ophthal

• Jones -1 test:
• Positive: primary hypersecretion of tears
• Negative: perform jones-2 test
• 1.Positive: partial obstruction of proximal lacrimal passages (puctal/canalicular) or pump failure
• 2.Negative: partial obstruction of distal nasolacrimal duct

• Hirschberg test:
• Corneal reflex test
• Estimates angle of deviation of corneal light reflex from the center of the pupil
• Used in detection of squint (Q)

• Differentiate coloured halos of immature cataract from acute congestive glaucoma
• Cracking of halos in cataract (C@C), but halos remain intact in glaucoma

• @MAC
• Maddox rod test
• Amsler grid test(Q)
• Cardboard test(two light discrimination test)

Refractive index of cornea

• Absence of crystalline lens from its normal position Vs condition of aphakia corrected with an IOL
• Surgical limbal scar: present Vs present
• Anterior chamber: deep(>4mm) vs normal/slightly deep(<4mm)
• Iridodonesis(tremulousness of iris): present Vs absent
• Purkinje image test: only 2 purkinje images seen (3rd and 4th purkinje images are absent) Vs all four purkinje images seen (3rd and 4th purkinje images are present)

Intraocular lens ( posterior chamber IOL)

• B/l thining and bulging of central cornea, which becomes cone shaped
• Descemet’s membrane may rupture
• Female, progressive myopia (NOT hypermetropia)
• Munson’s sign: bulging of lower lid on looking downwards
• Slit lamp: thining and ectasia of corneal stroma, Fleischer’s ring (d/t iron deposition in epithelium)
• Retinoscopy: scissor reflex
• NOTE: kayser Fleischer’s ring present in wilson’s disease and chalcosis (d/t copper deposition in Descemet’s membrane)

Alport’s syndrome (progressive hereditary nephritis)

• Marfan syndrome(b/l): supero-temporal subluxation
• Ehlers- Danlos syndrome
• Homocystinuria(b/l): infero-nasal subluxation (Q) (NOT homocysteinemia)
• Weill-Marchesani syndrome (AR condition with mesodermal dysplasia): antero-inferiorly
• Trauma
• EXCEPT: congenital rubella(Q), Batten Mayou disease
• NOTE: systemic disorders are frequently a/w b/l subluxation of lens

• Color blindness:
• Anomalous trichromatic color vision:
• @ R-GB colors…..red-1, green-2, blue-3
• Pahela(1): Prot-anomalous - defective red color perception
• Dusra(2): Deuter-anamalous - defective green color perception
• Tisra(3): Trit-anomalous: defective blue color perception
• NOTE: for color objects the field is largest for blue

• Low vision: Visual acuity <6/18 to <6/60 in in the better eye with the best correction
• Bindness: Visual acuity of <3/60, or corresponding visual field loss to < 100, in the better eye with the best correction

• Main symptoms: redness, irritation Vs severe excruciating pain
• Tenderness: nil/minimal Vs moderate to severe
• Congested vessles: bright red in color, move easily with the help cotton bud Vs purple red in color, cannot move easily with cotton bud
• Blanching of vessels: occurs with 10% phenylephrine Vs doesnot ocurrs with 10% phenylephrine

Chemical conjunctivitis

• With in 24 hrs: Silver nitrate(AgNO3)
• With in 48 hrs: gonorrhea
• 5-7 days: HSV-II
• >7 days: Chlamydia Trachomatis

• Organisms that penetrates normal/intact corneal epithelium:
• Neisseria gonorrhoea(Q)
• Corynebacterium diphtheriae

Chlamydia

• Enterovirus 70, coxsackie virus A-24, adenovirus
• EXCEPT: CMV

Pain (pain is minimal)

• Moraxella lacunata( diplobacillus)
• Also kn/as diplobacillary conjuctivitis
• Bacterial conjuctivitis caused by Moraxella Lacunata is not a/w a polymorphonuclaer response (Q)
• T/t: oxytetracycline(DOC), zinc sulphate or zinc oxide

