Ophthalmology Made Simple

1. Canthus of the Eye

  • Definition: The point where both eyelids meet.
  • There are two canthi of the eye:
    • Medial Canthus: The inner corner of the eye, where the upper and lower eyelids meet near the nose.
    • Lateral Canthus: The outer corner of the eye, where the upper and lower eyelids meet near the temples.
Table showing medial and lateral canthus of the eye with locations.

2. Eye Muscles and Nerve Control

  1. Medial Rectus:
    • Function: Responsible for adducting the eye (moving it inward).
    • Weakness: Causes the eye to diverge.
    • Innervation: Controlled by the Oculomotor Nerve (CN III).
    • Signs:
      • Ptosis (drooping eyelid)
      • Mydriasis (dilated pupil)
  2. Lateral Rectus:
    • Function: Responsible for abducting the eye (moving it outward).
    • Weakness: Causes the eye to converge and can lead to squint.
    • Innervation: Controlled by the Abducens Nerve (CN VI).
Table of extraocular muscles with function, weakness, nerve supply, and signs

Here are other materials for NLE NRE step 1

3. Superior Oblique Muscle and Down Syndrome

  1. Superior Oblique Muscle:
    • Innervated by CN IV (Trochlear Nerve)
    • Function: Helps with eye movement, allowing the eye to look downward and inward (important for focusing).
  2. Down Syndrome:
    • The Superior Oblique Muscle is typically not affected in Down syndrome. The condition can impact other aspects of vision, but the specific nerve and muscle control for eye movements usually remain intact.

4. Eye Findings and Their Significance

  1. Bitot’s Spot:
    • Location: Conjunctiva (white patches on the conjunctiva)
    • Cause: Due to vitamin A deficiency, which is often seen in conditions like xerophthalmia.
  2. Roth’s Spot:
    • Location: Retina
    • Cause: Associated with infective endocarditis, these are retinal hemorrhages with a white center (often caused by emboli).
Table of Bitot’s and Roth’s spots with causes and locations.

5. Conjunctivitis

1. Conjunctivitis Types and Symptoms

TypeSymptoms
ViralWatery discharge- Redness- Mild fever
BacterialMucopurulent discharge (thick, yellowish)- Watery discharge- High fever
AllergicItching- Watery discharge
Table of viral, bacterial, and allergic conjunctivitis with symptoms

2. Night Blindness

  • Cause: Vitamin A deficiency
  • Effect: Impaired ability to see in low light or darkness due to insufficient levels of retinal (a form of vitamin A) in the eye.

3. Eyelash and Eyelid Conditions

ConditionDescription
Outward (Ectropion)Eyelid turns outward, causing the lower lid to fall away from the eye.
Inward (Entropion)Eyelid turns inward, causing the lashes to rub against the cornea and eye.

4. Eyelid Pathology

ConditionSymptoms
StyeTenderness + Fever
ChalazionMild tenderness
Table of ectropion, entropion, stye, and chalazion with descriptions

6. Glaucoma

Cause: Increased aqueous humor production or decreased drainage.

Types:

TypeDescription
Closed-Angle GlaucomaMore severe and faster progression
Symptoms: blurred vision, redness, Pressure > 40 mmHg– Requires emergency care
Open-Angle GlaucomaIridocorneal angle does not drain properly- Drainage decreases, causing fluid retention and increased pressure

Treatment:

MedicationAction
TimololBeta-blocker, reduces aqueous humor production
AcetazolamideCarbonic anhydrase inhibitor, reduces fluid production

Surgical Treatment: Iridotomy: A surgical procedure to improve drainage.

7. Cornea

ConditionDescription
Keratitis (Cornea)Inflammation of the cornea, often caused by infection or injury.
Cataract (Lens)Opacity in the lens, leading to decreased vision.- Senile Cataract: Most common in old age.
Retinal DetachmentPainlessVisual lossCurtain-like shadow falling over vision.
Central Retinal Artery OcclusionPainlessVisual lossPale retina due to lack of blood supply.
Central Retinal Vein OcclusionPainlessAngry-looking retina due to blood congestion.
Table of keratitis, cataract, retinal detachment, CRAO, and CRVO with features.

1. Refractive Errors

ConditionDescription
MyopiaNear-sightedness– Can see near objects clearly but cannot see far objects.
HyperopiaFar-sightedness– Can see far objects clearly but cannot see near objects.
AstigmatismBlurred vision– Can also cause double vision due to irregular curvature of the cornea or lens.
PresbyopiaAge-related condition where the ability to focus on near objects decreases with age.

Check your NRE Step 1 result after completing the exam.

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