Term
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Definition
| study of the distribution and determinants of disease in populations; helps narrow your differentials and direct your history |
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Definition
| habits, conditions, or characteristics that have been shown to increase one's odds of developing a disease |
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Definition
| disturbance of normal mechanical, physical and biochemical functions that a disease causes |
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Definition
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Definition
| any sensation or change in bodily function that is experienced by a patient |
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Definition
| feature of disease as detected by the doctor during examination |
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Definition
| additional problem that arises following a procedure, treatment or illness and is secondary to it |
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Term
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Definition
| certain symptom or sign is always that disease |
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Term
| What is the volume of the conical of the orbit? |
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Definition
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Term
| What does the orbit contain? |
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Definition
| External ocular muscles, opthalmic artery and its branches, orbital veins and nerves, CN II,III,IV,V,VI, lacrimal gland |
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Term
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Definition
| Bulging eye(s), a sign of underlying disease |
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Term
| What is axial proptosis vs. non-axial proptosis? |
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Definition
| Axial is intraconal and non-axial is extraconal. Axial is displaced along the visual axis and indicates possible dysthryoid eye disease. Non-axial is off the visual axis and indicator of tumors. |
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Term
| What are some signs/symptoms of proptosis? |
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Definition
| burning, irritation, fever, general malaise, pain, no pain, headaches, diplopia, blurred vision, EOM restriction, rapid pulse, irrtability, excessive sweating, fluctuating vision, pulsating, pressure feeling, nausea, afferent pupilary defect |
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Term
| Main signs/symptoms of proptosis? |
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Definition
| Change in appearance, diplopia, visual disturbances, EOM restriction |
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Definition
| Either the simulation of abnormal prominence, true assymmetry that is not the result of increased orbital contents |
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Term
| What is a blowout fracture? |
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Definition
| Break in floor of orbit (maxillary bone), more common than ethmoid fractures |
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Term
| What are some critical signs of recent blow-out fractures? |
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Definition
| Orbital creptitus (bones grinding together), hypoesthesia of the ipsilateral cheek (minor include edema, restriction of ocular EOMs) |
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Term
| what is orbital cellulitis? |
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Definition
| Infection posterior to the orbital septum, dangerous because close proximity to caverous sinus (meninges and brain) |
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Term
| What are some symptoms of cellulitis? |
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Definition
| Fever, lid edema, proptosis, significant pain, muscle restrictions, diplopia, vision loss, APD |
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Term
| What are 3 things that can be inflamed in the orbit? |
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Definition
| muscles, lacrimal gland, idiopathic |
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Term
| What is one way to treat a myositis? |
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Definition
| Treat it with a steroid to see if it will decrease swelling. |
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Term
| Definition of ocular surface disease? |
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Definition
| Any condition that REDUCES production, ALTERS the composition, or IMPEDES the distribution of the preocular tear film |
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Term
| What are the two most common ocular surface disorders? |
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Definition
| Tear film disorders & blepharitis |
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Term
| Name 4 lid/lash malformations and describe them. |
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Definition
Ecchymosis: bruising/accumulation of blood in the tissue
Entropion: inversion of lid margin
Trichiasis: lashes turning inward
Ectropion: eversion of the lid margin |
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Definition
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Definition
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Definition
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Definition
| scales from bacterial debris centered around the base of lashes |
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Term
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Definition
| dilated superficial blood vessel |
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Term
| Posterior margin staining |
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Definition
| ridge of staining, not good conj surface, blatant chronic disease |
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Term
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Definition
Active, localized, infection/inflammation.
