Notes in Ophtho Book

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Status	Last Update	Fields
Published	08/28/2024	{{c1::Floaters & Flashes}} are classic symptoms of retinal detachment and tears
Published	08/28/2024	Transient vision loss in a young person is more likely to be {{c1::vessel spasm}}
Published	08/28/2024	Transient vision loss in an older person is more likely to be {{c1::micro-emboli}}
Published	08/28/2024	Chronic itching and tearing is indicative of {{c1::allergies}} or {{c1::blepharitis}}
Published	08/28/2024	Symptoms of headaches and scalp tenderness are indicative of {{c1::Temporal (giant cell) Arteritis}}
Published	08/28/2024	Vcc means {{c1::vision with glasses}}
Published	08/28/2024	PHNI means {{c1::pinhole no improvement}}
Published	08/28/2024	P means {{c1::pupils}}
Published	08/28/2024	Tap means {{c1::pressure with applanation}}
Published	08/28/2024	CF means {{c1::confrontational fields}}
Published	08/28/2024	EOMI means {{c1::extraocular movements intact}}
Published	08/28/2024	SLE means {{c1::slit lamp exam}}
Published	08/28/2024	EXT means {{c1::external}}
Published	08/28/2024	L/L means {{c1::lids & lacrimation}}
Published	08/28/2024	C/S means {{c1::conjunctiva & sclera}}
Published	08/28/2024	K means {{c1::cornea}}
Published	08/28/2024	A/C means {{c1::anterior chamber}}
Published	08/28/2024	Vit means {{c1::vitreous}}
Published	08/28/2024	DFE means {{c1::dilated fundus exam}}
Published	08/28/2024	CE means {{c1::cataract extraction}}
Published	08/28/2024	APD means {{c1::afferent pupillary defect}}
Published	08/28/2024	{{c2::OD}} means {{c1::right eye}}
Published	08/28/2024	{{c2::OS}} means {{c1::left eye}}
Published	08/28/2024	{{c2::OU}} means {{c1::both eyes}}
Published	08/28/2024	Key diseases in past medical history in ophthalmology to ask about are {{c1::diabetes, HTN, coronary artery disease::3}}
Published	08/28/2024	In past ocular history, one must always ask about history of {{c1::cataract surgery, trauma, glaucoma::3}}
Published	08/28/2024	When asking a patient about ocular family history, focus on {{c1::glaucoma & blindness::2}}
Published	08/28/2024	In an Ophthalmology history, ensure you ask about allergies to {{c1::sulfa drugs (eg. Diamox)}}
Published	08/28/2024	All dilating drops have {{c1::red}} caps
Published	08/28/2024	Beta-blocker drops usually have {{c1::yellow}} caps
Published	08/28/2024	{{c1::Vision, pupil, & pressure::3}} are the “vital signs” of ophthalmology
Published	08/28/2024	Vision, pupil, and pressure should be checked {{c1::before dilating the eye::when?}}
Published	08/28/2024	You measure {{c1::visual acuity}} with a Snellen letter chart
Published	08/28/2024	The sequence of testing for visual acuity should be snellen chart, and if failure, then counting {{c1::fingers @ different distances}}, and if failure…
Published	08/28/2024	Use the {{c2::Pinhole Test}} to determine if poor snellen chart performance is due to {{c1::refraction}}
Published	08/28/2024	Shining light into the pupils elicits a {{c1::constriction}} response in the illuminated eye, and a {{c1::consensual}} response in the other eye.
Published	08/28/2024	Afferent pupillary defects are detected using {{c1::Swinging Light Test}}
Published	08/28/2024	With the Swinging Light Test the good eye will show constriction but when you cross to the other bad eye, {{c1::both eyes seem to dilate a little::phe…
Published	08/28/2024	{{c1::Pressure}} is measured by determining how much force it takes to flatten a predetermined area of the corneal surface.
