Anatomy of the eye

2017-2011

*embryology

- Embryological development of the retina . *

- development of the lens . *
- development of vitreous humor . ***

*the eye ball

- Gross & minute anatomy of ciliary body . *

- Macula : macro & micro anatomy .*****
- Anatomy of of chorio capillaries . *
- Anatomy of angle of AC . **
- Circle of Zinn . *
- Iris : gross & minute anatomy . *
- Cornea : microscopic anatomy . e drawing & N . supply . ***
- Anatomy of Schlemm`s canal & its drainage .****

- Iris : epithelial layer . ***

- Lens : gross anatomy & zonules . **
- Circulus iridis major and minor : how are formed – st . supplied by them .*
- BL supply of the iris . **
- Trabecular meshwork : microscopic anatomy & its drainage .**
- Anatomy of choroid e bl & N . supply . *
- Gross and minute anatomy of vitrous humor .*

*the orbit

- sup orbital fissure *

- inf. orbital fissure . *
- Optic canal & st. passing through it & its relations . ***
- Medical wall of orbit : anatomy – st . related & related & attached to it . **
- floor of the orbit : anatomy & its relations *
- Anatomy of orbital margin *

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* EOM

- Anatomy of levator superious ms . ****

- Anatomy of inf . oblique ms . ****
Origin – insertion – relasions N & BL supply – action – attachments
- lat. rectus ms : origin – insertion – relations – BL & N . supply .*
- Anatomy of sup . oblique ms . ***

* ocular appendages

- N. supply to lacrimal gland . ***

- bL . supply of eyelids & venous drainage * N . supply . ***
- bL supply to lacrimal drainage system .**
- Anatomy of lacrimal system . e drawing . ***
- draw a sagittal section in upper eye lid .*
- anatomy of the orbital system . *
- Anatomy of Nasolacrimal duct . *

* BLVS

- ophthalmic artery : origin – branches .**

- BL supply to visual cortex . *
- Anatomy of convernous sinus , tributaries & drainage . **
- BL supply of the optic nerve .**
- BL supply of the optic disc . *

*Neuroanatomy .

- Abducent N . : course , superficial origin & relations .***

- ciliary ganglion & its connection .***
- Anatomy of nsociliary nerve .*
- oculomotor N . : superficial origin – course – relations .**
St . supplied
- Anatomy of the trochlear N .*
- Optic chiasma : relations – n fibers distribution inside it . **
- Anatomy of the visual cortex . *
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 Physiology of the eye 2017-2009
* eye lid
- causes of reflex blinking
* tear film
- Human tear ph & factors affecting it *
- stability of tear film
- mechanisms of elimination of tears page 46 ‫المذكرة‬
- functions of tear film *
- basic tear secretion : origin – function – nerve control
- precorneal tear film : composition – physical chch
- test of innermost layer of tear film .
* corneal
- corneal deturgescence / dehydration ***
- corneal transparency
- corneal permibility to electrolytes *
- mechanism of transport across cornea .
- Role of corneal endothelium in maintaining corneal hydruction .
- Corneal hysteresis : def – clinical significance .
- factors affecting drug penetration through cornea
- ocular rigidity : def – factors affecting it
* Aqueous humor
- Methods of IOP measuring .
- Factors affecting IOP
- Active secretion of aqueous humor
- Mechanism of aqueous formation *
- Factors affecting aqueous secretion
- Factors affecting aqueous outflow
- Stability of tear flow & its assessment
- Role of ciliary epithelium in aqueous secretion
- Role of metabolic enzymes in aqueous secretion
*lens
- Metabolism of human lens
- Lens proteins
- Resolving power of the eye ? = visual acuty
*Ocular circulation
- Regulation of retinal circulation .
- Mechanism of autoregulation of retinal vessels
- Uveoscleral outflow & influence of drugs on its rate
- Neurological factors controlling ocular circulation
- Black - out phenomenon page 162 ‫المذكرة‬
*V / A
- Objective measurements of VA
- Relation between V/A & level of retinal illumination ( with drawing )
- Physiological changes occurring in visual function as a result of aging .
- Def. stile – Crawford effect .

