Ocular Disease Stuff

Front 1

_____ _____ results in retinal whitening w/o damage to surrounding blood vessels, and is due to ocular trauma.

Back 1

Commotio retinae

*Known as BERLIN'S EDEMA when the macula is involved
*Commotio retinae usu resolves on its own w/o sequelae w/in 24-28 hrs
*Permanent vision loss can occur
*PR outer segment disruption causes the whitening

Front 2

Because significant IOP increases can occur, patients should keep their head elevated (ideally at 30-deg) when what is present in the anterior chamber?

Back 2

Hyphema

Keeping head elevated encourages RBC's to settle inferiorly

*60% of patients w/ hyphema will also have angle recession since trauma is the main cause of hyphema

Front 3

Most common bacteria causing orbital cellulitis in adults and in kids (2)?

Back 3

S. aureus - adults

H. influenzae - kids

Front 4

Diabetics and immunocompromised patients w/ orbital cellulitis can develop ________, an aggressive fungal infection that shows characteristic black eschar (scab) of the nose and mouth.

Back 4

Mucormycosis

Can be life-threatening

Front 5

Medications that can lead to oculogyric crisis?

Back 5

Phenothiazines and cetirizine (Zyrtec)

Also (from wikipedia): carbamazepine, chloroquine, diazoxide, levodopa, lithium, nifedipine, phencyclidine ("PCP")

Front 6

"Stare" appearance in Graves' disease is known as what?

What other ocular signs occur in Graves?

Back 6

Kocher's sign

-Von Graefe's sign (lid lag on downgaze)
-Corneal exposure signs (SPK, SLK)
-EOM swelling (IR > MR)

Front 7

Patient presents w/ extreme redness and chemosis of the conj, and a lateral rectus palsy. Patient recently experienced head trauma. Dx?

Back 7

Carotid-cavernous sinus fistula

Abnormal communication between arterial and venous systems

High-pressure blood in cavernous sinus (from carotid A) impedes return of venous blood back to cavernous sinus

Build-up of pressure on posterior globe causes redness, chemosis of the conj on the involved side

CNVI is affected w/ palsy ~50% of the time

*Another etiology of CCF is rupture of an INTRAVERNOUS ANEURYSM

Front 8

Most common benign orbital tumor in adults?

In children?

Back 8

Cavernous hemangioma

Capillary hemangioma

Front 9

Most common primary orbital malignancy in kids?

Secondary orbital malignancy?

Back 9

Rhabdomysarcoma

Neuroblastoma (poor prognosis) - primitive neural crest cell hyperplasia from tumor in abdomen, mediastinum, or neck

Front 10

Neurofibroma is a benign, yellow-white tumor made of what cell type?

Back 10

Astrocytes

Can occur in isolation of neurofibromatosis

Front 11

Goldenhar's syndrome triad?

Back 11

Limbal dermoids

Preauricular skin tags

Vertebral dysplasia

Front 12

Optic nerve gliomas occur most often in the first decade of life and are associated w/ what systemic disease 50% of the time in infants?

Back 12

Neurofibromatosis

Front 13

Bilateral pseudotumor in adults should raise suspicion for what type of 2 types of systemic disease?

Back 13

Vasculitis, e.g. Wegener's granulomatosis, polyarteritis nodosa

Lymphoma

Front 14

Tolosa-Hunt syndrome

Back 14

Painful ophthalmoplegia caused by nonspecific inflammation of the cavernous sinus or superior orbital fissure. Dx of exclusion.

Painful exophthalmoplegia and diplopia, loss of CNV sensory innervation

Front 15

Ocular rosacea occur most-commonly in what gender and ancestry?

Back 15

Females, Northern Europeans

Front 16

Ocular cicatricial pemphigoid occurs mostly in females of what age?

What ocular drugs can cause pemphigoid?

Back 16

Over 60

Topical glaucoma meds - timolol, epinephrine, pilocarpine (though whether these cases are in fact the same disease as idiopathic OCP is questionable)

Front 17

Floppy eyelid syndrome occurs most-commonly in what epidemiologic group?

Back 17

Obese men w/ sleep apnea

Sx include chronic red eyes in the AM, often w/ mild mucous discharge

Signs - chronic papillary conjunctivitis, loose upper eyelids that evert easily

During sleep, spontaneous lid eversion exposes superior tarsal conj to bedding

Front 18

When is benign essential blepharospasm called Meige's syndrome?

Back 18

BEB + lower facial abnormalities (e.g. difficulty chewing, opening mouth, jaw spasms, pain)

Front 19

T/F: Myokymia affects the procerus and corrugator muscles.

Back 19

F

Myokymia only affects the orbicularis oculi of one eye.

Benign essential blepharospasm affects all 3 muscles.

Front 20

Most common causes of nasolacrimal duct obstruction in adults? Kids?

Most common cause of calaliculitis?

Back 20

Adults - involutional stenosis

Kids - membranous blockage at valve of Hasner (congenital)

Canaliculitis - actinomyces israeli (streptothrix) infection

*Yellow sulfur granules upon expression
*Note that dacryocystitis usu has more swelling, tenderness, pain than canaliculitis

Front 21

Etiologies of acute and chronic dacryoadenitis?

Back 21

Acute - bacterial or viral infection

Chronic (more common) - inflammatory disorders, e.g. sarcoid, TB, Graves'

Front 22

Jones 1 vs Jones 2 testing

Back 22

Jones 1 test uses NaFl to assess patency of nasolacrimal system (blow nose after 5 min)

Jones 2 test is done if Jones 1 is negative - use saline to try and irrigate NaFl out - look for reflex fluid out of same punctum (canallicular blockage) or retrograde flow through opposite canaliculus and punctum (nasolacrimal blockage)