What is total blindness indicative of?
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A problem in the eye itself or in the optic nerve before it reaches the optic chiasm.
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What is total blindness indicative of?
A problem in the eye itself or in the optic nerve before it reaches the optic chiasm.
What condition is associated with bitemporal hemianopia?
Lesions compressing the optic chiasm, such as a pituitary tumor or craniopharyngioma.
What does homonymous hemianopia indicate?
A lesion somewhere between the optic chiasm and the occiput.
What is proliferative diabetic retinopathy (PDR)?
A severe form of diabetic retinopathy characterized by the growth of new blood vessels in the retina.
What virus causes Dendritic Corneal Ulcers?
Herpes Simplex Virus.
What is tunnel vision a result of?
Chronic glaucoma.
What are the signs of non-proliferative diabetic retinopathy?
Microaneurysms, retinal hemorrhages, and exudates.
What is the normal response of the pupil to direct light?
Constricted pupil.
What is retinal detachment?
A condition in which the retina is separated into two layers: Retinal Pigment Epithelium (RPE) and sensory retina.
What is a characteristic of nuclear cataract?
Occurs in the center of the lens.
What is a characteristic appearance of Dendritic Corneal Ulcers?
Dendritic stained appearance.
What is focal diabetic maculopathy?
A condition where localized areas of retinal damage occur in the macula due to diabetes.
What are the three layers of the precorneal tear film?
Outer lipid layer, middle aqueous layer, inner mucin layer.
What does the consensual light reflex test for?
Efferent motor nerve (Oculomotor nerve).
What are the types of retinal detachment?
Primary (simple/rhegmatogenous) and secondary (tractional and exudative).
What temporary vision change might occur in the early stages of nuclear cataract?
Patients may become more nearsighted or experience temporary improvement in reading vision, known as 'second sight'.
What condition may cause central scotoma?
Macular degeneration.
What is a common cause of gradual painless loss of vision?
Diabetic Retinopathy.
What are common predisposing factors for Herpes Simplex Corneal Ulcers?
Fevers, menstruation, and immunosuppressive drugs.
What characterizes diffuse diabetic maculopathy?
Widespread retinal damage affecting the macula, leading to vision impairment.
What is the function of the outer lipid layer of the precorneal tear film?
Reduces evaporation and lubricates the eyeball.
What is the significance of the swinging light test?
It tests for Relative Afferent Pupillary Defect (RAPD) for the optic nerve.
What visual distortion can occur with macular degeneration?
Distortion of straight lines.
What happens to vision as nuclear cataract progresses?
The lens gradually turns yellow and clouds vision.
What causes tractional retinal detachment?
The retina is pulled by vitreous fibrosis due to conditions like cyclitic membrane, organized vitreous hemorrhage, and proliferative diabetic retinopathy.
What are the common diseases of the eyelid?
Blepharitis, Hordeolum, Chalazion, Pre-septal and Orbital Cellulitis.
What are the symptoms of Herpetic Epithelial Keratitis?
Symptoms are similar to those of corneal ulcers.
What is ischaemic diabetic maculopathy?
A condition where reduced blood flow to the macula causes damage and vision loss.
Which glands produce the outer lipid layer of the precorneal tear film?
Meibomian gland and gland of Zeis.
What does a normal red reflex indicate?
Clear lens.
What difficulties might patients with nuclear cataract face?
Seeing in dim light and driving at night may be especially troublesome.
What is a common cause of transient visual loss that returns to normal within 24 hours?
Amaurosis fugax.
What are the two types of glaucoma covered in the tutorial?
Angle Closure Glaucoma and Primary Open Angle Glaucoma.
What is exudative retinal detachment?
The retina is pushed by fluid from the choroid that gains access to the subretinal space through damaged RPE.
What is the treatment for Herpetic Epithelial Keratitis?
Local antiviral drugs like Acyclovir and TFT eye drops.
What is diabetic macular edema (ME)?
Swelling of the macula due to fluid accumulation from damaged blood vessels in diabetic retinopathy.
What is the source of the middle aqueous layer of the precorneal tear film?
Lacrimal gland, accessory gland of Krause, and Wolfring.
What does reduced red reflex suggest?
Immature cataract.
What are the potential causes of painless visual loss?
Retinal artery occlusion, retinal vein occlusion, ischemic optic neuropathy, retinal detachment.
What are the treatment options for tractional retinal detachment?
Vitrectomy.
What are the causes of acute red eye?
Iritis, Conjunctivitis, and Corneal Ulcer.
What areas of the lens can be involved in cortical cataract?
It may involve the anterior, posterior, or equatorial cortex.
