10. Rods and Cones
• rod cells: light sensors
– 120 million
– Functions in less intense light
– Used in peripheral vision
– Responsible for night vision
– Detects black, white and shades of grey
• cone cells: detects colour
– 7 million
– Highest concentration at fovea centralis
– Functions best in bright light
– Perceives fine details
– 3 types of cone cells, each sensitive to one of the three
primary additive colours: red, green, and blue
27. STY –
Its Infection & Inflammation Of Meibomian Gland
(Sebaceous Glands) Of The Eyelid Margins.
CAUSES:-
• Bacterial Infection (Staphylococcus)
• Unhygienic Of Eye
• Environmental Pollutants
• Sleep Deprivation
C/M :-
• Eyelid Margins Become Red & Edematous
• Eye Pain & Tenderness
• Eye Irritation & Itching
• Heaviness Of Eyelid
• Discomfort During Blinking Of The Eye
28. D/E:-
• - H.C. & P.E.
TREATMENT :-
• Antibiotics Eye Drops (Ciprofloxacin)
• Eye Irrigation
• Warm Application (10-15minutes)
• Eye Care & Eye Hygiene
• Wear Glasses
• Avoid Eye Exposure To Sunlight
• Avoid To Do Itching
• Avoid To Tear Edematous Eyelid By Hand
29. CHALAZION:-
-A Chalazion Is Inflammation Or Cyst Formation Of
Meibomian Gland.
-Chalazion Is Differ From Sty In That They Are More Painful
Than Sty.
C/M:-
• Hard Lump & Non Tender
• Foreign Body Sensation In Eyelid Margins
TREATMENT:-
• Warm compress
• Antibiotic eye drops
• Administer injection of Steroid medicine in area of lump
• Drainage in the orifice
31. - It’s A Condition In Which The Eyelid Margin Rolls Inwards.
Either Lower Or Upper Or Both.
TYPES:-
1. Congenital
2. Senile
3. Mechanical
SYMPTOMS:-
• Eye Pain
• Eye Irritation
• Lacrimation
• Corneal ulcer
• Foreign body sensation
32. D/E:-
- H.C. & P.E.
MANAGEMENT:-
Wheeler’s Operation :-
-It is skin muscle operation and removal of excessive lid tissue .
-Surgical correction of eye lid and eyelash transplantation.
34. -It’s A Condition In Which The Eyelid Margin Rolls Outwards.
TYPES:-
Paralytic
Senile
SYNPTOMS:-
Eye Irritation
Conjuctivitis
Eye Pain
D/E:- H.C. & P.E.
MANAGEMENT:-
Wheeler’s Operation :-it is skin muscle operation and removal of
excessive lid tissue .
Surgical correction of eye lid and eyelash transplantation.
36. -Trichiasis Is A Condition In Which Misdirection Of Eye
Lashes, So Its Rub Against The Cornea.
CAUSES:-
-Secondary To Blephritis
-Secondary To Entropion
-Mechanical Injury
-Scar Or Burn Of Eyelid Margins
C/M.:-
• Foreign Body Sensation In Eye
• Lacrimation
• Eye Pain & Irritation
• Corneal Ulcer
37. TREATMENT:-
Misdirected Cilia Removed By Epilation Forceps
Electrolysis Epilation (With A Fine Platinum Needle The Root Is
Destroyed.
39. CONJUCTIVITIS
-Conjunctivitis Is The Inflammation Of Conjunctiva
Membrane. Conjunctiva covering whites of eyes and
membranes on inner parts of eyelids.
CAUSES:-
-Bacterial Infection
-( Staphylococcus, Streptococci, H.Influeza)
-Viral Infection ( Myxovirus, adenovirus, Herpes Simplex)
-Irritating Toxic Stimuli
-Seasonal Allergy
45. TRACHOMA /
GRANULAR CONJUCTIVITIS/
COMJUCTIVITIS GRANULAR /
EGYPTIAN OPTHALMIA
Trachoma Means “Rough Eye” (Greek Word)
-Its An Infection Of Conjunctiva Caused By Chlamydia
Trachomatis Bacteria.