Published	08/28/2024	{{c1::Goldman Applanation Tonometer}} is used to measure pressure in clinic
Published	08/28/2024	In the hospital or acute settings, pressure can be measured using {{c1::Tono-pen}}
Published	08/28/2024	Having the patient stare at your nose and then count your fingers as you move them to different quadrants is a method of testing {{c1::confrontational…
Published	08/28/2024	Having a patient follow your finger to different quadrants is to assess {{c1::extraocular movements}}
Published	08/28/2024	When evaluating double vision, you must first determine whether the doubling is {{c1::monocular}} or {{c1::binocular}}.
Published	08/28/2024	If double vision persists after covering one eye then it is {{c1::monocular}} diplopia
Published	08/28/2024	Monocular diplopia is usually due to {{c1::refractive error}}
Published	08/28/2024	{{c1::Binocular}} diplopia indicates a misalignment between the two eyes
Published	08/28/2024	Binocular diplopia is usually caused by {{c1::neuromuscular paralysis}} or {{c2::muscle entrapment (trauma)}}
Published	08/28/2024	Description of findings with the slit-lamp exam begins with the {{c1::outer eyelids}} and works towards the {{c1::back of eye}}
Published	08/28/2024	{{c1::Ptosis}} is drooping of the eye
Published	08/28/2024	{{c1::Proptosis}} is extruding of the eyes or "bug eyes"
Published	08/28/2024	If a patient has a suspected viral conjunctivitis, check {{c1::the pre-auricular and sub-mandibular nodes ::what?}}
Published	08/28/2024	The {{c1::external exam (EXT)}} portion of the slit-lamp examination asseses for ptosis, proptosis, and conjunctivits
Published	08/28/2024	The lids and lacrimation (L/L) portion of the slit-lamp examination includes assessing lid margins and lashes for signs of {{c1::blepharitis (eyelid i…
Published	08/28/2024	The lids and lacrimation (L/L) portion of the slit-lamp examination includes {{c1::everting the eyelids::maneuver}} to look for follicles or papillary…
Published	08/28/2024	The conjunctiva and sclera (C/S) portion of the slit-lamp examination includes checking that the sclera is white and non-{{c1::icteric}} and the vesse…
Published	08/28/2024	If the vessels are injected upon slit-lamp examination you must check if vessels {{c1::blanch when patient dilated with phenylephrine::do what?}}
Published	08/28/2024	The cornea (K) portion of the slit-lamp examination includes examining the surface for erosions or abrasions, the clarity of the {{c2::middle stroma}}…
Published	08/28/2024	{{c1::Fluorescin dye}} can make it easier to spot corneal surface abrasions
Published	08/28/2024	The anterior chamber portion of the slit-lamp examination includes looking for {{c1::cell}} and {{c1::flare}}
Published	08/28/2024	On anterior chamber examination in the slit-lamp exam, lights must be turned down and a beam of light into the eye will show {{c1::cells}} as flecks o…
Published	08/28/2024	On anterior chamber examination in the slit-lamp exam you must comment on {{c1::the depth::characteristic}} of anterior chamber
Published	08/28/2024	In the iris (I) portion of the slit-lamp examination you must see if the iris is flat and pupils round, if patient has diabetes comment if {{c1::neova…
Published	08/28/2024	In the lens (L) portion of the slit-lamp examination you should see if the lens is clear or hazy (indicating {{c1::cataract}}) and if they are {{c2::p…
Published	08/28/2024	{{c1::Phakic}} means they have their own lens
Published	08/28/2024	{{c1::Pseudophakic}} means they have a prosthetic lens
Published	08/28/2024	{{c1::Aphakic}} means they have no lens in their eye
Published	08/28/2024	In the vitreous (V) portion of the slit-lamp examination you should examine the vitreous cavity for {{c1::blood cells }}
Published	08/28/2024	Retinal Exam has four components:1. {{c1::Macula}} - {{c1::flat? light reflex?::comments}}2. {{c2::Vessels}} - {{c2::signs of AV nicking? attenuation …
Published	08/28/2024	Retinal exam technique with direct ophthalmoscope:1. Set light to highest setting2. Set light to medium-size3. Set focus (default 0)4. Starting far, f…
Published	08/28/2024	The slit-lamp can examine the posterior fundus in magnified detail using a {{c1::90-diopter}} lens
Published	08/28/2024	A(n) {{c1::Indirect Ophthalmoscope}} is used to examine the peripheral retina and requires a dilated eye and uses a {{c2::20 diopter (larger)}} lens
Published	08/28/2024	Ask a glaucoma patient about history of {{c1::heart problems}} or {{c1::asthma}} before starting a beta-blocker
