. Polyopia 1. Retinoscopy-irregular pupillary reflex 2. Slit lamp-corneal irregularity 3. Placido’s disc test-distorted circles(pg522) 4. CCT-irregular corneal curvature 1. Contact lens 2. PTK with excimer laser 3. Sx-Penetrating keratoplasty or DALK
29
Purkunje images
4 in normal eye | 2 in aphakic eye
30
What is anisometropia? | How much diff causes diplopia?
Diff refractory power btw2 eyes >2.5D nd >5% diff magnification causes diplopia. *1D=2% magnification Spectacles upto 4D Contact lens for higher IOL in aphakia, Refractive corneal Sx,PRL nd RLE(very high) Early t/t to prevent amblyopia
31
What is aniseikonia? Etiology? Types?
Images projected to the visual cortex from 2 retinae are in unequal in size nd or shape *Upto 5% well tolerated Etio-Optical,Retinal,Cortical 2 types-1.Symmetrical= Spherical,Cylindrical 2.Asymmetrical =Prismatic-inc in 1 direction Pin cushion-inc in 2 directions(high plus correction) Barrel- decr in 2 directions(high minus correction) Oblique distortion
32
What is presbyopia?
Condition of failing near vision d/t age related decrease in amplitude of Accomodation or Increase in punctuation proximum. Near point 7@10 yrs 25@40 yrs 33@45yrs
33
Causes of presbyopia?
Age related-1.Changes in lens- decrease elasticity or increase sclerosis 2.Decreased ciliary muscle power Premature causes-1.Uncorrected Hmt 2. Premature sclerosis 3. Chronic simple glaucoma
34
Presbyopic glasses guide
45 yrs=+1 to +1.25 50 yrs=+1.5 55 yrs=+2 60 yrs=+2. 5
35
Disadvantages of spectacles in aphakia
1. High magnification-diplopia 2. Spherical aberration-Pin cushion effect 3. Prismatic aberration-Roving ring scotoma/Jack in box phenomenon
36
What is cycloplegia? | Causes?
Paralysis of Accomodation 1. Drug ind-Atropine,HA 2. Paralytic internal ophthalmoplegia 3. Complete 3rd nerve paralysis 1. Blurring of near vision 2. Photophobia(glare) 3. Decrease in near Point
37
Spasm of Accomodation?
Excess Accomodation 1. Drug ind-strong miotics 2. spont Relaxed by atropine

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