FORMACIÓN DEL PERSONAL A CARGO DEL ORGANISMO REGULADOR

Ans. Drooping of upper lid.

Q.59. What are the causes of ptosis? Ans. a. Congenital b. Acquired: 1. Neurogenic 2. Myogenic 3. Mechanical 4. Aponeurotic Q.60. What is pseudoptosis?

Ans. Apparent drooping of upper eyelid due to lack of support. Seen in:

a. Phthisis bulbi b. Anophthalmos c. Microphthalmos

Q.61. What is trichiasis?

Ans. Distortion of the cilia, so that they are directed backward

and rub against the globe.

Q.62. What are the causes of trichiasis? Ans. a. Congenital- distichiasis

b. Acquired: • Blepharitis • Conjunctivitis • Trachoma • Burns • SJS • Entropion

Q.63. What are the complications of trichiasis? Ans. • Recurrent corneal erosion

• Corneal atheromatous ulcer • Vascularisation of cornea

Q.64. What is distichiasis? Ans. Congenital condition

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Q.65. What are the treatment options of trichiasis? Ans. • Epilation of offending lashes

• Electrolysis of hair follicle • Eletro diathermy

• Cryo surgery

Q.66. What is madarosis? Ans. Loss of cilia

Q.67. What is poliosis? Ans. Whitening of cilia

Seen in VKH syndrome, ageing

Q.68. What is ankyloblepharon?

Ans. Narrow palpebral tissue due to adhesion between two lid

margin at canthus.

Q.69. What is blepharophimosis? Ans. Narrow palpebral fissure Q.70. What is xanthalesma?

Ans. Yellow subcutaneous plaque on eye lid

Seen in increased cholesterol level or familial

Q.71. What is blepharitis? Ans. Inflammation of lid margin Q.72. What are the types of blepharitis? Ans. • Squamous blepharitis

• Ulcerative blepharitis

Q.73. What are the clinical features of squamous blepharitis? Ans. Itching of eyes

Yellowish crusts at lid margin

Q.74. What is the aetiology of squamous blepharitis? Ans. Associated with dandruff in scalp.

Q.75. What are the clinical features of the ulcerative blepharitis? Ans. Crusts at lid margin if removed tiny ulcers cause bleeding. Q.76. What are the predisposing factors of blepharitis?

Ans. • Staphylococcal infection

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• Chronic conjunctivitis • Unhygienic lid condition • Use of – kajal,surma,mascara etc

Q.77. What are the complications of blepharitis? Ans. • Trichiasis

• Madarosis • Ectropion • Tylosis

• Blepharoconjunctivitis

Q.78. How will you treat blepharitis? Ans. To maintain hygienic status

• Use of medicated shampoo • Correction of refractive errors • Treatment of louse infestations

– Local- 3% sodium-bicarbonate lotion is applied with cotton buds to lid margin to soak the crusts or scales 2-3 times daily or baby shampoo may be used. – Antibiotic steroid ointment to be applied by rubbing

the lid margin 3 times daily. – Stop using oil on scalp.

– An antibiotic eye drop – if secondary infection is suspected.

– Systemic—a course of tetracycline or doxycycline orally for 2-3 times is useful in severe ulcerative blepharitis.

Q.1. Define conjunctiva.

Ans. It is a mucous membrane covering the inner surface of the

eyelids and reflected to cover the anterior part of the eye ball over sclera, upto the equatorial margin.

Q.2. What are the parts of conjunctiva? Ans. (Fig. 3.1)

Fig. 3.1 : Conjunctiva with eyeball

• Palpebral part - it starts at the grey line of the lid margin. It consists of marginal ,tarsal and orbital part. It is firmly adherent to the deeper tissues.

• Bulbar part - overlies the sclera, it is freely mobile. • Fornices - junction of palpebral and bulbar conjunctiva

(cul-de-sac).

• Limbal - conjunctiva around the limbus, it is adherent.