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*Retina
- Functions of RPE
- Role of RPE in the process of version
- Recycling of photochemi pigment
- Photodecomposition & phototransduction of rhodopsin . *
- Chemistry & metabolism of rhodopsin . *
- Function of horizontal cells in retina
- Types & functions of ganglion cells
- Function of cells found in area V 1 in visual cortex
- Photochemical changes affecting retina on exposure to light
*Adaptation
- Mechanism of dark adaptation
- Role of visual pigment on process of dark adaptation
- physiologic events taking place in retina in dark
*Entopic phenomenon
- Haidinger`s bruches phenomenon : def – clinical value
- After image : def – types – clinical importance ***
*Color version
- Purkinge shift phenomenon. ***
*Critical flicker fusion
- Critical fusion frequency & its clinical applications . **
*Pupil
- Near reflex : components &pathway *
- Tonic pupil : def – causes – chch
*Electrophysiology of retina
- ERG as a macular function test : origin – types – clinical application .*
- EOG & its clinical value
- EOG : components – def arden ratio clinical application of EOG
- VEP : components – clinical application .*
- Def early recepor potential page 95 ‫المذكرة‬
*Binocular vision
- Binocular vision : def – components – advantages .**
- Prerequisites of normal binocular vision
- Mechanism of fusion
- The horopter
- Importance of pannus ares in binocular vision
- Stereopsis ( depth perception ) : def – mech – tests of recognition .*
- Binocular factors affecting depth perception
*EOM
- Pursuit movements of the eye & nerve control
- AC/A ratio : def – how to measure it
- Physiological chch of EOM . ***
- Vestibule ocular reflex : describe – how can you test it – clinical significance
*Nystagmus
- Optokinetic nystagmus & its clinical application

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 Clinical optics 2017-2011
*Introduction
- Plorization of light & its clinical application ****
- Coherent light : chch & its applications
*Reflection & refraction .
- Catoptric images & its cl uses
- Critical angle & its cl . applications
*Prism
- Cl .uses of prism
- Types of prisms in ophthalmic instruments ***
- Frensel prism & prensel lens *
- Cl app . of frensel prism *
- Therapeutic uses of prisms in glasses
- Maddox rod ****** - Maddox wing
*Lenses
- Antireflexion glasses
*magnification
- Types of magnification by a lens
*Spherical & astigmatic lens
- Conoid of strum
*Abberations
- High order abberations*
- Aberration of optical system .
- Coma abberations .
- Wave – front abberations : cl app
*V/A
- How to test V/A in children .
- Methods of V/A testing
- Contrast sensitivity testing *
*Myopia
- Classify myopia
- Optics of methods of correction *
*Hypermetropia
- Components of hypermetropia *
- Types of hypermetropia .**
- Methods of correction .
*Subjective refraction
- optical principle duochrome test *** and its clinical uses
- Jackson`s cross cylinder **

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- Uses of astigmatic fan .
- Uses of stenopic slit .**
*anisometropia
- Management of anisometropia amblyopia *
*Direct ophthalmoscope
- The relative merits ‫ المزايا النسبيت‬of direct & indirect ophthalmoscope
- Optical principle of direct ophthalmoscope
*Indirect ophthalmoscope
- Optics of indirect ophthalmoscope **
- Image magnification of indirect ophthalmoscope *
- Factors affecting magnification **
- Field of view by indirect ophthalmoscope
*Retinoscope
- Optics of retinoscopy
- Factors affecting red reflex during retinoscopy .
- Neutral point in retinoscopy .
*Microscope & slit lamp
- Simple microscope & its uses**
- Angular magnification in simple microscope *
- Magnification & optics of compound microscope **
- Methods of ex. by slit lamp *
- Lenses used e slit lamp *
*Applanation tonometer
- Optical principle of applanation tonometry *
*Low visual aids
- Basic principles of low-vision aiding
- Management of different grades of low vision .
*keratometer & focimeter & Goniscopy
- Optical principle of keratometer ** -corneal topography
- Optical principle of lensometer ***
- Optics of goniscopy .
*CL
- Flurescein pattern of hard cl . *
- Toric soft cl .
- Optical principle of gas permeable cl .
- Optical principle of rigid cl
- Types of cl used for astigmatism .
- Cl fitting in keratoconus .
- Magnification in cl use .