• Type I hypersensitivity reaction
• Exogenous allergens: dust, pollen, heat
• Seasonal incidence (more comon in summer)
• B/l, marked symptom: itching
• White Ropy discharge: maxwell lyon sign (containing eosinophils)
• Signs:
• Conjunctivial signs: cobble stone appearance/ pavement stone fashion (palpebral), Horner-Trantas spots(bulbar)
• Corneal sign: shield ulcer (corneal ulcer with scarring)
• T/t: steroids, Di-sodium chromoglycate
• NOTE: follicles are not seen in VKC

• Type III/ delayed hypersensitivity reaction
• Endogenous microbial proteins (tubercular(m/c) or staphylococcus)
• U/L, symptoms: irritation, discomfort, reflex lacrimation (itching is not most marked symptom as seen in VKC)
• Conjunctival sign: phlycten or nodule at limbus is characteristic
• Corneal sign: fasicular ulcer(prominent leash of vessels develops in floor of phlyctenular ulcer), ring ulcer

• SAFE strategy has been developed for the control of:
• Trachoma
• S: Surgery for correction of entropian and trichiasis
• A: Antibiotics(tetracycline is t/t of choice) to reduce severity of inflammation and disease transmission
• F: Face washing/cleanliness
• E: Environment improvement

Lamellar keratoplasty

• Herpes zoster ophthalmicus:
• Caused by varicella zoster virus
• Corneal involvement is always a/w tip of nasal involvement and ulcers
• It is lodged in the gasserian ganglion
• EXCEPT: punctate keratitis may coalesce and unite to form dendritic ulcer which simulate herpes simplex

• CA: aspergillus fumigatus (m/c), fusarium
• H/o trauma to eye with vegetative matter(wooden stick)
• Feathery margins, Satellite nodule
• Non sterile hypopyon

Pneumococcus (it is also called hypopyon corneal ulcer, hypopyon is sterile d/t bacterial toxin(not d/t bacterial invasion))

Ability of pseudomonas to produce biofilms or “slime enclosed microcolonies”

• B/l non-suppurative uveitis (Q)
• Etiology: Penetrating injury (source:mudit khanna) involving ciliary body in one eye(exciting/injured eye) can lead to uveitis in other/fellow (symapathetic/ uninjured)eye
• Develops: 4 wks to 8 wks after trauma
• Earliest symptom: photophobia > blurring of near vision(d/t loss of accomodation)
• Earliest sign: retrolental flare (cells in retrolental space because inflammation starts in ciliary body)
• Posterior segment shows: dalen-fuch’s nodules(lymphocytes and plasma cells nodular aggregation on uveal tract)
• Mutton fat KP’s
• Koeppes nodules (small nodules seen at the papillary margin of the iris(Q) in patients with granulomatous anterior uveitis, which occurs in conditions such as sarcoidosis and tuberculosis.)
• T/t: corticosteroids, cycloplegics (atropine)

• Abnormal accumulation of serous fluid in outer layer of ciliary body and choroids
• Ciliochoroidal detachment (detachment of ciliary body, choroid ,retina)
• Structural defect in sclera (thick sclera)
• A/w Nanophthalmos and hypermetropia (NOT myopia)

• Pupil: miotic, irregular Vs dilated, vertical oval
• Anterior Chamber: normal Vs very shallow
• Cornea: hazy Vs hazy (both d/ to corneal oedema)
• IOP: usually normal Vs raised

Acute congestive glaucoma

• Atropine (DOC) (Q)
• Steroids: topical (t/t of choice for anterior uveitis), systemic
• Cyclosporine

• Complication of topical/sytemic steroids:
• Topical steroid: glaucoma
• Sytemic steroid: cataract

