Examination technique of senile cataract

 V- DOTS (shared by Namratha KN)

*Visual acuity testing

*Distant direct ophthalmoscopic examination 

* Oblique illumination examination 

* Test fr iris shadow

* Slit lamp examination

"DWARF" for describing Nystagmus

Direction=plane of movement-horizontal,vertical

Waveform= Pendular or Jerky

Amplitude= fine or coarse

Rest=At primary position or gaze evoked

Frequency= How often the eye moves

UVEITIS

Systemic Features of Sarcoid: FILLED BAGEL

Facial nerve palsy

Infiltrates of lung parenchyma, Insufficiency of pituitary

Lymphadenopathy (esp lung hilae)

Liver & spleen enlargement

Elevated ACE & calcium

Dilated cardiomyopathy

Bone cysts

Arthralgia

Granulomata of skin

Erythema nodosum

Lupus pernio

Features of Behcet's Disease: ORAL UPSET

Occlusive periphlebitis

Retinitis

Anterior uveitis

Leakage from retinal vessels

Ulceration (aphthous/genital)

Pustules after skin trauma (Pathergy test)

Scratching leaves lines (dermatographism)

Erythema nodosum

Thrombophlebitis

Clinical features of Reiter’s: PLUCKING

Plantar Fasciitis

Urethritis

Conjunctivitis

Keratoderma blenorrhagica

Inflamed joints

Nail dystrophy

Gum ulceration

Ophthalmic features of TB: BCG GP

Busacca & Koeppe nodules on iris

Choroiditis

Granulomata in choroid

Granulomatous uveitis (with mutton fat KP’s)

Periphlebitis

Stye and Chalazion

STYE is Hordeolum externum (STAY OUT) ; Moll's gland / Zeis gland affected
Chalazion is Hordeolum INternum - Chronic Inflammatory granuloma of MEiBOMian glands (Remember : See (C)  me in Bombay)

Cataracts: causes

CATARAct:
Congenital
Aging
Toxicity (steroids, etc)
Accidents
Radiation
Abnormal metabolism (diabetes mellitus, Wilson's)

Surgeries for Ptosis

F L U F F Y
F- fasanella servat operation
L- levator resection {blaskovics n everbush's}
F- frontalis sling operation

Causes of lid retraction

4M= Myasthenia Gravis, Marcus Gunn jaw winkling syndrome, Myotonic causes like dystrophica myotonica. Metabolic causes like uraemia,cirrhosis

4P= Perinauds syndrome, Parkinson's Disease/ Progressive supranuclear palsy, Ptosis of other eye, Palsy (aberrant III cranial nerve regeneration)

Causes of retinal detachment

Mnemonic: SITS

Secondary to some intraocular problem (melanoma)
Idiopathic
Trauma
Surgery for cataract

Nerves passing through superior orbital fissure

“Live Frankly To See Absolutely No Insult”

• Lacrimal nerve
• Frontal nerve
• Trochlear nerve
• Superior division of oculomotor nerve
• Abducens nerve
• Nasociliary nerve (branch of ophthalmic nerve)
• Inferior division of oculomotor nerve

Etiology of Neovascular Glaucoma

RUBEOTIC

Retinopathy and Retinal vein occlusion (PDR, CRVO)
Retinal detachment
Uveitis
BRVO
Eale's Disease
Ocular Ischemic Syndrome
Trauma
Intraocular tumours (choroidal melanoma)
Carotid Cavernous Fistula

ANGLE SRUCTURES

"I Can See Till Schwalbe's Line"

Iris root

Cilliary Body

Scleral spur

Trabecular Meshwork

Schwalbe's Line

ACROMEGALY & MARFANS

Remember ocular features of acromegaly with ACROM

Angiod streaks

Chiasmal syndrome

Retinopathy

Optic atrophy,papilloedema

Muscle enlargement

Remember the systemic features of Marfan syndrome with MARFANS

Mitral prolapse

Aortic dissection

Regurgitant aortic valve

Fingers long (arachnodactyly)

Arm span>height

Nasal voice (high arched palate)

Sternal excavation

characteristics of Perinaud's Dorsal Midbrain Syndrome with "CLUES"

Convergence retraction nystagmus

Lightnear Dissociation

Upgaze paralysis

Eyelid retraction

Skew deviation

Characteristics of congenital nystagmus with CONGENITAL

Convergence & eye closure dampens

Oscillopsia absent

Null zone that is present,increases foveation time which results in increased acuity

Gaze poisition doesnot change the horizontal direction of nystagmus

Equal amplitude and frequency in each eye

Near acuity is good

Inversion of optokinetic response

Turning of head to acheive null point

Abolishes in sleep

Latent (occlusion) nystagmus occurs

Causes of downbeat nystagmus with DoWNBEAT

Degeneration,Demyelination or Drugs (Lithium)

Wernicke's Encephalopathy

Neoplasm or paraneoplastic cerebeller degeneration

Brainstem disease (Syringomyelia)

Encephalitis

Arnold-Chiari malformation

Trauma or Toxin

Content & veins draining the Cavernous Sinus with Rule of 3

3 Afferent veins: Sphenoparietal sinus (Vault veins), Supf Middle cerebral Vein (Brain), Ophthalmic vein (Orbit)
3 Efferent Veins: Superior petrosal sinus, Inferior Petrosal Sinus, Communicating vein to pterygoid plexus
3 Contents; Cranial Nerves (III,IV, V1,V2 & VI)
3 Areas Drain into it: Vault Bones, Brain (Cerebral Hemisphere), Orbit
3 Nerves: Motor(III,IV,VI),Sensory (V1,V2), Sympathetic

Structures derived from surface ectoderm with

 S1L2E3

Skin of Eyelids and its derivatives viz. cilia, tarsal glands, conjunctival gland
Lens,
Lacrimal Gland,
Epithelium of Conjunctiva,
Epithelium of Cornea,
Epithelium of lacrimal passage

Ocular structures derived from neuroectoderm

Muscles of pupil
Optic Nerve
Retina (with RPE)
Epithelium of Iris
Epithelium of Cilliary Body

Sterilization in ophthalmology with ABCDEFG

AUTOCLAVE
BOILING
CHEMICALS like Alcohol (Rectified spirit), Isopropyl alcohol/CIDEX: 2% Glutaraldehyde
DRY HEAT temperature of 150°C is used for 90 minutes
ETHYLENE OXIDE for sterilization of IOL etc.
FUMIGATION of operation theatre/ FORMALIN vapour
GAMMA-IRRADIATION: Gamma rays from Cobalt-60

Causes of trabecular pigmentation

"PIGMENT"

Pseudoexfoliation & Pigment dispersion syndrome
Iritis
Glaucoma (Post angle closure Glaucoma)
Melanosis of angle (oculodermal melanosis)
Endocrine (Diabetes & Addison’s Syndrome)
Naevus (Cogan-reese syndrome)
Trauma