OPHTHALMOLOGY( All Topic's in one Post )~~~~( Eye Lid )~~~~1)-What's the anatomy of the eye lid ? & what's the main functionsSuperficial lamella : Skin // muscular layerdeep lamella : tarsal plate // conjunctiva lamellae separated by gray lineProtection of eye ball & distribution of tear film______________________________________2)-How many meibomian glands or tarsal glands found in upper lid and lower lidUpper have 50, lower 25_______________________________________3)-Define the following- Epicanthus FoldEpi : bilateral vertical fold of skin that extends from upper to lower lid toword the medial canthus- Poliosisimmature whit of hair lash or eye brow-*DistichiasisExtra row of maldirected lashes in the position of openings of rudimentary meibomian glands-*BlepharospasmProgressive B/L involuntary spasm of orbicularis muscle & upper facial muscles______________________________________4)-If the meibomian gland is inflamed .. Chronologically , Mention the types of it & How to treat each typeAcute (Hordeolum internum) .. treated by hot compresses / local and systemic antibiotic / surgery if neededChronic granulomatous (Chalazion) .. 30% resolve spontaneously but treated by vertical incision / intra-lesional steroid / prophylaxis by systemic tetracycline with recurrent chalazia if ass. With Acne Rosacia____________________________________5)-Define the Coloboma .. And regarded to which type of eye lid disorders & How to treatPartial or full thickness eye lid defect occurs where the eye lid development is incompleteCongenital typeTreatment .. if small by primary closure // if large by skin graft and rotation flaps___________________________________6)-Mention the types of Entropion & Which type occurs with Symblepharon in long term affect with chemical injuryCicatricial .. Spastic .. Congenital // Cicatricial__________________________________7)-What's the Complications of Ectropion ? And mention 4 causes of itComplications : Thickening of conjunctiva .. drying of mucous membrane .. corneal irritation and damage .. Epiphora if lower lid involvedCauses : Muscle weakness(most common one) .. facial paralysis .. scars .. previous surgery like (blepharoolasty) __________________________________8)-What's the most common offending drug (topical agent) can leading to Ectropion by 53%Dorzolamide ( Carbonic anhydraze inhibitor )__________________________________9)-Q9/ What's the types of acquired Ptosis & What's the most common type ? and mention 2 points ass. With congenital ptosis ? and mention 2 causes of ptosis ass. With anisocoriaNeurogenic .. Myogenic .. Aponeurotic .. MechanicalAponeurotic is most common*weakness in superior rectus *absence of lid creaseHorner syndrome // surgical 3rd cranial nerve palsy __________________________________________10)-Q10/ Define the Hutchinson's Sign & Which Virus leads to it ? & How to treatSkin lesion on the tip of the nose / HZV / Acyclovir topical cream steroid antibiotic cream .. systemic Valciclovir or Famciclovir __________________________________________11)-Which disease is related to recurrent Styes & XanthelasmaDm__________________________________________12)-/ Blepharospasm .. precipitated by What & relieved by What ? And What's the first choice treatmentppt by reading .. driving .. stress .. bright lightrelieved by talking .. walking .. relaxationFirst Choice Treatment is ( Botulinium toxin injection )~~~~~~~~~~~~~~~~~~~~~~~~~( Lacrimal )~~~~~~~~~~~~~~~~~~~~~~~~~1)-what's anatomical structure of lacrimal apparatus? and what types of lacrimal glandA - Lacrimal apparatus consists of :1. Lacrimal glands ( secretory part) ? Main lacrimal gland - accessory lacrimal gland2. Lacrimal passages ( excretory part) ? puncti - canaliculi - nasolacrimal duct - inferior miatusB .. two types : main lacrimal gland and accessary l.glands______________________________________2)-how many layers of tear film ? and mention glands secretary to every layersA - three layers :Outer lipid layer - middle aqueous layer - inner mucin layerB - lipid secreted by meibomian glandAqueous secreted by main and accessory lacrimal glandMucin secreted by goblet cells_____________________________________3)-what's the function of lipid layer? and mucen layerA - lipid : retard evaporation of aqueous layer - lower surface tension - lubricate the eyeMucen : change