External (involves follicles of lashes)
Internal (involves meibomian gland) |
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Term
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Definition
| What is left of the hordeolum after inflammation is gone. |
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Term
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Definition
| Mound of WBCS, if upper lid, Chlamydia |
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Term
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Definition
| small bump with associated vessel in center |
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Term
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Definition
| extra membrane attached to conj |
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Term
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Definition
| White areas on upper tarsal plate |
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Term
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Definition
| lower lid is attached to cornea |
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Term
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Definition
| White patches on the palp conj, normal part of aging, result of chronic inflammation or irritation |
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Term
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Definition
| indication of some kind of dry eye |
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Term
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Definition
| degeneration of collagen fibers in the conj, causes dry eye by improper lid closure |
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Definition
| growth of membrane into cornea |
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Term
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Definition
| build up of WBCs and fibrotic material on the limbal area |
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Term
| What is the function of the tear film? |
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Definition
1. provide smooth regular optical surface
2. remove waste
3. protective/bacteriolytic
4. lubrication
5. nutritional
6. promotes tissue maintenance and wound healing |
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Term
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Definition
1. inner most of three layers
2. produced by goblet cells
3. Coats the hydrophobic corneal epithelium with a hydrophilic layer
4. prevents pathogens reaching the surface and maintenance of ocular surface hydration |
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Term
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Definition
| Long chain molecules formed by corneal cells that help hold mucin to the corneal surface |
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Term
| What is the middle layer of the tear film and what is its function |
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Definition
| Aqueous layer; 1. nutrition and defense for cornea, (carries oxygen to, carries wastes away) proteins (lysozymes and lactoferrin, and vitamin A) |
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Term
| What are the 2 categories of aqueous-deficient dry eye? |
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Definition
| Sjogren's and non-sjogren's |
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Term
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Definition
| Autoimmune destruction of lacrimal and salivary glands, hyposecretion of tears and saliva |
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Term
| What causes non-sjogren's? |
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Definition
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Term
| What is the top layer of the tear film and what does it do? |
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Definition
| Lipid layer, mainly waxy and cholesterol ester. It has the tarsal gland (Zeis and Moll) and decreases evaporation of tear fluid and stabilizes tear film |
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Term
| What is Schrimer's Test 1? |
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Definition
| Done w/o anesthetic, measures total tears, >15mm in 5 mins = norm. <5mm diagnostic of dry eye |
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Term
| What is Schrimer's Test 2? |
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Definition
| Done with anesthetic, measure basal tears, > 10mm in 5 mins = norm, <3mm diagnostic |
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Term
| What is the tear clearance test? |
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Definition
| Instill fluroesceine into lower fornices, wait 5 mins, place strip for 5 min, below 96 = dry eye; below 34 = Sjogren's |
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Term
| What are the risk factors of dry eye? |
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Definition
1. Bone marrow transplantation and cancer survivors
2. Menopausal hormone therapy
3. Sex hormones
4. Essential fatty acids
5. Systemic medications
6. Low humidity environments
7. Computer use
8. Contact lens wear
9. Refractive surgery |
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Term
| 4 milestones of evolution of dry eye |
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Definition
1. loss of water from tear film
2. decreased conj goblet-cell density & corneal glycogen
3. increased corn. epi. desquam
4. destabilization of cornea-tear interface |
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Term
| Goals of treatment of dry eye |
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Definition
1. Relieve symptoms
2. Reduce inflammation
3. Re-establish normal ocular surface |
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Term
| What is Hering's law of equal innervation? |
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Definition
| We send info in a bilateral way; we send the same amount of neural impulse to R eye as we do to the L eye |
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Term
| 5 ways to classify ptosis? |
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Definition
1. Myogenic
2. Aponeurotic
3. Neurogenic
4. Mechanical
5. Traumatic |
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Term
| Difference between congenital and acquired ptosis? |
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Definition
Congenital: ptosis lid higher in down gaze; due to levator
Acquired: ptosis lid remains ptotic in all directions, due to aponeurosis usually |
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Term
| Name 3 acquired acquired neurogenic ptosis? |
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Definition
| Myasthenia gravis, horners, nerve palsy |
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Term
| Clinical symptoms of myasthenia gravis? |
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Definition
| Droopy eyelid, double vision, difficulty swallowing, breathing, chewing, easily fatigued |
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Term
| Explain myasthenia gravis and a test for diagnosis? |
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Definition
| Autoimmune disease where IgG seen on receptor end plates. Acetyl rep antibodies seen in 90% of pts, effects NMJs, could be secondary to thymona, thyroid, diseasee or infection |
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Term
| Congenital and acquired examples of mechanical ptosis? |
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Definition
Congenital: Capillary hemangioma
