Cataract

types of cataract :
1. sunflower cataract : chalcosis n Wilson's disease

2.rosset shaped cataract : blunt trauma

3.snow flak cataract : diabetes

4.senile cataract : MC acquired cataract.

5.oil drop cataract : galactosemia

6.Christmas tree cataract : myotonic dystrophy

7.post. subcapsular causes
--drug induced
---radiation induced
---max.visual handicapped
---complicated cataract.

8.MC type of congenital cataract : blue dot

9.MC type of congenital cataract  diminision of vision : lameller cataract or zonular cataract

10.cataract seen in rubella :
neuclear pearly followed by zonular cataract.

Ries-Buckler dystrophy

4R
•Recurrent corneal erosions
•Reticular pattern
•Reduced corneal sensations
•Recurrence after graft
2 F
•fibrous tissue replaces epith basement membrane and bowmans membrane
•ferritin lines in epithelium.
#ophtha
•pepper pot fundus--chorioretinitis
•Pepper pot skull—hyperthyroidism�

• cavernous optic atrophy also k/a Schnables atrophy
-atrophy of nerve fibres
-no glial cell proliferation
-mucoid degeneration of glial cells leading to lacunae formation

Eye Muscles

INFO::EOM

Longest extraocular muscle of eye - superior oblique

Shortest extraocular muscle of eye - inferior oblique

Longest among extraocular rectus muscles of eye - medial rectus

Shortest  among extraocular rectus muscles of eye - lateral rectus

Embryologically 1st  extraocular muscle - lateral rectus

Extraocular muscle with 2 origins - lateral rectus

Extraocular muscle with only 1 muscular artery - lateral rectus

muscle not originating from apex of orbit INFERIOR OBLIQUE

muscle not affecting in retro orbital block SUPERIOR OBLIQUE

In isolated eyeball  EOM helps to recognise side of eyeball-IO

in isolated eyeball which EOM helps to recognise side of eyeball -IO

Opthalmology - Diabetes

OPHTHALMOLOGY
Diabetes mellitus
Ocular involvement in diabetes is very common. Structure-wise ocular lesions are as follows:
1. Lids. Xanthelasma and recurrent stye or internal
hordeolum
2. Conjunctiva.Telangiectasia,sludgingoftheblood
in conjunctival vessels and subconjunctival
haemorrhage
3. Cornea. Pigment dispersal at back of cornea,
decreased corneal sensations (due to trigeminal neuropathy), punctate kerotapathy, Descemet’s folds, higher incidence of infective corneal ulcers and delayed epithelial healing due to abnormality in epithelial basement membrane
4. Iris. Rubeosis iridis (neovascularization)
5. Lens. Snow-flake cataract in patients with IDDM, posterior subcapsular cataract, early onset and
early maturation of senile cataract
6. Vitreous.Vitreoushaemorrhageandfibre-vascular
proliferation secondary to diabetic retinopathy 7. Retina. Diabetic retinopathy and lipaemia retinalis
8. Intraocular pressure. Increased incidence of
POAG, neovascular glaucoma and hypotony in diabetic ketoacidosis (due to increased plasma bicarbonate levels)
9. Optic nerve. Optic neuritis
10. Extraocular muscles. Ophthalmoplegia due to
diabetic neuropathy
11. Changes in refraction. Hypermetropic shift in
hypoglycemia, myopic shift in hyperglycemia and decreased accommodation

Optic Nerve Drussen

Optic Nerve Drusen:

These are refractile deposits within the substance of the optic nerve head.

They are unrelated to drusen of the retina, which occur in age-related macular degeneration. Optic disc drusen are most common in people of northern European descent.

Their diagnosis is obvious when they are visible as glittering particles upon the surface of the optic disc. However, in many patients they are hidden beneath the surface, producing pseudo-papilledema.

It is important to recognize optic disc drusen to avoid an unneccessary evaluation for papilledema.

Ultrasound or computed tomography (CT) scanning is sensitive for detection of buried optic disc drusen because they contain calcium.

In most patients, optic disc drusen are an incidental, innocuous finding, but they can produce visual obscurations.

