anchor lecture Flashcards
corneal abrasions signs/symptoms
Redness, pain, tearing
Perhaps photophobia if iritis present
Fluorescein stain uptake
Corneal Abrasion causes
foreign body
Corneal Abrasion treatment
Tetanus update Topical, prophylactic antibiotics Patch Mydriatic (agent that causes the pupil to dilate for long periods of time), if photophobic Pain medications
Keratitis – Corneal Inflammation, signs/symptoms
Symptoms: Pain
Signs: Red Eye, Punctate fluorescein staining (Dendritic fluorescein pattern in HSV)
keratitis causes
Contact lenses
Chemicals
Herpes Simplex
keratitis treatment
- Mandatory referral for HSV and contact lens types
- May need corneal transplant
ultraviolet keratitis (sunburn of the cornea) signs and symptoms
Symptoms
Intense pain, burning, blurred vision
Signs
Hazy cornea
Multiple punctate “corneal abrasions”
ultraviolet keratitis cause/treatment
cause: UV radiation
treatment: same as corneal abrasion, beware of repetitive topical analgesia
corneal ulcer
symptoms: pain
signs: localized corneal infiltrate, red eye, hypopyon (collection of pus in anterior chamber)
corneal ulcer causes/treatment
infections, autoimmune, exposure,
tx: mandatory referral, may need corneal transplant
Foreign Bodies
symptoms: pain, redness, tenderness
signs: FB noted on thorough, magnified exam (hyper-thorough exam for metal-on-metal and high speed contaminations)
foreign bodies treatment
topical anesthesia, irrigation or other mechanical removal, atb drops, patch, pain meds, follow up
iritis
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
iritis causes/treatment
multiple causes, mandatory referral
cataracts
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
cataract causes
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
farsightedness
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
nearsightedness
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.
presbyopia (farsightedness due to aging)
age associated progressive loss of the focusing power of the lens.
Presbyopia Explanation
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.
glaucoma
optic nerve cupping and usually associated with excessive intraocular pressure
glaucoma cause
abnormal outflow leads to elevated intraocular pressure IOP>21 mmHG
treatment: topical medications, oral medications, surgery
glaucoma (primary open angle glaucoma)
gradual and asymptomatic until the late stages, decreased peripheral vision, night vision, large cup/disc ratio
acute angle closure glaucoma
symptoms: blurred vision and pain
signs: congested conjunctiva, hazy cornea, fixed pupil, increased IOP
causes: congenital narrowing of angle, mydriasis
acute angle closure glaucoma (treatment)
decreased aqueous humor production (acetazolamide, timolol) and increase aqueous outflow (glycerol, mannitol, pilocarpine)
macular degeneration
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)
macular degeneration
may get destruction of Bruch’s membrane with subsequent fluid exudation into retina (causing detachment) and deep (between Bruch’s membrane and retina) neovascularization.
macular degeneration
Increasing space between choroid and retina may jeopardize orientation of photoreceptors and cause ischemia
macular degeneration rx
May respond to photocoagulation (if not by macula)
Low vision aids
UV protection
Antioxidants (Lutein)
retinopathy
visual disturbances, photophobia, photopsia (flashing lights), metamorphopsia, red spots (hemmorhages, microaneuryms), white spots (cotton wool spots, hard exudates, drusen)
retinopathy
Disturbances of blood vessels Increased light reflex Generalized narrowing Crossing changes Arteriolar straightening Tortuosity Neovascularization
Childhood Blindness in the US
cortical visual impairment, retinopathy of prematurity, and optic nerve hypoplasia.
cortical visual impairment
caused by peri- or postnatal hypoxia-ischemia
Optic nerve hypoplasia (ONH)
is a congenital condition in which the optic nerve is underdeveloped (small)