Globally 84million People Suffer From This Disease.
Incubation Period- 5 To 12 Days
Mode Of Transmission:- Direct Contact & Throat Secretions
46. WHO CLASSIFICATION:-
1. Trachomatous Inflammation Follicular(tf):- Presence Of
5 Or More Follicles (0.5mm DIAMETER) IN
CONJUCTIVA
2. Trachomatous Inflammation Intense (Ti):-
Inflammatory Thickening Of Upper Tarsal Conjuctiva
3. Trachomatous Scarring(ts):- Presence Of Easily Visible
Scars In Conjunctiva
4. Trachomatous Trichiasis(tt):- Present Of Trichiasis
Along With Conjunctiva Inflammation
5. Corneal Opacity(co):- Corneal Opacity Present Along
With Conjunctivae Inflammation
48. MANAGEMENT:-
The Key To The Treatment Of Trachoma Is The SAFE
Strategy Given By Who.
S- Surgery
A- Antibiotic Therapy
F- Facial Cleanliness
E- Environmental Change
49. Surgery- CorrectThe Eyelid Problems LikeTriachiasis By
Epilation. Keratoplasty For Corneal Opacity.
Antibiotic Therapy - Who Recommends 2 Antibiotics
Like Oral Azithromycin & Tetracycline Ointment.
Facial Cleanliness - Facial Cleanliness Reduce
Severity.
Environmental Change - In That Promotion Of Clean
Water Supplies, Household Hygiene, Safe Disposal Of
Waste & Feces.
50. KERATITIS
-Keratitis Is An Infection & Inflammation Of The Cornea.
CAUSES:-
• Bacteria (Staphylococcus, Pseudomonas)
• Virus (Herpes Simplex,herpes Zoster & Adenovirus)
• Exposure To Ultraviolet Radiation
TYPES:-
• SuperficialKeratitis:-
– InvolvesSuperficialEpitheliumLayerOfTheCornea.AfterHealing
DoesNotLeaveAScar.
• DeepKeratitis:-
– InvolvesDeeperLayerOfTheCornea,LeavesTheScarAfterHealing.
51. C/M:-
→ Pain
→Foreign Body Sensation In Eye
→Difficulty In Opening Eye
→Lacrimation
TREATMENT:-
→ Antibiotics Eye Drops (Every 30 Minutes For Few Days)
→Antibiotics Ointment
(Oxytetracycline Ointment)
→ Eye Irrigation
Keratoplasty If Its Required For Vision Disturbance Because Of
Deep Scar.
56. CATARACT
-Cataract Is Defined As A Clouding Or Opacity Developing
In The Crystalline Lens Of The Eye.
-Cataract Greek Word Cataractos Which Means Rapidly
Running Water.
CAUSES:-
• Age
• Heredity
• Exposure To UV Rays
• High Altitude
• Exposure To Heat (Industrial Workers Like Welders & Glass
Blowers)
• Secondary To Glaucoma
• PhototoxicMedicationsLikePhenothiazines,Tetracycline,Oral
Contraceptives&Corticosteroids
57. P/P:-
DUE TO ETIOLOGY
DEGENERATIVE CHANGES STARTED IN LENS
DENATURATION OF LENS PROTEIN
ACCUMULATION OF WATER
LENS BECOME CLOUDY
BLURRED VISION
58. CLASSIFICATION OF CATARACT:-
A. ETIOLOGICAL CLASSIFICATION
B. MORPHOLOGICAL CLASSIFICATION
A. ETIOLOGICAL CLASSIFICATION:-
1. CONGENITAL CATARACT
2. ACQUIRED CATARACT
59. B. ACQUIRED CATARACT
1. Senile Cataract
2. - Its Also Called As Age Related Cataract.
3. Traumatic Cataract
–Blunt Injury Or Penetrating Injury To Eye.