On perimetry they give rise to enlarged blind spots and arcuate scotomas from damage to the optic disc. With increasing age, drusen tend to become more exposed on the disc surface as optic atrophy develops. Hemorrhage, choroidal neovascular membrane, and aion are more likely to occur in patients with optic disc drusen. No treatment is available.

Extra ocular muscles

ACTIONS OF EOM

Medial Rectus and Lateral Rectus have only primary action.

All other muscles have a primary and two subsidiary actions.

Primary action of oblique muscles is tortion

Primary action of SR is elevation and IR is depression.

Subsidiary actions

Mnemonic:SINRAD

All superiors are Intorters- SR and SO

All inferiors are Extorters-IR and IO

All Recti are Adductors

All obliques are abductors

Superior Oblique-Copying muslce

Inferior oblique-Stargazers muscle.

SO- depression

IO- Elevation

In abducted  position SR acts as pure elevator.

In adducted position SO pure depressor.

Opthal Numbers

vol of orbit- 30ml.

volume of globe/eyeball- 6ml.

dark adaptation time - 20min.

depth of ant chmbr- 3mm.

incision fr icce-10-12mm,

ecce-8mm,

sics-6mm,

phaco- 3mm..

duration of action of tropicamide- 6hrs. complete dilation of pupil- 9 to 10mm

Cornea tests

👀corneal thickness - pachymeter🔬

👀corneal endothelium - specular microscope🔬

👀corneal curvature - keratometer🔬

👀corneal surface - slit lamp biomicroscopy🔬

👀corneal sheen or shine - placido disc🔬

Corneal dystrophy mnemonic

Marilyn---macular
Monroe --MPS----> alcian blue

Got --- Granular
Her --- Hyaline
Man---Massons trichrome

in Los-- Lattice
Angeles---Amyloid---> congo  

Schnyder's ----cholesterol-->oil red o & Sudan black

Eye ruptures

Most common site for globe rupture after trauma – Upper nasal quadrant OR Supero-nasal limbus

Weakest point is in the vicinity of canal of schlemm concentric to the limbus.

Most common site of retinal detachment – Upper temporal quadrant

Retinal layers

RETINAL LAYERS

RETINAL PIGMENT EPITHELIUM
PHOTORECEPTORS(RODS $CONES)
EXTERNAL LIMITING MEMBRANE
OUTER NUCLEAR LAYER
OUTER PLEXIFORM LAYER
INNER NUCLEAR LAYER
INNER PLEXIFORM LAYER
GANGLION CELL LAYER
RETINAL NERVE FIBER LAYER
INTERNAL LIMITING LAYER

RETINAL.LAYERS INVOLVED IN EYE DISEASES

🐾TYPICAL RETINOSCHISIS-split at outer plexiform layer

🐾RETICULAR RETINOSCHISIS-split at level of nerve fibre layer

🐾DIABETIS RETINOPATHY-(mainly affects capillaries which are DEEPLY located) b/w outer plexiform and inner nuclear layer
👉MICROANEURYSM-b/w outer plexiform and inner nuclear layer(compact middle layers of retina)
👉HARD EXUDATES/TRUE/LEKAGE OF LIPOPROTENOUS MATERIAL IN TO RETINA- b/w outer plexiform and inner nuclear layer
👉DOT $ BLOT HEMORRHAGES-
  ➰From microaneurysms-b/w outer plexiform and inner nuclear layer(compact middle layers of retina)VERTICAL BLEED
➰superficial flame shaped hemorrhages-located in nerve fiber layer
➰SOFT EXUDATES-due to retinal ischemia of arterioles in nerve fiber layer

🐾HYPERTENSIVE RETINOPATHY(mainly affects arterioles which are SUPERFICIAL)
➰SOFT EXUDATES/COTTON WOOL SPOTS/NOT TRUE-due to edema of Nerve fiber layer
➰FLAME SHAPED HAEMORRHAGES-bleed in nerve fiber layer which is HORIZONTALY arranged

{📌Although soft exudates and flame hemorhages more common in HT retinopathy these findings also seen in DM retinopathy📌}

🐾CHERRY RED SPOTS-in NFL and ganglion cell layer

🐾 MOST RADIOSENSITIVE layer of retina-rods and cones

🐾MOST RADIORESISTANT layer of retina-ganglion layer

🐾ARMD-RPE dysfunction

🐾CYSTOID MACULAR OEDEMA-accumulation fluid in outer plexiform layer due to defect in inner blood retinal barrier