What is contraindicated in the treatment of Herpetic Epithelial Keratitis?
Corticosteroids.
What are the functions of the middle aqueous layer?
Supplies oxygen and has antibacterial function.
What is the surgical definition of a cataract?
Opacification of the lens.
What is the normal color of the optic disk?
Pink.
What is the most common type of diabetes associated with diabetic retinopathy?
Type 1 diabetes mellitus.
What conditions can cause painful visual loss?
Acute angle closure glaucoma, uveitis, optic neuritis, endophthalmitis.
What is a must-know condition related to the retina?
Retinal Detachment.
How do opacities start in cortical cataract?
They start as clefts and vacuoles between the lens fibers due to hydration of the cortex.
What are the early symptoms of retinal detachment?
Flashes of light (photopsia) and floaters (musca volitans).
What is a common clinical picture of Herpes Zoster Ophthalmicus?
Dermatoblepharitis, epithelial keratitis, and secondary glaucoma.
What is the major cause of blindness related to cataracts?
Cataracts are a major and preventable cause of blindness.
What is the first step in managing Diabetic Retinopathy?
Complete Ocular Examination.
What is the role of the inner mucin layer in the precorneal tear film?
Converts the corneal epithelium from hydrophobic to hydrophilic surface.
What should be noted about the macula during examination?
Presence of hemorrhage or exudate.
What are the two main pathogenesis mechanisms of diabetic retinopathy?
Microvascular occlusion and microvascular leakage.
What is the difference between monocular and binocular diplopia?
Monocular diplopia remains when the uninvolved eye is occluded; binocular diplopia is eliminated when either eye is occluded.
What is a significant ocular manifestation in neurological disorders?
Eye Manifestations in Neurological Disorders.
What late symptoms indicate retinal detachment?
Field defect (black curtain) and failure of vision in foveal involvement.
What is the treatment for Herpes Zoster Ophthalmicus?
Acyclovir tablets and steroids with antibiotic ointments.
What is a corneal ulcer?
Loss of corneal epithelium with inflammation in the surrounding area.
What is the limbus in relation to the cornea?
It is the border between the cornea and conjunctiva where corneal epithelium stem cells are found.
What is the most common type of cataract?
Age-related cataract.
What does a pupil that is round but not symmetrical indicate?
One pupil is more dilated than the other, which may indicate an abnormality.
What tests are included in a complete ocular examination for Diabetic Retinopathy?
Visual acuity, local examination, intra-ocular pressure, pupil assessment, and slit lamp examination.
Which cells produce the inner mucin layer of the precorneal tear film?
Conjunctival goblet cells, gland of Henle, and Manz.
What are some risk factors for diabetic retinopathy?
Duration of diabetes, poor metabolic control, pregnancy, hypertension, nephropathy, obesity, hyperlipidemia, and anemia.
What are common causes of flashes of light?
Retinal break, retinal detachment, posterior vitreous detachment, migraine.
What are some risk factors for retinal detachment?
Chorio-retinal degeneration (high myopia), blunt trauma, aphakia, and family history of RD.
What is a common corneal disease that students must know?
Corneal Ulcer.
What are the ocular complications associated with Herpes Zoster Ophthalmicus?
Retinal vasculitis, optic nerve issues, and orbital edema.
Why is a corneal ulcer considered an ocular emergency?
It is one of the common causes of blindness.
What is the appearance of opacities in cortical cataract?
They result in typical radial spoke-like opacities.
What are the five layers of the cornea?
Name a congenital cause of cataracts.
Genetic and metabolic diseases such as Down's syndrome.
What is the most common cause of central vision loss in the elderly in developed countries?
Age-related macular degeneration (ARMD).
What is the significance of checking for Neovascularisation of the iris and angle?
It helps identify potential complications in Diabetic Retinopathy.
What is classified as no apparent retinopathy?
The first stage of diabetic retinopathy classification.
What is the significance of a clear lens with a normal red reflex?
Indicates no cataract or lens opacity.
What is a corneal ulcer classified as?
An ocular emergency.
What can cause light sensitivity (photophobia)?
Corneal abnormality, anterior uveitis, albinism, congenital glaucoma.
What is proptosis?
Proptosis refers to the abnormal protrusion of the eye.
What are early complications of non-perforated corneal ulcers?
What is the purpose of prophylactic treatment for retinal detachment?
To treat retinal breaks and peripheral predisposing retinal lesions by laser or cryotherapy.
What is a common age-related eye condition?
Age Related Macular Degeneration.
What are some acquired causes of cataracts?
Age-related cataract, traumatic cataract, metabolic diseases, diabetes mellitus, and certain drugs.