Published	08/28/2024	Eyelids protect and lubricate the eye and are supported by a {{c1::tarsal plate}}
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Published	08/28/2024	{{c1::Meibomian glands}} secrete oil into the tear film so that they do not evaporate too quickly
Published	08/28/2024	Meibomian glands may become inflamed and swell into a {{c1::granulomatous chalazion}} that needs to be excised
Published	08/28/2024	A {{c1::stye}} is an infection of a sebaceous gland or eyelash follicle and is superficial to the tarsal plate
Published	08/28/2024	Styes are {{c1::painful::painful?}} and chalazions are {{c1::not painful::painful?}}
Published	08/28/2024	The two muscles of eyelid movement are {{c2::orbicularis oculi}} and {{c1::levator palpebrae}}
Published	08/28/2024	The {{c2::orbicularis oculi}} muscle closes the eyelids and is innervated by CN {{c1::7}}
Published	08/28/2024	A patient with {{c1::Bell's Pallsy}} cannot close their eyes and has a lesion to CN 7
Published	08/28/2024	The {{c2::levator palpebrae}} muscle opens the eye and is innervated by CN {{c1::3}}
Published	08/28/2024	CN 3 (oculomotor) palsy is a major cause of {{c1::ptosis}}
Published	08/28/2024	{{c1::Conjunctiva}} is a semi-transparent mucus membrane that covers the front of the eyeball
Published	08/28/2024	The conjunctiva starts at the edge of the cornea (known as the {{c1::limbus}}) and flows behind the eye and loops back onto the undersurface of the ey…
Published	08/28/2024	Most tears are produced by accessory glands in the {{c1::eyelid}} and {{c1::conjunctiva}}
Published	08/28/2024	The {{c1::lacrimal gland}} is responsible for reflexive tearing
Published	08/28/2024	Tears flow down the eye and drain into the {{c1::lacrimal punctum}} at the medial lids
Published	08/28/2024	After tears enter the lacrimal puncta, they flow down lacrimal tubing and reach the {{c1::inferior turbinate}}
Published	08/28/2024	Why do eyedrop medications have such profound effects?{{c1::Bypasses liver metabolism}}
Published	08/28/2024	The white and fibrous outer wall of the eye (under the conjunctiva) is the {{c1::sclera}} and is composed of collagen
Published	08/28/2024	The {{c1::cornea}} is a clear extension of the sclera
Published	08/28/2024	At the back of the eye the sclera forms the {{c1::optic sheath}} that encircles the optic nerve
Published	08/28/2024	The 3 chambers of the eyeball are {{c1::anterior, posterior, and vitreous::3}}
Published	08/28/2024	{{c1::Vitreous humor}} fills the vitreous chamber and has a gel consistency
Published	08/28/2024	When vitreous humor liquefies it can fall in on itself which is known as {{c1::posterior vitreous detachment}}
Published	08/28/2024	{{c1::Aqueous humor}} fills the anterior and posterior chambers and has a watery consistency
Published	08/28/2024	Aqueous humor provides nutrients to the {{c1::cornea and lens::structures}}
Published	08/28/2024	{{c1::Aqueous}} humor is produced in the posterior chamber and flows through the pupil to the anterior chamber
Published	08/28/2024	The {{c1::cornea}} is the clear front surface of the eye
Published	08/28/2024	The {{c1::cornea-air interface}} provides the majority of the eye’s refractive power
Published	08/28/2024	The cornea is avascular and gets nutrients from tears (external), aqueous humor (internal), and blood vessels at the {{c1::peripheral limbus}}
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Published	08/28/2024	The cornea has {{c1::5}} distinct layers
Published	08/28/2024	The outside surface of the cornea is {{c1::epithelium}} and injuries are painful and usually do not leave a scar
Published	08/28/2024	The layer beneath the epithelium of the cornea is {{c2::Bowman's layer.}} Below this layer is the {{c1::stroma}}
Published	08/28/2024	The corneal {{c1::stroma}} makes up 90% of the thickness
Published	08/28/2024	{{c1::Stroma::layer of cornea}} damage often leads to scar formation
Published	08/28/2024	{{c1::Descemet's membrane}} is the basal lamina of the endothelium
Published	08/28/2024	The {{c1::inner endothelium}} of the cornea is one cell layer thick and {{c2::keeps the cornea dehydrated::function}}
Published	08/28/2024	If the {{c1::endothelium}} of the cornea is damaged, aqueous fluid can flow into the stroma and cloud up the cornea with edema
Published	08/28/2024	{{c1::Endothelial}} cell count is important since these cells do not regenerate and a low count may need for corneal transplant
Published	08/28/2024	The {{c1::iris}}, {{c2::ciliary body}}, and {{c3::choroid plexus}} are all continuous with each other and are collectively called the {{c4::uvea}}.
