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

🔶D.D decreased corneal sensation
▪️herpes simplex keratitis
▪️herpes zoster ophthalmicus
▪️DM
▪️Trigeminal dysfunction

🔶D.D OF RED EYE
▪️conjunctivitis
▪️keratitis
▪️endophthalmitis
▪️scleritis &episcleritis

🔶D.D enlargement of blind spot
▪️POAG
▪️papilledema

🔸Ring Scotoma
▪️POAG
▪️Retinitis pigmentosa