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Q.3. Describe the microscopic structure of conjunctiva. Ans. • Epithelial layer - two layers of epithelium over the

palpebral conjunctiva and the transitional stratified squamous epithelium at the inter marginal strip .

Epithelium becomes gradually thicker from fornices to the limbus, forming stratified non- keratinized epithelium near the corneal margin.

The rest of the palpebral conjunctiva leaving the lid consists of thinner non keratinized epithelium .

Goblet cells are present throughout the epithelium; more near the fornices.

• Subepithelial layer – Adenoid layer consisting of loose connective tissue containing leucocytes.

• Fibrous layer – Below the adenoid layer a much denser layer, blends with the deeper structures - lid or sclera.

Q.4. What is the blood supply of the conjunctiva?

Ans. • Anterior conjunctival artery from the anterior ciliary

artery

• Posterior conjunctival artery from the lacrimal artery • Palpebral branch of the nasal artery

Q.5. What is the nerve supply of the conjunctiva? Ans. Ophthalmic division of trigeminal nerve. Q.6. What are the functions of conjunctiva?

Ans. • Tear production (mucin by the goblet cells, aqueous by

the accessory lacrimal gland)

• Supply oxygen directly to the cornea when eyes are open • Protection of the eye by defence mechanism e.g an intact

epithelial barrier and lacrimation

• Specific immunologic mechanism - outpouring of mast cells , leucocytes, antibody IGA

Q.7. What are the organisms normally present in the conjunctival sac ?

Ans. • Staph. Epidermidis

• Diphtheroids

• Propionibacterium acne • Corynebacterium xerosis

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Q.8. What are the common symptoms of conjunctival disorders? Ans. • Redness • Stickiness • F.B sensation • Grittiness • Lacrimation • Photophobia

• Slight blurring if excess secretion • Burning sensation

Q.9. What is papilla?

Ans. • They are hyperplasia of the normal vascular system with

glomerulus like branches of capillaries growing into the epithelium in inflammatory conditions.

• They are raised areas with flat topped velvety appearance and reddish in color.

Q.10. What is follicle?

Ans. Localized aggregation of lymphocytes in subepithelial

adenoid layer. They appear as yellowish white round elevation, 1–2 mm in diameter.

Q.11. What is chemosis ?

Ans. Odema of conjunctiva due to exudation from the abnormally

permeable capillaries is chemosis. Conjunctiva becomes swollen and gelatinous in appearance .

Q.12. What are the conditions where you might get chemosis of conjunctiva ?

Ans. • Acute inflammation—

Conjunctivitis Orbital cellulitis Panophthalmitis

• Obstruction to the circulation — dysthyroid ophthalmopathy

• Blood disorders — anaemia, angioneurotic edema.

Q.13. What is concretion?

Ans. It is inspissated mucous secretions seen in the palpebral

conjunctiva.

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Q.14. What are the causes of conjunctivitis? Ans. • Infectious – Bacterial Staph . aureaus/albus Haemophilus aegiptus N . gonorrhoa – Viral Herpes simplex Herpes zoster Adeno virus – Chlamydia- Trachoma – Fungal - Aspergillus – Parasite • Non infectious – Allergic – Toxic – Irritants

Q.15. What are the causes of membranous conjunctivitis? Ans. • Cornyaebacterium diphtherae

• Beta haemolytic streptococcus • Strept. Pneumonae

• N . gonorrhea

Q.16. What is pseudomembranous conjuncitivits?

Ans. It is caused by organisms ( mentioned above), but in milder

form. On everting the lids, palpebral conjunctiva is seen to be covered with a white membrane which peels easily without much bleeding.

Q.17. What is symblepharon?

Ans. If the palpebral and bulbar conjunctiva are stuck together, it

is called symblepharon.

Q.18. What are the causes of symblepharon? Ans. • Chemical injury

• Burn

• Stevens-Johnson's syndrome

PTERYGIUM (SHORT CASE)