فروقات مهمة
1. Lacrimation is watery eye due to increase the secretory part of lacrimal
System

But Epiphora is due to obstruction in the drainage part of lacrimal system

2. Proptosis is passive forward protrusion of eye ball

But exophthlamous is active forward proteusion of the eye ball

3_ trachomatous pannus is vasculization with diffuse cell infiltration

But Herberts rosette is vascularization with local cell infilteration

#عيون

Types of trachomatous pannus

1 Tenius( thin) is vascularization and infiltration is mild

2 Carnosus ( thick fleshy pannus )
Is infiltration is excessive

3_ Vasculosus is vascularization is excessive

4_ Annulosus is all around the cornea

5_ Siccus ( dry or healed pannus ,,)

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In Fungal keratitis signs more than
symptoms

But in Bacterial keratitis symptoms more than signs

Penitrating keratoplasty for deep corneal opacities but lamellar kertoplasty for superficial opacities

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Veneral conjunctivitis = sporadic gonoccocal conjunctivitis

But vernal conjunctivitis =
Spring cattarh = external allergy
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Shiemer test 1 measure the basal + reflex lacrimal tear secreation

Shiemer teat 2 measure the reflex secretion

Common site of blockage of NLD in children is at it's lower portion

Common site of blockage of NLD in adult is at sac __NLD junction

#عيون

◽️ When 'The patient sees nothing and the doctor sees nothing'

🔻You must think of " Retrobulbar optic neuritis " And look for multiple sclerosis which is the MOST common cause.

🔹Note / 25% of MS patients come with rapid painful lose of vision as only presention ❗️

#Opthalmology

🔸D.D of pupil irregularity
▪️posterior& anterior synechiae
▪️ iris atrophy
▪️injury of the iris
▪️trauma

🔶D.D of leukokoria :
▪️cataract
▪️toxocariasis
▪️retinoblastoma
▪️coats disease
▪️retinopathy of prematurity

🔶D.D of hyphema
▪️trauma
▪️metallic intra ocular foreign body
▪️Rubeosis iridis
▪️drug:Asprine

🔶D.D of hypopyon
▪️endophthalmitis
▪️chemical injuries
▪️keratitis
▪️TB

🔶D.D causes of axial proptosis
▪️Greaves disease
▪️retrobublar hemorrhage
▪️ optic nerve tumor
▪️ orbital cellulitis

🔶D.D uses of ROSE BANGAL stain
▪️DRY EYE
▪️ corneal ulcer

🔶 D.D uses of local ANESTHESIA
▪️tonometry
▪️suture remove
▪️Goniolens
▪️probing &dilatation

🔶D.D of PARACENTESIS
▪️hyphema
▪️hypopyon
▪️keratocele

🔶D.D Binocular Diplopia
▪️paralytic squint (4,6)
▪️pterygium
▪️blowout fractures

🔶D.D of watery eye (neonate)
▪️congenital NLD obstruction
▪️congenital glaucoma
▪️ophthalmia neonatorum

🔶D.D of Blue sclera
▪️Buphthalmous
▪️marfan syndrome
▪️High myopia
▪️scleral staphyloma
▪️physiological (children , infant)

🔶D.D of EYE reflex :
🔴Red reflex _........ (NORMAL)
⚪️white reflex ......(leukocoria)
🔘 Grey reflex......( retinal detachment)
⚫️ Black reflex ,,(vitreous hemorrhage)
🟡Yellow reflex .....( vitreous pus)
🔴🔴Double red reflex ..(poly coria,, iridodialysis,,, peripheral iridoectomy )
⭕️ ring red reflex ....( nuclear cataract)

🔶D.D narrow palpebral fissure
▪️odema of lids
▪️ptosis
▪️phtaitis bulbi
▪️micro phthalmos

🔶D.D wide palpebral apertures (fissure)

▪️proptosis
▪️buphthalmos
▪️upper lid retraction

🔶 D.D Marcus Gunn pupil (RAPD)
▪️optic neuritis
▪️retinal detachment
▪️ CRAO
▪️CRVO