28: Approach To Eye Complaint Flashcards
Pertinent history questions to ask with an eye complaint
Age, pregnant, glasses/contacts, injury/trauma, surgeries, eye infections, recent travel
Important associated sx to ask for eye complaint
Pain, drainage, itching, burning, vision changes/blurry vision, flashing lights
What can cause ectropion
Age, prior surgeries, previous infection, genetic disorders
Causes of mechanical ptosis
Inflammation, eyelid tumors, dermoid cysts
What causes aponeurotic ptosis?
Dehiscence of aponeurosis connecting levator muscle to eyelid
Some neurologic causes to ptosis
CN 8 palsy, Horner’s syndrome, botulinum toxin, myasthenia gravis
Myogenic ptosis
Rare muscular disorders involving mitochondria
Chalazion vs hordeolum location
Chalazion: in the lid
Hordeolum: along the lash line
Chalazion
Blocked meibomian gland, generally nontender unless it becomes inflamed
Hordeolum
Bacterial infection of the meibomian gland, tender and painful
Other term for stye
Hordeolum
Blepharitis
Eyelid margin inflammation, causing eye irritation
Causes of blepharitis
Bacterial (s. aureus), inflammatory skin conditions, allergens or irritants
Symptoms of blepharitis
Red/swollen/itchy eyes, gritty/burning sensation, excess tearing, poss blurred vision
Treatment for blepharitis
Warm compress and eyelid washing, artificial tears, topical Abx
Clogged tear duct
Transient, very common in infants
Dacrostenosis
Stenosis of nasolacrimal duct, causing a persistent clogged tear duct
Treatment of dacrostenosis
Milking the duct, sometimes requires opening the duct with a probe
Dacrocystitis
Infection of the lacrimal duct, most common in newborns and older folks
Allergic conjunctivitis
Mild, bilateral, gritty pruritic irritated eyes with clear discharge
Viral conjunctivitis
Mild/moderate bilateral sx, gritty, burning, irritated eyes with clear discharge, eyes matted shut in the morning
Bacterial conjunctivitis
Usually unilateral, copious amounts of purulent drainage throughout entire day
Common conjunctivitis cause for pts with contacts
Pseudomonas
Arcus senilis age profile
Common in 60+ y/o’s, if under 40, check for cholesterol
Acute angle closure glaucoma
Medical emergency; sudden increase in intraocular pressure
What causes acute angle closure glaucoma
Failure of aqueous fluid to flow from ciliary body into irido-corneal junction
S/S acute angle closure glaucoma
Acute severe pain, decreased vision, pupil dilated and fixed
Cover/uncover test
Stare straight ahead to a fixed point, and cover one eye. Observe uncovered eye as it focuses on point. If it moves, a tropia is present in that eye
Amblyopia
When strabismus is left untreated and vision weakness occurs
Glaucomatous cupping
Increased intraocular pressure within eye -> cupping
Nl cup to disc ratio vs glaucoma
Nl: 0.4
Glaucoma: 0.7+
Cotton wool spots appearance
White/gray ovoid lesions with irregular soft borders
What causes cotton wool spots
Extruded axoplasm from retinal ganglion cells caused by microinfarcts of retinal nerve fiber layer
What conditions can cause cotton wool spots
DM, HIV, HTN
Drusen bodies
Yellow round spots that vary in size, edges can be soft or hard; consisting of dead pigment epithelial cells
What condition would you see Drusen bodies in ?
Macular degeneration
Retinal detachment is a warning sign of…?
Posterior Vitreous Detachment (PVD)
S/S retinal detachment
Painless vision loss, black dots, curtain over portion of visual field
What causes otosclerosis?
Bony overgrowth of stapes
