For a good clean feeling, no matter what!
The main 4 criteria to differentiate preseptal vs orbital cellulitis.
What is: DERP
decreased VA, EOM restriction, RAPD, Pain
BONUS: what microorganisms can cause this?
The cause of a "pouting puncta" that causes tenderness
What is: canaliculitis caused by actinomycetes Israeli.
BONUS: what is seen when the canaliculi are expressed?
most frequent isolated cause of bacterial conjunctivitis in all ages due to high association with blepharitis.
what is staph aureus.
BONUS: name the microbiology test steps required to confirm staph aureus
call on someone else to explain how we test gram neg vs positive and why the results are as such
Cataract surgeon did not want to do surgery after seeing the patient with Fuchs had this finding.
BONUS: minimum of how many cells are required for cornea edema?
Agar used for both nisseria gonorrhea and haeomphilus influenzae
Thayer Martin
BONUS: name other agars you remember!
The most common cause for unilateral OR bilateral proptosis in middle age patients
What is Thyroid Eye Disease
BONUS: list as many signs of Graves as you can!
QUICK! Name those dimensions:
vertical cannaliculi:
horizontal cannaliculi:
lac sac:
nasolacrimal duct:
What are:
2mm
8 mm
10 mm
15mm
The conditions in which we see follicles.
What are: chlyamdia, herpes, adenovirus (acute, EKC, PCF), toxic (allergy, molluscum, lice)
ok that was easy easy...what else can you CHAT about regarding the above conditions? choose one to explain and then call on someone else to explain another and so on
Meesman
Granular
Lattice
Schnyder
What are: MarilynMonroe GotHers LA SouthernCali
messmates-mucopolysach
granular-hyaline
lattice-amyloid
synder-cholesterol
BONUS: what else is related to cholesterol in the cornea? in the vitreous?
Secondary causes of non-sjogens DRUH-EY.
B SPECIFIC PLZ
What are:
Attacked glands d/t inflammatory (sarcoid, lymphomas)
Blocked ducts (trachoma, pemphigoid, burns)
Cut nerves (damage to CN VI or VII - CL wear, DM, palsy, drugs, herpes, corneal surgery)
Bilateral orbital psuedotumor is suspected in these conditions.
What are: Wegeners granulomatosis, polyarteritis nodosa, or lymphoma
BONUS: how do we test for Wegeners?
Henry preforms this on a patient and hopes to make makes the patient GAG!
Jones II
BONUS: interpret the results (+/-) and implications!
Now call on someone to explain jones I
This contains a central vessel serving as source of infiltration for these types of cells and is affiliated with these types of conditions.
What is a papillae.
Infiltration of eosinophil, mast cell, neutrophils, lymhocytes
associated with allergic or bacterial conjunctivitis and conditions resulting from FRICTION
BONUS: name examples of friction
don't peak below:
[FES, filamentary keratopathy, concretions, GPC]
Your pod-mate checks the cornea and say all clear. Although you are only supposed to be scribing, you don't want to get an article passively aggressively sent to you re:corneal infiltrates so you decide to take another look. You lift the lid and now come up with these differentials: a) sterile infiltrate, b) sterile corneal ulcer, and c) infectious ulcer.
You do this next to decide which it is.
What is: stain the cornea!
possible results:
1:1 ratio = infectious ulcer
less than 1:1 ratio = sterile ulcer
no staining = sterile infiltrate b/c NO EPI DEFECT
Depressions within the cornea visible as pooling fluoroscein.
What is dimple veiling - caused by small gas bubbles trapped under GP.
BONUS: explain diff b/w flourscein POOLing and what flourscein STAINS
what other condition results in pooling?
The most common intrinsic tumor of the optic nerve.
What is optic nerve glioma
BONUS: what condition is it most commonly associated with? -> call on someone to name additional signs of this condition
Systemic condition causing inflammation of lacrimal gland leads us to this testing.
What is chest X-ray for sarcoid!
BONUS: name all 7 findings related to sarcoidosis!
GPC most commonly occurs due to these conditions (list at least three as specific as possible)
What are: silicone hydrogel contact lenses (95%), exposed suture, blebs, scleral buckle, allergies
bonus: explain pros/cons of diff material of lenses
The astute intern did this after seeing train track lesions and vesicles in slit lamp.
What is: GONIO!
condition: PPMD can lead to metaplasia of endo cells causing spread to iris and angle -> ACG! must check IOP and gonio
BONUS: what type of dystrophy is this and name any other disorders in this layer - then call on someone else to explain that disorder
You prescribe this medication to your patient who presents with a bilateral complaint of FB sensation and photophobia but the eyes are QUIET without injection.
What is steroids!
you are a H E R O ! for thygesons
BONUS: what other conditions can you be a HERO for according to chad?
What is an CT/MRI showing WIDESPREAD INFLAM of EOM and including tendons (unlike TED), dacyroadenitis, ON inflammation, dry eye, conj edema, possible hyperopic shift from pushing on ON
On slit lamp you view this and it appears to be jelly around the limbus with vascularization onto the cornea. What do you use to stain it and what are you worried about?
What is: OSSN (ocular surface squamous neo) AKA CIN
it stains with LISSAMINE GREEN NOT NAFL
you worry it becomes SCC
BONUS: recall what PAM can progress into
Medication you prescribe after finding follicular + papillary conjunctivitis inferiorly with (+) preauricular nodes + subepithelial infiltrates
What is: azithro
Alt: doxy
Bonus: name the signs related to the "cousin" condition to AIC
Describe the pathophysiology of this condition causing acute pain upon awakening, lacrimation and photophobia and how we detect it under slit lamp.
What are poor hemisome attachment to underlying basement membrane as result of trauma, dystrophy (EBMD) and/or age related THICKENING of BM.
NEGATIVE STAINING with NAFL!
Bonus: what secretes the BM?
call on someone else to explain a condition that is also a hypersecretion of a corneal BM like layer
This procedure requires 400 micron residual cornea remaining after surgery and treats this range of RX.
What is: Photorefractive Keratectomy PRK
Treatment range: -8D to +4D, up to 4D cyl
remember 4's (4, 8, 400)
BONUS: how does healing process differ from LAIK healing process