What are the main indications for cataract surgery?
Visual indication, medical indication, and cosmetics.
What are the two types of Age-related Macular Degeneration?
Dry (non-exudative) and Wet (exudative).
What is the purpose of a Dilated Fundus Examination?
To rule out neovascularization and macular edema.
Why is early diagnosis of corneal ulcers important?
It can save vision.
What are common causes of itchy eyes?
Conjunctivitis (especially allergic), blepharitis, dry-eye syndrome, topical drug allergy.
What conditions can cause eyelid abnormalities such as ectropion and entropion?
Ectropion is the outward turning of the eyelid, while entropion is the inward turning, both can lead to discomfort and potential corneal ulcers.
What are late complications of non-perforated corneal ulcers?
What surgical methods are used for curative treatment of retinal detachment?
Scleral buckling and pars plana vitrectomy.
What characterizes mild non-proliferative diabetic retinopathy (NPDR)?
Presence of microaneurysms only.
What is a key skill practiced in the skill lab?
Eye Exam.
What are the four levels of visual function?
What parameters are used for IOL power calculation?
A-scan and keratometry.
List some risk factors for developing cataracts.
Age, diabetes mellitus, excessive sunlight exposure, radiation exposure, prolonged use of steroids, and smoking.
What are some predisposing factors for Age-related Macular Degeneration?
Age, hypertension, cardiovascular diseases, excessive sunlight exposure, poor nutrition, obesity, smoking, family history, and light-colored iris.
What laboratory investigations are recommended for Diabetic Retinopathy management?
Fasting blood sugar and glycosylated hemoglobin.
What should be done before applying antibiotic drops for corneal ulcers?
Corneal scrapings should be taken first.
What conditions can lead to night blindness?
Refractive error, advanced glaucoma, small pupil, retinitis pigmentosa, vitamin A deficiency.
What is trichiasis and its potential consequence?
Trichiasis is the misdirection of eyelashes towards the eye, which can lead to corneal ulcers.
What is a specific characteristic of Acanthamoeba as a causative agent of corneal ulcers?
Transmitted when washing contact lenses with tap water.
What defines severe non-proliferative diabetic retinopathy (NPDR)?
More than 20 intraretinal hemorrhages in each quadrant, two quadrants of venous beading, or one quadrant of prominent intra-retinal microvascular abnormalities (IRMA).
What is a condition characterized by optic nerve inflammation?
Optic Neuritis.
What are some local predisposing factors for corneal ulcers?
Trauma, loss of corneal sensations, ocular causes like xerosis, vitamin A deficiency, lagophthalmos, and prolonged use of steroids.
What type of cells make up the corneal epithelium?
Stratified squamous non-keratinized cells, including surface flat cells, intermediate polyhedral cells, and basal columnar cells.
What visual acuity defines Normal Vision?
20/20 or 6/6.
What are the types of cataracts based on location?
Nuclear cataract, cortical cataract, and posterior/anterior subcapsular cataract.
What does the A-scan measure in cataract surgery?
Axial length.
What treatment options are available for Clinically Significant Macular Edema?
Focal or grid laser treatment and anti-VEGF agents.
What are the Amsler Grid findings associated with ARMD?
Distorted horizontal and vertical lines, and central scotoma.
What are some reversible causes of gradual painless loss of vision?
Refractive error, cataract, diabetic retinopathy.
What type of antibiotics are used for corneal ulcers?
Topical broad-spectrum antibiotic eye drops.
What are the causes of ocular pain?
Corneal abrasion, foreign body, anterior uveitis, scleritis, acute angle closure glaucoma.
What is the significance of visual acuity (VA) testing?
Visual acuity testing assesses the clarity of vision, often using a Snellen chart.
What is a significant risk associated with Diphtheria in corneal ulcers?
It can penetrate normal corneal epithelium, causing corneal ulcer.
What is proliferative diabetic retinopathy (PDR)?
Characterized by neovascularization at the optic disc or elsewhere, vitreous/pre-retinal hemorrhage.
What is the primary characteristic of an ulcer with lagophthalmos?
A primary ulcer in the lower 1/3 of the cornea with incomplete lid closure.
What are some general predisposing factors for corneal ulcers?
Malnutrition, diabetes, liver and renal failure, and pregnancy.
What is the function of Bowman's membrane?
It is an acellular condensation that never regenerates and ends as a round border.
What are the maturity stages of cataracts?
Immature, mature, hypermature, and Morgagnian cataracts.
What visual acuity range defines Low Vision?
Less than 3/60 to 6/18 or a corresponding visual field loss to less than 20° in the better eye.
What is the purpose of a B-scan in cataract evaluation?
