OptoPrep Pearls II

non-silicone hydrogel soft lens group:

low water content (<50%) and composed of NON-ionic polymer

group 1

non-silicone hydrogel soft lens group:

high water content (>50%) and composed of NON-ionic polymer

group 2

non-silicone hydrogel soft lens group:

low water content (<50%) and composed of ionic polymer

group 3

non-silicone hydrogel soft lens group:

high water content (>50%) and composed of ionic polymer

group 4
(associated with protein deposits)

refractive power of the crystalline lens at birth:

45D

reflexive afferent pathways involving optic nerve:

dazzle reflex, glare reflex, and menace reflex

subcortical reflex resulting in bilateral narrowing of the palpebral fissures when retina is stimulated with a very bright light source

dazzle reflex

bilateral reflexive closure of the eyelids in response to the rapid approach of an object to the eye, such as blinking quickly

menace reflex

pre-retinal hemorrhages occur between which 2 layers:

ILM & NFL

cystoid macular edema (CME) is accumulation of fluid occurring between which 2 layers:

OPL & INL

central serous retinopathy has edema that occurs between which 2 layers:

neurosensory retina & RPE

sub-retinal hemorrhages occur between which 2 layers:

neurosensory retina & RPE

elevation in wet macular degeneration occurs between which 2 layers:

RPE & bruch's membrane

sub-RPE hemorrhages occur between which 2 layers:

RPE & choroid

membrane potential changes from dark → light:

-40 mV → -60 mV

what process occurs when photoreceptors signal the presence of light?

hyperpolarization

cornea diameter horizontal & vertical

11.7mm & 10.6mm

shapes of anterior and posterior human cornea respectively:

anterior- elliptical with long axis horizontally
posterior- spherical

condition most frequently seen with normal tension glaucoma

raynaud's phenomenon (peripheral vasospasm)

combination of brinzolamide (CAI) & brimonidine (alpha-2 adrenergic agonist)

(hint: no beta blocker)

simbrinza®

combination of timolol (beta blocker) & dorzolamide (CAI)

cosopt®

combination of timolol (beta blocker) & brimonidine (alpha-2 adrenergic agonist)

combigan®

fluoroquinolone MOA that makes them strong antimicrobial agents

blocks bacterial DNA gyrase and topoisomerase IV
(aka inhibit bacterial DNA synthesis)

penicillin & cephalosporin MOA

blocks bacterial cell wall synthesis

vancomycin MOA

blocks elongation of the peptidoglycan necessary for cell wall synthesis

aminoglycoside MOA that makes them strong antimicrobial agents

blocks protein synthesis by binding to bacterial ribosomes (30S)

topical NSAID MOA

blocks only the COX arm of the inflammatory cascade

topical steroid MOA

blocks phospholipase A2 and then,
blocks both COX and LOX arms of the inflammatory cascade

total internal reflection (critical angle) formula:

(can only occur when light travels from a high IR to low IR)

ic = sin^-1 (n²/n¹)

types of junctions in corneal epithelium:

tight junctions and desmosomes

types of junctions in corneal endothelium:

macula occludens, zona occludens and macula adherens

type of mutation: single nucleotide substituted for another

nonsense mutations
(most dangerous bc can lead to a stop codon)

type of mutation: single bases are added or removed

insertion or deletion mutations
(causes disruption of protein function)

type of mutation: nucleotides are added or removed

frameshift mutations
(improper reading of the nucleotide sequence)

high abbe number means ___ chromatic aberrations

low
(ex: abbe 58 has lower chromatic abberations than abbe 30)

STD that commonly occurs along with gonorrhea

chlamydia

percent of IOP decrease with a topical beta blocker (such as timolol)

25%

henderson-hasselbach equation:

pH= pKa + log [base]/[acid]

PNS non-neuronal cells that coat axons in a myelin sheath, making action potentials faster

schwann cells

CNS cells that insulate neuronal cell axons

oligodendrocytes

most numerous type of glial cell that support the structure of the brain, form BBB, and remove excessive extracellular potassium

astrocytes

cells called into action in the event of injury/dx/infection, capable of phagocytosis (hint: its a type of macrophage)

microglia

cells that line CNS cavities/brain’s ventricle walls; also form the epithelium of the choroid plexus (which secretes CSF)

ependymal cells

test that uses red-green glasses to evaluate position of each eye in nine primary positions of gaze; used to document/detect ocular paresis

hess-lancaster

patient with strict criterion level on threshold test will display…?

low number of false positives & low number of hits

patient with lax criterion level on threshold test will display…?

high number of false positives & high number of hits

principal fibers of crystalline lens insert from the ___ onto the lens capsule

ciliary body

embryonic tissues involved in development of ocular structures

neural crest and surface ectoderm
(NOT endoderm)

oral hyperosmotic agent that should be avoided in uncontrolled diabetics

glycerin
(b/c its metabolized into glucose)

lateral portion of the eyelid lymphatics drains into..?

preauricular lymph node

medial portion of the eyelid lymphatics drains into..?

submandibular lymph node

antibiotic most effective against MRSA

vancomycin

strongest attachment point of the vitreous

ora serrata
(serves as anterior vitreous base)

second strongest attachment point of the vitreous

optic nerve head

third strongest point of attachment of the vitreous

macula

portion of nephron that is NEVER permeable to water

ascending limb of the loop of Henle

“eye size" of a frame / "lens size" of a spectacle lens refers to which measurement