4. Complicated Cataract
– Secondary To Other Occular Disease Catarct Is Developed.
5. Metabolic Cataract
– Due To Endocrine Disorders & Biochemical Abnormalities
6. Radiation Cataract
– Cataract Develop Due To Radiation Damage.
7. Electric Cataract
– Due To Passage Of Powerfull Electric Current.
8. Dermatogenic Cataract
– Cataract Associated With Skin Disorders.
9. Toxic Cataract
– Phototoxic Medications Like Phenothiazines, Tetracycline, Oral Contraceptives
& Corticosteroids
60. B. Morphologic Classification
1. Capsular Cataract –
It Involves Anterior Or Posterior Capsular Part Of Lens.
2. Subcapsular Cataract –
It Involves Sub Capsular Part Of Lens.
3.Cortical Cataract –
It Involves Fibres Of The Cortex Part Of Lens.
4.Nuclear Cataract –
It Involves Nucleus Part Of Lens.
5. Supranuclear Cataract –
It Involves Part Just Outside Of Nucleus Of Lens.
6. Polar Cataract-
It Involves Polar Region Of The Lens.
62. C/M.:-
Painless Blurring
Loss Of Vision
Decreased Color Perception
Poor Vision
Photophobia (Light Sensitivity)
D/E:-
H.C & P.E.
Direct Opthalmoscopy
Slit Lamp Examination
Snellen Visual Acuity Test
Penlight Examination Of Pupils
63. MANAGEMENT:-SURGERY-
• Extra Capsular Cataract Extraction (ECCE)
– Removing the lens and anterior portion of lens capsule.
• Intra Capsular Cataract Extraction (ICCE)
– Remove entire lens and capsule manually.
• Phacoemulsification
– Destruction Of Lens Nucleus By Ultrasonic Sound Waves
(40,000 Hz) By Inserting Titanium Needle & This Needle
Vibrates At This Frequency & Lens material Is Emulsified.
• IOL (Intraocular Lens ) Implantation
– After removal of cataract IOL is implanted into eye.
• Contact lens
– Wear contact lens is option for those who don’t receive IOL
implantation.
• Cryosurgery – Freezes The Lens With Liquid Nitrogen.
68. GLAUCOMA:-
-Glaucoma Is Defined As Increased Intraocular Pressure ( Iop ) More
Than 25mmof Hg & Characterized By Optic Nerve Dystrophy & Peripheral
VisualFieldLoss.Normal Iop Less Than 20mmofhg.
Etiology/ Risk Factors:-
-Aging
-Genetic / Family History
-Idiopathic
-Ocular Surgery
-Myopia
-DM
-Migraine ( headache )
-Hypertension
-Injury/ Trauma
-Secondary To Ocular Infection
70. 1. Primary Glaucoma
A. Primary Open Angle Galucoma (POAG)
B. Primary Close Angle Glaucoma (PCAG)
A. Primary Open Angle Glaucoma (POAG) –
– Its Results From Over Production Or Obstruction Of Aqueous Fluid
Through The Trabecular Meshwork Or Canal Of Schlemm’s Canal.
B. Primary Close Angle Glaucoma (PCAG) -
– Its Results From Obstruction To The Outflow Of Aqueous Humor.
This Obstruction Caused By Anatomically Narrow Angle Between
The Anterior Iris & The Posterior Corneal Surface, Closing The
Angle, Absence Of Trabecular Meshwork.
71. C/M:-
• Mild To Severe Headache
• Pain In Eye (Pcag)
• Increased Iop More Than 25 (Poag)
• INCREASED IOP MORE THAN 40-70mm Of Hg (pcag)
• Photophobia
• Visual Disturbance
• Corneal Edema
D/E:-
• H.C. & P.E.
• Tonometry
• Opthalmoscopy
• Gonioscopy
• Slit Lamp Examination
72. MANAGEMENT:-
1) Beta Adrenergic Blockers :- To Reduce IOP By Decrease Aqueous
Humor Production.