🐾ANGIOID STREAKS-crack b like dehisence of brush membrane of choroid with secondary changes in RPE

Lens

👀👓 CARDINAL DATA OF A LENS::
➡ CENTRE OF CURVATURE (C) of the spherical lens is the centre of the sphere of which the refracting lens surface is a part.
➡ RADIUS OF CURVATURE of the spherical lens is the radius of the sphere of which the refracting surface is a part.
➡ The PRINCIPAL AXIS (AB) of the lens is the line joining the centres of curvatures of its surfaces.
➡ OPTICAL CENTRE (O) of the lens corresponds to the nodal point of a thick lens. It is a point on the principal axis in the lens, the rays passing from where do not undergo deviation. In meniscus lenses the optical centre lies outside the lens.
➡ The PRINCIPAL FOCUS (F) of a lens is that point on the principal axis where parallel rays of light, after passing through the lens, converge (in convex lens) or appear to diverge (in concave lens).
➡ The FOCAL LENGTH (f) of a lens is the distance between the optical centre (O) and the principal focus (F).
➡ POWER OF A LENS (P) is defined as the ability of the lens to converge a beam of light falling on the lens. For a converging (convex) lens the power is taken as positive and for a diverging (concave) lens power is taken as negative. It is measured as reciprocal of the focal length in metres i.e. P = 1/f. The unit of power is dioptre (D). One dioptre is the power of a lens of focal length one metre.

CALCULATION OF IOL POWER

🔬 CALCULATION OF IOL POWER (BIOMETRY)::
🔰 The most common method of determining IOL power uses a regression formula called ‘SRK (Sanders, Retzlaff and Kraff) formula’.
🔰 The formula is P = A – 2.5L – 0.9K, where:
✒ P is the power of IOL.
✒ A is a constant which is specific for each lens type.
✒ L is the axial length of the eyeball in mm, which is determined by A-scan ultrasonography.
✒ K is average corneal curvature, which is determined by keratometry.
🔰 The ultrasound machine equipped with A-scan and IOL power calculation software is called ‘Biometer’.

Prescribing lens

😎👓 WHILE PRESCRIBING GLASSES::

🔍 For atropine use correction factor; deduct (-1).
🔍 For all others; deduct (-0.5).

🔍 At 1meter distance, deduct (-1).
🔍 At <1meter distance or closer, deduct (-1.5).
🔍 At arms distance (or) 2/3rd meter distance, deduct (-1.5).

🔍 While prescribing glasses, follow this rule ➡ Smallest whole number will be given as sphere.

🔍 When the power is not same in both axes after correction while prescribing glasses, it is known as HYPEROPIC ASTIGMATISM.

REQUISITES FOR RETINOSCOPY

👀🔎 REQUISITES FOR RETINOSCOPY::
🔦 Dilated cycloplegia - To relax accomodation in hypermetropes. Commonly used drug is CYCLOPENTOLATE.
🔦 Dilator without cycloplegic effect - PHENYLEPHRINE.
🔦 Longest acting dilator cycloplegic - ATROPINE (duration is 7-14days/1-2weeks).
🔦 Shortest acting dilator cycloplegic - TROPICAMIDE.
🔦 For children <3years of age - ATROPINE eye ointment.
🔦 For adults - use TROPICAMIDE.
🔦 For school going/older children - HOMATROPINE (action lasting 1-2days) [or] CYCLOPENTOLATE (action lasting 12-24hours).

High yield ENT and Opthalmology

5 cleans for eliminatn of neonatal tetanus
Clean delivary surface
Clean hands
Clean cord cut
Clean cord tie
Clean cord stump

5 f's of sanitation barrier
Fingers
Flies
Fomites
Food
Faeces

5 d's of ill health
Disease
Discomfort
Disability
Dissatisfaction
Death

5 i's of ageing
Impairment
Instability
Incontinence
Immobility
Isolation

Causes of lagopthalmos..oc pens..
Orbicularis oculi palsy
Cicatricial
Proptosis
Ectropion
Nocturnal lagopth
Symblepharon...

