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20-OPHTHALMOLOGY Cataract-Ds Brushfield-Down Synd Christmas 20-OPHTHALMOLOGY cataract-ds BrushfielD-Down synd christmas tree-myotonic dystrophy coronaRY-pubeRtY cuneiform-cortical(polyopia) cupuliform-post subcapsular(max vision loss) Elschnig pearl, ring of Soemmering-after(post capsule) experimenTal-Tyr def glassworker-infrared radiation grey(soft), yellow, amber, red(cataracta rubra), brown(cataracta brunescence), black(cat nigrans)(GYARBB)-nuclear(hard) heat-ionising radiation Membranous-HallerMan Streiff synd morgagnian-hypermature senile oildrop(revers)-galactossemia(G1PUT def) post cortical/bread crumb/polychromatic lustre/rainbow-complicated post polar-PHPV(persistent hyperplastic prim vitreous) radiational-post subcapsular riders-zonular/lamellar(vitD def, hypoparathy) roseTTe(ant cortex)-Trauma, concussion shield-atopic dermatitis snowstorm/flake-juvenile DM(aldose reductase def, T1>T2, sorbitol accumulat) star-electrocution sunflower/flower of petal-Wilson ds, chalcosis, penetrating trauma syndermatotic-atopic ds total-cong rubella zonular-galactossemia(galactokinase def) stage of cataract lamellar separation incipient/intumescence(freq change of glass) immature mature hypermature Aim4aiims.inmorgagnian sclerotic lens layer ant capsule ant epithelium lens fibre[66%H2O, 34%prot-aLp(Largest), Bet(most aBundant), γ(crystalline, soluble)] nucleus embryonic(0-3mthIUL) fetal(3-8mthIUL)-Y shape(suture) infantile(8mthIUL-puberty) adult(>puberty) cortex post capsule thinnest-post pole>ant pole thickest, most active cell-equator vitA absent in lens vitC tpt in lens by myoinositol H2O tpt in lens by MIP26(Maj Intrinsic Prot26) dislocation(luxation)-complete outside patellar fossa(ant/post) subluxation-partly displace in patellar fossa(shining golden crescent) Marfan synd-suptemp subluxat homocystinuria(b/l)-infnas subluxat Weil Marchesani synd-antinf subluxat hyperlysinemia, ED synd, sulfite oxidase def, Stickler synd, trauma cataract Sx ECCE-6.5mm incision, post capsule, suture remove after 3w, near specs after 8w SICS-3.5mm phacoemulsification-2.75mm incision, hallow needle-titanium phaconit-1.5mm spectacle for-6w postSx complicat-bld fr post ciliary vess lens-made of contact hard-PMMA soft-HEMA semisoft-PMMA+silicon+CAB rigid gas permeable-cellulose acetobutyrate magnific d/t contact lens in aphakia=8% intraocular optic part Aim4aiims.in nonfoldable-PMMA(diam=5mm) foldable-silicon, acrylic, hydrogel, collamer rollable-phaconit, hydrogel implantable collomer multifocal-pseudoaccomodation principle haptic polypropylene, PMMA, acrylic phakic IOL=+12-–20D biometry(IOL power calculat) Sanders Retzlaff Kraff formula P=A–2.5L–0.9K A-contant for lens type L-axial lth eyeball(A scan/USG eye) K-mean corneal curvature(keratometry) struct-refractive index air=1.000 aq humor, vitreous humor=1.336 cornea=1.376 lens=1.386-1.406 pupil-ds Argyl Robertson(Accomdat Refex+, light rxn–)-pretectal nucl inj, neurosyphilis, dorsal midbrain synd, perinaud synd D shape-iriDoDialysis festoon, small irregul sluggish-a/c ant uveitis Holmes Adie(tonic dilate pupil)-ciliary ganglion inj, idiop, HSV Marcus Gunn(relative affer pupil defect)-CNII neuritis, CNII compression total