epithelium of cornea from hydrophobic to hydrophilic_____________________________________4)-what's the physiological structure of tear ? and what the most protein foundA - value= 7 -+ 2PH= 7.1 - 8.6 Concentration protein ( albumin - globulin - lysozyme ) igA - igG - igE - urea - Na - K - ClB - albumin it is most type___________________________________5)-what's the main of dry eye ? and mention the cause ? and mention symptomsA - disorder causing ocular discomfort and ocular surface damage due to tear deficiency or excessive tear evaporationB - hyposecretive ( sjogren - non sjogren ) and EvaporativeC - irritation - FB sensation - burning - mucus discharge - transient blurring of vision - itching - photophopia .__________________________________6)-how to ttt ptn with dry eye and common test used? and mention complicationA -Reduction of room temperature- permanent occlusion of puncti by diathermy - small lateral tarsorrapthy - and tear substitute drops, gels and ointment - schirmar test B - mucus strand and debris -Filament - mucus plaqueCorneal abrasion and ulcer_________________________________7)-what's the definition of watery eye ? and how to different between epiphoria and lacrimationA - excessive tears include epiphora and lacrimationB - lacrimation : due to excessive secretion of tearsEpiphora : due to obstruction of any part of nasolacrimal passagesby jons test________________________________8)-mention 4 cause of epiphora ? and how to diagnosis ptn with chronic dacryocystitisA - 1. eversion of the lower punctum2. Occlusion of the puncti3. Occlusion of the canaliculi4. Chronic dacryocystitisB - testing tear drainage - jones test - examination of the nose (ENT )-dacryocystographyand regurgitation test________________________________9)-how to manage congenital nasolacrimal duct obstruction ? and mention to D/DA - massage of nasolacrimal duct and AB dropsNot improvement after 12 month Probing Not improvement you should be another probing after 6 monAfter three times not improvement you have DCR B - bacterial conjunctivitis /// congenital glaucoma /// ocular trauma_______________________________10)-in acute dacryocystitis mention 3 symptoms ? and complication ? How to tttA - severe pain - epiphora - fever and headacheB - fistula formation - extension leading to orbital cellulitis - cavernous sinus thrombosisC - local and systemic broad spectrum antibioticWarm compresses _ analgesic and surgical ( DCR________________________________11)-mention cause of chronic dacryocystitis ? and which common types acute or chronic ? and mention causative organismA - stricture of the nasolacrimal duct from chronic inflammation- obstruction of the lower end of the nasal duct by nasal polyp , hypertrophied inferior turbinate bone B - chronic dacryocystitis it is commmonC - 1. Pneumococci2. Staphylococci3. Streptococci4. Very rare TB -candida________________________________12)-mention types of surgery of chronic dacryocystitis ? and which common type ? and mention indicated of DCRDCR .. only done in chronic dacrocystitisIndication.. NLDO ..Mucocele~~~~~~~~~~~~~~~~~~~~~~~~~~~( Counjuctiva )~~~~~~~~~~~~~~~~~~~~~~~~~~~1)-Mention the Anatomy & function of conjunctivaAnatomy : Palpebral & Bulbar &fornicial Conjuctiva Function : 1 Tear production ( Goblet cell + accessory lacrimal gl )2 Oxygen supply to Cornea 3 Defense Mechanisme ( Mast cell Leucocyte IgA lymphoid tissue )__________________________________________2)- Define the Counjuctivits & mention the CausesInflamation of the surface of the eye Causes : Infectious : bacterial viral ParasticNon infectious :Irritation Allergic Toxic ___________________________________________3)- Define the Ptyrgium & how affect the visionTriangular fibroVascular tissue arise from Conjuctiva toward Cornea , affect vision directly by : reach the pupil area & indirectly by cause Irregukar Astigmatism .__________________________________________4)- How you ttt the Ptyrgium & how differentiate bt True & false Ptyrgium ?TTT by Surgical excision with graft , differentiate by hook__________________________________________5)- Mention the causes of sub conjunctival hge ( which Most Common cause ? )Trauma ( most common ) Viral keratits severe he leukemia - Cx of surgery severe sneezing or coughing6)- How to manage case with Sub conjunctival hge ?Ttt the underlying cause & make sure pt without Bl Ds or Operative by Measure BP & CBC ___________________________________________7)- Define The Ophthalmia neonatium & mention the causative organisms ( which is the most common) ? D.O.CAny discharge from the eyes in the 1st week Chlamydia ( most common ) gonococal Staph Strepto HSV2 )D.O.C : tetracyclin ( for children Erthromycin ) topical & sys .