Eyelids Atlas

Normal Eyelid Position

Eyelid and Lid Margin Anatomy
Lid Abscess
 Stye (Hordeolum Externum)
• Diffuse Stye • Localized Stye with Pus
Pointing
Chalazion
Infected Chalazion Sebacous
(Hordeolum Internum) Adenocarcinoma
Seborrheic, Scaly Blepharitis
Ulcerative, Staph Blepharitis
 Complications of Ulcerative Blepharitis
1- Phlycten 2- Marginal keratitis 3- Recurrent Styes
4- Madarosis 5- Trichiasis 6- Tylosis
Parasitic Blepharitis Angular Blepharitis
Distichiasis
Trichiasis
Cicatricial Entropion
Congenital Entropion Involutional Entropion
Cicatricial Ectropion Congenital Ectropion
Involutional Ectropion Mechanical Ectropion
Paralytic Ectropion
 Ptosis
1- Congenital Ptosis 2- Involutional Ptosis
 3- Neurogenic Ptosis

Oculomotor Palsy Horner’s Syndrome Myasthenis Gravis

4- Mechanical Ptosis
 Ptosis Examination

• Margin-Reflex Distance • Levator Function (Thumb Test)

Amblyopia
 Treatment of Ptosis
• Mild to moderate (levator • Severe (Frontalis Sling)
resection)
Conjunctiva Atlas
Anatomy of the Conjunctiva
Ophthalmia Neonatorum
Clinical Features of Conjuctivitis
Conjunctival Follicles
Conjunctival Papillae
 Clinical Features of
Conjuctivitis
Phlycten Preauricular Lymph
Nodes
 Trachoma (Egyptian Ophthalmia)
Intracytoplasmic inclusion bodies of
chlamydia trachomatis (Giemsa stain)
Trachomatous Post- Post-
Trachomatous Trachomatous
Follicles and Arlet’s line
Papillae Degenerations Concretions
Palpebral Conjunctival Fibrosis by
Trachoma
 Corneal Features of Trachoma
(Mainly Upper)
Herbert’s Rosettes Herbert’s Pits Active Pannus Healed Pannus
Trachoma with Combined Active
and Healed Lesions
 SAFE Strategy for Trachoma
Management and Prophylaxis
Spring Catarrh (Vernal Kerato-Conjunctivitis)

Cobblestone Papillae
Bulbar Spring Catarrh
Spring Catarrh (Vernal Kerato-Conjunctivitis)
Corneal Punctate Epithelial Macro-erosion
Erosions (Micro- (Shield Ulcer)
Pannus erosions)
Phlyctenular kerato-Conjunctivitis
Pterygium
Pinguecula
Symblepharon
Cornea Atlas
Anatomy of the Cornea
Corneal Histology
Keratitis

Positive fluorescein staining

of a corneal epithelial defect
under cobalt blue filter of the
slit lamp
Bacterial Corneal Ulcer
Therapeutic graft for a resistant bacterial
corneal ulcer
 Healed Bacterial Corneal Ulcers

Nebula Leucoma non- adherent Leucoma adherent

 Complications of Corneal Ulcer

Descematocele Perforated corneal

ulcer
 Viral Herpetic Keratitis

Infected perioral lesions

 Manifestations of Herpes Simplex
Keratitis

Punctate epithelial erosions Stellate epithelial defects Dendritic corneal ulcer

(herpes simplex keratitis)

Rose Bengal staining of devitalized Geographical ulcer with steroids use

epithelium
Pseudo-dendritic Ulcer
Fungal Keratitis
 Acanthamoeba

Cystic form Trophozoite form

 Acanthamoeba Keratitis

Pseudo-dendritic Radial Ring ulcer

keratitis Keratoneuritis
 Non-Infectious Corneal Ulcers

Neurotrophic Corneal Ulcer Exposure Keratopathy

 Corneal Degenerations
Arcus Senilis Band Keratopathy
Keratoconus (Corneal Ectasia)

Corneal thinning and

steepness on slit lamp
 Clinical Picture of KC

Vogt Striae Munson’s Sign Hot Spot (Cone

of Keratoconus)
Acute Hydrops and healing by
Leucoma Formation
 Treatment of Keratoconus

Intracorneal Ring Segments Penetrating Keratoplasty

Sclera Atlas
Anatomy of the Sclera
Blue Sclera
Simple Episcleritis
Nodular Episcleritis
 Types of Scleritis

Diffuse Scleritis Nodular Scleritis Necrotizing Scleritis

 Staphylomas
Anterior Staphyloma Scleral staphyloma Posterior staphyloma
Lacrimal System Atlas
Anatomy of the Lacrimal System
Congenital Dacryocystitis
Acquired Dacryocystitis (Chronic)

