Group⟨D⟩~[4th Year]^(39)

🔻فيديو للدكتور عبدالمغني البراق يشرح فيه الادوات مع استخدامهن

💢بالنسبة لإختبار العيون : سيكون غداً الأربعاء الساعة8 تماماً في مستشفى الكويت 🔸الإختبار بيكون على مرحلتين: 1. عملي (أوسكي+أدوات+حالة) ... في "عيادات الليزر" 2. شفوي ... في "مكتب الدائرة السريرية" مكان ما كنا نبصم 🔻وعليه .. بتبدأوا إختبار #عملي في عيادات الليزر، وبعدين تتجهوا مباشرة إلى مكتب الدائرة السريرية لإختبار #الشفوي ، مش تجلسوا تتمشوا لأن اي طالب ينادوا بإسمه وهو مش موجود يعتبر غائب 📍 ملاحظات :- - التزموا بلبس اللابكوت وتغليق الزرارات - لاتنسوا الlogbook - درجات الإختبار "120"درجة، كالتالي : 10 حضور وغياب 10 حق ال log book 30 أوسكي (8صور) 20 حالة 10 أدوات 40 شفوي #بالتوفيق_للجميع

IMPORTANT NOTES 📝 في ال Incomitant siqunt هناك نوعين والذي هما Paralytic squint and Restrictive siqunt. لكن كيف نفرق بينهم؟ Differences between restricted squint and paralytic squint Restricted Squint Definition: A misalignment of the eyes due to mechanical restriction of ocular movement, often caused by structural or physical limitations. Causes: Orbital trauma (e.g., fracture of the orbital floor or medial wall). Fibrosis or scarring in extraocular muscles. Thyroid eye disease (Graves' orbitopathy). Tumors within the orbit. او يمكن انه يجي Congenital زي ال Duane's Restrictive syndrome وغيرها Characteristics: Forced duction test is positive (indicating mechanical restriction). Management: Treat underlying cause (e.g., surgical correction for fractures). في حالات ال  sever cases : muscle grafting (e.g., using frontalis muscle) to maintain alignment in primary gaze. The main goal of treatment is to maintain proper alignment in the primary gaze, even if diplopia persists in other directions. Ex:When the lateral rectus muscle is permanently damaged or non-functional , a graft from another muscle, such as the frontalis muscle, can be used to restore some degree of alignment in the primary gaze. This surgical approach focuses on improving the patient's ability to see clearly when looking straight ahead (primary gaze), which is crucial for daily activities like reading and interacting with others. Paralytic Squint Definition: A misalignment of the eyes due to weakness or paralysis of one or more extraocular muscles, caused by nerve dysfunction. Causes: Cranial nerve palsies (e.g., III, IV, or VI cranial nerves). Characteristics: Forced duction test is negative (indicating no mechanical restriction). Management: Treatment of Paralytic Squint depends on the cause and severity of the condition. Management typically follows a structured approach and is not initiated immediately in most cases unless complications require urgent intervention. When to Treat? During the first few weeks or months, surgical treatment is usually avoided. Why? Because spontaneous recovery is possible, especially in cases of temporary causes (e.g., nerve inflammation or vascular-related paralysis). During this phase(تعبتر Acute phase)  : Monitor the patient regularly. Prescribe prism glasses to reduce diplopia (double vision). Use patching of one eye to eliminate diplopia temporarily, if necessary. Chronic Phase (after 6 months): If no spontaneous recovery occurs and the condition stabilizes after 6 months, definitive treatment can be initiated. Treatment options include: Botox injections: Temporary use to balance muscle function. Surgical correction: To restore muscle balance and compensate for the paralyzed muscle. If there is an identifiable cause: Vascular causes : Manage the underlying condition (e.g., controlling blood pressure, diabetes). Tumors or nerve compression: Surgical or radiotherapy interventions, depending on the situation. Nerve inflammation: Use anti-inflammatory medications like corticosteroids. Goals of Treatment: Reduce diplopia, especially in the primary gaze position. Enhance the patient’s quality of life. Note: Definitive treatment, especially surgery, is only performed after the condition stabilizes to ensure the intervention addresses the final state of the paralysis effectively. يعني ننتظر لمدة ستة أشهر او حتى سنة لانه في أغلب الحالات يحدث recovery خاصة لمن يكون هناك mild cause

Horner's syndrome "oculosympathetic paresis " Characterized by classic triad of ptosis, miosis, and anhidrosis. Is due to disruption of the sympathetic nerve pathway here It occured 2ry to bacterial infection, this occurred when the child got sick another time by any sickness as common cold .