CI of stapedectomy -IPOD
Infection
Perforation
Only hearing ear
Deafness

Squelae of otitis media -SCALP COST
Snhl
Cholesteatoma
Atelectasis
Learning disability
Perforation tm
Conductive HL
Ossicular necrosis
Speech impairment
Tympanosclerosis

Local causes of epistaxis -Indian Drink FANTA
Infection
Dns
Foreign body
Atmospheric
Neoplasm
Trauma
Allergic

Etiology of submucous fibrosis -STAMINA
Socio eco
Tobacco
Areca nuts
Multi factorial
Immune status
Nutrition
Alcohol

Indications of
tympanoplasty -ABCDE S
Age above 10years
Benign
Conductive deafness corrected
Dry perforation
Eustachian tube func properly
Stapes mobile

Cherry red spot in retina-

Rembr:Cherry Tree Never Grows Tall
CRAO
TAYSACHS DISEASE
NIEMANAPICKS dis
GAUCHERS dis
TRAUMA.

Func of tracheostomy -VIP BAR
Ventilation
Ippr
Protects d airways
Breathing
Administer of
anaesthesia
Removal of secretions

Interstial keratitis -TIC TAC S                                    

 tb
Inherited syphilis
Congenital syphilis
Trypanosomiasis
Acquired syphilis
Cogan syn
Sarcoidosis

Causes of SNHL -FANSI  TOPS
Familial progress HL
Au.neuroma
Noise induced
Systemic diseases
Infection
Trauma
Ototoxic
Presbycusis
Sudden hearing loss

Retinal detachment causes 4'F
Floaters
Flashes
Falling acuity
Field loss

D/D of
membrane over tonsillitis:
M2-VIDAAL (form Widal test for
T yphoid)
It is:
- Membranous tonsillitis
- Malignancy
- Vincent's angina
- Infectious mononucleosis
- Diptheria
- Apthous ulcers
- Agranulocytosis
- Ludwig's angina
- T : Trauma

FESS Indications :-

FARMER

Fungal sinusitis
AC polyp
Recurrent bacterial sinusitis
Mucocele
Endoscopic septoplasty
Removal of foreign bodies

Indications for Caldwell luc-

COFFE BOARD
Chronic  max sinusitis

Oroantral fistula

Fracture maxilla

Foreign body removal

Ethmoidectomy

Biopsy for suspected neoplasm

Opening of pterygopalatine fossa for ligation of max artery

Antrochoanal polyp recurrence

Reduction of orbital blow out fracture

Dental cyst

Causes of atropic rhinitis -

HERNIA

Heridity
Endocrinal Disturbance
Race-whites
Nutritional defeciency-vit             A,D,Fe

Infective
Autoimmune

Causes of stridor :-
ABCDEFGHIJ L

Abscess(retro pharyngeal,peri tonsillar)
Adenotonsillar hypertrophy

Bacterial tracheitis

Croup

Diphtheria

Epiglottitis

Foreign body

Hemangioma

Injury,Inf. Mononucleosis

Jaw and tongue abnormalities

Laryngomalacia
Laryngeal web
Laryngeal edema
Laryngitis

Etiology of Submuous Fibrosis.STAMINA

S-Socio-economic ststus
T-Tobacco
A-Areca Nuts
M-Multifactorial
I-Immmune process
N-Nutritional
A-Alcohol

Classification of secondary glaucoma.-lip tip shant
Lens induced
Inflammatory
Pigmentary
Traumatic
Iridocorneal dystrophy
Pseudoexfoliative
Steroid induced
Hemorrhagic
Aphakic
Neovascular

Causes of scleritis
S - SURGERY INDUCED
C - COLLAGEN VASCULAR DISEASES
L - LEPROSY
E -
R - RADIATION
I - INFECTION
T - THYROTOXICOSIS
I - IDIOPATHIC
S - SLE

Kearns-Sayre syndrome :-

Kearns-Sayre syndrome :-

Muscle weakness:
1.Proximal myopathy (difficulty rising from a squat)
2.Ptosis (usually bilateral but may be symmetrical initially)
3.External ophthalmoplegia.