"A" measurement
(horizontal length of the lens)

vertical length of the lens refers to which measurement

"B" measurement

width of the lens itself along the horizontal midline
(can vary significantly from the "A" measurement and is rarely used)

"C" measurement

dimension found by doubling the distance from the geometric center of the lens to the apex of the lens bevel that sits farthest from the center… helpful in determining the minimum lens blank size

effective diameter (ED)

distance b/w two boxes when both lenses are boxed in the frame

(can be determined by measuring the distance b/w grooves in nasal eye wires at the narrowest point)

distance between lenses (DBL)

visual angle subtended by the foveola (where there is maximal visual acuity and resolution)

1.2 degrees

arcuate fibers (bjerrum's fibers) of the retina occupy which portion of the optic nerve?

superior and inferior temporal regions

info from left visual field of right eye is ultimately processed at the:

right dorsal lateral geniculate nucleus

muscles responsible for CLOSURE of eyelids

procerus, orbicularis oculi, and corrugator

muscles responsible for retraction of eyelids

frontalis & levator palpebrae superioris

approximate volume of the vitreous:

4 mL

type of conjunctivitis: acute, transient attacks of ocular itching, redness, watering, nasal discharge and sneezing (mild sx)

(occurs year-round but tends to exacerbate in the autumn months due to animal dander, dust mites, and fungal allergens)

perennial allergic conjunctivitis (PAC)

type of conjunctivitis: hay fever (more severe sx)

(occurs mostly in spring and summer months due to tree and grass pollens)

seasonal allergic conjunctivitis (SAC)

type of conjunctivitis: seen in young male patients who suffer from some form of atopy (such as eczema, asthma, or hay fever); main sx: severe itching

vernal conjunctivitis

vernal keratoconjunctivitis (VKC) has an increased incidence of which other corneal disease?

keratoconus
(b/c of the atopic disease in both conditions)

excitation peak of fluorescein

490 nm

emission peak of fluorescein

530 nm

area of the retina most sensitive to detecting light flicker:

peripheral retina

CSF of an elderly person will typically be shifted towards the ___ due to decrease in spatial frequencies, pupil miosis, decreased retinal illumination, and increased light scatter

left

meibomian glands are what type of gland

holocrine glands

type of surface that appears same brightness when viewed from any angle, don’t appear shiny or glossy, and reflect light evenly in every direction

perfectly diffusing surface
(ex: blackboard)

type of surface that appears even, reflective, and glossy

specular surface
(ex: mirror or glossy photo)

type of surface that reflects light unevenly and irregular

nonspecular surface
(ex: magazine)

percentage range likely to produce the sound of a carotid bruit upon auscultation due to arterial stenosis:

50-90% occluded

cycloplegic durations for the following:
- tropicamide
- cyclopentolate
- homatropine
- scopolamine
- atropine

- 8 hrs
- 1 day
- 2 days
- 1 week (7 days)
- 2 weeks (12-14 days)

acronym not for order but what they do “STop ACH”
acronym for duration longest → shortest “ASHCT”
phenylephrine is 3 hours, but NO cycloplegic effect, just mydriatic

ciliary muscle of the ciliary body is composed of which muscle type

smooth muscle

magnification formula:
(aka rated magnification/ effective magnification / standard magnification / nominal magnification)

M = (d)x(F)
F = focal power of lens
d = object distance
(for hand magnifiers, assume a distance of 25 cm)

difference in axial length of 1mm corresponds to ~ __D of refractive error

3D

increased levels of ___ stimulates the synthesis of cholesterol

insulin

organisms most likely to penetrate intact cornea

• H influenzae

• N gonorrheae

• C diphtheriae

causative pathogen of ophthalmia neonatorum 2-5 days after birth

Neisseria gonorrhea

causative pathogen of ophthalmia neonatorum 5-14 days after birth

Chlamydia trachomatis

oculosympathetic pathway as the neurons descend from the brain

hypothalamus → ciliospinal center of Budge → superior cervical ganglion → ophthalmic division of trigeminal nerve

normal tear production after 5 minutes of schirmer I test

10 mm

cortical hypercolumn is comprised of:

ocular dominance columns for both eyes & a complete set of orientation columns

area of TM with greatest resistance to aqueous outflow

juxtacanalicular tissue

confirmatory test for ankylosing spondylitis

x-ray of sacroiliac joints

if the index of refraction of a lens is increased, the radius of curvature should ____ in order to maintain the same effective power

also increase

patient with esophoria will note ____ paddle movement on alternate cover test

“against”

patient with exophoria will note ____ paddle movement on alternate cover test

“with”

other names for primary visual cortex
(which sends its projections to the extrastriate cortex)

- striate cortex
- visual area 1 (V1)
- brodmann's area 17

areas contained within the extrastriate cortex

- visual area 2 (V2)
- visual area 4 (V4)
- visual area 5 (V5) (aka middle temporal cortex (MT))
- inferotemporal cortex (IT)

visual info stream known as the "what" system

ventral stream (aka temporal stream)

visual info stream known as the "where" system

dorsal stream (aka parietal stream)