• Wilson’s disease, chalcosis, trauma(retension of intraocular FB): sunflower cataract
• Blunt Trauma: Rosette(Rose)/flower shaped cataract, vossius ring
• DM: snow flake/snow strom cataract
• Myotonic dystrophy: christmas tree/ stellate cataract
• Galactosemia: oil drop cataract/ dust like lenticular opacity
• Complicated cataract: polychromatic lustre/ bread crump appearance/rainbow cataract
• Atopic dermatitis: shield cataract (shield ulcer in VKC)
• Lamellar/ zonular cataract: spoke of a wheel pattern/riders
• Acute congestive glaucoma: glaukom-flecken
• Hypermature senile cataract: Morgagnian cataract

• Uveitis (m/c), retinitis pigmentosa, high myopia, RD, Glaucoma, intraocular tumors
• Posterior cortical cataract (in axial region)
• Polychromatic lustre or bread crumb appearance

• Non inflammatory swelling of optic nerve head Vs inflammatory condition
• Laterality: b/l Vs u/l
• Onset: insidious and transient Vs sudden
• Pain: absent/ present
• Loss of vision: negligible, gradual Vs marked
• Swelling of disc: marked/ moderate
• Visual field defect: enlargement of blind spot Vs central or centrocecal scotoma
• EXCEPT: sudden loss of vision(for papilloedema only)

• Ptosis, miosis, anhidrosis
• Enophthalmos (NOT Exophthalmos)
• Loss of cilio-spinal reflexes
• Hyperactive accomodation(NOT cycloplegia)
• EXCEPT: excessive sweating

• Open angle glaucoma: medical (eg:timolol) (filtration surgery: Trabeculectomy)
• Angle closure glaucoma: surgical (Nd YAG laser peripheral Iridotomy)
• Acute congestive glaucoma: pilocarpine (because it is acute stage, so surgery cannot be done immediately)
• Congenital glaucoma: trabeculotomy or Goniotomy

• Allergic blepharoconjunctivitis(Q)
• Corneal hypoesthesia

• Triad: Photophobia, blepharospasm, lacrimation (@PBL)
• Buphthalmos (large eye)
• Bluish discoloration of eye (d/t visualisation of underlying uvea because of stretching ,thining and translucent of sclera)
• Opacitiy d/t Haab’s stria (horizontal break in descemet’s membrane):
• double contoured opacities(double ‘tram-track’ lines or stria) concentric to the limbus
• Anterior chamber: deep; Ectopia lentis (subuxation of lens)
• Axial myopia
• Increased corneal diameter

Phacolytic glaucoma

Hypermature cataract

Opacification of posterior capsule

• Guanethidine is used for:
• Thyrotoxic ophthalmopathy (to counter act eyelid retraction in grave’s disease)

• @ Cherry Tree Never GGrow MMore Tall/heighty freely
• CRAO(Q)
• Blaunt Trauma (berlin edema/ commitio retinae) (Q)
• Niemann pick disease(Q)
• Gaucher disease, GM1 Gangliosidosis(Q)
• Metachromatic leukodystrophy,Multiple sulfatase deficiency(Q)
• Tay-sach’s disease(90%)
• Hurler’s disease(not hunter’s disease)
• Faber disease
• EXCEPT: CRVO, krabbe’s disease, tangier’s disease, wilson’s disease

• Optic nerve: ipsilateral blindness
• Optic nerve(proximal part, near chiasma): ipsilateral blindness with contralateral hemianopia
• Optic chaisma(pituitary tumor,prolactinoma, craniopharyngioma/ supra sellar tumors, acromegaly, aneurysm): Bi-temporal hemianopia
• Optic tract/ optic radiation: homonymous hemianopia
• Occipital lobe: homonymous hemianopia (with macular sparing)
• Temporal lobe: Quadratic homonymous defect
• Visual cortex(both occipital lobes): total hemianopia→cortical blindness

• Sudden loss of vision, NO H/O Trauma (spontaneous)
• Absence of fundal glow, Anterior chamber: normal
• T/t: if hemorrhage doesnot clear in 6 months: vitreo-retinal surgery

