Thursday, August 26, 2010

Mnemonics in Ophthalmology

Allergic eye disease
Mnemonic: HFS
H Delayed Hypersensitivity
F HayFever conjunctivitis
S Spring catarrh

Clinical presentation of conjunctivitis
Mnemonic: BURN
B Burning and lacrimation along with itching and possibly photophobia
U Usually bilateral, if unilateral consider another differential diagnosis
R Red and inflamed conjunctiva, eyelids may be stuck together with purulent
discharge
N Normally self-limiting, can be treated with antibiotics

Signs of optic neuropathy
Mnemonic: PLAC
P Pale disc
L Loss of visual acuity/Loss of red colour vision
A Afferent pupillary defect
C Central scotoma

Causes of retinal detachment
Mnemonic: SITS
S Secondary to some intraocular problem (melanoma)
I Idiopathic
T Trauma
S Surgery for cataract

The 4 Fs of retinal detachment
Mnemonic: 4 Fs
F Floaters (small dark spots on a bright background are generally harmless)
F Flashes (migraine)
F Field loss (dark cloud covers a field of vision)
F Falling acuity (serious)

Causes of excess lacrimation
Mnemonic: FACE
F Foreign body or corneal abrasions
A Acute glaucoma
C Conjunctivitis
E Emotion (typical man, I list this last!)

Remember Keratoconus with the help of CONES:
Central scarring & Fleischer ring
Oil drop reflex / Oedema (hydrops)
Nerves prominent
Excessive bulging of lower lid on downgaze (Munson’s sign)
Striae (Vogt’s)
Remember Iridocorneal Endothelial Syndrome with ICE
Iris Naevus
Chandler Syndrome
Essential Iris Atrophy

Remember Behcet's Disease with the help of ORAL UPSET

Occlusive periphlebitis
Retinitis
Anterior uveitis
Leakage from retinal vessels
Ulceration (aphthous/genital)
Pustules after skin trauma (Pathergy test)
Scratching leaves lines (dermatographism)
Erythema nodosum
Thrombophlebitis

Remember posterior scleritis with POST SCLER

Proptosis
Ophthalmoplegia
Swelling of disc
Thickening of sclera (US/CT) & T sign (fluid in sub-Tenon’s space)
Subretinal exudates
Choroidal foLds
Exudative RD
Ring choroidal detachment
Remember Keratoconus with the help of CONES:
Central scarring & Fleischer ring
Oil drop reflex / Oedema (hydrops)
Nerves prominent
Excessive bulging of lower lid on downgaze (Munson’s sign)
Striae (Vogt’s)
Remember Iridocorneal Endothelial Syndrome with ICE
Iris Naevus
Chandler Syndrome
Essential Iris Atrophy

Remember Behcet's Disease with the help of ORAL UPSET
Occlusive periphlebitis
Retinitis
Anterior uveitis
Leakage from retinal vessels
Ulceration (aphthous/genital)
Pustules after skin trauma (Pathergy test)
Scratching leaves lines (dermatographism)
Erythema nodosum
Thrombophlebitis

Remember posterior scleritis with POST SCLER
Proptosis
Ophthalmoplegia
Swelling of disc
Thickening of sclera (US/CT) & T sign (fluid in sub-Tenon’s space)
Subretinal exudates
Choroidal foLds
Exudative RD
Ring choroidal detachment

Remember causes of Choroidal neovascular membrane with HAMMAR
Histoplasmosis
ARMD
Multifocal Choroiditis
Myopia
Angiod
Rupture of the choroid

Remember the causes of trabecular pigmentation with PIGMENT
Pseudoexfoliation & Pigment dispersion syndrome
Iritis
Glaucoma (Post angle closure Glaucoma)
Melanosis of angle (oculodermal melanosis)
Endocrine (Diabetes & Addison’s Syndrome)
Naevus (Cogan-reese syndrome)
Trauma

Remember sterilization in ophthalmology with ABCDEFG
AUTOCLAVE
BOILING
CHEMICALS like Alcohol (Rectified spirit), Isopropyl alcohol/CIDEX: 2% Glutaraldehyde
DRY HEAT temperature of 150°C is used for 90 minutes
ETHYLENE OXIDE for sterilization of IOL etc.
FUMIGATION of operation theatre/ FORMALIN vapour
GAMMA-IRRADIATION: Gamma rays from Cobalt-60

Remember the ocular structures derived from neuroectoderm with MORE
Muscles of pupil
Optic Nerve
Retina (with RPE)
Epithelium of Iris
Epithelium of Cilliary Body

