anchor lecture

Question 1

corneal abrasions signs/symptoms

Answer 1

Redness, pain, tearing
Perhaps photophobia if iritis present
Fluorescein stain uptake

Question 2

Corneal Abrasion causes

Answer 2

foreign body

Question 3

Corneal Abrasion treatment

Answer 3

Tetanus update
Topical, prophylactic antibiotics
Patch
Mydriatic (agent that causes the pupil to dilate for long periods of time), if  photophobic
Pain medications

Question 4

Keratitis – Corneal Inflammation, signs/symptoms

Answer 4

Symptoms: Pain
Signs: Red Eye, Punctate fluorescein staining (Dendritic fluorescein pattern in HSV)

Question 5

keratitis causes

Answer 5

Contact lenses
Chemicals
Herpes Simplex

Question 6

keratitis treatment

Answer 6

• Mandatory referral for HSV and contact lens types

- May need corneal transplant

Question 7

ultraviolet keratitis (sunburn of the cornea) signs and symptoms

Answer 7

Symptoms
Intense pain, burning, blurred vision

Signs
Hazy cornea
Multiple punctate “corneal abrasions”

Question 8

ultraviolet keratitis cause/treatment

Answer 8

cause: UV radiation
treatment: same as corneal abrasion, beware of repetitive topical analgesia

Question 9

corneal ulcer

Answer 9

symptoms: pain
signs: localized corneal infiltrate, red eye, hypopyon (collection of pus in anterior chamber)

Question 10

corneal ulcer causes/treatment

Answer 10

infections, autoimmune, exposure,

tx: mandatory referral, may need corneal transplant

Question 11

Foreign Bodies

Answer 11

symptoms: pain, redness, tenderness
signs: FB noted on thorough, magnified exam (hyper-thorough exam for metal-on-metal and high speed contaminations)

Question 12

foreign bodies treatment

Answer 12

topical anesthesia, irrigation or other mechanical removal, atb drops, patch, pain meds, follow up

Question 13

iritis

Answer 13

symptoms: photophobia, blurred vision, pain referred to brow or temporal area
signs: red eye, constricted pupil, ciliary flush (reddish discoloration at the edge of cornea), decreased vision

Question 14

iritis causes/treatment

Answer 14

multiple causes, mandatory referral

Question 15

cataracts

Answer 15

an opacification of some or most of the lens that results in glare, blurry image, decreased color perception, reduced visual acuity, altered red reflex, hazy retinal detail

Question 16

cataract causes

Answer 16

congenital (from intrauterine infections with rubella or CMV or galactosemia), age related, trauma, systemic disease (DM, myotonic dystrophy, atopic dermatitis), steroids, uveitis (iritis)
rx: surgery for functional impairment

Question 17

farsightedness

Answer 17

difficulty seeing objects which are nearby. eyeball is too small or the focusing power is too weak. often present at birth, but most kids outgrow condition. risk factor for glaucoma

Question 18

nearsightedness

Answer 18

person sees near objects clearly, while objects in the distance are blurred. occurs when the physical length of the eye is greater than the optical length. develops in teens,. to treat, shift focus point from in front of the retina to the retina.

Question 19

presbyopia (farsightedness due to aging)

Answer 19

age associated progressive loss of the focusing power of the lens.

Question 20

Presbyopia Explanation

Answer 20

the focusing power of the eye, which depends upon the inherent elasticity of the lens, is gradually lost as people age. age 45. reading glasses.

Question 21

glaucoma

Answer 21

optic nerve cupping and usually associated with excessive intraocular pressure

Question 22

glaucoma cause

Answer 22

abnormal outflow leads to elevated intraocular pressure IOP>21 mmHG
treatment: topical medications, oral medications, surgery

Question 23

glaucoma (primary open angle glaucoma)

Answer 23

gradual and asymptomatic until the late stages, decreased peripheral vision, night vision, large cup/disc ratio

Question 24

acute angle closure glaucoma

Answer 24

symptoms: blurred vision and pain
signs: congested conjunctiva, hazy cornea, fixed pupil, increased IOP
causes: congenital narrowing of angle, mydriasis

Question 25

acute angle closure glaucoma (treatment)

Answer 25

decreased aqueous humor production (acetazolamide, timolol) and increase aqueous outflow (glycerol, mannitol, pilocarpine)

Question 26

macular degeneration

Answer 26

leading cause of permanent vision loss in the elderly, no known cause, reversible risk factor is exposure to cigarette smoke, initially may notice drusen (discrete yellow deposits) around macula (precursor to macular degeneration)

Question 27

macular degeneration

Answer 27

may get destruction of Bruch’s membrane with subsequent fluid exudation into retina (causing detachment) and deep (between Bruch’s membrane and retina) neovascularization.

Question 28

macular degeneration

Answer 28

Increasing space between choroid and retina may jeopardize orientation of photoreceptors and cause ischemia

Question 29

macular degeneration rx

Answer 29

May respond to photocoagulation (if not by macula)
Low vision aids
UV protection
Antioxidants (Lutein)

Question 30

retinopathy

Answer 30

visual disturbances, photophobia, photopsia (flashing lights), metamorphopsia, red spots (hemmorhages, microaneuryms), white spots (cotton wool spots, hard exudates, drusen)

Question 31

retinopathy

Answer 31

Disturbances of blood vessels
Increased light reflex
Generalized narrowing
Crossing changes
Arteriolar straightening
Tortuosity 
Neovascularization

Question 32

Childhood Blindness in the US

Answer 32

cortical visual impairment, retinopathy of prematurity, and optic nerve hypoplasia.

Question 33

cortical visual impairment

Answer 33

caused by peri- or postnatal hypoxia-ischemia

Question 34

Optic nerve hypoplasia (ONH)

Answer 34

is a congenital condition in which the optic nerve is underdeveloped (small)