Acquired: Acquired neoplasm, involutional
S-shaped lid implies this kind. |
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Term
| 6 classifications of ectropion? |
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Definition
| Congenital, involutional, paralytic, cicatrical, inflammatory, mechanical |
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Term
| 4 classifications of entropion |
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Definition
1. congenital
2. acute spastic
3. involutional
4. cicatricial |
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Term
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Definition
| Dusting of pigment that deposits on endothelium |
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Term
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Definition
| Missing or absent endothelial cells |
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Term
| What is a posterior synechiae? |
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Definition
| Attachment of the pupillary margin of the iris to the anterior lens capsule |
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Term
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Definition
| has a prominent Schwalbe's line |
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Term
| Anatomy posterior to most anterior |
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Definition
| Iris root, ciliary body, scleral spur, trabecular meshwork, (J,C,I) Schwalbe's line |
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Term
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Definition
| highly pigmented Schwalbe's line |
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Term
| Peripheral Anterior Synechiae (PAS) |
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Definition
| iris has attached itself right above Schwalbe's line |
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Term
| Name some iris transillumination defects and why do you look for them? |
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Definition
| Glukomfleckon, pseudoexfoliation found in the pupillary margin and pigment dispersion in the periphery; used to evaluate glaucoma |
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Term
| What is pseudoexfoliation? |
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Definition
| Whitish material you see on anterior surface, get bull's eye effect |
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Term
| What is pigment dispersion syndrome? |
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Definition
| see in younger male patients, can see kruckenburg spindles |
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Term
| Angle Closure Glaucoma can be caused by 2 broad mechanisms. Name them and how these occur. |
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Definition
| Pushing forward of the iris: Pupillary block, choroidal hemorage, tumors, iris plateau. Pulling of the iris: rubeosis, inflammation |
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Term
| What can cause secondary open angle glaucoma? |
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Definition
1. Steroid induced
2. Angle recession
3. Pseudoexfoliation syndrome
4. Pigment dispersion syndrome |
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Term
| 4 classifications of primary ACG with pupillary block? |
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Definition
1. Suspect
2. Sub-acute
3. Acute
4. Chronic |
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Term
| Rate of Primary angle closure glaucoma |
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Definition
| Eskimo > Asians >> Caucasians = African |
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Term
| Who has the highest risk for acute angle closure glaucoma? |
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Definition
| Elderly phakic hyperopic females |
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Term
| What percentage of acute angle closure glaucoma is due to pupillary block? |
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Definition
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Term
| What is the provocative test? |
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Definition
| Take pt's pressures then have them sit in dark room for 45 minutes, retake; if pressures increase by 8mm or more, should be concerned a/b dilating |
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Term
| What can trigger pupillary block? |
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Definition
1. Diagnostic dilation
2. Dim lighting
3. Emotionally upsetting events
4. use of anti-cholinergic and sympathomimetic drugs |
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Term
| Symptoms of acute close angle glaucoma? |
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Definition
1. Blurred vision
2. Tearing
3. Halos
4. PAIN
5. Photophobia
6. Frontal HA
7. Nausea and vomiting |
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Term
| Signs of acute angle closure glaucoma? |
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Definition
1. Unilateral
2. Lid edema
3. Conjunctival injection
4. Corneal edema
5. Narrow angle
6. Fixed, mid-dilated pupil
7. Shallow AC
8. Extremely high IOP |
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Term
| What are the goals of treatment of acute angle closure glaucoma? |
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Definition
1. Reduction of IOP
2. Suppression of inflammation
3. Reversal of angle closure
4. Evaluation of fellow eye for treatment |
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Term
| When can you consider the attack over? |
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Definition
1. Mitotic pupil due to pilocarpine
2. Check the angle is open with gonio
3. IOP is normal |
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Term
| What are the goals of pharmaceutical therapies when it comes to acute angle closure glaucoma? |
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Definition
1. Block aqueous production
2. Reduce vitreous volume
3. Facilitate aqueous outflow
4. Stop inflammation |
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Term
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Definition
1. IOP spike
2. Iritis
3. Iris vessel bleed
4. Corneal edema
5. Posterior synechiae (iris adheres to lens)
6. Hasten cataract formation |
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Term
| Chronic Primary Angle Closure Glaucoma Rates |
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Definition
| Elderly patients w/o symptoms, females > males, Asian >>>> African > white |
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Term
| What is common with chronic angle closure glaucoma? |
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Definition
| Peripheral anterior synechiae, peri. iris attaches anteriorly in the AC angle, can only see with gonio |
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Term
| Refers to the continuous total tear production of the lacrimal gland. |
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Definition
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Term
| Excess tear production resulting from corneal and conjunctival sensory stimulation is related to what type of lacrimal gland secretion |
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Definition
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Term
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Definition
| fogginess of the lens and conj due to allergic rxn |
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