Notes opthalmology year 4

90%.

A condition in which the retina is separated into two layers: Retinal Pigment Epithelium (RPE) and sensory retina.

Widespread retinal damage affecting the macula, leading to vision impairment.

Seeing in dim light and driving at night may be especially troublesome.

Orbital cellulitis, trauma, sinusitis, orbital tumor, migraine.

Herpes Simplex Virus.

Patients may become more nearsighted or experience temporary improvement in reading vision, known as 'second sight'.

Microaneurysms, retinal hemorrhages, and exudates.

Diabetic Retinopathy.

Meibomian gland and gland of Zeis.

Vitrectomy.

Occurs in the center of the lens.

Reduces evaporation and lubricates the eyeball.

Amaurosis fugax.

Corticosteroids.

Complete Ocular Examination.

One pupil is more dilated than the other, which may indicate an abnormality.

Genetic and metabolic diseases such as Down's syndrome.

Chronic glaucoma.

Macular degeneration.

A condition where reduced blood flow to the macula causes damage and vision loss.

Retinal artery occlusion, retinal vein occlusion, ischemic optic neuropathy, retinal detachment.

They start as clefts and vacuoles between the lens fibers due to hydration of the cortex.

Acyclovir tablets and steroids with antibiotic ointments.

Retinal vasculitis, optic nerve issues, and orbital edema.

Proptosis refers to the abnormal protrusion of the eye.

1. Corneal opacity (nebula, macula, leucoma), 2. Keratectasia (ectopic cornea, weak corneal scar & increased IOP).

Trichiasis is the misdirection of eyelashes towards the eye, which can lead to corneal ulcers.

Refractive error, cataract, diabetic retinopathy.

To check for any vitreous or retinal disorder.

Constricted pupil.

Fevers, menstruation, and immunosuppressive drugs.

Clear lens.

Iritis, Conjunctivitis, and Corneal Ulcer.

Dermatoblepharitis, epithelial keratitis, and secondary glaucoma.

It is the border between the cornea and conjunctiva where corneal epithelium stem cells are found.

They result in typical radial spoke-like opacities.

To treat retinal breaks and peripheral predisposing retinal lesions by laser or cryotherapy.

Presence of microaneurysms only.

More than 20 intraretinal hemorrhages in each quadrant, two quadrants of venous beading, or one quadrant of prominent intra-retinal microvascular abnormalities (IRMA).

Corneal abrasion, foreign body, anterior uveitis, scleritis, acute angle closure glaucoma.

Every 9 months.

A severe form of diabetic retinopathy characterized by the growth of new blood vessels in the retina.

Primary (simple/rhegmatogenous) and secondary (tractional and exudative).

Blepharitis, Hordeolum, Chalazion, Pre-septal and Orbital Cellulitis.

Lacrimal gland, accessory gland of Krause, and Wolfring.

Acute angle closure glaucoma, uveitis, optic neuritis, endophthalmitis.

Eye Manifestations in Neurological Disorders.

Chorio-retinal degeneration (high myopia), blunt trauma, aphakia, and family history of RD.

An ocular emergency.

Conjunctivitis (especially allergic), blepharitis, dry-eye syndrome, topical drug allergy.

Corneal scrapings should be taken first.

Focal or grid laser treatment and anti-VEGF agents.

A problem in the eye itself or in the optic nerve before it reaches the optic chiasm.

A condition where localized areas of retinal damage occur in the macula due to diabetes.

Distortion of straight lines.

The retina is pushed by fluid from the choroid that gains access to the subretinal space through damaged RPE.

Opacification of the lens.

Presence of hemorrhage or exudate.

Conjunctival goblet cells, gland of Henle, and Manz.

It helps identify potential complications in Diabetic Retinopathy.

Dry (non-exudative) and Wet (exudative).

Age, diabetes mellitus, excessive sunlight exposure, radiation exposure, prolonged use of steroids, and smoking.

20/20 or 6/6.

A primary ulcer in the lower 1/3 of the cornea with incomplete lid closure.

Lesions compressing the optic chiasm, such as a pituitary tumor or craniopharyngioma.

Outer lipid layer, middle aqueous layer, inner mucin layer.