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 ‫ اسئلة امتحبنبت الجراحة العبمة‬2015-2009
*waund & trauma
- Classify wounds
- Factors affecting wound healing
- Priorities of multiple injured patient
- Clinical appearance of keloid scar & management .
- Complications of wound healing **
*Surgical site of infection
- Classify surgical site infection
- Recommendation to minimize SSI
*Shock
- Define shock
- Causes of chock
- Manage one type of chock
- Algorithm for managing pt e hypovolemic shock
- Define (MODS) multiorgan dysfunction syndrome
- Septic shock : eitiology – C/P – monitoring – management .
*Blood transfusion
- Comlications of blood transfusion
*Burns
- Define major burn
- C/P of burn injuries
- Assessment of burn depth & extension **
- Methods of assessment of surface area of burn
- General complications of burn
- Management of major burn in 1 s t 24 hrs .
- Mechanism of burn injury in face & neck .
*Acid – base regulation
- Causes of hypokalemia
- Compare between metabolic acidosis & alkalosis .
*Thyroid
*case hyperthyroidism .
- causes of hyperthyroidism.
- clinical manifestations – investigations
*case : hard fixed swelling infront of neck e pain radiating to Rt ear
- diagnosis – investigations – π
* types of toxic goiter
- investigations for toxic goitre
- contraindications for usage of radioactive iodine in toxic goitre
* case : diffuse non tender smooth thyroid swelling
- diagnosis – investigations – π
*Eye signs e 1ry thyrotoxicosis .
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*Day case surgery
- definition - selective creteria for day case surgery .
- Benefits of day case surgery .
- Analgesia after day surgery .*
- Guidelines of safe discharge of pt after day surgey .
- Indications & limitations of day case surgery
- Postoperative morbidity after day surgery
- Requirements of successful day surgery .
- Day case surgery unite .
*Steralization & disinfection
- def sterilization – def disinfection .
- Antiseptic agents & 2 examples of common use .
-Techniques of steralization of instruments .
- sterile precausions & theatre safety as regard sterilization & disinfection .
*theatre Safety
*General principles of theatre safety
*postoperative complications
- postoperative pulmonary complications .
*cardiac arrest : principles of CPR .
*skull injury
- Clinically assess a case of head injury e history of concussion .
*Maxillofacial injuries
- Classification of types maxillofacial injuries
- Management of maxillofacial injury
- Investigations
- Drug used as general principles in facial injuries .
- Compare between extradural & subdural hematomas .
- Extradural hemorrhage : C/P – management .
- Types of intracranial He .
*Salivery glands – parotid gland
* case : Acute parotitis : investigations – π .
- Causes of parotid swelling it parotid gland : DD – investigations – π .
- Complications of submandibular salivery gland excision .
- Obstructive parotitis : causes – C/P – management .
- Classify salivery gland tumors .
- C/P of malignant salivery tumors .
- Pathological types of salivery neoplasms . 2017 .
- Sjoren syndrome .
*Pharynx : premalignant lesions of oropharynx .
* surgical ethics : def – informed consent .
*Convernous sinus thrombosis
*trauma of the nose – epistaxis
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 Int medicine 2015-2013
*HTN
- 5 comp of uncontrolled HTN . ***
- endocrinal causes of 2 ry HTN .
- 5 causes of headache . *
*DM
- 5 complications of DM - 5 causes of comp of DM . *
- variates of DM comps .
- 5 clinical features of diabetic retinopathy .
- 5 vascular comp – ( micro & macroangiopathy ) of DM .
* liver
- 5 causes of acute hepatitis .*
- 4 main criteria of 1ry biliary cirrhosis .
- 5 conditions associated e autoimmune hepatitis .
* cardio
- 5 causes of atrial fibrillation . ***
- 5 causes of acute chest pain e shock .
* blood
- 5 causes of pancytopenia .*
- 5 causes of thrombocytopenia .*
- Clinical manifestations of pul . thromboembolism .
- hematological features of paramalignant $ .
- 5 causes of iron def . anemia .
- 5 differences between purpura & coagulation defect .
* lung
- 5 causes of hemoptysis . *
- 4 cardiopulmonary causes of resp. alkalosis .
- chch of chronic suppurative lung disease .
* thyroid
- 5 manifestations of hypothyroidism . *
- 5 manifestations of hyperthyroidism . **
- 8 causes of solitary nodule of thyroid gland .
- 5 differences between grave`s & toxic nodule goitre .
* renal
- 5 causes of proteinuria .
* Rheumatology
- 5 causes of playarthritis . *
- 4 systemic disorders associated e erythema nodosum .
- neurological complications of SLE .

