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MARY YVETTE ALLAIN TINA RALPH SHERYL BART HEINRICH PIPOY TLE JAM CECILLE DENESSE VINCE HOOPS CES XTIAN LAINEY RIZ KIX EZRA GOLDIE BUFF MONA AM MAAN ADI KC
PENG KARLA ALPHE AARON KYTH ANNE EISA KRING CANDY ISAY MARCO JOSHUA FARS RAIN JASSIE MIKA SHAR ERIKA MACKY VIKI JOAN PREI KATE BAM AMS HANNAH MEMAY PAU
RACHE ESTHER JOEL GLENN TONI
SUBJECT: optha
TOPIC: ocular media and binocular vision
Page 2 of 7
- Flexible mechanism by which the eye changes -routinely done in children <6yo
refractive power due to changes in shaoe of the -utilizes the objective method which uses a
crystalline lens retroscope to accurately measure refractive error
- Results from an innervational stimulus producing
an increase tonicity of ciliary muscle and XII. Types of Optical Lenses Used
relaxation of zonules allowing elasticity of lens to Glasses and plastic lenses
assure a more biconvex state and produce a Contact lenses
greater refractive power o Extended wear contact lens
- Consist of vertical and horizontal meridian o Daily wear contact lens
***circle of least confusion: focusing of iris (like a o Rigid gas permeable contact lens
camera) o Toric contact lens: expensive
o Astigmatism correction ≥100
IX. Astigmatism
- Light rays entering eye focus on 2 separate lines Intraocular lenses
instead of a point o Specialized
- Light is not refracted equally on all meridians o Polymethacrylate
- Sometimes clear vision, sometimes blurred o Silicon polymethacrylate
vision o Hydrogels
- Blurred vision: only complaint in higher o Become more inert
astigmatism error o Causes lot of reactions: uveitis
- Tilting of head: 2nd most frequent complaint in XII. Other modalities of correcting Refractive errors
high degrees of oblique astigmatism Photorefractive Keratectomy (PRK)
- Narrowing of the eyelids to achieve a pinhole or Laser-in-situ keratomileusis (LASIK)
stenopeic effect
Intracorneal lens
- Squints both for distance and near task
- Frontal headaches are common Implantable contact lens
- Test by using astigmatic clock (five finger) or dial Radial Keratotomy (R.K.)
(circle)
X. Types of Astigmatism
1. Simple hyperopic astigmatism (SHA)
-focus of light rays one behind and one above
the retina
2. Simple myopic astigmatism (SMA)
-focus of light rays one in front and one above
the retina
3. Compound hyperopic astigmatism (CHA)
-focus of light rays both behind the retina but in
**Radial Keratotomy is an
different levels
established surgical
4. Compound myopic astigmatism (CMA)
procedure whose purpose is
-focus of light rays both in front of the retina but
to remove or reduce
in different levels
ametropia resulting from
5. Mixed astigmatism (MA)
myopia and/or myopic
-focus of light rays on top of retina in two
astigmatism. The whole
different degrees
point of RK is to reduce the
-surgical
central corneal curvature sufficiently so as to move the
cornea's focus back onto the retina
XI. Method of Refraction
1. Subjective Method
-utilize individual’s ability to choose the lens I. Anatomy of Extraocular muscle and inner fascia
-utilizes a set of Trial lenses 3 pairs of EOM
-patient must be intelligent o Horizontal – medial and lateral recti
-trial and error o Vertical – superior and inferior recti
2. Objective Method
o Oblique – superior and inferior obliques
-uses retinoscope
-useful in children, decreased IQ, unconscious or
semi-conscious
-see vertical or horizontal light
3. Cycloplegic Method
-drugs used to paralyze accommodation power
of ciliary body such as:
Atropine 1%
Tropicamide 0.5%
Cyclopentolate and homatropine (2%)
SUBJECT: optha
TOPIC: ocular media and binocular vision
Page 3 of 7
b. Inferior rectus
i. Primary- depression
ii. Secondary- adduction and
excycloduction
V. Oblique muscles
Superior oblique muscle
o originate from the annulus of zinn and
passes anteriorly and upward along the
superomedial wall of the orbit becoming
tendinous before passing through the
trochlea located on the nasal side of the
superior orbital rim. The tendon is reflected
inferiorly, posteriorly and laterally, forming
an angle of 51° with the visual axis of the
II. Nerve Supply
eye and inserts in the posterosuperior
a. Lateral rectus – CN 6 (Abducens)
temporal quadrant of the yeball passing to
b. Superior oblique – CN4 (Trochlear)
the SR muscle
c. The rest of the EOM are supplied by CN3
o Primary action – incycloduction
i. Upper division (levator palpabrae
o Secondary action – depression and
muscle & Superior rectus)
abduction
ii. Lower division (Medial rectus, inferior
Inferior oblique muscle
rectus, inferior oblique)
o The parasympathetic innervations to the o originates from the periosteum of the
spinchter papillae and ciliary muscle travels maxillary bone, just posterior to the orbital
with the branch of the lower division of the rim and lateral to the orifice of lacrimal
occulomotor nerve which supplies the fossa. It passes laterally, superiorly and
inferior oblique muscle posteriorly, going to the inferior rectus and
o Formula: LR6SO4 under the lateral rectus to insert in the
posterolateral position of the globe. It
III. Horizontal rectus muscles
forms an angle of 51° with the visual axis n
Medial and lateral rectus muscles – arise
primary position
from annulus of zinn, course along the
o primary action: excycloduction
medial and lateral orbital wall and
o secondary: elevation and abduction
inserts 5.5mm and 7mm from the
**ANNULUS OF ZINN – holds EOM together except
limbus, respectively
IO
B. Acquired
1. Comitant accomodative esotropia
- Onset is from 6 months to 7 years with an
yes parang model lang…
average of 2 ½ years
- Aften hereditary
hehehe
- Ambitopia is frequent, with no diplopia
- Refractive accommodative, Non-refractive
accommodative and combined form or
mixed mechanism esotropia are some of the
types.
2. Non- accommodative esotropia
- Stress induced and can be precipitated by
debilitating illness, emotional trauma,
physical injury and ageing
- Can be cyclic or have a variable cycle of 24- Moments daw oh…
48 hours
- Treatment: full hyperopic correction. Some
require surgery when they progress to cyclic
deviation
3. Incomitant esotropia
- Medial rectus muscle restriction such as in
thyroid myopathy, medial orbital wall
fracture, excessively resected medial rectus
muscle
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