Ophthalmology

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• Superficial layer of the eyelid consist of: Skin, sweat glands, sebaceous glands, modified sweat and sebaceous glands, fibers of orbicularis oculi m
• Deep layer of eyelid consist of: Tarsal plate, tarsal muscle, palpebral conjunctiva, sebaceous glands (tarsal or meibomian glands)
• Lacrimal system consists of 2 secretions: tear fluid, tear drainage
• The tear secretion consists of: lacrimal gland, accessory glands of Kruse and Wolfring, meibomian glands
• The tear drainage structures are: orbicularis oculi m, superior and inferior puncta lacrimales, superior and inferior lacrimal canaliculi, lacrimal sac, nasolacrimal duct, inferior concha
• Layers of tear film: Oily layer, watery layer, mucin layer
• Name of the inner layer of tear film is: Mucin layer
• Orbicularis oculi m is innervated by: temporal (orbital, palpebral) and zygomatic (lacrimal) beaches of facial n
• Orbicularis oculi m is supplied by: Maxillary, superficial temporal, facial and ophthalmic a
• Where is located plica semilunaris? Half moon shaped fold of mucous membrane in the medial corner of the palpebral fissure
• 3 main tasks of conjunctival sac? Motility of the eyeball, articulating layer, protective function
• The conjunctiva consists of: Bulbar conjunctiva, conjunctival fornices, palpebral conjunctiva
• What is the isocoria? Both pupils are normally the same size even when one eye is bild. Up to 1 mm diff
• What is the normal pupils size range? 1mm (miosis) to 8mm (mydriasis)
• The near reflex consists of: Convergence, accommodation and constriction of the pupils (miosis)
• What is it? One eye is illuminated but both pupils will narrow Indirect or consensual light reflex
• 3 risk factors for glaucoma? Family history, myopia, glaucoma of other eye, differences between the optic cup
• The average normal intraocular pressure in adults? 15mmHg
• The aqueous humor is formed by: Double layered epithelium covering the ciliary body
• 2 channels of aqueous humor flows out, how much % from each channel? 85% Trabecular meshwork --> canal of schlemm --> radial collecting channels --> episcleral venous plexus. 15% uveoscleral vascular system --> venous blood
• Portions of optic nerve intraocular, intraorbital, intracranial
• The optic nerve is supplied with blood from short posterior ciliary arteries and central retinal artery
• An average area of the optic disc is approximately 2, 7mm2 with diameter of 1, 8mm
• A total length of the optic nerve is 35-55mm
• 6 parts of the visual pathway optic nerve, optic chiasm, optic tract, lateral geniculate body, optic radiations (geniculocalcarine tracts), primary visual area (striate cortex)
• Describe the neurons of the visual pathway 1. rods and cones, 2. bipolar cells, 3. ganglion cells, 4. optic radiations
• Which fivers of the optic nerve cross the midline in the optic chiasm From nasal halves
• Where 4th neuron of the visual pathway start Cell body in lateral geniculate body --> axons to optic radiations --> ends in visual cortex in occipital lobe
• 7 bones of the orbital cavity Frontal, ethmoid, lacrimal, sphenoid, maxillary, palatine, zygomatic
• Describe structures of the superior orbital fissure oculomotor n, trochlear n, abducent n, ophthalmic n (lacrimal, frontal, nasociliary), superior ophthalmic v
• Which parts of the orbital cavity are the thinnest Ethmoidal air cells
• Structures of the optic canal optic n, ophthalmic a
• Uveal tract consist of Iris, ciliary body, choroid
• Arterial supply of the uveal tract consist of ophthalmic a: short posterior ciliary a, long posterior ciliary a, anterior ciliary a
• What are the two muscles of the iris, please give the names and their neuronal supply Dilator pupillae m sympathetic nerve fibers from long ciliary n, sphincter pupillae m parasympathetic nerve fibers from short ciliary n
• What are the layers of the iris Anterior mesodermal stromal layer and posterior ectodermal pigmented epithelial layer
• Ciliary body consist of Anterior pars plicata and posterior pars plana
• The epithelium of ciliary body produces aqueous humor
• What are the layers of the choroid Hallers layer, sattlers layer, choriocapillaris, bruchs membrane
• What is the function of the choroid regulates temperature, nourishes the outer layers of the retina
• Bony socker of orbital cavity consist of seven bones, please name them frontal, ethmoid, lacrimal, sphenoid, maxillary, palatine, zygomatic
• Please name orbital openings at least three Optic canal, superior orbital fissure, inferior orbital fissure, infraorbital canal