CNS dysfunction:
1.Retinitis pigmentosa
2.Cerebellar ataxia
3.Cognitive deficits
4.CataractsEncephalopathy (in acute presentation with lactic acidosis)

Cardiac:
1.Bradycardia
2.Congestive cardiac failure

Endocrine:
1.Short stature (38% of affected individuals)
2.Hypogonadism (20% of affected individuals)
3.Other (eg, signs of hypothyroidism)

Opthalmology mnemonics

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 withPIGMENT

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 with8303 (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= MMarcus Gunn jaw winkling syndrome,Myotonic causes like dystrophica myotonica.Metabolic cuses like uraemia,cirrhosis

4P=Perinauds syndrome,Parkinson's Disease/Progressive supranuclear palsy,PPalsy (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 withDoWNBEAT

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 withCONGENITAL

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 withMARFANS

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 withCLUMPS

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

Dots and lines in Opthalmology

Dots in ophthalmology

Gunn’s dot= light reflections from internal limiting membrane around disc and macula
Horner-Trantras Dot=Collections of eosinophils at limbus in vernal conjunctivitis.
Kayes’ dot=subepithelial infiltrates seen in corneal graft rejection
Mittendorf’s dot=whitish spot at posterior lens surface,remnant of hyaloid artery.
Lines in Ophthalmology
Arlt’s Line = conjunctival scar in sulcus subtarsalis.
Ehrlich-Turck Line = linear deposition of KPs in ueitis
Ferry’s Line = corneal epithelial iron line at the edge of filtering blebs.
Hudson-Stahil Line= Horizonatl corneal epithelial iron line at the inferior one third of cornea due to aging.
Khodadoust Line = corneal graft endothelial rejection line composed of inflammatory cells.
Paton’s Line = Circumferential retinal folds due to optic nerve edema.
Sampaoelesi line = Increased pigmentation anterior to Schwalbe’s line in pseudoexfoliation syndrome.
Scheie’s Line = pigment on lens equator and posterior capsule in pigment dispersion syndrome.
Schwalbe’s Line = Angle structure representing peripheral edge of Descemets membrane.
Stockers Line = Corneal epithelial iron line at the edge of pterygium
White lines of Vogt = Sheathed or sclerosed vessels seen in Lattice degeneration

Spots and dots

• Histo spot: Punched-out chorioretinal scars in Presumed ocular histoplasmosis syndrome (POHS)

• Cotton-Wool Spots: Diabetic retinopathy is the most common cause of cotton-wool spots. Cotton-wool spots have been associated with numerous other abnormalities, such as systemic arterial
hypertension, collagen vascular diseases, cardiac valvular disease, carotid artery obstructive
disease, coagulopathies, metastatic carcinoma, trauma, and human immunodeficiency virus infection.

Efield spot=Whitish grey spot in peripheral iris,seen in Down’s syndrome.

• Elschnig spot=Yellow patches overlying area of choroidal infarction in hypertension.

• Fischer-Khunt spot= Senile scleral paque,area of hyalinised sclera anterior horizontal rectus muscle insertion. Seen in old age.

• Foster Fuch’s spot=Pigmented (RPE hyperplasia) macular leisons in pathological myopia.

• Gunn’s dot=light reflectios from internal limiting membrane around disc and macula

• Horner-Trantras Dot= Collections of eosinophils at limbus in vernal conjunctivitis.

• Kayes’ dot (Krachmer’s spot)= subepithelial infiltrates seen in corneal graft rejection

• Mittendorf’s dot= whitish spot at posterior lens surface, remnant of hyaloid artery.

• Roth spots= haemorrhages with white centres ,seen in SABE, severe anaemia, collagen vascular disorders.

• Cherry red spot: Central retinal artery occlusion, Commotio retinae (Berlin’s oedema),Tay-Sachs’ disease, Niemann-Pick’s disease, Gaucher’s disease

• Cream-colored spots: The classic diagnostic feature of bird-shot vitiliginous chorioretinitis is cream-colored spots, often as large as 0.5 to 1 disc diameter, that are scattered throughout the
fundus.

• Koplik’s spots: on conjunctiva in measles Lines & Rings in Ophth

• Arlt’s Line = conjunctival scar in sulcus subtarsalis in Trachoma.

• Ehrlich-Turck Line = linear deposition of KPs in uveitis

• Ferry’s Line = corneal epithelial iron line at the edge of filtering blebs.

• Hudson-Stahil Line= Horizonatl corneal epithelial