• Causes of Vitreous hemorrhage:
• DM, HTN
• Trauma, Eales’ disease
• EXCEPT: vitreous degeneration

• Diabetes (NOT HTN, trauma)
• Proliferative diabetes retinopathy is the m/c cause of spontaneous vitreous hemorrhage in adult

• In young adults, vitreous hemorrhage indicates:
• Eale’s disease

• M/c intraocular tumor of childhood, present within first 2 years of life
• M/c presentation: leukocoria (stabismus is 2nd m/c), glaucoma, intraocular inflammation
• Mutation in RB gene are seen at 13q14
• 25% B/L, 6% familial, 94% sporadic
• Calcification is common(intraocular/cranial), optic foramen is enlarged
• M/c non-ocular malignancy in RB: osteogenic sarcoma(osteosarcoma)

• Intraocular tumors (retiunoblastoma, melignant melanoma)
• Large retained intraocular FB
• Perforating injury to eye with loss of vision
• Painful blind eye
• Anterior staphyloma (Q)

Panophthalmitis > Endophthalmitis

Rhabdomyosarcoma

Rhabdomyosarcoma

• M/c soft tissue sarcoma in children
• M/c primary orbital malignancy in children
• M/c location: head and neck region
• M/c histological subtype: Embryonal Rhabdomyosarcoma

• M/c type of lid carcinoma is:
• Basal cell carcinoma

• Has a peak incidence in first decade(2-5 yrs of age)
• Arises from astrocytes and oligodendrocytes of the optic nerve
• A/w type I Neurofibromatosis
• EXCEPT: causes meningeal hyperplasia

• Mydriasis, Loss of light reflex, photophobia
• EXCEPT: decreased intraocular tension ( IOP tends to rise, so contraindicated in all types of glaucoma except malignant glaucoma)

Tropicamide

Extraocular muscle movements:

Inferior rectus (IR→MR→SR→LR)

LPS (Levator Palpebrae Superioris)

• D/t weakness or paralysis of one or more of extraocular muscles
• Esotropia Vs Exotropia :
• convergent Vs not always divergent
• one or both eye turn inward d/t LR palsy Vs 3rd nerve palsy
• uncrossed diplopia (Q) Vs crossed diplopia(Q)
• Both t/t: surgery
• Important points:
• Diplopia, vertigo
• Patient may turn head to compensate for paralytic muscle (NOT: normal position of head)
• Secondary deviation is greater then the primary

Myasthenia gravis

• Myasthenia graves
• Eaten lambert syndrome
• Fisher syndrome (ocular variant of Guillain Barre Syndrome, produce ophthalmoplegia, areflexia, ataxia)
• Thyrotoxicosis

• Horner’s syndrome (Q)
• Very mild congenital ptosis

• Optic nerve
• Marcus gunn pupil

• RAPD, Retrobulbar neuritis
• RAPD refers to reduced constriction of one pupil relative to the other in response to light, d/t a defect in the afferent pupillary pathway. This is usually manifested as paradoxical pupillary dilatation to light on performing swinging light reflex
• 1.Pupil in dim light are equal
• 2.Light directed into affected eye(U/L APD): partial or sluggish constriction (d/t afferent pupillary pathway)
• 3.Light directed into normal eye: normal constriction of both pupil (no defect in APD)
• 4.Light directed into affected eye: apparent paradoxical dilatation of both pupils (d/ relatively weaker/sluggish constriction)

• Vision: good Vs good
• Pupil: constricted Vs slightly dilated
• Effect of illumination: nil Vs larger in bright light
• Pupillary Light reflex (direct/consensual): absent Vs absent/ sluggish(poor)
• Accomodation reflex: brisk (active) Vs slow
• Atropine: no mydriasis Vs mydriasis
• Pilocarpine(mitotic): constrict Vs constrict with very weak solution
• A/w: Neurosyphilis Vs Shy Drager Syndrome, absent knee jerk

• M/c ocular FB is:
• Chiesel hammer (chips of iron and steel)
• NOTE: chips of iron and steel, most commonly result from the chiesel, when chiesel and hammer are used.