Published	08/28/2024	The {{c1::iris}} is the colored part of the eye and its primary function is to control the amount of light hitting the retina
Published	08/28/2024	Sympathetic stimulation of the pupil leads to pupil {{c1::dilation}} and parasympathetic stimulation leads to {{c1::constriction}}
Published	08/28/2024	The inner iris flows back and becomes the {{c1::ciliary body}}
Published	08/28/2024	2 functions of the ciliary body are {{c1::secrete aqueous humor}} and {{c1::control shape of lens}}
Published	08/28/2024	The ciliary body contains sphincter muscles that change the lens shape by {{c1::relaxing::relaxing/contracting}} the zonular fibers that tether to the…
Published	08/28/2024	The {{c1::choroid}} is a bed of vessels that lie under the retina
Published	08/28/2024	The choroid supplies nutrition to the outer one-third of the retina which includes the {{c1::rod and cone photoreceptors::what?}}
Published	08/28/2024	The {{c1::lens}} is a magnifying glass inside our eye that helps focus light.
Published	08/28/2024	Lens gets all of its nutrients from {{c1::aqueous humor}}
Published	08/28/2024	The {{c1::lens}} has the highest protein concentration of any tissue in the body
Published	08/28/2024	From outside to in, the layers of the lens are {{c1::capsule}} --> {{c1::cortex}} --> {{c1::nucleus}}
Published	08/28/2024	The {{c1::capsule}} of the lens is thin and holds the rest of the lens in place
Published	08/28/2024	The {{c1::cortex}} is the middle layer of the lens and the {{c1::nucleus}} is the inner layer
Published	08/28/2024	Cataracts are described based on {{c1::their location}}
Published	08/28/2024	The lens capsule is held in place by suspensory ligaments called {{c1::zonules}} that insert around the periphery and connect to the muscular ciliary …
Published	08/28/2024	Hardening and loss of the ability to rounden the lens in order to focus on near objects with age is known as {{c1::presbopia}}
Published	08/28/2024	The {{c1::retina}} is the sensory portion of the eye and contains layers of photoreceptors, nerves, and supporting cells.
Published	08/28/2024	Major layers of the retina from external to internal are:- {{c1::Photoreceptor}} layer - {{c1::Ganglion nerve}} layer
Published	08/28/2024	The {{c1::macula}} is the pigmented area of the retina that is responsible for central vision.
Published	08/28/2024	Within the central macula is the {{c1::fovea}}, which is a small pit that is involved with extreme central vision.