To check for any vitreous or retinal disorder.
What is a common symptom of Dry ARMD?
Gradual loss of vision and metamorphopsia (straight lines appearing wavy or bent).
How often should patients with Mild NPDR be followed up?
Every 9 months.
What is the duration for isolating aerobic bacteria in keratitis?
Most are seen within 48 hours; some may be recognized in 12 to 15 hours.
What are some irreversible causes of gradual painless loss of vision?
Chronic open angle glaucoma, optic atrophy, age-related macular degeneration (ARMD), retinitis pigmentosa (RP).
What are early complications of perforated corneal ulcers?
What does a result of 6/60 indicate in visual acuity testing?
It indicates that the patient can see at 6 meters what a person with normal vision can see at 60 meters.
What can cause periorbital pain?
Trauma, pre-septal cellulitis, herpes infection.
What is asthenopia?
Eye strain or fatigue, often associated with prolonged visual tasks.
What percentage of diabetics are affected by proliferative diabetic retinopathy?
5-10%.
What is Bell's phenomenon?
A reflex that occurs when the eye is closed, causing the eyeball to move upward.
What percentage of corneal thickness is made up by the stroma?
90%.
What are common causative organisms of corneal ulcers?
Bacterial (e.g., Gonococcus, Diphtheria, Pneumococcus), fungal (e.g., Aspergillus, Fusarium), viral (e.g., Herpes Simplex Virus, Herpes Zoster Virus), and Acanthamoeba.
What are common symptoms of cataracts?
Painless gradual loss of vision, misty or blurred vision, glare, dull colors, frequent changes in prescription, and monocular diplopia.
What visual acuity defines Blindness?
Less than 3/60 or a corresponding visual field loss to less than 10° in the better eye.
What is the significance of drusen in the macular region?
It is an early finding in ARMD, appearing as bright yellow or white masses below the vessels.
What is the recommended follow-up for Severe NPDR?
Every 3 months.
What are the components of preoperative evaluation for cataract surgery?
Complete ocular examination including visual acuity, pupil reaction, IOP, ocular adnexa, slit lamp examination, and dilated fundus examination.
How long should aerobic cultures be held?
For 7 days.
What is a common symptom of cataract?
Glare in the dark and difficulty driving at night.
What is the River Green Sign associated with?
It indicates a positive Seidel test in cases of corneal fistula.
What is the purpose of the pinhole test in vision assessment?
The pinhole test is used to exclude refractive errors in visual acuity.
What are potential causes of orbital pain?
Orbital cellulitis, trauma, sinusitis, orbital tumor, migraine.
What is diabetic maculopathy?
An advanced form of diabetic retinopathy that includes focal, diffuse, ischemic types, and macular edema.
What are the risk factors for fungal ulcers?
Impaired host defense/immunity, trauma by vegetable matter, preexisting corneal disease, surgical manipulation, and drugs like antibiotics and steroids.
What causes tearing and lacrimation?
Inflammation or irritation of the eye.
What is the treatment for an ulcer with lagophthalmos?
Methyl cellulose drops 0.5% several times a day and the Torsarov procedure to suture the lower lid until the ulcer heals.
What are the main symptoms of a corneal ulcer?
Severe pain, diminution of vision, photophobia, lacrimation, and blepharospasm.
What is the role of Descemet's membrane?
It is a homogeneous, highly elastic, and resistant layer that easily regenerates.
What are some signs of cataracts?
Lens opacity and reduced visual acuity.
What are some psychosocial impacts of visual impairment?
Loss of confidence, fear of isolation, possibility of depression, lost education and employment opportunities, lower productivity, impaired quality of life.
What treatments are available for Age-related Macular Degeneration?
Antioxidants, vitamins, Omega 3, Zinc, low vision aids, and in the case of Wet ARMD, photocoagulation, photodynamic therapy, and anti-VEGF treatments.
What is the immediate treatment for Proliferative Diabetic Retinopathy?
Full Pan-Retinal Photocoagulation (PRP) immediately.
What are the three types of cataract surgery?
Phacoemulsification with PCIOL, ECCE with PCIOL, and ICCE.
What is the treatment for cataract?
Cataract surgery.
What is the reported culture positive rate in presumed infectious keratitis?
Varies from 40 to 73%.
What defines diabetic macular edema (ME)?
Retinal thickening within 500 μm of the foveal center or hard exudates associated with thickening.
What does a fixed head and eye position indicate during an eye examination?
It indicates that the patient may have limitations in ocular motility or pain.
What are late complications of perforated corneal ulcers?
What are the main causative agents of fungal ulcers?