Iron(Q) or steel

Metals like gold(Q), silver, platinum, tantalum

Copper

• 1.Senile entropion: m/c variety affecting lower lid, seen in elderly
• Surgery -Tucking or plication of inferior lid retractor(Q), modified wheeler’s operation, weiss operation
• 2.Cicatrical entropion: m/c variety affecting upper lid, seen in trachoma
• Surgery - modified burrow’s operation
• 3.Spastic entropion: d/t spasm of orbicularis oculi muscle, t/t - injection botulinum toxin
• 4.Congenital entropion: rare, present since birth, t/t - plastic reconstruction

Causes of loss of vision:

Acute iridocyclitis, acute congestive galucoma, chemical and mechanical trauma to eyeball

• CRAO, CRVO, RD, Eale’s disease (vitreous and retinal hemorrhages)
• Macular edema, macular degeneration(AMRD- exudative/wet type), Central serous retinopathy
• Optic neuritis, methyl alcohol amblyopia

Chronic iridocyclitis, chronic simple glaucoma, corneal ulceration

• Cataract(Q), ARMD-dry type, Retinitis pigmentosa (RP), diabetic retinopathy, Optic atrophy
• Refractive error, presbyopia, progressive pterygium, corneal dystrophy/ degeneration

• Angle closure glaucoma
• Retinal Detachment (RD)
• Central retinal arterial occlusion (CRAO)
• EXCEPT: central serous retinopathy(resolves spontaneously, no acive t/t required)

• Keratoconus
• Leprosy
• Neurofibromatosis
• EXCEPT: herpes simplex keratitis

• Afferent: V1(ophthalmic: nasociliary branch)
• Efferent: VII(temporal branch: orbicularis oculi)

• Retinal artery- central retinal artery(superior/ inferior)
• Choroidal artey- short posterior ciliary artery (NOT long posterior ciliary artery):
• Circle/Plexus of zinn and haller:Some branches of the short posterior ciliary arteries also supply the optic disc via an anastomotic ring wich is k/as circle of zinn and haller
• The retina recieves its blood supply from all, except: a. posterior ciliary artery, b. central retinal artery, c. retinal arteries, d. plexus of zinn and haller arteries
• Posterior ciliary artery (best answer of exclusion, as it donot supply retina directly but indirectly via the plexus of zinn and haller arteries, long posterior ciliary artery donot supply retina, only short posterior ciliary artery supplies retina indirectly)

• Image: Virtual, Erect Vs True(real), Inverted (SLIT lamp is indirect so, @IT)
• Magnification: 15 times Vs 5 times

Indirect ophthalmoscopy

• Protection against oxidative damage
• Enzymes: glutathione, peroxidase, catalase, superoxide dimutase
• Vitamins: vitamin C (ascorbic acid)
• Present at low level at aqueous humor, have less antioxidant role in lens than other: beta carotene/ provitamin A (NOT vitamin A), vitamin E
• M/c cause of u/l proptosis in children:
• Orbital cellulitis

Dermoid cyst

Chloroma(extramedullary manifestation of AML)

Thyroid ophthalmopathy

• @VSD-M (VSD-Myocardium)
• Von Graefe’s sign: lagging behind of upper eyelid( failure of eyelid to move downward proptly with eyeball and lid moves tardily and jerkily)
• Stell-wag’s sign (@sewag sign)(Q): imperfect closure of lids and decreased frequency of blinking
• Dal-rymple’s sign: unnatural degree of separation between margins of two lids
• Mobius’s sign: imperfect power of convergence