affer pupil defect-CNII transection/avulsion vertic oval, dilate, non reactive, fix-PACG reflex Marcus Gunn jaw winking-CNV CNIII synkinesis, LPS Aschner Dagnini/oculocardiac reflex-aff-CNV1(ciliary ganglion), traction applied to EOM→ eff-CNX, ↓HR,jn rhythm,asystole app-condition Amsler sign-Fuch heterochromic iridocyclitis angioid streaks-pseudoxanthoma elasticum arcus senilis-old age asteroid hyalosis(body)-Ca, HTN, DM, lipid(cholesterol) bld&thunder fundus, splashed tomato-CRVO bony spicule pigmentat, ring scotoma, waxy pallor disc, arteriolar attenuation-retinitis pigmentosaAim4aiims.in bull eye maculopathy-chloroquine Busacca nodule-near collarette, large candle wax Spot-Sarcoid cattle tracking(fundus), box scarring(fluoresc angiography)-CRAO cherry red spot(edem all over retina except foveola) Cherry-CRAO Tree-Trauma(Berlin edema) Never-Neimann pick(sphingomyelina) Grow-Gaucher ds(βglucosidase), GM1,GM2 ganglioside Tall in-Tay sach ds(hexosaminidaseA) Sand-Sandoff ds(hexosaminidaseB) dendritic/geographic ulcer-HSV dOT&fleck retinopathy, oil globule reflex(Ant lenticonus)-AlpOrT synd double immune ring of Weseley-Acanthamoeba keratitis egg yolk(lipofuschin)-fundus dystrophy egg yolk, scrambled egg, pseudohypopyon-Best ds epibulbAR dermoid-GoldenhARs synd Ferrys line-Filtering bleb Fleischer ring(Fe deposit), Munson sign, Vogt sign, oil Droplet reflex(DDopth), SCissoring reflex(retinoSCopy), a/c corneal hydrops-keratoconus(Down synd) flowerpetal(Henle layer)-DM macular edema, cystoid macular edema Haabs striae-buphthalmos headlight in fog, satellite lesion, Jenson juxtapapillary choroiditis-Toxoplasma Hollenhorst plaque-amaurosis fugax Hutchinson sign, nummular keratitis-HZV infectious crystalline keratopathy-Str viridans interstitial keratitis, ground glass, Salmon patch-cong Syphilis iris bombé, Arlts triangle-Ant uveitis iris pearL-Leprotic uveitis Kayser Fleischer ring(Descemet memb)-Wilson ds Koeppe nodule-at pupillary bord, form post synechiae Krukenberg spindle-pigm dispers synd, pigm glaucoma lattice degeneration retina, tigroid fundus, annular crescent, Foxter Fuch spot(dark area around fundus)-path myopia macular scar configuration-neuroretinitis memb conjunctivitis-C diphtheriae morning glory-optic disc coloboma mUlBERry-tUBERous sclerosis multip cotton spot around disc-Puestur retinopathy(Pancreatitis, head trauma, chest trauma, air/fat embolism) mutton fat keratic ppt(lymphocyte), retrolental flare, Dalen Fuchs nodule(subRPE)-panuveitis/sympathetic ophthalmitis MuziOAim4aiims.in phenom-Oguchi ds(cong static night blindness) Norrie ds-cong b/l blindn+pseudogliom oculodigital sign-Leber amaurosis pizza fundus, tomato ketchup retinopathy, sauce cheese, brushfire vasculitis-CMV retinitis ring scotoma-retinitis pigmentosa, high myopia, POAG, aphakic spectacle correction, panretinal photocoagulation Roth spot-bact endocarditis salt&pepper fundus-Toxoplasma, cong syphilis, rubella scintillating scotoma-migraine sclerosing keratitis-RA Shafer sign-retinal detachment smoke stag, enlarged inkblot-central serous retinopathy snowball opacity-sarcoid, amyloid, Lyme ds, candidiasis snowbanking, snowball-pars planitis Stocker line-pterygium synchisis scintillans-liquefactive vitreous tear drop