__________________________________________7)-Define & mention the causes of Chemosis ?Edema of conjunctiva Causes :Viral conjuctivits allergic conjuctivits trauma orbital cellulits .____________________________________________8)- what are the types of conjuctivits lead to Preauricular L.N enlargement ?Gonococal chlamydia viral conjuctivits__________________________________________9)- the microorganism which cause Trachoma Called D.O.C is Chlamydia Trachomatis A,B,AB,C Type D.O.C is Tetracyclin topical & sys .___________________________________________10)- Trichiasis + Panus + herp's pit's these tried indicate Trachoma___________________________________________11)-Trants dot's indicate How to manage ?Spring Katar Cold Compress + Topical Steroid + Mast cell stabilizer___________________________________________12)- mention the causes of Panus ?Tacoma spring Katar Conact Lens Syphalis Leprosy ~~~~~~~~~~~~~~~~~~~~~~~( Lens )~~~~~~ ~~~~~~~~~~~~~~~~~1)-Whats definition of cataract and causes !!!Lens OpacityAgingSytemic dis as DmPrious surgery Drugs .. steroid . PhenothiazineTruma XrayCong /inherditary____________________________________2)-What's most common type !!cortical senil cataract____________________________________3)-What's cause s of cong. Cataract and what's name of surgery done in this case !!Idiopathic .. genetic .. hereditary .. metabolic .. ocular abnormalities .. maternal infections : Rubella .. syphilis .. CMV .. toxolimbal lensectomy____________________________________4)-What's D.D of graudal painless decrease of visi !!diabetic retinopathy .. POAG .. cataract .. optic atrophy .. retinopathy .. Keratocouns____________________________________5)-What's D.D of pre senile cataract !!diabetic .. my tis.dysatrophy . Atopic dermat_____________________________________6)-Rosette shaped cataract ass e .................. and oil droplet cataract ass e ................. !!blunt trauma // galactosemia_____________________________________7)-What's indication of ICCE !! And what s CPxccataract with sublaxation or dislocated, vitreous loss RD,macular degeneration_____________________________________8)-After cataract Cxp of any type of Surgery !! And how treated !!!!after ECCE and treated by Yag laser_____________________________________9)-What's late cxp of cataract surgery !!!post. capsular opacification // malposition of IOL // CMO // retinal detachment_____________________________________10)-posterior capsule opacification // astigmatism // subluxated or dislocated IOLWhat's cause s of decrease vision after cataract surgery !!____________________________________11)-Day blindness can occur which any type of cataract !!nuclear____________________________________12)-What's C.l of IOL implantion !!Recurent uveitisNeovascular glHigh myopiaProlif.diabetic R.pathyAGE relatively c.i~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~( Refraction Errors )~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~? Define the myopia -Parallel rays focus infront retina , near sight ? What is the types of myopia -Simple myopia .. progresive myopia.. congenital? Most common type of myopia is -Axial myopia..simple type? What is the difference between simple & pathological myopia -Degenerative changes in fundus present in Pathological but n't in simple/ simple is n't progressive but pathological is a progressive type ? what is the most common symptom in myopia -indistinct far vision? what is the causes of myopia -increase in Anteroposterior diameter of globe (most common cause)? Talk about complications of myopia -vitreous degeneration , tear and Hge in retina... , retinal detachment , complicated posterior cortical cataract , POAG? which complications are commonly seen -Regmategnous retinal detachment? Talk about the treatment of the myopia -First glassConcave lens Radial keratotomy bute not used new LASIKExcimer laser__________________________________________? Define the hypermetropia -Rays focus