• Varicose vein in the eye, m/c cause of intermittent proptosis
• U/l proptosis, compressible,
• Non pulsatile, No thrill/bruit
• Precipitaed by increasing venous pressure(bending forward, coughing)
• MRI: Retroorbital mass with echogenic shadows(phleboliths: calcified thrombi within vein)

• It is the viscous biological glue that contibutes to retinal adhesion
• Matrix Metalloproteinase
• Tissue Inhibitors of Metalloproteinases (TIMP)
• Sialoprotein Associated with Rods and Cones(SPARC)
• EXCEPT: Memicane

• D/t deposition of calcium in bowman’s membrane,stroma, epithelium (ABC)
• Causes:
• idiopathic(m/c)
• Chronic uveitis: JRA,sarcoidosis(Q)
• Systemic hypercalcemia: sarcoidosis, vitamin D poisoning(Q), hyperparathyroidism

• Patau syndrome(trisomy 13)
• Trisomy 22

• Fluorescein Angiography(FA):
• Study of retinal vasculature
• Definitive Dx of Central Serous Retinopathy(Q)
• Indocyanine Green Angiography (ICG Angiography):
• Study of choroidal vasculature
• Occult Choroidal Neovascularisation (Occult CNV) (Q) (NOT: Classic Choroidal Neovascularistion)
• Suspected Retinal Pigment Epithelium Detachment (RPE detachment)

• Spontaneous serous detachment of neurosensory retina in macular region. usually u/l
• Dignostic test: Fluorescein Angiography(FA): expanding dot sign is seen (Q), mushroom/umbrella pattern is seen
• Ophthalmoscopy: circular ring reflex is seen
• self limiting disease, no t/t required

• May develops after cataract surgery (ICCE>ECCE)
• Diagnostic test: Fluorescein Angiography(FA): flower petal appearance(Q)
• Ophthalmoscopy: honey comb appearance
• Most cases resolves spontaneously within 6 months, no specific t/t
• May develops Irvine gass syndrome (Chronic CME after cataract surgery/ post cataract CME)
• EXCEPT: visual prognosis is poor

• Retinal Veins: dilated, Non tortuous Vs dilated, tortuous
• Retinal artery perfusion pressure: decreased Vs normal/increased
• Ophthalmodynamometry (non invasive method of estimating pressure within ophthalmic artery): decreased VS normal/increased

Orbital mucormycosis (CRAO is a complication of orbial mucorcycosis)

• CRVO, CRAO, Eale’s disease
• NOT: JRA

• Donor tissue should be removed within 24 hrs of death (ideally within 4-6 hrs)
• Specular microscopy analysis is used to assess endothelial cell count
• Donar cornea is most commonly preserved as a corneoscleral rim(edge/border)(Q. whole eye not preserved)
• HLA matching is not mandatory
• Donor age has not been a significant factor in determining the success of transplantation, although young donor corneal tissues are preffered
• (donor age > 60 yrs is not a contraindication to accept corneal tissue)

• Slow degenrative dystrophy of photoreceptors of retina (rods>cons)
• Nyctalopia(night blindness)
• Later stage: optic atrophy (consecutive)
• Visual field loss: tubular/tunnel vision, ring scotoma
• Triad: pale waxy optic disc, attenaution/narrowing of retinal arterioles, bony corpusle/spicles retinal pigmentation
• EXCEPT: retinal hemorrhage, ERG:normal

• Primary optic atropy Vs secondary optic atropy Vs consecutive optic atrophy:
• Disc color: chalky white Vs dirty grey Vs pale waxy
• Margins: well defined Vs blurred Vs well defined
• Retinal vessels: normal Vs attenuation of arteries, tortuous veins Vs marked attenuation of arteries
• Surrounding retina: normal Vs edema Vs associated retinal pathology
• Example: optic nerve tumor, pituitary tumor Vs papilledema, papillitis Vs Retinitis Pigmentosa (RP)
• Defination:
• Primary optic atrophy: optic atrophy from lesions proximal to the optic disc without swelling of the optic nerve head. Caused by lesions affecting the visual pathways from the retrolaminar portion of the optic nerve to the lateral geniculate body
• Secondary optic atrophy: optic atrophy secondary to long standing swelling of the optic nerve head (long standing pailloedema/ papillitis I.e. post-neuritic/ post-papilloedematous))
• Consecutive optic atrophy: optic atrophy caused by diseases of the inner retina or its blood supply