Published	08/28/2024	The {{c1::optic disk}} contains the central retinal artery, central retinal vein, and optic nerve
Published	08/28/2024	the roof of the orbit is a continuation of the {{c1::frontal bone}}
Published	08/28/2024	The {{c1::zygomatic}} bone forms the strong lateral wall of the orbit
Published	08/28/2024	The {{c1::maxillary}} bone forms the floor of the orbit
Published	08/28/2024	The medial wall of the orbit is mainly formed by the {{c1::lacrimal}} bone and the {{c1::ethmoid}} bone
Published	08/28/2024	The thinnest part of the orbit is the {{c1::lamina papyracea}} and sinus infections can erode this and cause {{c2::orbital cellulitis}}
Published	08/28/2024	Blunt trauma most commonly fractures the orbital {{c1::floor}}
Published	08/28/2024	During orbital floor fractures, the maxillary bone fractures downward and the orbital contents herniate into the {{c1::maxillary sinus}}. This is know…
Published	08/28/2024	A "blowout fracture" of the inferior orbit can present with {{c1::enophthalmia (sunken eyeball)}} and problems with eye-movement from entrapment of th…
Published	08/28/2024	The back of the orbit is formed by the {{c1::greater}} wing of sphenoid bone, and the {{c1::lesser}} wing surrounds the optic canal
Published	08/28/2024	The orbital {{c1::apex}} is the entry point for all the nerves and vessels supplying the orbit.
Published	08/28/2024	The {{c1::superior orbital fissure}} lies between the wings of the sphenoid bones and is where many vessels and nerves pass into the orbit.
Published	08/28/2024	The {{c1::"Annulus of Zinn"}} is a muscular band that rests on top of the superior orbital fissure and serves as the insertion point for most of the o…
Published	08/28/2024	The four rectus muscles insert at the {{c1::sclera (behind limbus)}} and pull the eye in the direction of their attachment
Published	08/28/2024	The superior, medial, and inferior rectus muscles are all controlled by the {{c1::oculomotor nerve (III)::CN #}}
Published	08/28/2024	Te lateral rectus muscle is controlled by the {{c1::abducens nerve (VI)::nerve}}
Published	08/28/2024	The {{c1::superior oblique}} muscle originates in the posterior orbit and courses nasally until it reaches the {{c2::trochlea}}, and then inserts onto…
Published	08/28/2024	The {{c1::inferior oblique}} muscle originates from the orbital floor and inserts behind the globe near the macula
Published	08/28/2024	The oblique muscles are primarily responsible for {{c1::intorsion}} and {{c1::extorsion}}
Published	08/28/2024	The inner two-thirds of the retina gets its nutrition from the {{c1::retinal vessels}}
Published	08/28/2024	Which extraocular muscle doesn’t originate at the orbital apex?{{c1::Inferior oblique}}
Published	08/28/2024	Which full-thickness eyelid laceration is more dangerous - medial or lateral?{{c1::Medial}}
Published	08/28/2024	{{c2::Glaucoma}} is a disease where the {{c1::optic}} nerve dies and is associated with increased intraocular pressure
Published	08/28/2024	Within the irido-corneal angle the aqueous humor exits the eye through the {{c1::trabecular meshwork}} into the {{c2::Canal of Schlemm}} where it retu…
Published	08/28/2024	An imbalance between production and drainage of aqueous humor can lead to {{c1::glaucoma}}
Published	08/28/2024	Two types of glaucoma are {{c1::open}} and {{c1::closed}} angle
Published	08/28/2024	{{c1::Open}}-angle glaucoma is the most common type
Published	08/28/2024	{{c1::Open}}-angle glaucoma occurs by impaired aqueous humor drainage from an unidentified dysfunction or microscopic clogging of the trabecular meshw…
Published	08/28/2024	Closed-angle glaucoma is also known as "{{c1::acute}} glaucoma" and occurs when the angle between the cornea and iris closes abruptly
Published	08/28/2024	Most chronic open-angle glaucoma patients are {{c1::>40::age}} and is more common in {{c1::African Americans::demographic}}
Published	08/28/2024	Risk factors for glaucoma are family history, age, race, {{c2::high eye pressure}}, large {{c1::vertical nerve cupping}}, and {{c3::thin}} corneas
Published	08/28/2024	The mechanism of open-angle glaucoma involves degeneration of the {{c1::trabecular meshwork filter}}, usually by unknown causes, leading to increased …
Published	08/28/2024	Prolonged increased IOP in early open-angle glaucoma leads to atrophy of the {{c1::retinal ganglion}} nerves
Published	08/28/2024	3 exam findings of open-angle glaucoma are {{c1::increased eye pressure}}, {{c2::optic disk changes}}, and {{c3::repeatable vision loss patterns}}
Published	08/28/2024	Normal pressure values with the Goldman applanation tononometer are {{c1::10-22}} mmHg
Published	08/28/2024	{{c1::Corneal}} thickness can impact pressure measurements of the eye
Published	08/28/2024	The Goldman applanation tonometer measures the amount of force to flatten a {{c1::3}} mm diameter area of corneal surface
Published	08/28/2024	The pressure measurements on the Goldman tonometer were calibrated using an average corneal thickness of approximately {{c1::540}} microns.