behind retina(far vision? what is the causes of hypermetropia -decrease curvature and axial length...post displacement of lensAphacia__________________________________________? which type of the lens used to treat hypermetropic pt -+ ve Convex lens___________________________________________? Define the Astigmatism & Mention the causes -Focus of light in different diopter with different side in the retina a piontcause : sub lxation of lens & changes in corneal meridian___________________________________________? types of astigmatism .......... & what the difference bt it -Regular.. irregular.. regular grudal changes in Refraction but iirgular suddeeeee nly___________________________________________? what is the treatment of astigmatism -Regular .. cylindircal lens Irrgular contact lenssss___________________________________________? Anisometropia mean -un equal refration between 2 eyes___________________________________________? ttt of isometropia -Contact lens different power____________________________________________? Presbyopia mean -~~Loss of near vision d t loss of accommodation ____________________________________________? causes of presbyopia -Physiological (aging) ..Pathological (1ry ang .glucoma .. cycloplgic drugs Anemia ____________________________________________? what is the causes of sudden drop of vision -Vitriuos hge .. CRVO - CRAO..RD ..Optic neuritis~~~~~~~~~~~~~~~~~~~~~~~~( Squint )~~~~~~ ~~~~~~~~~~~~~~~~~~1)-? what's the types of squintTrue sq (manifest .. latent ) pseudo sq other class...converge and divergent______________________________2)-? what's cause of psudosqunit ? Any type cause high myopiapseudo squint ?false converg. ( epicanthus .. myopia .. short IPD) pseudo divergent( Hypermetropia .. wide IPDconvg_____________________________3)-? what meaning of paralytic sequnit ? And common in adult or childrenI.i sq by abn .in ms by neuropathy or myopathy .. com. In adult_____________________________4)-? what most common type of squintConverge_____________________________5)-? in convergent and divergent sq what refraction error it's findingHypermetropia .. conv //... myopia divrg..6)-? what amblyopia? And how to managementDecrease v.A with normal visual pathway and normal anatomy ..cant treat by glasses ..Mx.. oclusion therapy .. wk for every month .. synitophere for exercise after ttt7)-? what types of convergent and divergent sqDivergent , Constant & intermittentCovg non accommoda.. accomod .. partial accom...8)-? how to dig sq ptnhistory first Corneal lihgt reflex OphthalmoscopeV.A testingCover test - cover uncover testEOM movement_____________________________9)-? how to measure angle of sqHirshberg test : corneal light reflexSynptophore10)-? what are indication of surgery ? And types of surgeryImprove bsv , Correct dviationrecetion and resection___________________________11)-? in corneal light reflex at adage of limbus Angle4512)-? how far LR - MR - IR from the limbusLR 7mmMR 5.5 mmIR 6.5mm~~~~~~~~~~~~~~~~~~~~~~~~~( Glucoma )~~~~~~ ~~~~~~~~~~~~~~~~~~~1)-whats the cause of decrease of aqueos humor secretionhypoxia - hypothermia - ciliay body shut down like in iridocyclitis____________________________________________2)-how can measurement of intraocular pressuregoldman's applantion tonometry___________________________________________3)-whats the common type of glaucoma and most risk factorPOAG - MYOPIA__________________________________________4)-WHAT the drug increase lashes growxalatan latanoprost - PG analoge__________________________________________5)-whats the most common sign in PCAG and whats the error refraction risk factor more in male or femalecupping ..... hypermetropiaFemale : male 4:1_________________________________________6)-whats the sign of acute congestive glaucomapupil semi dilated non reactive oval verticaliris bombecornea cloudyciliary congestionlid edemasure high IOP________________________________________7)-in congenital glaucoma common in girls or boys and most common symptom and differential diagnosisboys , d/d blue sclera +watery eye + cloudy cornea_______________________________________8)-in treatment of congenital glaucoma if corneal diameter less than 13 mm or more than 13 mm how can tttif corneal diameter less than 13 mm goniotomy or trabeculotomy if more than 13 mm trabeculectomy______________________________________9)-whats