The lens gradually turns yellow and clouds vision.

Local antiviral drugs like Acyclovir and TFT eye drops.

Pink.

Microvascular occlusion and microvascular leakage.

Duration of diabetes, poor metabolic control, pregnancy, hypertension, nephropathy, obesity, hyperlipidemia, and anemia.

The first stage of diabetic retinopathy classification.

To rule out neovascularization and macular edema.

Age, hypertension, cardiovascular diseases, excessive sunlight exposure, poor nutrition, obesity, smoking, family history, and light-colored iris.

Nuclear cataract, cortical cataract, and posterior/anterior subcapsular cataract.

Malnutrition, diabetes, liver and renal failure, and pregnancy.

Trauma, pre-septal cellulitis, herpes infection.

Complete ocular examination including visual acuity, pupil reaction, IOP, ocular adnexa, slit lamp examination, and dilated fundus examination.

It is a homogeneous, highly elastic, and resistant layer that easily regenerates.

Fusarium (filamentary fungi), Candida (yeast forming fungi), and Aspergillus.

Effective against Gram-negative bacteria and most Staphylococcus species.

Distortion of vision, where straight lines appear wavy.

Arteriolar attenuation, retinal bony spicule pigmentation, waxy disc pallor.

A lesion somewhere between the optic chiasm and the occiput.

Efferent motor nerve (Oculomotor nerve).

The retina is pulled by vitreous fibrosis due to conditions like cyclitic membrane, organized vitreous hemorrhage, and proliferative diabetic retinopathy.

Swelling of the macula due to fluid accumulation from damaged blood vessels in diabetic retinopathy.

Type 1 diabetes mellitus.

Monocular diplopia remains when the uninvolved eye is occluded; binocular diplopia is eliminated when either eye is occluded.

Retinal break, retinal detachment, posterior vitreous detachment, migraine.

Indicates no cataract or lens opacity.

It can save vision.

Fasting blood sugar and glycosylated hemoglobin.

Axial length.

It is an acellular condensation that never regenerates and ends as a round border.

Eye strain or fatigue, often associated with prolonged visual tasks.

Glare in the dark and difficulty driving at night.

Loss of confidence, fear of isolation, possibility of depression, lost education and employment opportunities, lower productivity, impaired quality of life.

Progressive conical protrusion of the cornea starting at puberty due to weakness of the central part.

Little or no ciliary injection, raised dry grey-white lesions with feathery margins, satellite lesions, stromal deep infiltrate, endothelial plaques, and hypopyon.

Inability to close the eyelids completely.

Trauma, burns, thyroid eye disease, and blepharitis.

Congenital enlargement of the anterior segment with a large cornea and deep anterior chamber.

Lamellar (superficial ulcer) and penetrating (whole thickness ulcer).

Dendritic stained appearance.

It tests for Relative Afferent Pupillary Defect (RAPD) for the optic nerve.

Angle Closure Glaucoma and Primary Open Angle Glaucoma.

Supplies oxygen and has antibacterial function.

Converts the corneal epithelium from hydrophobic to hydrophilic surface.

Visual acuity, local examination, intra-ocular pressure, pupil assessment, and slit lamp examination.

Age-related macular degeneration (ARMD).

Age-related cataract, traumatic cataract, metabolic diseases, diabetes mellitus, and certain drugs.

A-scan and keratometry.

Stratified squamous non-keratinized cells, including surface flat cells, intermediate polyhedral cells, and basal columnar cells.

Characterized by neovascularization at the optic disc or elsewhere, vitreous/pre-retinal hemorrhage.

1. Iris prolapse, 2. Anterior synechia, 3. Corneal fistula, 4. Malposition of the lens, 5. Intra-ocular hemorrhage.

Every 3 months.

Severe pain, diminution of vision, photophobia, lacrimation, and blepharospasm.

1. Anterior polar cataract, 2. Leucoma adherent, 3. Anterior staphyloma, 4. Secondary glaucoma, 5. Atrophia bulbi.

Clinical signs of keratitis plus growth of organism in two or more media or confluent growth in one solid media.

In cases of deep stromal infiltrates like intra-stromal abscess and deep mycotic keratitis.

Smaller wound, suture-less, faster wound healing, and faster vision recovery.

