50The Orbit and The Eye

Fixed and dilated pupils:
Pupils are dilated and do not respond to ___
Unopposed action of the ___ muscle which is innervated by ___
Indicates possible ___ damage involving the region of the ___
Complete injury causes a ___

Horner’s syndrome:
damage to ___ fibers from the ___, resulting in ___

Horner’s Syndrome:
Classic syndrome
Ptosis – ___ because of paralysis of ___ muscle
Anhidrosis – loss of ___ on the affected side
Miosis – ___ pupil due to unopposed action of ___ muscle

The Accomodation Reflex:
___ axons contract ciliary muscles. This ___ tension on the zonule fibers. The lens ___, its normal state. Pupils ___ as well.
In ___, lens can no longer thicken because it loses its flexibility. Cannot focus on near objects.

Cataracts:
A cataract is an ___ of the lens.

Cataracts are typically associated with ___.

In persons with diabetes mellitus, high glucose or sorbitol levels in the lens stroma ___. It can also thicken the lens causing ___.

The Pigmented Epithelium layer of the retina:
single layer of polygonal cells - has three important functions:
1. acts to ___ that would distort vision.
2. the storage and release of ___
3. ___ the turned-over membrane from the photoreceptor lamellae
failure of the pigmented epithelium to remove the membranous debris from the photoreceptor lamellae has been implicated in hereditary retinal dystrophy in rats and may be involved in the human disease ___.

Embolic occlusion of central retinal artery:
Small pieces of atherosclerotic plaques or clots from other origins can travel to the central retinal artery and occlude it.
Occlusion of the central retinal artery causes ischemic death of the ___ cells [in the 3rd most inner layer of the retina] and consequent ___.

Age Related Macular Degeneration (ARMD):
Two types of age-related macular degeneration
Both separate the photoreceptors from their blood supply
1. Dry ARMD
Approximately ___ percent of patients with ARMD
About ___ million in US
2. Wet ARMD
Approximately ___ percent of patients with ARMD
Most severe
Greatest vision loss
___ million in US

Dry ARMD:
Drusen is an accumulation of material between ___.

Wet ARMD:
New ___ push up against the pigmented epithelium and cause further separation of ___.

Amsler charts, a set of charts showing various geometric patterns in black and white, e.g., grids or parallel lines, used for detecting defects of the ___, e.g. ___

Detached Retina:
The differential blood supply of the retina results from the way the retina develops from an ___
Detachment occurs between the ___.
When this happens, the photoreceptors are deprived of ___ and will ___.

Papilledema:
___ causes the ___ to bulge into the eye.

Glaucoma, primary open-angle glaucoma:
most common type and is a major cause of ___
Persons with ___ are more likely to develop primary open angle glaucoma.
angle of the anterior chamber appears ___.
caused by ___.
slow, insidious problem and goes unnoticed by the patient
defects can ultimately be detected in the visual field.

Glaucoma, primary closed-angle (narrow-angle):
rarer
angle of the anterior chamber is ___
when the pupil is ___, the iris is flattened and stretched and the angle is open
when the pupil ___ the angle is blocked
closed-angle glaucoma has a rapid progression, i.e. sudden onset, and is an emergency situation
presents as ___

Optic Cupping:
Increased ___ Pressure
___ colored optic disc
Disc appears ___
Can lead to ___

Vitreal Body:
___ synthesis collagen fibrils and glycosaminoglycans
Helps maintain ___ in its appropriate position

Floaters:
Deposits in the ___
Probably aggregates of vitreal ___
Normally not noticeable, but can be seen if one stares at a white ceiling of wall without trying to focus
Floaters seen as fine dust-like particles moving about
Typically benign and do not interfere with vision
Sudden appearance of many floaters can indicate ___

Loss of Vitreous Humor:
Lost vitreous humor must be replaced to ___
___ is the removal of cloudy or bloody vitreous humor
Vitreous is replaced with ___