1) Timolol, Betaxolol
2) Miotics :- To Reduced IOP By Outflow Of Aqueous Humor.
1) Carbacol , Pilocarpine .
3) Carbonic Anhydrase Inhibitors :-To Reduce Iop By Decrease
Aqueous Fluid Production
1) Dorzolamide, Methazolamide
4) Prostaglandin Analogs :- To Reduce IOP By Increasing
Uveoscleral Flow
1) Latanoprost
5) Osmotic agents :- To Reduce IOP
1) Mannitol
73. SURGICAL MANAGEMENT:-
1. Argon Laser Trabeculoplasty.
– Thermal Argon Laser Burns Are Applied To Trabecular
Meshwork To Open Trabecular Spaces And Widen The
Canal Of Schlemm For Outflow Of Aqueous Humor And
There By Decrease Iop.
2. Laser Iridotomy.
– Opening Made In Iris By Laser Beam To Remove Block
And Promote Outflow Of Aqueous Humor
3. Cyclocryotherapy (Freezing Ciliary Body).
– Freeze Probe Applied On Ciliary Body To Reduce
Production Of Aqueous Humor.
4. Trabeculotomy.
– Sclera Is Removed To Opening For Outflow Of Aqueous
Humor
5. Drainage Implants & Shunts :
– Open Tubes Applied In Anterior Chamber To Outflow Of
Aqueous Humor Into Conjunctiva
74. RETINAL DETACHMENTS
Retinal Detachment Is Separation Of The Retina From
Choroid Layer.
(Retina –Sensory Layer & Pigment Epithelium Layer) [Normally These 2
LayersAreLooselyAttachedToEachOtherWithSpaceInBetween]
78. P/P:-
DUE TO ETIOLOGY
TEAR IN RETINAL LAYER
ALLOWS VITROUS FLUID TO SEEP UNDER THE RETINA
PULLS RETINA
VISION LOSS
79. Classification:-
1. Rhegmatogenous Retinal Detachment:-
It Is Associated With Hole/Tear In The Sensory Retina.
2. Tractional R.D.
Due To Injury Fivrovascular Tissue Formed & Pulling
Sensory Layer.
3. Exudative R.D.
Due To Inflammation Accumulation Of Fluid Underneath
Retina Without Presence Of Hole/Tear.
80. C/M:-
• Dark Spots Coming In Vision
• Photopsia (A Sensation Of Bright Light)
• Blurred Vision
• Feeling Of Heaviness In The Eye
• Slightly Increase Iop
• Mild To No Pain (Some Time Painless)
D/E:-
• H.C. & P.E.
• Slit Lamp Examination
• Opthalmoscopy
81. • Management:-
• Photocoagulation
– If you have A hole or tear in your retina but your retina is still
attached, your doctor may perform A procedure called
photocoagulation with A laser. The laser burns around the tear
site, and the resulting scarring affixes your retina to the back
of your eye.
• Cryotherapy:-
– Cryotherapy uses extremely low temperatures to seal the
retina to the back wall of the eye by forming A scar. This scar,
which takes approximately one week to heal, forms A bond
which seals the retina around the retinal tear and prevents A
detachment.
• Vitrectomy
– To remove vitreous, A gel-like fluid from your retina
82. • Electro diathermy :-
– Electro node needle pass through the sclera , to allow sub
retinal fluid to escape.
• Scleral buckling
– Eye surgeon sews one or more silicone bands (or tyres) to
the sclera (the white outer coat of the eyeball). The bands
push the wall of the eye inward against the retinal hole,
closing the break or reducing fluid flow through it and
reducing the effect of vitreous traction thereby allowing
the retina to re-attach.
• Retinopexy
– A third option is pneumatic retinopexy to repair minor
detachments. For this procedure, your doctor will put A
gas bubble in your eye to help your retina move back into
place up against the wall of your eye. Once your retina is
back in place, your doctor will use A laser or freezing probe
to seal the holes.