Fusarium (filamentary fungi), Candida (yeast forming fungi), and Aspergillus.
What is epiphora?
Excessive tearing due to obstruction in the tear drainage pathway.
What defines keratoconus?
Progressive conical protrusion of the cornea starting at puberty due to weakness of the central part.
What is the primary nerve supply to the cornea?
The 5th cranial nerve (trigeminal nerve), specifically the ophthalmic division.
What signs may indicate a corneal ulcer?
Lid edema, conjunctival injection, corneal opacity, loss of luster, hypopyon, and exaggerated corneal sensation.
What are some reversible causes of gradually declining vision?
Refractive Error, Cataract, Diabetic Retinopathy (DR).
What are the symptoms of Wet ARMD?
Abrupt onset and rapid worsening of symptoms, visual distortions, reduced central vision, decreased color intensity, and a well-defined blurry or blind spot.
What is the initial treatment for Laser panretinal photocoagulation?
2000 - 3000 burns.
When is ICCE indicated?
Intraoperative conversion from phacoemulsification or ECCE with extensive zonular disruption or planned ICCE in cases of lens dislocation.
What are the stages of diabetic retinopathy?
No DR, NPDR, PDR, diabetic maculopathy.
What are the criteria for a significant positive culture?
Clinical signs of keratitis plus growth of organism in two or more media or confluent growth in one solid media.
What is the indication for using Gentamycin in corneal ulcers?
Effective against Gram-negative bacteria and most Staphylococcus species.
What are common causes of red eye?
Trichiasis, conjunctivitis, keratitis, and trauma.
What are the clinical features of fungal ulcers?
Little or no ciliary injection, raised dry grey-white lesions with feathery margins, satellite lesions, stromal deep infiltrate, endothelial plaques, and hypopyon.
What does the presence of hypopyon in the anterior chamber indicate?
Hypopyon indicates the presence of inflammatory cells in the anterior chamber, often due to infection or inflammation.
What are the early signs of keratoconus?
Spinning or scissoring retinoscopy, ring distortion on Placido disc, and mild keratometry readings (<48D).
How does the cornea receive nutrition?
Through diffusion from the tear film, aqueous humor, and limbal capillaries.
What is the pathogenesis of corneal ulcers?
Pathogenic bacteria colonize the corneal stroma, leading to an inflammatory reaction, antigen-antibody response, and subsequent necrosis and thinning of the cornea.
What are some irreversible causes of gradually declining vision?
Primary Open-Angle Glaucoma (POAG), Age-Related Macular Degeneration (ARMD), Optic Atrophy, Hereditary Retinal Dystrophies.
What are some signs of Wet ARMD?
Subretinal fluid, retinal edema, grey-green discoloration under the macula, exudates, retinal pigment epithelium detachment, and subretinal hemorrhage.
What happens during cataract surgery?
The clouded lens is removed and a clear artificial lens is implanted.
When is a corneal biopsy indicated?
In cases of deep stromal infiltrates like intra-stromal abscess and deep mycotic keratitis.
What is a classic symptom of age-related macular degeneration?
Distortion of vision, where straight lines appear wavy.
What is the concentration of Ciprofloxacin used for corneal ulcers?
0.3% for both guttae and ointment.
What is lagophthalmos?
Inability to close the eyelids completely.
What is the role of the ophthalmic branch of the trigeminal nerve (CN V) in eye examinations?
It is responsible for corneal sensation, which can be tested using light touch with cotton wool.
What is the treatment for fungal ulcers?
Scrapings, topical antifungals (Natamycine 5%, Miconazole 1%, Amphotericin B 0.3%), systemic antifungals (Ketoconazole 400mg/day, Fluconazole 400mg/day), and surgical treatment (PKP).
What is Munson's sign?
Notching of the lower lid when looking down, indicative of keratoconus.
What are the stages of pathology in corneal ulcers?
Infiltration stage, ulceration stage, and healing stage.
What anatomical factors contribute to corneal transparency?
Avascular structure, non-keratinized epithelium, regular stromal lamellae, non-myelinated nerves, and precorneal tear film.
What does improvement with Pin-Hole (IPH) indicate?
Refractive Error.
What is the purpose of cycloplegics in corneal ulcer management?
To relieve ciliary spasm and prevent formation of posterior synechiae.
What are the advantages of phacoemulsification over ECCE?
Smaller wound, suture-less, faster wound healing, and faster vision recovery.
What is the classic clinical triad of retinitis pigmentosa?
Arteriolar attenuation, retinal bony spicule pigmentation, waxy disc pallor.
Which antibiotic is known for broad-spectrum coverage including Pseudomonas?
Norfloxacin.
