Approach to eye complaint Flashcards
What is some pertinent information that should be obtained in the history involving an eye complaint?
Age Pregnant glasses and contacts injuries and trauma eye infections recent travel current eye issues
What are the associated symptoms of the eye complaints?
Pain Discharge Itching and burning vision changes blurry vision flashing lights
List some of the relevant ROS with an eye complaint
General: fever, weight change Neuro CV Endocrine MSK skin gastrointestinal
What are some relevant past medical history associations with eye symptoms?
Glaucoma Diabetes Thyroid HIV IBD
What are some medications that can have ocular side effects
Steroids Plaquenil Antihistamines Antidepressants Antipsychotics Antiarrhythmics Beta blockers
What are the things that you need to inspect during an ocular examination?
Brows Periorbital area Lashes Lacrimal Conjunctiva Cornea
While inspecting the eyebrows you should look for these common things…
symmetry
signs of plucking
scaly skin
scars
What should you look for while inspecting the periorbital area
edema change in elasticity bruising injury allergic shiners xanthelasma (cholesterol indication) proptosis/exophthalmos rash
What are things that you should look for when inspecting the eyelids and eyelashes ?
do the eyes close completely? Flakiness and crusting Erythema swelling scabs and lesions ptosis do the lids invert or evert? palpate the lid over the globe
_______ is a blocked meibomian gland; generally nontender unless it becomes inflamed
this is IN THE LID
Chalazion
________ is a blockage of the meibomian gland of tear eyelash follicle or tear gland
this is tender and painful and is located along the lash line
Hordeolum
_______ is inflammation at the base of the hair follicles from S. aureus; caused by allergies
Blepharitis
What are you looking for when examining the lacrimal gland?
punctae (skin lesions or cancer, autoimmune) and dacrocystitis
What are some of the abnormal conjunctival findings?
Subconjunctival hemorrhage
Pterygium
With this, the patients may complain of a gritty irritated feeling in the eye, swollen eyelids, discharge, and red eyes. Can be viral, bacterial, or allergy induced
conjunctivitis
How do you examine the cornea?
Should be clear; look for brown tints consistent with hyphema, white scarring from abrasion, corneal sensitivity
These are diagnosed with fluorescein stains and are typically quite painful
corneal abrasions
______ ______ is a white linear area that encircles the colored iris
Marcus senilis
What is the red reflex and what are some reasons that it could be absent?
Red reflex is the redness that is seen in the pupils; the lens should be clear, so if there is a cataract in the eyes, then it can appear yellow or gray or even brown speckles
Define icterus
yellowing of the sclera that is seen in neonates, liver disease, and pancreatic cancer
Describe the cover/uncover test
have the patient stare straight ahead at a fixed point; cover one eye and observe the uncovered eye; remove the hand and watch the newly uncovered eye as it tries to focus; if it veers off, then the test is positive
_______ is when the eye turns in on the cover/uncover test
Estropia
______ is when the eye turns out on the cover/uncover test
exotropia
Why do esotropia and exotropia occur?
weak extra ocular muscles
Define amblyopia
lazy eye; weak vision
Define mydriasis
dilating the pupils with prescription eye drops
True or false: you should NEVER dilate if the patient has a shallow anterior chamber as it can trigger and acute narrow glaucoma
TRUE
True or false use opthalmoscope: right eye right hand for the patients right eye
TRUE
_______ is the swelling or engorgment of the optic disc that is due to increased intracranial pressure
papilledema
______ are brighter than _______ because the oxygenated blood makes them appear more red
arterioles
venules
What disease are cotton wool spots (white/gray lesions with irregular borders from extruded axoplasm from the retinal ganglion caused by micro infarcts in the retinal nerve fiber)
diabetes, HTN HIV
_______ ______ are yellow round spots that vary from tiny to small; can be soft or hard. Usually concentrate at the posterior pole between the optic disc and the macula
Drusen bodies
Drusen bodies can be seen in age related ______ ______
macular degeneration
What is glaucomatous cupping?
Increased intraocular pressure that leads to increased backward depression of the disc