85. UVEITIS:-
It is defined as inflammation of middle layer of the eye.
Etiology:-
• Trauma / injury
• Viral or bacterial infection
Types:-
1. Anterior uveitis - this is inflammation of iris (iritis) & ciliary
body (iridocyclitis).
2. Posterior uveitis – this is inflammation of choroid.
88. Its Defined As Drooping Of Eyelid Because Of Weakness Of Muscle.
CAUSES-
• Weakness OF The Muscle Responsible For Raising Eyelid.
• Damage To Nerve Supplies To This Muscle
• Injury
• Exposure To Toxin (Snake Bite / Medication Side Effect)
• Aging
• Stroke
• Brain Tumor
89. C/M:-
• Droopling Of One Or Both Eyelids
• Increased Tearing
• Vision Disturbance
D/E :-
• H.C. & P.E.
• Neurological Examination
Treatment:-
• Surgical Correction Of Weakened Muscle
91. SQUINT (STRABISMUS):-
Its Defined As Misalignment Of The Two Eyes, So That Both
Eyes Are Not Looking In The Same Direction.
ETIOLOGY:-
• Idiopathic
• Developmental Problems
• Injury To The Muscle (Muscles Responsible For Eye Ball
Movement)
• Nerve Damage Which Supplies To Muscle Responsible For Eye
Ball Movement
92. PROBLEMS WITH SQUINT
EACH OF EYE IS FOCUSING ON DIFFERENT OBJECTS
OR SENDS SIGNAL TO BRAIN
THESE 2 DIFFERENT IMAGE REACHING TO BRAIN
DEVELOP CONFUSION
MAY HAVE EITHER OF 2 EFFECTS
PERSON WOULD IGNORE IMAGING
COMES FROM DEVIATED EYE
[LOST DEPTH OF PERCEPTION]
POOR DEVELOPMENT OF VISION
93.
94. C/M:-
• Cross Eye (Eyes Do Not Align In Same Direction)
• Double Vision
• Uncordinated Eye Vision
D/E:-
• H.C & P.E.
• Snellen Chart
• Neurological Examination
Management:-
• Surgical Repair
96. TYPES:-
• Customized Prosthesis:-
• Preparing Eye Shells For The Patient According To Their
Socket.
• Stock Eyes :-
• Ready Made Eye Shells That Are Available In Market.
MAINTENANCE OF PROSTHESIS
• Wash Hand Before Handling Prosthesis.
• Shells Has To Be Cleaned Once A Day With Clen Water, Dried &
Worn.
• Precautions Should Be Taken To Reduce Scratches.
• Eye Lubricants Should Be Used Properly.
• Polishing Must Be Done Once A Year.
97. REFRACTIVE ERRORS / AMETROPIA
EMMETROPIA:-
• It Is The Normal Condition Of The Eye. When Parallel Rays Of
Light From Infinity Come To Focus On Retina (Fovea Centralis).
• There is no any refraction errors .
AMETROPIA:-
• When The Parallel Rays Of Lights Coming From Infinity Are
Focused Either In Front Or Behind The Retina In One Or Both
Meridians.
• In Refractive Errors, Vision Is Impaired Because Of Light Rays
Are Not Focusing On Retina.
98. TYPES:-
Refractive Errors Are Categorized As
1. Spherical Errors
2. Cylindrical Errors
1. SPHERICAL ERRORS:-
It Occurs When Optical Power Of The Eye Is Either
Too Large Or Too Small To Focus Light On The Retina.
-Myopia
-Hypermetropia
2. CYLINDRICAL ERRORS:-
It Occurs When The Optical Power Of The Eye Is Too
Powerful Or Too Weak Across One Meridian.
- Astigmatism
99.
100. Myopia:-
• Also Called Short-sightedness.
• In This Type Parallel Rays Of Light Coming From The Infinity
Are Focused In Front Of The Retina.
