(1) Eye Exam Flashcards
General History for patient’s presenting with eye complaints
- Age
- Pregnant?
- Glasses/contacts
- Injuries/trauma
- Surgeries
- Eye infections
- Recent travel/activities
- Current eye issue (OLD CAAARTS)
What are examples of associated symptoms with eye complaints?
- Pain
- Drainage
- Itching/burning
- Vision change
- Blurry vision
- Flashing lights
What are some examples of relevant past medical hx with eye complaints?
Glaucoma
DM
Thyroid disease
ASCD
Collagen Vascular Disease
HIV
Inflammatory bowel disease
***All of these are associated with some form of eye involvement
What are some classes of medications that can have ocular side effects?
- Steroids
- Plaquenil
- Antihistamines
- Antidepressants
- Antipsychotics
- Antiarrhythmics
- Beta blockers
What do we ALWAYS do first during the physical exam?
INSPECT
What are you looking for on external examination of the eyes?
- Symmetry
- Plucking?
- “Falling out”
- Scaly skin -aka seborrheic dermatitis
- Scars
What do you look for in the periorbital area?
General:
- Edema
- Bruising
- Injury
- Rash
Specific:
- Change in elasticity
- Allergic shiners (look like low on sleep, brusing under eyes)
- Xanthelasma (check cholesterol level)
- Proptosis/Exophtalmos (eyes buldging out)
- Dacrocystitis (infection in tear duct)
What do you always want to do when you are inspecting the eyelids/eyelashes?
Remove glasses
What are you looking for when inspecting the eyelids/eyelashes?
- Do the lids close completly?
- Do lids invert/evert?
- Flakiness/crustiness
- Erythema
- Swelling
- Scabs/new skin lesions
- Ptosis (drooping of eye)
What is the picture on the LEFT revealing?
Entropion
Lash line is INVERTED
What is the picture on the RIGHT revealing?
Ectropion
Lash line is facing outward
What is this called?
Where is it found?
Hordeloum
ALONG THE LASHLINE
What is this called?
Where do you find it?
Chalazion
IN THE LID
What is a similarity between hordeolum and chalazions?
Both blocked meibomian gland
What are the differences between hordeolum and chalazion?
Hordeloum: Tender/painful, located along lash line
Chalazion: Non painful (unless becomes inflammed), located in the lid
What is this called?
Blepharitis
(right side=chronic)
Lacrimal apparatus:
What do you want to look for?
What can deformations of this strucure indicate?
Look at the punctae
Could indicate skin lesions/cancer or autoimmune diseases
How do you inspect the conjunctiva?
What should it look like?
Lower the lower eyelid and have patient look up
Raise the upper eyelid and have patient look down
Should be clear
Conjunctiva
If you see:
- Erythema
- Purulence
What could they indicate?
- Erythema = subconjunctival hemorrhage
- Purulence = “pink eye”, conjunctivitis
What is pterygium?
Overgrowth of the conjunctiva