Positive regurge test

Treatment of Congenital Dacryocystitis

Massaging the lacrimal Probing the lacrimal

sac passages DCR
Treatment of Acquired Dacryocystitis
Acute Dacryocystitis

Lacrimal abscess
Dry Eye Atlas
Tear Film Components
Dry Eye
Bitot Spots
 Investigations for Dry Eye

Tear Film Break Up Time Schirmer Test

Rose Bengal Staining Lissamine Green Staining

Treatment of Dry Eye
7- Sutural
 Polychromatic
Posterior subcapsular
Lustre
Glaucomflecken
Vossiu’s Ring
 Types of Senile Cataract

Starting Immature Cortical Immature Cortical Mature Cortical Cataract

Spikes Cataract
 Types of Senile Cataract

Nuclear Cataract Nuclear Cataract Hypermature Cataract Hypermature

with Shrunken Lens Morgagnian Cataract
Capsule
Phacolytic Glaucoma Phamorphic Glaucoma
 Posterior Chamber
Intraocular Lens (PC-
IOL)
Foldable Intraocular
Lens (IOL)
 Posterior Chamber Anterior Chamber
Intraocular Lens (PC-IOL) Intraocular Lens (PC-IOL)
 Posterior Capsule
Opacification (PCO)
Uvea Atlas
Anatomy of the Uveal Tract
Blood-Aqueous Barrier
Clinical Picture of Acute Iridocyclitis

Pigmented (longstanding)
Sterile hypopyon
 Complications of Anterior Uveitis

Festooned pupil Posterior Occlusio pupillae

synechiae
 Complications of Anterior Uveitis

Peripheral anterior Secondary open Secondary cataract

Synechial angle
synechiae angle glaucoma closure glaucoma
with polychromatic
luster
Complications of Longstanding Anterior
Uveitis

Atrophia bulbi
Band keratopathy
 Chronic Anterior Uveitis

Mutton fat keratic

Iris nodules
precipitates
 Endophthalmitis

Corneal edema and B Scan Ultrasound showing

hypopyon a vitreous abscess
 Panophthalmitis

Slit lamp picture of Orbital cellulitis complicating

panophthalmitis panophthalmitis
Glaucoma Atlas
Aqueous Circulation
Anatomy of the Angle of the Anterior
Chamber
Gonioscopy by Goniolens
 Tonometry

Digital

Digital Applanation Tonometer

Air Puff Tonometer Tonopen

Buphthalmos
Goniotomy
Trabeculotomy
Glaucoma Shunt Operation
Surgery:

•Extrusion
Subscleral
Trabeculectomy (SST)
Subscleral Trabeculectomy (SST)
Angle Closure Glaucoma
Pain and Headache Halos around the Light

Very Shallow Anterior Chamber

Open Angle
Glaucoma
 Absolute Glaucoma

Cyclodestruction by Cyclodestruction by
Cryotherapy LASER
Retina Atlas
Diabetic
Retinopathy
Non-Proliferative
Diabetic
Retinopathy
 Proliferative Diabetic Retinopathy

Neovessels at the disc Neovessels at the angle Rubeosis Iridis

“NVD” (b) and elsewhere (NVA)
“NVE” (a)
 Complications of Diabetic Retinopathy

Vitreous Hemorrhage

Tractional Retinal Detachment

Investigations of DR

B-Scan Ultrasound showing Vitreous Hemorrhage

OCT showing tractional retinal detachment

and macular edema Fundus Fluorescein Angiography Showing neovessels at the
disc and blocked fluorescence by hemorrhage
Treatment of Diabetic
Retinopathy
Treatment of Diabetic Retinopathy

Anti Vascular Endothelial

Intravitreal Injection
Growth Factors (Anti-VEGFs)
Treatment of Diabetic Retinopathy

Vitrectomy
 Hypertensive Retinopathy

Arteriolar attenuation with Malignant Hypertension with

Chronic Hypertension disc edema and macular star
Arteriolosclerotic Retinopathy
Centra l Retina l Vein
Occlusion
B ra nch Retina l
Vein Occlusion
Centra l Retina l A rter y
Occlusion (CRAO)

B ra nch Retina l A rter y Occlusion

CRAO with cilioretinal arter y

Retinitis P igm entosa (RP )
A ge- Rela ted Macula r
Degenera tion

Daily Amsler for Macular Drusens

Retinopathy of
Prematurity (ROP)
Rhegmatogenous Retinal Detachment

Horse-Shoe Tear Giant Tear

 Retinal Tear with
Rhegmatogenous Retinal
Detachment
Trea tm ent of Rhegm a togenous Retina l
Det achm ent