A child nearly 4 years , was treated for middle ear bacterial infection 5 months ago , and now comes with ptosis , miosis and hot right side . What do you think this rare condition is !?

✴️what is name of this instrument ? ➡️caliber.( indentation tonometery ) ✴️ what are thre use of this instrument? examination of corneal diameter. for diagnosis large cornea and mainly used for diagnosis congenital glaucoma. ✴️normal corneal diameter in children? ➡️ 9- 9.5mm اذا كان اكثر من 11mm التشخيص يكون glaucoma.

❇️اوسكي ❇️ ✴️what are youre diagnosis ? bilateral congenital glaucoma ✴️symptoms? 1- lacrimation. 2- photophobia. ✴️what is youre finding (signs)? 1- large pupil.( mainly) others 2- blue sclera 3- large globe 4-iris tremulous ✴️ main complications ? 1- bilateral amblyopia. 2- unilateral squint. 3- bilateral nystagmus. 3 4-late optic nerve damage ✴️investigation? كيف تشخص الحالة 1- by family history. 2- examination of corneal diameter. اذا كان اكثر من 11mm ملي ميتر هذا. glaucoma مافي نقاش نستخدم ال Caliber 3- measurement of IOP ? by ➡️ perkins tonometer. or ➡️tono-pen. 4-gonioscopy. to examination of angle of A/C. 5- ophthamology:- show glaucomatous cupping. _ ❇️شفوي❇️ متكرر اذا اجئت صورة glaucoma يطلب الاتي ✴️2- Def of glaucoma: it is damage of optic nerve irreversible. or optic neuropathy. ✴️what are characteristics of optic neuropathy: (Triad):- 1-highe IOP. 2-visual field defect. 3- glaucomatous cupping. ✴️types of glaucoma اذكرهم.

What is the clinical diagnosis? What is the cause? What is the treatment? ▫️Dx: Pterygium (fibrovascular tissue extending from nasal limbus toward the cornea) ▫️caused by  excess uv exposure ▫️Tx:.surgery (irritation, vision effect ,cosmetic ) ▫️Effect the vision by *direct cover *refractive error (astigmatism) #ophthalmology

Dx:Ectropion: eversion of lower eyelid Causes: ▫️congenital ▫️acquired: *senile(involutional) * facial nerve palsy (mostly unilateral) *cicatricia(scarring of skin ) *post surgical (blepharoplasty) …associated with excess lacrimation because of misdirection of inferior punctum Tx:surgical(mainly) #ophthalmo_OSCE

What is the clinical diagnosis? What is the cause? What is the treatment ? The answer: Dx:Entropion Causes : *involution *spastic (after cva) *cicattricia  (scarring of conjunctiva) Tx..surgery #ophthalmo_OSCE

What is the diagnosis of this condition? What is the cause? How to treat it? Dx :Upper eye lid…stye … Cause :Acute staphylococcus infection of the hair follicle Tx: cleaning +local antibiotics +removal of related lashes to facilitate drainage #ophthalmo_OSCE

1_What is the clinical  diagnosis? 2_What is the disease typically associated with it? Answers👇 1_subluxation of lens 2_Homocystinuria typically the subluxation 👉inferonasal with disintegration of zonules #ophthalmo_OSCE

▫️what is the diagnosis? ▫️what is the cause? ▫️what is the treatment? Answer: ….dx :.chalazia … Cause: Retention of secretion of meibomian gland lead to lipogranulomatus inflammation Tx /surgical drainage unless near the tear drainage system or the lesion is multiple and difficult to remove …so treated by local steroid injection #ophthalmo_OSCE

1_What is the clinical diagnosis? 2_defination of it? Answers👇 1_Rhegmatogenous retinal detachment 2_seperation of the neurosensory retina from retinal pigmental epithelium secondary to full-thickness defect in the sensory retina👉fluid leakage from viterous to subretinal space #ophthalmo_OSCE

1_What is your diagnosis? 2_What are the type in A and B and what most serious type? 3_What are the complication of case in picture B? 1_Dislocated lens 2_A-posterior dislocation B_anterior dislocation most serious 👉anterior dislocation 3_ iridocyclitis acute secondary glaucoma corneal opacity #ophthalmo_OSCE