Ohp II Mt 1 (Excluding Red Eye)

CB --> homogenous pigmentation
TM --> speckled pigmentation

The central AC depth of 1.8 mm is a concern for angle closure. This means that the depth of the anterior chamber (AC) in the eye is 1.8 mm, and this measurement is considered to be a potential issue for angle closure. Angle closure refers to the narrowing or closing of the drainage angle in the eye, which can lead to increased intraocular pressure and potential damage to the optic nerve. Therefore, a central AC depth of 1.8 mm raises concerns about the risk of angle closure.

The pigmented trabecular meshwork is indeed more posterior than the non-pigmented trabecular meshwork. The trabecular meshwork is a specialized tissue in the eye that helps regulate the outflow of aqueous humor, which is important for maintaining proper intraocular pressure. It is located in the anterior chamber angle of the eye, where the cornea and iris meet. The pigmented trabecular meshwork is located deeper within the angle, closer to the iris, while the non-pigmented trabecular meshwork is located more superficially, closer to the cornea. This anatomical arrangement allows for efficient drainage of aqueous humor from the eye.

Visible/retrieved dye = Positive Jones I test

If dye does NOT appear in Jones I, but appears in Jones II --> functional block

Uveitis is the most common cause of peripheral anterior synechiae (PAS). Uveitis refers to the inflammation of the uvea, which is the middle layer of the eye that includes the iris, ciliary body, and choroid. When uveitis occurs, it can lead to the formation of adhesions between the iris and the cornea, known as peripheral anterior synechiae. This condition can result in a variety of complications, such as increased intraocular pressure and impaired drainage of aqueous humor, which can lead to further eye problems.

You SHOULD do compression gonio to evaluate synechiae and also to brea an angle closure attack

The correct answer is "all of the above". Iris neovascularization can be caused by various factors including diabetes, carotid dz (disease), and vein occlusion. These conditions can lead to the abnormal growth of new blood vessels in the iris, which can cause vision problems and other complications.

In angle recession, trauma often leads to tearing of the CB resulting in a wider/larger CB

The pigmented trabecular meshwork is considered the filtering portion of the angle. This structure is located in the anterior chamber angle of the eye and plays a crucial role in regulating the outflow of aqueous humor. It consists of a network of pigmented cells and connective tissue beams that help filter and drain the fluid from the eye. The pigmented trabecular meshwork acts as a sieve, allowing the aqueous humor to flow out of the eye while preventing the passage of larger particles or cells.

Higher risk for angle closure:
- small corneal diameter
- shallow AC (1.8 mm)
- thick lens
- steep anterior lens
- short axial lengths
- hyperopes

Jones Basal Secretion evaluates the minimum amount of tear secretion and requires an anesthetic. This statement is true because Jones Basal Secretion is a test used to measure the baseline tear production in an individual. It involves placing a small strip of filter paper in the lower eyelid to absorb tears for a certain period of time. Anesthetic eye drops are used to numb the eye during the test to minimize any discomfort. By measuring the amount of tear secretion, this test helps in diagnosing conditions such as dry eye syndrome.

The normal range for the phenol red thread test is 9-18 mm. This test is used to measure tear production and assess the quality of tears. The test involves placing a thread impregnated with phenol red dye in the lower eyelid for a certain amount of time. The length of the thread that changes color indicates the amount of tears produced. A range of 9-18 mm is considered normal, indicating adequate tear production.

this would only occur if there were multiple traumatic events (e.g. boxer)

all others will DECREASE TBUT

Schirmer II --> tickle/iritate the nasal mucosa for 10-15 seconds

Posterior embryotoxin refers to the anterior displacement of Schwalbe's line, which is the termination of Descemet's membrane in the cornea. This displacement is commonly seen in conditions like Axenfeld-Rieger syndrome and can be identified through various imaging techniques. The term "Posterior embryotoxin" is used to describe this anatomical variation.

The Ocular Protection Index (OPI) is calculated by dividing the Tear Break-Up Time (TBUT) by the Interblink Period (IBP). In this case, the TBUT is 10 seconds and the IBP is 5 seconds. Therefore, the Ocular Protection Index would be 10/5, which equals 2.

If the view through the gonio lens is steamy, it is likely due to not enough fluid. The steamy view may indicate that there is not enough fluid between the lens and the cornea, causing the lens to fog up. This can make it difficult to see clearly and may require the addition of more fluid to improve visibility.

Angle closure glaucoma is a condition where the drainage angle of the eye becomes blocked, leading to increased intraocular pressure. Pupil block is the most common cause of angle closure glaucoma. In this condition, the iris gets pushed forward and blocks the drainage angle, preventing the aqueous humor from draining properly. This can occur due to various factors such as a shallow anterior chamber or a large lens pushing against the iris. Miotic drugs, peripheral synechiae (adhesions between the iris and other structures), and trauma can also contribute to angle closure glaucoma, but pupil block is the most common cause.