Published	08/28/2024	Corneal thickness can be measured using a(n) {{c1::ultrasound pachymeter}}
Published	08/28/2024	In normal patients, the optic disk has a cup that is {{c1::<1/3::ratio}} the disk diameter
Published	08/28/2024	Glaucoma has the ganglion nerve layer slowly degenerate which increases the amount of cupping of the optic disk causing a cup-disk ratio of {{c1::>…
Published	08/28/2024	In addition to an increased cup-disk ratio, another sign of glaucoma on the fundus exam is optic disk {{c1::asymmetry}} between eyes
Published	08/28/2024	The space between the inner cup and surrounding disk is called the {{c1::neural rim}} and is comprised of retinal ganglion nerves
Published	08/28/2024	In a normal eye, this "rim" of the optic disk follows the ISNT rule of thickness, meaning that the {{c1::Inferior}} rim is {{c2::thickest}} while the …
Published	08/28/2024	On fundus exam, glaucoma will show vertical thinning & notching of {{c1::inferior}} and {{c1::superior}} rims. You can also see {{c2::undermining …
Published	08/28/2024	The vision loss from chronic glaucoma occurs in characteristic patterns that can be followed by {{c1::automated perimetry}}
Published	08/28/2024	{{c1::Central}} vision is typically spared in glaucoma
Published	08/28/2024	The main focus of treatment with glaucoma is to {{c1::decrease IOP <20 mmHg}}
Published	08/28/2024	{{c1::Beta-blockers}} can treat glaucoma by decreasing aqueous humor production by the ciliary body
Published	08/28/2024	{{c1::Prostaglandin analogues}} (eg. {{c2::latanoprost}}, a.k.a. {{c2::Xalatan}}™) are a glaucoma drug that increase aqueous humor outflow
Published	08/28/2024	Side effects of prostaglandin analogues for glaucoma are {{c1::increased eyelash growth}} and {{c1::darkened iris colour}}
Published	08/28/2024	{{c1::Trabeculectomy}} is a surgical treatment for chronic glaucoma where an alternate drainage pathway is created
Published	08/28/2024	Trabeculectomy involves creating a small hole in the {{c1::superior limbus}} so that aqueous humor can drain under the conjunctiva
Published	08/28/2024	{{c1::Mitomycin-C}} is often given with a trabeculectomy to avoid scarring and closure of the hole
Published	08/28/2024	If Mitomycin-C is ineffective for preventing closure of the hole, a {{c1::plastic tube-shunt}} can be inserted into the {{c1::anterior chamber}} that …
Published	08/28/2024	{{c1::Argon laser trabeculoplasty (ALT)}} is a surgical treatment for chronic glaucoma that burns portions of the trabecular meshwork to increase outf…
Published	08/28/2024	The most common mechanism of acute glaucoma is {{c1::pupillary block}}
Published	08/28/2024	{{c1::Pupillary block}} occurs when the lens moves against the iris which blocks the flow of aqueous humor through the pupil
Published	08/28/2024	Pupillary block in acute glaucoma causes a {{c1::pressure gradient}} across the iris that forces the iris & lens to move anteriorly and close the …
Published	08/28/2024	People with {{c1::hyper}}opia and {{c1::asians::demographic}} are at an increased risk of acute glaucoma
Published	08/28/2024	The onset of acute glaucoma often occurs during {{c1::pupil dilation}}
Status	Last Update	Fields