Remember the structures derived from surface ectoderm with S1L2E3

Skin of Eyelids and its derivatives viz. cilia, tarsal glands, conjunctival gland
Lens,
Lacrimal Gland,
Epithelium of Conjunctiva,
Epithelium of Cornea,
Epithelium of lacrimal passage

Remember Stromal dystrophies with Marilyn Monroe Always Gets Her Man in LA City.
Macular dystrophy
Mucopolysaccharide
Alcian blue

Granular Dystrophy
Hyaline material
Masson's Trichrome

Lattice Dystrophy
Amyloid
Congo Red

Remember the drugs causing cataract with ABCD
Amiodarone
Busulphan
Chlorpromazine
Dexamethasone


Remember the causes of Uniocular diplopia as ABCD
Astigmatism
Behavioral: psychogenic
Cataract
Dislocated lens
Remember microtropia with 3 A
Anisometropia
Angle small
Absent central field (Central suppression scotoma)
Remember the refractive indices of ocular media with 8303 (from anterior to posterior)
cornea 1.38
aq humour 1.33
lens 1.40
vit humour 1.33
Remember the types of colour blindness with TuB PaR DoG
TRITOANOPES = BLUE
PROTOANOPES = RED
DEUTROANOPES= GREEN
Remember the causes of lid retraction with 4 MP
4M= Myasthenia Gravis,Marcus Gunn jaw winkling syndrome,Myotonic causes like dystrophica myotonica.Metabolic cuses like uraemia,cirrhosis
4P=Perinauds syndrome,Parkinson's Disease/Progressive supranuclear palsy,Ptosis of other eye,Palsy (aberrant III crnaial nerve regeneration)
Remember content & veins draining the Cavernous Sinus with Rule of 3
3 Afferent veins: Sphenoparietal sinus (Vault veins), Supf Middle cerebral Vein (Brain), Ophthalmic vein (Orbit)
3 Efferent Veins: Superior petrosal sinus, Inferior Petrosal Sinus, Communicating vein to pterygoid plexus
3 Contents; Cranial Nerves (III,IV, V1,V2 & VI)
3 Areas Drain into it: Vault Bones, Brain (Cerebral Hemisphere), Orbit
3 Nerves: Motor(III,IV,VI),Sensory (V1,V2), Sympathetic
Remember the causes of pseudo tumor cerebri with " Idiopathic IDEA"
Idiopathic
Infections-Otitis media,mastoiditis,viral infections etc
Drugs-Steroid withdrawl,Vitamin A intoxication,Nalidixic acid,amidarone,cyclosporin,minocycline
Endocrine-obese,amennorrheic woman of child bearing age, Hypoparathyroidism
Anaemia
Remember the causes of downbeat nystagmus with DoWNBEAT
Degeneration, Demyelination or Drugs (Lithium)
Wernicke's Encephalopathy
Neoplasm or paraneoplastic cerebeller degeneration
Brainstem disease (Syringomyelia)
Encephalitis
Arnold-Chiari malformation
Trauma or Toxin
Remember characteristics of congenital nystagmus with CONGENITAL
Convergence & eye closure dampens
Oscillopsia absent
Null zone that is present,increases foveation time which results in increased acuity
Gaze poisition doesnot change the horizontal direction of nystagmus
Equal amplitude and frequency in each eye
Near acuity is good
Inversion of optokinetic response
Turning of head to acheive null point
Abolishes in sleep
Latent (occlusion) nystagmus occurs


Remember "DWARF" for decribing Nystagmus
Direction=plane of movement-horizontal,vertical
Waveform= Pendular or Jerky
Amplitude= fine or coarse
Rest=At primary position or gaze evolked
Frequency= How often the eye moves

Remember the characteristics of Perinaud's Dorsal Midbrain Syndrome with "CLUES"
Convergence retraction nystagmus
Lightnear Dissociation
Upgaze paralysis
Eyelid retraction
Skew deviation

Remember ocular features of acromegaly with ACROM
Angiod streaks
Chiasmal syndrome
Retinopathy
Optic atrophy,papilloedema
Muscle enlargement

Remember the systemic features of Marfan syndrome with MARFANS
Mitral prolapse
Aortic dissection
Regurgitant aortic valve
Fingers long (arachnodactyly)
Arm span>height
Nasal voice (high arched palate)
Sternal excavation

Remember the ocular features of Marfan’s syndrome with CLUMPS
Cupping (glaucoma)
Lattice
Upward lens subluxation
Myopia
Cornea Plana
Sclera blue

Remember angle structures with "I Can See Till Schwalbe's Line"
Iris root
Cilliary Body
Scleral spur
Trabecular Meshwork
Schwalbe's Line

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