-Deep tendon reflex grading.

Deep tendon reflex grading

Grade(-):- Absent.
Grade(+):- Hypoactive(Weak).
Grade(++):- Normal(Average).
Grade(+++):- Hyperactive without clonus or moderate exaggeration without clonus.
Grade(++++):- Hyperactive with clonus or marked exaggeration with clonus.

Dr Ibrahim

 

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-Causes of sudden complete loss of vision.

Causes of sudden complete loss of vision

"March"

Malingeres.
Amaurosis fugax.
Rupture globe(painful)
Central retinal artery occulsion(painless).
Hysteria.

Dr Ibrahim

-Effect of blunt trauma on optic nerve.

Effect of blunt trauma on optic nerve
"Heat"

Hemorrhage of the optic nerve sheaths.
Edema of the optic nerve with hypotony.
Avulsion of the optic nerve with twisting injuries.
Traumatic optic atrophy usually of primary type due to ischemia due to rupture of the capillaries.

Dr Ibrahim

-Differential diagnosis of of leukocoria in infants.

Differential diagnosis of of (white pupil)leukocoria in infants
"predict"

• Presistent hyperplastic primary vitreous:congenital anomaly with fibrosis of anterior vitreous so there is opacity behind the lens.
• Retinoblastoma(the most important cause).
• Retinopathy of prematurity:- due to exposure of premature infants to high oxygen concentration in incubators with subsequent fibrosis and tractional retinal detatchment.
• Endopthalmitis.
• Dysplasia of retina.
• Inflammatory cyclitic membrane:- a membrane of exudate lie behind the lens.
• Congenital Cataract (the most common cause).
• Coat's disease:-unilateral extensive leakage from the retinal vessels resulting in large massses of subretinal lipids.
• Toxocariasis.

Dr Ibrahim

-Cuases of chronic catarrhal conjuctivitis.

Cuases of chronic catarrhal conjuctivitis
"Legs"

Local irritation with rubbing lashes.
Error of refraction.
General irritation with dust,smoke,wind or heat.
Sequelae of acute conjuctivitis.

Dr Ibrahim

-Treatment of dry eye.

Treatment of dry eye
"Spot"

Systemic steroids(in autoimmune cases).
Protective glasses and conycy lenses.
Occulsion of puncti to reduce tear drainage.
Tear substitutes (eye drops,eye gel)
Treatment of any associated diseases.

Dr Ibrahim

-Signs of Acute Dacryocystitis.

Signs of Acute Dacryocystitis
"Rate"

Marked Redness of skin over the sac.
Regurgitation test: -ve due to congestion of canaliculi.
Abscess formation with flactuation.
Tender swelling of lacrimal sac.
Marked Edema of skin over the sac.

Dr Ibrahim