This Opthalmology study guide contains important knowledge for fourth and final year medical school exams. It focuses on common pathologies, cause, diagnosis and management as well as examination of the eye.
Eyelids
Insertion of Levator muscles
Accessory lacrimal glands of Wolfring
Meibomium glands in tarsal plate
Orbicularis
Meibomium ducts (surface of tarsal plate)
30 on upper eyelid, fewer on the lower.
Lashes
Apocrine glands of Moll (posterior to
eyelash follicle)
Glands of Zeis (base of hair follicle)
Skin
, Chalazion
A Chalazion is a painless firm lump in the upper of lower eyelid due to chronic
inflammation/blockage of the Meibomium gland. A stye however is painful, and is a
sore red sump near the edge of the eyelid caused by an infected eyelash follicle.
Lid opening functions with Levator palpabrae superioris (CN3) and Muller’s
muscle (superior tarsal muscle innervated by sympathetic)
Lid closure functions with orbicularis oculi (CN7)
Tear film
Flow is 1.2microlitres/min
Lipid from Meibomium gland (slows the evaporation of tears)
Aqueous layer from lacrimal and accessory lacrimal glands of Krause and
Wolfring. 90% of tear volume mainly water with glucose, lysozyme, lactoferrin,
IgA and ions
Mucin from conjunctival goblet cells which improves tear film viscosity.
Imbalance in any constituents will cause symptoms such as dry eye, grittiness
etc.
Lacrimal gland>eye>punctum>ampulla>canaliculi>lacrimal sac>nasolacrimal
duct>valve of Hasner> Nasal cavity via nasolacrimal aperture (most inferior
meatus)
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