Age, family history of glaucoma, diabetes mellitus, myopia.

Know and accept the reality of the condition, learn to use residual vision, and seek support.

Symptoms are similar to those of corneal ulcers.

Immature cataract.

Retinal Detachment.

Field defect (black curtain) and failure of vision in foveal involvement.

Corneal Ulcer.

Corneal abnormality, anterior uveitis, albinism, congenital glaucoma.

Ectropion is the outward turning of the eyelid, while entropion is the inward turning, both can lead to discomfort and potential corneal ulcers.

Refractive error, advanced glaucoma, small pupil, retinitis pigmentosa, vitamin A deficiency.

Distorted horizontal and vertical lines, and central scotoma.

Immature, mature, hypermature, and Morgagnian cataracts.

5-10%.

It indicates a positive Seidel test in cases of corneal fistula.

Antioxidants, vitamins, Omega 3, Zinc, low vision aids, and in the case of Wet ARMD, photocoagulation, photodynamic therapy, and anti-VEGF treatments.

The 5th cranial nerve (trigeminal nerve), specifically the ophthalmic division.

Hypopyon indicates the presence of inflammatory cells in the anterior chamber, often due to infection or inflammation.

It is responsible for corneal sensation, which can be tested using light touch with cotton wool.

It indicates normal anatomical structure without signs of pathology.

Bulging of the eye, often due to thyroid eye disease or orbital cellulitis.

Accumulation of pus in the anterior chamber of the eye.

It may involve the anterior, posterior, or equatorial cortex.

Cataracts are a major and preventable cause of blindness.

Age-related cataract.

1. Epithelium 2. Bowman's membrane 3. Stroma 4. Descemet's membrane 5. Endothelium.

Age Related Macular Degeneration.

Eye Exam.

Optic Neuritis.

Visual acuity testing assesses the clarity of vision, often using a Snellen chart.

Most are seen within 48 hours; some may be recognized in 12 to 15 hours.

It is an early finding in ARMD, appearing as bright yellow or white masses below the vessels.

Methyl cellulose drops 0.5% several times a day and the Torsarov procedure to suture the lower lid until the ulcer heals.

It indicates that the patient may have limitations in ocular motility or pain.

No DR, NPDR, PDR, diabetic maculopathy.

The clouded lens is removed and a clear artificial lens is implanted.

To relieve ciliary spasm and prevent formation of posterior synechiae.

Penetrating keratoplasty and lamellar keratoplasty.

Large cornea diameter, deep anterior chamber, tremulous iris, and subluxation of the lens.

Arcus Juvenilis may occur in hyperlipidemia or juvenile diabetes mellitus.

Flashes of light (photopsia) and floaters (musca volitans).

Loss of corneal epithelium with inflammation in the surrounding area.

It is one of the common causes of blindness.

1. Secondary iridocyclitis (toxins), 2. Secondary glaucoma (open angle), 3. Descematocele (small translucent bleb).

Scleral buckling and pars plana vitrectomy.

Transmitted when washing contact lenses with tap water.

Topical broad-spectrum antibiotic eye drops.

Gradual loss of vision and metamorphopsia (straight lines appearing wavy or bent).

Bacterial (e.g., Gonococcus, Diphtheria, Pneumococcus), fungal (e.g., Aspergillus, Fusarium), viral (e.g., Herpes Simplex Virus, Herpes Zoster Virus), and Acanthamoeba.

An advanced form of diabetic retinopathy that includes focal, diffuse, ischemic types, and macular edema.

Cataract surgery.

Abrupt onset and rapid worsening of symptoms, visual distortions, reduced central vision, decreased color intensity, and a well-defined blurry or blind spot.

Pathogenic bacteria colonize the corneal stroma, leading to an inflammatory reaction, antigen-antibody response, and subsequent necrosis and thinning of the cornea.

Infiltration stage, ulceration stage, and healing stage.

Vascularization and fibrous tissue formation leading to scarring.

Topical beta blockers.

Trauma, herpes simplex/zoster iritis, or blood dyscrasia.

Visual indication, medical indication, and cosmetics.