Primary optic atrophy

Lens capsule (after cataract: posterior lens capsular opacification)

• Myopia
• NOTE: also kn/as posterior staphyloma, ectasia(distention/ bulging and thining) of sclera at the posterior pole which is lined by choroid. Occurs in high degree axial myopia (pathological myopia)

Myopia

Ectasia of sclera with incarceration of root of iris

15-25 D (20-30 D)

Retinal detachment

Hypermetropic

• Vitamin A deficiency
• High myopia
• Retinitis Pigmentosa
• Oguchi’s disease
• EXCEPT: tobacco amblyopia, cone dystrophy

Pars planitis( chronic form of cyclitis seen in children and young adults, floaters before eye, snowball/ cotton ball like white exudates near ora serrata which coalesce to form a white plaque giving snow banking effect)

• Oculus Dex-ter refers to Right Eye (OD @ RE) (Q)
• Oculus Sinis-ter refers to left Eye (OS @ LE)
• Oculus Uter-que refers to Both Eye (OU @ BE)

Toxoplasmosis

Prismatic deformity (at the edge of lens)

Base ( at its attachement to ciliary body)

Ring of schwalbe

Descemet’s membrane

Posterior chamber lens

• Twilight vision is because of:
• Both rods nad cones

Angle between visual axis and optical axis (@ 1P)

Angle between visual axis and pupillary axis (@2P)

• Anisometropia :
• High difference of refractive error between the two eyes (significant, when difference between the refraction of two eyes exceeds 2.5 D)
• T/t: contact lens

Difference in size and shape of retinal images by 2 eyes

• Waardenburg syndrome:
• AD condition characterised by:
• Lateral displacement of inner canthi and puncta
• Heterochromia
• Pigmentary disturbances: white forelock
• Synophrys (growing together of the two eyebrows)
• EXCEPT: narrow palpebral tissue

Dacroadenitis

• M/c site: floor (posteromedial wall of maxillary bone, @PM on floor of maxilla)
• CT scan: tear drop or candle dripping sign
• Signs: periocular echymosis, enophthalmos, diplopia, infraorbial nerve anesthesia

inferior

Conjugate + nonrhythmic movement of eye

• Sphincter pupillae: Edinger-westphal nucleus→3rd nerve→cholinergic/parasympathetic fiber→sphincterpupillae
• Dilator pupillae: sympathetic cervical ganglion chain→adrenergic sympathetic fiber→dilator pupillae

Adrenergic fibers

• Spontaneous
• Trauma
• Eye rubbing
• Pertusis (vigorous coughing)
• EXCEPT: high intraocular tension

VII

Phacoemulsification

Extracapsular cataract extraction

Phacoemulsifier

• A common criterion for cataract operation is: a complications, b. maturation of cataract, c. loss of vision, d. all of the above
• Loss of vision

Isolated ocular muscle paralysis

• Cornea
• 1st /2nd/3rd oder neurons in optic pathway:
• 1st order neuron: bipolar cells of retina
• 2nd order neuron: ganglion cells of retina(Q)
• 3rd order neuron: neurons in the 6 layers of LGB

• Common ocular manifestation in trisomy 13 is:
• B/l micorophthalmos

Idoxuridine (used in t/t of keratitis caused by herpes simplex virus (HSV))

Sulphonamides systemically

• Drugs used in t/t of Diabetic Macular edema/Retinopathy:
• Ruboxistaurim
• Pyridazinones
• Benfotiamine
• EXCEPT: Tamoxifen (cause Retinopathy and macular edema)

Pilocarpine