First Aid to MRCSEd (Ophthalmology) Part I
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2 First Aid to MRCSEd (Ophthalmology) Part I
3 First Aid to MRCSEd (Ophthalmology) Part I Dr. Lee Mun Seng Associate Professor Dr. Datu Kamarudin Datu Mudin Associate Professor Dr. Zainal Ariffin Mustapba PenerbitJ~"'~ Kota Kinabalu Sabah 2007 hnp:jlwww.urns.cdu.myjpenerbit
4 o Universiti Malaysia Sabah, 2007 All rights reserved. Except as pennitted by Act 332, Malaysian Copyright Act of 1987, no parts of this publication may be reproduced or distributed in any fonn or by any means, or stored in a data base or retrieval system, without prior written pennission from the Universiti Malaysia Sabah. Pennission of rights subjected to royalty payment. Perpustakaan Negara Malaysia Cataloguing-in-Publication Data Lee, Mun Seng, First aid to MRCSEd (Ophthalmology) I Lee Mun Seng, Datu Kamarudin Datu Mudin, Zainal Ariffin Mustapha. ISBN (pt. 1) 1. Ophthalmology. I. Datu Kamarudin Datu Mudin, 1968-, II. Zainal Ariffin Mustapha, 1963-, I. Title Layout Artist & Cover Designer: Rosalind Ganis & Mohd. Azaren Aminullah Type face for text: TImes New Roman Text type and leading size: 11/13.2 point Printed by: Capital Associates Printing (S) Sdn. Bhd.
5 Dedicated to. our wives
6 Dear colleague, It has been quite sometime for us to prepare this revision book for postgraduate ophthalmologist, eventually it becomes real. Throughout the world. MRCSED Part I exam is conducted conjointly with many other examination boards especially in Hong Kong and Singapore. Successful in this exam is a door way to the next stage of the postgraduate exam. This book is written solely of giving the candidates some ideas regarding this exam, we sincerely hope you will be successful in your anempt. Certainly, to make the book more interactive, we do prepare some quiz in each chapter. If you would like to confinn your answer with us or have more assistance, please feel free to us(seanlee@ums.edu.my). Once again, we thank you for your support. Dr. Lee Mun Seng Associate Professor Dr. Datu Kamarudin Datu Mudin Associate Professor Dr. Zainal Ariffin Mustapha School of Medicine Universiti Malaysia Sabah
7 Preface Chapter 1 ANATOMY 1.1 Ocular Anatomy Lacrimal Duct Lacrimal Gland Eyelid Anatomy Orbital Wall Orbital Apex Sphenoid Sinus Sphenoid Bone Superior Orbital Fissure Inferior Orbital Fissure Structure Passing Through Optic Canal Ligaments Medial Palpebral Ligament Ophthalmic Artery Cavernous Sinus Ciliary Ganglion Insertion of Inferior Oblique Cornea Descemet's Membrane GAS Drainage of Aqueous Lens Retina Choroid Bruch Membrane 1.2 Neuroanatomy Trigeminal Nerve Abducen Nerve Optic Chiasma Visual Cortex Papillary Light Reflex 1.3 Head and Neck Circle of Willis Facial Artery
8 Chapter 2 Chapter 3 Chapter 4 Chapter Embryology Neuroectoderm Neural Crest Origin Surface Ectoderm Mesoderm PHYSIOLOGY 2.1 Ocular Physiology Ciliary body Saccidic Movement Blinking Reflex ERG Pattern ERG Reduced Cone Function EOG Pulfrich Phenomenon Binocular Field Vision 2.2 General Physiology ECG ABO Groups Hormones Carotid Sinus GENETICS 3.1 Genetic Pattern 3.2 Retinoblastoma 3.3 Marfan's Syndrome MOLECULAR AND CELL BIOLOGY 4.1 Biosynthesis of Prostaglandins 4.2 PCR PATHOLOGY 5.1 Increase in Cell Number and Proliferation 5.2 Conjunctival Pigmentation 5.3 Melanoma 5.4 Juvenile Xanthogranuloma 5.5 Cataract and Its Aetiology 5.6 Causes of Neovascularisation of the Iris 5.7 Aniridia and Its Features 5.8 Optic Neuritis
9 Contents Chapter 6 Chapter 7 Chapter 8 Cbapter9 5.9 Uveitis and Its HLA Relation 5.10 Peter's Anomaly MICROBIOLOGY 6.1 Plasmids 6.2 Tetanus Toxoid 6.3 Diffusible Substances in Streptococcus Pyogenes 6.4 Staphylococcus Aureus 6.S Acanthamoeba 6.6 Chlamydia Trachomatis Conjunctivitis IMMUNOLOGY 7.1 Phacophytic Cell 7.2 Immunoglobulins PHARMACOLOGY 8.1 Factor Affecting Drug Penetration of Cornea 8.2 Side effect of Carbonic Anhydrase Inhibitor (CAl) 8.3 Warfarin 8.4 Heparin 8.S Vitamin A 8.6 Vancomycin 8.7 Acetylcholine 8.8 Treatment of Corneal Ulcer 8.9 Antibiotics that Affect Cell Wall Synthesis 8.10 Drug Penetrating CSF 8.11 NSAIDS 8.12 Cyclopentolate 8.13 Local Anaesthesia 8.14 Ketamine 8.1S Consequences of a Clear Surgical Wound BASIC PRINCIPLES OF OPHTHALMIC SURGERY 9.1 Cardiogenic Shock 9.2 DVT 9.3 Needles 9.4 Black 6/0 Silk Sutures 9.5 Suture Materials 9.6 Oxygen Pulsimetry Measures 9.7 Autoclaving
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