sign-blunt trauma eye tesellate fundus-myopia, retinitis pigmentosa ulcus serPens-Str Pneum VoSSius ring(ant capS lenS)-concuSSion inj watered silk-hypermetropia fungal corneal ulcer We-Wessley sterile immune ring Saw-Symptom<sign Vegetative-Vegetative material trauma D-Dry looking ulcer P-Pseudohypopyon(convex) S-Satellite lesion Film-Feathery finger like extension into stroma seasonal allergic/spring catarrh/vernal keratoconjunctivitis Ropy-Ropy discharge Cobblestone-Cobble stone(eosinophil), pavement stone, papillary hypertrophy Can-Cupid bow outline Provide-Pseudogerontoxin Maximum-Maxwel Lyon sign(eosinophil) Shield in-Shield ulcer in cornea Hot-Horner Tranta dot, T1HSR Summer-Summer problem type-palpebral(MC), bulbar, mixed Rx-olopatadineAim4aiims.in drop hypopyon-corneal ulcer, fungal ulcer(Aspergillus, Fusarium), Behcet ds(recur), endophthalmitis, panuveitis, panophthalmitis pseudohypopyon-retinoblastoma, Best ds a/c/epidem hgic conjunctivitis(PACESH) Picornavirus Adenovirus11(MC) CoxsackievirusA24 Enterovirus70, Echovirus31 Str pneum Haemophilus blindness WHO-ICD—visual acuity with best correction ction—NPCB, India(LESMA) catI=6/18-6/60-Low vision catII=6/60-3/60-Economic/work blindness catIII=3/60-1/60-Social/walk blindness catIV=1/60-PL+-Manifest blindness catV=PL–-Absolute blindness WHO-cataract, RE, childhood blindn, trachoma, onchocerciasis NPCB-cataract, RE, childhood blindn, corneal blindn(trachoma), DM, HTN retinopathy blindn sudden painful-PACG, a/c iridocyclitis, chem&mech inj eyeball, endophthalmitis, optic neuritis painless-macular edema, CRAO, CRVO, CSR, retinal detachm, exudat ARMD, vitreous& retinal hge, methyl alcoh amblyopia, subluxat/dislocat lens gradual painful-corneal ulcer, POAG(c/c simple glaucoma), c/c iridocyclitis painless-progressive pterygium, corneal dystrophy, corneal degenerat, cataract, chorioretinal degenerat, dry ARMD, DM retinopathy, RE, presbyopia, Leber heredit optic neuropathy tubular vision retinitis pigmentosa high myopia POAG CRAO with sparing of cilioretinal a synd with ocular m palsy WeberAim4aiims.in synd=i/l CNIII palsy+ c/l hemplegia(cerebral peduncle) Nothnagel synd=i/l CNIII palsy+ c/l cerebellar ataxia(sup cerebellar peduncle) Benedict synd=i/l CNIII palsy+ c/l tremor/chorea/athetosis(red nucleus inj) Claude synd=Benedict+Nothnagel FOville synd=lat gaze palsy+ i/l CNVII palsy+ c/l hemiparesis(dOrsal pOntine inj) Millard Gubler synd=c/l hemiplegia+ dysarthria+ i/l lat rect palsy+ i/l paresis of upper&lower face(vent pont inj) classif of trachoma-WHO(1987)(FITSO) to be used for field worker TF trach inflam follicular->5follicle(>0.5mm diam) on upper tarsal conjunctiva TI trach inflam intense-inflam&papillary hypertrophy obscuring> ½of tarsal vess TS trach scarring-scarring over upper tarsal conjunct, Arlts line TT trach trichiasis-≥1trichiatic cilia rubbing globe/evidence of recent removal CO corneal opacity extending over pupil MacCallan classif of trachoma stage1(Incipient)-immature follicle on sup palpebral conjunctiva stage2(Established)-mature follicle on sup palpebral conjunctiva stage3(Cicatrizing)-follicle/scarring over sup tarsus stage4(Healed)-no follicle, extensive conjunctival scarring
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