the type of cataract association with photolytic glaucomahyper mature cataract_____________________________________10)-Define the GulcomaIts Optic Neuropathy characterised by Triad : increase IOP; Pathological Cupping ; Defective in V.F~~~~~~~~~~~~~~~~~~~~~~~~~~~( Uvitis )~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~1)- Definition of Uveitis !!inflammation of uveal tract and adj structure ________________________________________2)- What's most useful classification of uvritis!Anatomical - pathological - aetiological - clinical________________________________________3)-What's most common type of uveitis ; whats sign in it !Ant Uvitis , Sign's :CcCKpAQ.Cells and flare Irregular constructed pupil_________________________________________4)- Mention 2 Autoimmune diseases ass with Ant. Uveitis and 2 with post !!Ant. Uveitis : juvenile RA - ankylosing spon .Post. Uveitis : behcet d. - harada syndrome__________________________________________5)- Which type of uveitis inter in D.D of leukocoria !Intermediate___________________________________________6)- Talk about masquerade synxRetinopastoma - leukemia - malignant melanoma__________________________________________7)- What types of RD caused by Post uveitis .. which one most commonExudative - tractional Most : exudative___________________________________________8)- Fundus examination is mandatory In all Cases of Ant uveitis ..why !!some cases of post uveities present e inflam in ant segmenteye e RRD may have mild to moderate uveitiesto exclude masquared syndrometoxplsmos in posterior uvevitis may be also causes__________________________________________9)- Caues of decrease vision in uveitis !!!GlucomCataractRDCOM__________________________________________10)- Types of glucoma 2ry to uveitis !!2ry OAG b.c Post Synchea ..2ry CAG b.c peripheral Ant. SyncheaSteroid induced_________________________________________11)- What's ttt of uveitis !!atropine analgesic steroid NSAID AB_________________________________________12)- Hypopian sign present in uveitis ass eAss e HlA B27 ( Ank.spo....Bahcets did )~~~~~~~~~~~~~~~~~~~~~~~~( Retina )~~~~~~~~~~~~~~~~~~~~~~~~1)-what's the most sensitive part of retina & whyFoveaB.c. have more numerous of cons only .A vascularThin layer so rays fall direct on cons____________________________________2)-what's presenting symptom in a pt e vitreos hge ? most important cause what about red reflexsymptome sudden painless loss vision cause trumano or black reflex____________________________________3)-other types of reflexes you can seeBlack reflex: vitreous hgeGrey : retinal detachment Yellow: endophthalmiumWhite : D/D of leukocoria__________________________________4)-what's diagnostic criteria of retinitis pigmentosaarteriolar attenuation // waxy disc pallor // bone spicule pigmentation____________________________________5)-about retinitis pigmentosa what's the most common inheritance & most severeAD and isolatedmost common AD,most sever X-linked ....____________________________________6)-what's the types of retinal detachment ? what's the sings of fresh RRDsigns: convex & corrugated appearance ...blood vessels appear darker ..subretinal fluid extend to orra serrata shows good mobility ^^____________________________________7)-what's classification of diabetic retinopathyBack ground DRPPROlif DRPAdvanced DRPMACULOPATHY e any Above Stag___________________________________8)-what's the sings of preproliferative DRPcotton wool spots // IRMA // venous changes // dot and blot hge ___________________________________9)-what's ttt of proliferative stage og DRPARGON LASSER PAN R PHACOCOAGULTION (2000 ..3000 SHOT S)Extra information :uses of argon laser panretinal photocoagulatuion in :proliferative DRP ..ischemic CRVO___________________________________10)-what's the causes of poor vision in DMVitriuos HgeMACULOPATHYTRD__________________________________11)-what's the late complication of ischemic CRVONeovessel formation macula edema secondry gluacomaLate 100day glucoma specific late cpx for ischemic CRVO__________________________________12)-what's the ttt of CRAOAdmissionOcular massageSupine positionIv dimoxO2 at least 92% AnticoagulantTreat cause and Cxp if presentDone pt .Urgent ECG and Echodon't forget,,, A/C paracentesis ,,, breathing of carbogen ( O2 95% + 5% carbon ) no