9
 Int . medicine for ophthalmology master
- 5 points for each question : -
*causes of headache *causes of 2ry HTN *comp. of uncontrolled HTN
-migraine -CRF - target organ damage
-HTN -Acromegaly - TIA , stroke
-Benign tumors -cann`s , caushing $ - Intracranial
-meningitis
‫ ــــــــ‬irits
-Hypothyrodism - ARF , CRF , MI , Angina
-referred ‫ ـــــــ‬glaucoma -hyperparathyrodism - HTN encephalopathy
‫ ــــــ‬teeth diseases -cyclosporins , OCP - HTN retinopathy
- ICI

C/P of DM *complications of DM *causes of Acute hepatitis

- polyurea , polydipsia
- hanger
- fatigue
- skin infection
- blurred vision , tingling
- feet , toes numbness
- D nephropathy - viral ‫ ــــــ‬HCV , HAV
- D retinopathy ‫ ـــــــ‬CMV , HSV
- D neuropathy -Non viral ‫ ـــــ‬Q fever
- skin infection , tags - Drugs , Alcohol ,
- D foot paracetamol
- Aboration , Eclampsia -metabolic ‫ ــــ‬Wilson`s D
- TIA , stroke , MI

D criteria 1ry biliary cirrhasis Conditions e autoimmune hepatitis Causes of AF

- Rt upper quadrent - DM - idiopathic
discomfort - RA - thyrotoxicosis
- hebatomegaly - autoimmune thyroiditis - COPD
- jaundice - ulcerative colitis - MI , Angina
- fatigue . pururitis - Pul . embolism
- HTN . valvular heart
- hyperpigmentation disease
- sica syndrome

*Causes of pancytopenia *Causes of thrombocytopenia Manifestations of pul embolism

- A plastic anemia * production - tachypnea , tachycardia
- Gaucher`s disease - idiopathic aplastic anemia - chest pain
- metabolic carcinoma – bone - Gaucher`s disease - hemoptesis
- lymphoma - carcinoma - fever
- leukemia - leukemia - shock
- leishmaniasis - foleate deficiency - vit B 12 - Acute RVF
* destruction : hypersplenism - Sudden death
- DIC - SLE

11
 Int . medicine for ophthalmology master
*Hematological features of
paramalignant syndrome
- chromic anemia
- DIC
- thrombocytopenia
- leukopenia
- autoimmune hemolytic
anemia
Causes of resp .alkalosis
- co2 : hyperventilation
- hyperventilation $
- encephalitis
-pneumonia
-pul . embolism
hypothyroidism manifestations
- over weight .
- cold intolerance .
- hypothermia .
- bradycardia .
- skin: cold , pallor ,
yellowish
- apathy , slow thinking
*causes of polyarthritis
- SLE
- RA
- progressive systemic
- Ankylosing spondylitis
- reactive arthritis
*causes of iron anemia *causes of hemoptysis
- iron intake : old , infront - laryngeal ‫ ــــــ‬Inflamation
- absorption : malabsorption ‫ ــــــ‬Tumors
- loss : chromic blood loss - bronchogenic carcinoma
ankylostoma dudenale - lung abscess , pneumonia
- demand : pregnancy - acute pul . edema
- hemophilia
Features of Causes of
chromic sup . lung disease solidity thyroid nodule
- pale toxic face - simple nodule
- puffy eye lids - toxic nodule
- clubbing of fingers - adenoma
- bronchiactasis - Cyst
- basal consolidation - carcinoma
*hyperthyroidism manifestations Causes of protenuria
- under weight - DM
- hyperthermia - HTN
- tachycardia - Amyloidosis
- skin , fushed , worm - CRF
- tremors , outstretched hand - HF
- RA- sarcoidosis
Syst.disorder e erythema nodosum Neurological comp . of SLE
- streptococcal pharyngitis - peripheral neuropathy
- sarcoidosis , TB - convulsions .
- hisoplasmosis - cerebrovascular accident
- hodgykin lymphoma . - mononeuritis multiplex
- inf . bowel disease . - Depression
- behcet`s D
- pan creatitis
- leprosy - SLE
11
 Int . medicine for ophthalmology master