• Through optic canal passes following structures Optic n, ophthalmic a
• Through superior orbital fissure passes Oculomotor n, trochlear n, abducent n, ophthalmic n (lacrimal, frontal, nasociliary), superior ophthalmic v
• The structure that pass through the infraorbital canal is infraorbital nerve
• By inferior orbital fissure pass infraorbital n, zygomatic n, inferior ophthalmic vein
• Between which structures the orbital septa extend is? From orbital rim to superior and inferior tarsal plates, lateral and medial palpebral ligaments and eyelids
• Definition of the presbyopia is physiologic loss of accommodation in advancing age
• What is the visual acuity the sharpness of near and distance vision
• Emmetropia - please give definition Normal sight, The ratio of the axial length of the eye to the refractive power of the cornea and lens is balanced
• Which structure of the eye take part in accommodation lens, zonule fibers, ciliary m
• mydriatics - cyclplegics are medications which prevent accommodation and cause mydriasis, please give and example of those atropine, scopolamine, cyclopentolate inhibit function of ciliary m
• Range of accommodation, please define The maximum increase in refractive power that is possible by accommodation in diopters. Subtracting near-point refractive power from aft-point refractive power
• Please fill the gaps with the following words: anterior, posterior. Myopia is discrepancy between the refractive power and axial length of the eye such that parallel incident light rays converge at a focal point ......................... to the retina. Opposite to myopia is hyperopia where light rays are focused ..................... to the retina. 1. anterior, 2. posterior
• Definition of strabismus is deviation of an eyes visual axis from its normal position
• Major types of strabismus are Concomitant strabismus: deviating eye accompanies the leading eye in every direction with an angle of deviation that remains the same. Inconcomitant strabismus: due to paralysis of one or more eye muscles, angle of deviation doesn't remain the same in every direction
• Names of the extra ocular m are superior, inferior, medial and lateral rectus m, superior and inferior oblique m
• Distinct levels of quality of binocular vision are: 1. simultaneous vision, both eyes have same point of fixation which lands on the fovea centralis in each eye --> images of both retinas are the same in normal binocular vision. 2. fusion: two retinal images blend into a single perception. 3. stereoscopic vision (perception of depth): highest level of quality of binocular vision. Object on the same geometric horopter are perfect. the rest is blurry which helps to see differences in depth
• Esotropia is Inward deviation of the visual axis
• Vitreous body consists of 98% water, 2% collagen, hyaluronic acid
• Vitreous body is attached to following structures: ligament of wieger - posterior capsule of lens, vitreous base - ora serrata, funnel of martegiani - optic disc
• Vitreous body (in adult patient) contains following blood vessels and nerves: dosen contain vessels nor nerves, rarely has hyaloid artery
• Focal adhesions and tractions between vitreous body and retina can cause Focal traction forces --> retina tears and detachment
• Retina consists of (2 parts) Photoreceptive part (pars optica retinae), nonreceptive part (pars caeca retinae)
• How many layers the retina has? 1. Inner limiting membrane, 2. Layer of optic nerve fibers, 3. Layer of ganglion cells, 4. Inner plexiform layer, 5. Inner nuclear layer, 6. Outer plexiform layer, 7. Outer nuclear layer, 8. Outer limiting membrane, 9. Layer of rods and cones, 10. Retinal pigment epithelium, 11. Bruchs membrane
• Which is the most inner layer of the retina? Inner limiting membrane
• What separate retina from the choroid? Bruchs membrane
• Which photoreceptors are located in the fovea centralis? cones
• Give the names of anastomoses of central artery of the retina. Central retinal artery is a genuine artery without anastomoses and it divides into 4 branches
• What do central artery and central vein of the retina look like? Normally bright red with red reflex strips that become paler with age. Do not show pulse. Retinal veins are dark red with narrow reflex strip. Can show pulse
• What kind of the vision are rods responsible for? Mesoptic and scotopic vision (twilight and night vision)
• hat kind of the vision are cons responsible for? Photopic vision (daytime), resolution and color perception
• What types of cones do you know? Blue (short wave), green (middle wave), red (long wave)

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