anticoagulantIN CRAO :Only the fovea centralis remains visible as a cherry red spotbecause the red of the choroid shows through at this site~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ( Red Eye & Systemic Disease ) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~1)-Mention the ocular manifestation of congenital Rubella !!microphthalmia cataract cornea clouding glucoma uveitis salt & paper retinopathy_____________________________2)-What's the meaning of phlyctenule ..and Ass e which systemic diseasePhlyctenule .. localized lymphatic infiltration of conjuctiva ass e TB___________________________3)-Mention 4 ocular manifestation ass e HIV !!ant . uveitis sever HZ keratitis KCS SCC__________________________4)-What's the corneal features in Rheumatoid Arthritis !!PERIPHERAL CORNEAL THINNING__________________________5)-Pt e Recurent Styes and Xanthelasma .Usually ass e which systemic disease !!DM_________________________6)-What's Transient Refraction changes in diabetic pt !!1 . change in lens Hydration 2. Hypermetropia e hypoglycaemia3 myopia e hyperglycaemia_______________________7)-Mention caueses of visual loss in diabetic pt.!!vitr. hge... NVG...TRD_______________________8)-Von Graefes sign .. ass e which systemic disease !!!Thyrotoxicosis_______________________9)-Mention Pathological changes in preclamsia (pregnancy) .!!Scotoma ..diplopia .. hge.. Disc swelling .. ERD_______________________10)-B.L ptosis ; Vetical diplopia and nystagmus .. all worsing at end of day ..Indicate what !!Mysthina graves______________________11)-Mention 4 DD for painful red eye a d 4 DD for painly red eye !!Painfull ..as corneal abrasion and ulcer .. Uvitis .. Acute congestion glucoma Painless as Subconjuctival hge .. conductivities .. Blepharitis ..dry eye________________________12)-What's DD of CCC (circum ciliary congestion ) !!!Uveitis .. Acute congestive glucoma .. keratitis ..~~~~~~~~~~~~~~~~~~~~~~~ 'Eye Tumors ~~~~~~~~~~~~~~~~~~~~~~~1)-What's the most common human malignancy in ophthalmology ! And most common intra ocular malignancy in children's and adults !!!most common human malignancy in ophthalmology basal cell carcinomamost common intra ocular malignancy in children's retino blastomamost common intra ocular malignancy in adults choroidal melanoma______________________________2)-Mention types of BCC and SqCC !! And what's difference b.w them !!Nodular in bcc e surface vasculaization and scc no surface vasculaization... ulcer in bcc rolled edges but scc elevated edges_____________________________3)-In cases of recurrent chalaizon should be done Biopsy .why!!to exclude meibomian gland tumor_____________________________4)-What's the most common locations of BCC and SCC !!lower eye lid____________________________5)-What's method of choice to mx tumours in eyelid s !!surgical excision____________________________6)-Mention the general signs of malignancies !!Sudden pain sudden increase size and pigment ion ..and appears nodules___________________________7)-What's the types of cojunctival melanoma !!.from.PAm ..Neavus ..and 1ry____________________________8)-What's most common sign in chroidal melanoma on fundus !Chroidal fold ( mushroom shaped ..or color shot sign )___________________________9)-Retinoplastoma commonly seen in male or female !! And presented e any age !! What's most common presentation in this case !!females =males ...Age from 3m to 3yr Presented e leukocoria 60% .~~~~~~~~~~~~~~~~~~ ( Drug's ) ~~~~~~~~~~~~~~~~~~1)-Timolol . What's the action and S.E !decrease production & SE punctate keratitis BC hypotension________________________2)-DOC in POAG and DOC in PNAG !!PoAG ..Timolol and XalatanPNAG .. pilocarpine and diamox________________________3)-What's the most common SE of Xalatan !!incraese thickness and lengh of of lashes_______________________4)-what's the most dangerous S.E of Diamox!!BM DEPRESSIONC.i of pilocarpine : Pupilary blockage glucomaUveitisRubiosis iridisNeovascular glucomaIndication of steroids ..spring cattahr Episcleritis and scleritis Allergic conductivities_________________________5)-what's C.I of pilocarpinetemporary myopiapupillary block glucomaNeovascular glucoma>>> Uveitis_________________________6)-what's indication of steroidsspring catarrh >>uviitis >>scleritis >>allergic conjunctivitis___________________________________