TBUT Interpretation:

Schirmer I Interpretation:
= 5 mm : abnormal
5-10 mm : mild-mod KCS
> 10 mm: normal

3-5 mins = sufficient secretion
5-10 mins = borderline
> 10 mins = insufficient secretion

In the Lactoplate Test, a concentration of less than 0.9 mg/mL is considered abnormal. This means that if the concentration of lactoplate in the test is below 0.9 mg/mL, it indicates an abnormal result. This cutoff value is used to determine the presence of certain substances or conditions being tested for in the Lactoplate Test.

soft stop: probe hits an obstruction or collapses the lacrimal sac against the lacrimal fossa = abnormal

A positive Seidel's test indicates the presence of corneal perforation. This test involves applying fluorescein dye to the eye and observing for any leakage of the dye from the cornea. If there is a perforation, the dye will leak out and create a stream or pool of greenish fluid. On the other hand, a lower IOP (intraocular pressure) may also be an indication of corneal perforation. When the cornea is perforated, the fluid inside the eye can leak out, causing a decrease in intraocular pressure.

Lighter irises can result in decreased pigmentation of the trabecular meshwork. The trabecular meshwork is responsible for regulating the outflow of aqueous humor from the eye. Darker pigmentation in the iris is associated with a higher density of melanocytes, which produce pigments. These pigments can accumulate in the trabecular meshwork, leading to increased resistance to aqueous humor outflow and potentially causing glaucoma. In contrast, individuals with lighter irises have fewer melanocytes and less pigmentation in the trabecular meshwork, which may result in decreased resistance to outflow and a lower risk of glaucoma.

4 - CB
3 - SS
2- ant TM
1- ant TM/Shwalbe's Line
0 - no structures visible

Basal + Reflex

An orbital x-ray would be the best test to determine if there is an intraocular metallic foreign body (FB). This is because an orbital x-ray can provide a clear image of the eye socket and surrounding structures, allowing for the detection of any metallic objects that may be present. Other tests such as DFE (dilated fundus examination), DO (direct ophthalmoscopy), and NCT (non-contact tonometry) may be useful for assessing other aspects of ocular health, but they are not specifically designed to detect intraocular metallic FBs.

Schwalbe's = termination of Descemet's + anterior limit of angle wall

--> Sampolesi's Line = wavy line of pigment seen in exfoliation pts (pigment has settled on Schwalbe's Line which acts as a shelf for the loose pigment)

The staining in Zone 5 of the Van Bijstervald grading scale is located in the inferior nasal area.

The instrument used in Lacrimal Probing is the (Heather) Bowman probe. This probe is specifically designed for the procedure of Lacrimal Probing, which involves the insertion of a thin probe into the lacrimal drainage system to clear any blockage or obstruction. The (Heather) Bowman probe is a specialized tool used by ophthalmologists for this purpose.

Temperature and humidity do not have a direct effect on TBUT (Tear Break-Up Time). TBUT is a measure of the time it takes for a tear film to break up on the surface of the eye. It is primarily influenced by tear quality and quantity, as well as the health of the ocular surface. While environmental factors like temperature and humidity can impact overall eye comfort and dryness, they do not directly affect the tear film stability measured by TBUT.

Koeppe lens has no involves direct viewing with a light source and viewing microscope (no mirrors involved)

directs aqueous towards the peripheral AC and pushes the peripheral iris back to view the angle

Sno Strips test are timed until there is 10 mm of wetting.

The 3 classic signs are due to corneal swelling resulting from dysfunction of the endothelial pump caused by the high pressure

Schirmer I is affected by temp/humidity (evaporation)

Chronic angle closure refers to a condition where the drainage angle in the eye gradually becomes blocked, leading to increased eye pressure. In this context, the term "superior" refers to the upper part of the eye. The explanation for the correct answer, "superior," is that chronic angle closure tends to occur first in the upper part of the eye, specifically in the superior region. This is because the superior angle is more prone to narrowing due to anatomical factors, such as the position of the iris and the shape of the eye.

the corner angles tend to be the most shallow

An increase in episcleral venous pressure can lead to engorged episcleral veins and low intraocular pressure (IOP). Engorged episcleral veins occur when there is increased pressure in the veins, causing them to become dilated and visible. Low IOP can result from the impaired outflow of aqueous humor due to the increased pressure in the episcleral veins. This can lead to decreased fluid production and accumulation, resulting in lower pressure within the eye.

Impaired reflex tearing based on the Schrimer II test is considered when the measurement is less than 10 mm after 2 minutes. This test is used to evaluate tear production and assess tear film stability. A measurement of less than 10 mm indicates a decreased tear production, which can be indicative of dry eye syndrome or other ocular surface disorders. The shorter time frame of 2 minutes allows for a more accurate assessment of tear production compared to the longer time frame of 5 minutes.

Gonio is a short form for gonioscopy, which is a diagnostic procedure used to examine the drainage angle of the eye. It involves using a special lens to visualize the angle between the cornea and the iris. The indications for gonio include a history of blunt trauma, as it can help assess any damage to the angle caused by the trauma. It is also used to evaluate iris contour changes, which can indicate certain eye conditions. Gonio is performed to determine the presence of angle closure or open angle glaucoma, as it helps assess the drainage of fluid from the eye. Lastly, it can be used to rule out neovascularization of the iris, which is the abnormal growth of new blood vessels.

The Touch Tear Microassay is a reliable method for determining the presence of aqueous deficiency in the eye. This assay helps to measure the quantity and quality of tears produced, specifically focusing on the aqueous component. Aqueous deficiency refers to a condition where there is a lack of an adequate amount of watery fluid in the tear film. By using this assay, healthcare professionals can accurately diagnose and assess the severity of aqueous deficiency, allowing for appropriate treatment and management strategies to be implemented.

The ciliary body is generally 0.5 mm wide.

plateau iris bunches up at the angle