ETIOLOGY AND TYPES
A. ACCORDING TO UNDERLYING MECHANISM :-
B. ACCORDING TO CLINICAL TYPES :-
101. A. ACCORDING TO UNDERLYING MECHANISM :-
• Axial Myopia:-
– Increased Antero-posterior Length Of The Eyeball Than Normal.
• Curvature Myopia:-
– Curvature Of The Cornea Or Lens Is More Than Normal.
• Index Myopia:-
– Cortex Of The Crystalline (Refractive Index) Lens Is More Than Normal.
102. B. ACCORDING TO CLINICAL TYPES :-
1. Congenital myopia :- at birth
2. Simple myopia :- does not progress after
adolescent.
3. Pathological Myopia :- it is rapidly progress.
103. C/M:-
• Reduced Visual Acuity For The Distance, But Near Objects Are
Seen Clearly.
D/E :-
• H.C & P.E.
• Slit Lamp Examination
• Snellen Chart
• Opthalmoscope
104. Management:-
• It’s Managed By Prescribing CONCAVE Spherical Glasses.
(Exact Power Is Required)
• Contact Lens :- Eliminate peripheral distortion.
• Advice Patient For Eye Hygiene
• Advice Patient For Proper Position,
• Good Illumination
• Correct Distance From Book (about 25cm) While Reading.
• Lasik laser :- Laser assist in situ keratomileusis
– Reshape of cornea to refocus the eye.
• Removal of extra lens extraction and implantation of IOL
(intraocular lens) .
• Keratotomy :- radial incision made on cornea in order to
flatten curvature of cornea.
105. HYPERMETROPIA :-
• Also Called As Long-sightedness
• In This Type Parallel Rays Of Light Coming From The Infinity
Are Focused In Behind The Retina.
ETIOLOGY AND TYPES
A. ACCORDING TO UNDERLYING MECHANISM :-
B. ACCORDING TO CLINICAL TYPES :-
106. A. According to underlying mechanism :-
• Axial hypermetropia :-
– Decreased antero-posterior length of the eyeball than
normal.
• Curvature hypermetropia :-
– It is due to flat curvature of the cornea or lens is less
than normal.
• Index hypermetropia :-
– Cortex of the crystalline (refractive index) lens is
less than normal.
107. B. ACCORDING TO CLINICAL TYPES :-
1. Congenital Hypermetropia :- at birth
2. Developmental Hypermetropia :- It is result from
normal biological variation of development of eye.
3. Pathological Hypermetropia :- it result from
backward or posterior placement of lens .
4. Functional Hypermetropia :-it is result from nerve
paralysis .
108. C/M:-
• Headache
• Reduced Visual Acuity For The Near Objects, But Distance Objects Are
Seen Clearly.
D/E:-
• H.C & P.E. ,
• Slit Lamp Examination
• Snellen Chart
• Ophthalmoscope
Management:-
• It’s Managed By Prescribing CONVEX Spherical Glasses. (Exact
Power Is Required)
• Contact Lens
• IOL implantation
• Keratoplasty :- corneal transplantation.
109.
110.
111.
112. Astigmatism:-
In This Parallel Light Rays From Infinity Having 2 Focal Points Due To
Unequal Refraction In Different Meridians.
ETIOLOGY:-
-Unequal Curvature Of The Cornea Or Lens In Different Meridians
Types:-
• Simple A. :-
– One focal point on the retina, other focal point is either in front
or back of retina.
• Compound a. :-
– Both focal point are found in front or back of retina.
• Mixed a.:-
– One focal point is behind and one focal point is infront of
retina.
115. PRESBYOPIA
Presbyopia Is Not An Error Of Refraction But Age related
Physiologic Condition Leading To Decreased Near Vision.
ETIOLOGY:-
• Decrease Elasticity plasticity Of Lens With Age
• Decrease in the power of ciliary muscle
C/M:-
• Reduced Visual Acuity For The Near Objects
MANAGEMENT:-
• Treated By Spherical Convex Lens Or Glasses
• IOL