LASER around a Retinal Buckle Vitrectomy Silicon Oil Injection

Retinal Tear Surgery Surgery following Vitrectomy
 Complications of Silicon Oil

Silicon bubbles Emulsified Silicon

(Inverted
Band Keratopathy
floating in the
Anterior Chamber Hypopyon)
Tractiona l RD
Exuda tive RD
The Orbit Atlas
Unilateral or bilateral congestion and
chemosis (Soft tissue signs)
Exposure keratopathy
Compressive optic
neuropathy
 Amniotic membrane
Tarsorrhaphy graft
 Optic nerve glioma
Optic nerve glioma
Orbital metastasis
Trauma
Involutional

Fracture orbital
floor
 Thyroid Eye
Disease Atlas
1.Soft tissue
signs
Staring look and lid Lid lag on down gaze
retraction
 Errors of
Refraction
A tla s
Myopia (Near-
Sightedness)
 Signs a nd Com plica tions of High
M yopia

P seudo P roptosis

Lattice Degeneration
 Signs a nd
Com plica tions of
High M yopia
Lacquer Crack s

Tessellated fundus
a nd tem pora l m yopic Choroida l Neov a scula r Posterior St aphy lom a
crescent Mem bra ne (CNV )
 Signs a nd
Com plica tions
of High M yopia
Retinal tea rs with retinal
det achm ent
Treatment of
Myopia
Concave (diverging )
lenses
Hypermetropia
(Far-Sightedness)
 Signs of
Hyperopia

Oblitera ted (crowded) optic Sha llow a nterior cha m ber

disc a nd tortuous vessels a nd na rrow a ngle
 Treatment of
Hyperopia

Convex (converging ) lenses

Astigmatism
With the rule regular A g a inst the rule regula r
a stigm a tism a stigm a tism
Treatment of Regular Astigmatism

Cylindrica l lenses
Clinical Picture of Irregular
Astigmatism
Presbyopia
 Treatment of
Presbyopia
P resbyopic LA SIK

B ifoca l a nd m ultifoca l gla sses

Multifoca l IOLs
THA NK
YOU
Squint
Atlas
 Recti
Muscles
Oblique
Muscles
Cardinal Positions of Gaze
 Pseudo
(Apparent)
Strabismus
(Squint)
Patching in
cases of
amblyopia
Types of Squint
Surgeries for
concomitant squint

Recession of a
strong muscle

Resection of a
weak muscle
 Muscle
Transposition for
Incomitant Squint
 Restrictive
(Incomitant)
Squint
Tra um a A tla s
 Effects of B lunt Ocula r Tra um a

Subconjunctiva l
Subconjunctiv a l hem orrha ge with P a nda eyes or Racoon
hem orrha ge with ev ident extended posterior edge sign (fracture ba se of
posterior edge (fracture ba se of sk ull sk ull suspected)
suspected)
Effects of B lunt Ocula r Tra um a

Com m otio retina e

Iridodia ly sis (D-

Hy phem a shaped pupil)

Choroida l rupture
 Clinical Picture of Open Globe Injury

Irregula r a nterior
Limbal wound with iris prolapse
cha m ber with iris
prolapse
Siderosis Bulbi

Seconda r y
P seudo retinitis
Heterochrom ia cat aract and rust
on lens capsule pigm entosa
iridis
Chalcosis

Kayser Fleisher ring Seconda r y ca t a ract

Clinical Picture of
Sympathetic
Ophthalmitis

Mutton fat keratic

precipit a tes

Da len Fuchs nodules

Clinical Picture of Chemical Injuries
(variable with chemical type and
amount)
Ischemic Patches with Chemical
Injuries (Poor Prognosis)
Management of
Chemical Injuries
(Surgical)

Kera topla sty Kera toprosthesis

Tumors
Atlas
Clinical Presentations of
Retinoblastoma

Leucocoria Squint
Fundus Picture of
Retinoblastoma
Investigations of Retinoblastoma

B - Sca n Ultra sound M RI Orbit a nd bra in

Treatment of Retinoblastoma

LA SER therapy Cr yotherapy Radiotherapy

Enucleation Exentra tion

 Malignant Melanoma of the
Choroid

Fundus picture Tum or brea k ing

B - Sca n B - Sca n
through B ruch’s Ultra sound
Ultra sound
m em bra ne (Mushroom -
(dom e- shaped)
shaped
Thank You
Optic Nerve
Atlas
Anatomy of the Optic Nerve
 Anterior Ischemic
Papillitis
Optic Neuropathy
Altitudinal Scotoma
 Periventricular
Plaques in
Multiple Sclerosis
 Established Severe Established
Early Papilledema
Papilledema Papilledema
 Post-Papilledemic Optic
Chronic Papilledema
Atrophy
 Secondary Optic Atrophy
Primary Optic Atrophy

Post-glaucomatous Optic
Consecutive Optic Atrophy
Atrophy
Thank you
Neuro-Ophthalmology Atlas
Pupillary Light
Reflex
Visual Pathway
Lesions of the Visual Pathway
Horner’s
Syndrome
Thank you