1. Normal Vision 2. Visual Impairment (Low Vision, Moderate Visual Impairment, Severe Visual Impairment) 3. Blindness

Trauma, loss of corneal sensations, ocular causes like xerosis, vitamin A deficiency, lagophthalmos, and prolonged use of steroids.

It can penetrate normal corneal epithelium, causing corneal ulcer.

Chronic open angle glaucoma, optic atrophy, age-related macular degeneration (ARMD), retinitis pigmentosa (RP).

Less than 3/60 or a corresponding visual field loss to less than 10° in the better eye.

Inflammation or irritation of the eye.

Retinal thickening within 500 μm of the foveal center or hard exudates associated with thickening.

Intraoperative conversion from phacoemulsification or ECCE with extensive zonular disruption or planned ICCE in cases of lens dislocation.

Subretinal fluid, retinal edema, grey-green discoloration under the macula, exudates, retinal pigment epithelium detachment, and subretinal hemorrhage.

Refractive Error.

Underlying pathology.

Swelling of the conjunctiva, often due to allergy or periocular inflammation.

A bilateral peripheral fatty degeneration common in old age, characterized by an arc-shaped opacity in the cornea.

Less than 3/60 to 6/18 or a corresponding visual field loss to less than 20° in the better eye.

A reflex that occurs when the eye is closed, causing the eyeball to move upward.

The pinhole test is used to exclude refractive errors in visual acuity.

Full Pan-Retinal Photocoagulation (PRP) immediately.

Lid edema, conjunctival injection, corneal opacity, loss of luster, hypopyon, and exaggerated corneal sensation.

Spinning or scissoring retinoscopy, ring distortion on Placido disc, and mild keratometry readings (<48D).

Scrapings, topical antifungals (Natamycine 5%, Miconazole 1%, Amphotericin B 0.3%), systemic antifungals (Ketoconazole 400mg/day, Fluconazole 400mg/day), and surgical treatment (PKP).

Acanthamoeba keratitis is associated with severe pain, punctate or dendritic keratitis, superficial stromal keratitis, partial or complete ring of infiltration, limbitis, and scleritis.

Cataract extraction with intraocular lens implant.

Glasses.

It indicates that the patient can see at 6 meters what a person with normal vision can see at 60 meters.

For 7 days.

Lens opacity and reduced visual acuity.

Excessive tearing due to obstruction in the tear drainage pathway.

Trichiasis, conjunctivitis, keratitis, and trauma.

0.3% for both guttae and ointment.

Norfloxacin.

Debridement, topical treatments (Diamidines, Biguanides, Aminoglycosides, Antifungals), and sometimes keratoplasty.

Progressive visual field loss, ring scotoma or tunnel vision, blindness in advanced cases.

Painless gradual loss of vision, misty or blurred vision, glare, dull colors, frequent changes in prescription, and monocular diplopia.

Impaired host defense/immunity, trauma by vegetable matter, preexisting corneal disease, surgical manipulation, and drugs like antibiotics and steroids.

Varies from 40 to 73%.

2000 - 3000 burns.

Primary Open-Angle Glaucoma (POAG), Age-Related Macular Degeneration (ARMD), Optic Atrophy, Hereditary Retinal Dystrophies.

Avascular structure, non-keratinized epithelium, regular stromal lamellae, non-myelinated nerves, and precorneal tear film.

42 diopters (D).

Replacement of an opaque lens with a clear healthy donor cornea.

Optical (central corneal opacities, keratoconus), therapeutic (resistant corneal ulcer, corneal fistula), tectonic (to restore eye shape and integrity), and cosmetic.

Phacoemulsification with PCIOL, ECCE with PCIOL, and ICCE.

Refractive Error, Cataract, Diabetic Retinopathy (DR).

Through diffusion from the tear film, aqueous humor, and limbal capillaries.

Notching of the lower lid when looking down, indicative of keratoconus.

Glasses, toric contact lenses, or hard contact lenses (RGP), and corneal collagen cross-linking with riboflavin.

To differentiate bacteria and fungi.

To observe corneal details and microorganisms in vivo without dyes or stains.

Too tight sutures can change corneal curvature leading to post-operative astigmatism, while too loose sutures can cause wound leaks and infections.

Fungal filaments in light yellow color.