Varaites of DM comas 5 CL features of D retinopathy

- hypoglycemic coma - microangiopathy
- DKA - DOT & blot He
- hypoglycemic hyperosmolar non ketotic - flame shaped Hge
- diabetic lactic acidosis - Cotton wool spot .
- others : uremic , hepatic - macular edema .
- periretinal Hge .
- new vascularization .

5 vascular complications of DM 5 causes of Acute chest pain e shock

- microangiopathy - Angina , MI , Heart failure .
Retinopathy , nephropathy , neuropathy - cardiogenic shock
- microangiopathy : atherosclerosis - pulmonary embolism
- cerebral : TIA , stroke . - pneumothorax .
- coronary : angina , MI HF - perforating peptic ulcer .
- LL VS : ischemia , gangrine . - Cholecystitis
- HTN – cardio myopathy

Comparison between pupura Coagulation defect

- bleeding gums - No .
- good effect of comparison - poor .
- bleeding : usually spontaneous - usually post traumatic .
- bleeding time : prolonged . - normal .
- PT , PTT : normal - prolonged .

Comparison between graves Toxic nodule goitre

- most common - less common
- autoimmune d : T 3 , T 4 - somatic mutation of tsh receptors
- peritepial myxedema . - No
- diffuse enlarged gland - palpable nodules : Hot or hyper functing
- ophthalmological signs enumerate - No

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 Neuro-ophthalmology 2015-2006

* diplopia
- enumerate causes of vertical diplopia
- causes of transient diplopia *
- classify diplopia
- DD of diplopia**
- evaluation of diplopia

* papilledema
- def – eitiology – DD – TTT *****
* optic neuritis
- discuss optic neuritis *
- retrobulber neuritis *
- discuss Leper’s optic atrphy
* ptosis
- classify ptosis
- causes of ptosis*
* Nystagmus
- BPPN : causes –diagnosis

* 3rd N. palsy
- list causes of nuclear 3rd N. palsy
* 6th N. palsy
-discuss isolated abducent N. palsy
* 7th N. palsy
- facial palsy

* clinical importance of eye examination in neuropsychatric disorders

* Horner’s syndrome
- discuss Horner’s syndrome ****
- diagnosis of Horner’s syndrome & ttt

* sudden loss of vision

- evaluate a case of acute visual loss
- sudden loss of vision (uni & bilat.)
- causes of acute visual loss *
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* Amourosis fugax
- def , DD **
- def , eitiology , C/P
* carotid art. Aneurysm
- intracranial aneurysm
* cavernous sinus thrombosis.
- cavernous sinus: anatomy, eitiology, C/P of cavernous sinus syndrome
- management of cavernous sinus thrombosis ***
- pathogenesis , ocular manifestations , DD , TTT , prognosis

* ophthalmoplegia – one & half S

- ophthalmoplegia**
- intranuclear ophthalmoplegia def , eitiology , C/P**
- discuss one & half S
* Wilson’s disease
- Hepatolenticulear degeneration

* Headache & Migraine

- discuss retinal migraine
- classify migraine : diagnostic criteria - DD
* pseudotumor cerebri
- evaluate a case of pseudotumor cerebri
- describe benign increases ICT & its management *

* M.S.
- ophthalmic manifestations of MS & TTT**
* Giant cell arteritis
- describe giant cell arteritis & ocular manifestations
- GCA : pathology , investigations , TTT
- evaluate a case of GCA & its management
- discuss acute temporal arteritis

* ophthalmological signs of brain tumors

* evaluate neuro-myelitis optica **
* ocular myasthenia : pathogenesis , diagnosis , TTT
* Visual manifestations of head trauma
* Hallucinations
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