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Numero-Ophthalmology !Numero-Ophthalmology !
By
Dr.Ahmed Alsherbiny
MSc. Ophth , FICO , FRCS Ophth (Glasg(
“ 1 “
One Mirror Goldmann
Goniolens
Duane syndrome type I
Neurofibromatosis I
Optic nerve glioma (15–40%(
T1 weighted MRI
“ 1 1/2 “
One and Half Syndrome
“ 2 “
Neurofibromatosis II
often include bilateral acoustic neuroma (90%(
Duane syndrome type II
T2 weighted MRI
“ 3 “
Duane
syndrome
Type III
Third nerve palsy
Remember
Three Mirror Goldmann goniolens
Remember:The Smaller the Mirror, The Peripheral The View
3Step test
“ 4 “
4bones form the Medial orbital wall
Remember: The lamina papyracea, which forms part of the medial wall, is
paper-thin and perforated by numerous foramina for nerves and blood
vessels. Orbital cellulitis is therefore frequently secondary to ethmoidal
sinusitis.
Four recti muscles forms
the spiral of Tillaux
4th
nerve palsy
Remember: Bilateral involvement should always be excluded, particularly
following head trauma.
In pars plana vitrectomy the trocars
are inserted ( 4 mm behind the limbus
in phakic eyes(
Worth 4-dot test
“ 5 “
Topical Antiviral Dose : five
times per day
Chromosome 5:
Stromal Dystrophies:
1-Lattice Dystrophy type 1
2-Lattice Dystrophy type 3
3-Granular Dystrophy type 1
4-Granular dystrophy type 2 “ Avellino”
“ 6 “
6th
nerve palsy
Remember: False localizing sign
6th
layer of the cornea
)Dua’s Layer(
“ 7 “
7th
nerve palsy
Remember: LMNL affects the eye
“ 8 “
8th
nerve
Deafness & The Eye
1-Usher Syndrome
2-Alport syndrome
3-Cogenital syphilis
4-Rubella
5-Stickler syndrome
6-Vogt- Koyanagi – Harada
7-Friedreich ataxia
8-DIDMOD
9-Refsum Syndrome
10-Cogan syndrome
8ball Hyphema
Figure of 8 corneal stitch
“ 9 “
Nine directions of gaze
“ 10 “
Ten layers of the retina
“ 11 “
Chromosome 11
Aniridia , Remember : Inheritance & WAGR syndrome
Albinism “ Tyrisonase negative “
“ 12 “
Corneal diameter
measurement; >12 mm prior
to the age of one year is
highly suspicious to
buphthalmos
“ 13 & 14 “
Chromosome 13: retinoblastoma
13q14
“ 15 “
15D Condensing lens
)magnifies x4: field about 40°(
Levator function (upper lid
excursion) is measured by
placing a thumb firmly
against the patient’s brow
to negate the action of the
frontalis muscle, with the
eyes in downgaze. The
patient then looks up as far
as possible and the amount
of excursion is measured
with a rule. Levator
function is graded as normal
(15 mm or more(
“ 16 “
Chromosome 16:
Macular corneal dystrophy
“ 17 “
Chromosome 17:
Neurofibromatosis I
Neurofibromatosis I
OCULAR Features:
Orbit : Optic Nerve Glioma
Cornea : Prominent corneal nerves
Uvea : Lisch nodules
Lid : Neurofibroma
Angle : Glaucoma
Retina : Choridal naevi &
Astrocytoma
“ 18 “
Trisomy 18 ( Edwards syndrome(
“ 19 “
Chromosome 19:
Dystrophia myotonica
Remember: Christmas tree cataract
“ 20 “
In proptosis assessment, readings greater than 20
mm are indicative of proptosis and a difference of 2–3
mm or more between the two eyes is suspicious
regardless of the absolute values
20D Condensing lens
)magnifies x3: field about 45°(
“ 21 “
Trisomy 21 ( Down Syndrome )
Trisomy 21 (Down Syndrome)
“ 22 “
Chromosome 22 :
Neurofibromatosis II
“ 23 “
23gauge vitrectomy
“ 24 “
24 mm is the axial lenghth of
emmetrope eye
“ 25 “
25D Condensing lens
)magnifies x2.5: field about 50°(
Thank You

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Numero-Ophthalmology !