Approach to Eye Complaint Flashcards
What is a relevant ROS for eye complaints?
Endocrine: Hyperglycemia
When inspecting the periorbital area, what finding would indicate Grave’s disease?
Proptosis/exophthalmos
What are slightly raised, yellowish, well-circumscribed cholesterol-filled plaques that appear along the nasal portion of one or both eyelids?
Xanthelasma
What condition is characterized by blocked meibomian gland and are generally non tender/non painful unless becomes inflamed in the eyelid?
Chalazion
What condition is characterized by blocked meibomian gland or tear eyelash follicle, are tender/painful, and occur along the lash line recurrent?
Hordeolum
What condition is characterized by inflammation at the base of the hair follicles, is often from S. aureus, and can be caused by allergies? (yellow crusty stuff on eyelashes, common in long term care facilities)
Blepharitis
What condition is characterized by the white of eyes turning red due to ruptured blood vessels and it doesn’t affect vision, is non painful, and will go away?
Subconjunctival hemorrhage
What condition is due to excessive sun exposure and tissue grows on to iris?
Pterygium
What condition is due to viral, bacterial, allergic causes and the patients might complain of Gritty, irritated feeling, swollen eyelids?
Conjunctivitis
The cornea should be clear; what is the cause if there is a brown tint?
Hyphema (blood from trauma in anterior chamber)
If you can see brown speckles when checking the red reflex what does this indicate?
Cataracts
If a newborn does not have a red reflex what is it important to look for?
Tumor
If the sclera is blue instead of white, what does this indicate?
Brittle bone disease
If the sclera is yellow instead of white, what does this indicate?
Icterus liver disease, pancreatic cancer, GB disease
What test should be done if there was an imbalance of corneal light reflex?
Cover/Uncover test
What are the steps for the cover/uncover test?
- Stare straight ahead at near fixed point
- Cover one eye and observe uncovered eye as it focuses on point
- Remove cover and watch for movement of newly covered eye
- Repeat on other side
During a Cover/Uncover test, what is it called if the eye turns in?
Esotropia
During a Cover/Uncover test, what is it called if the eye turns out?
Exotropia
Esotropia and exotropia are forms of?
Strabismus (lazy eye)
What do the numbers mean in a visual acuity test such as 20/30?
20: The distance of the patient from the chart
30: The distance at which a normal eye can read the line of letters
What test is used when having the physician closes one eye and the patient covers the opposite eye while staring at your open eye; the physician’s wiggles their fingers 2 feet apart out of the patient’s view (lateral to patient’s ears) and slowly brings moving fingers forward into patient’s center of view; the patient is asked to tell the physician as soon as they see finger movement?
Static Finger wiggle test
What test is used when facing the patient, move a 5mm red topped pin inward from beyond the boundary of each quadrant along a line bisecting the horizontal and vertical meridians. Ask the patient when the pin appears to be red?
Kinetic Red Target Test
When using the ophthalmoscope, when do you NEVER dilate the pupils?
Patient has a shallow anterior chamber (dilation may trigger an acute narrow angle glaucoma)
Which hand and eye do you use when performing an ophthalmoscopic exam for a patient’s right eye?
Left eye?
1) Your R hand/eye for patient’s R eye
2) Your L hand/eye for patient’s L eye
When performing an ophthalmoscopic exam, what do you want to focus on?
Optic disc (yellowing, orange oval)
What condition is characterized by increased intracranial pressure which causes intraazonal edema along the optic nerve, leading to swelling and engorgement of the optic disc?
Papilledema
Cotton Wool Spots which result from extruded axoplasm from retinal ganglion cells caused by microinfarcts of the retinal nerve fiber layer are seen with what condition?
Diabetes
Drusen bodies which are yellowish, round spots that consist of dead pigment epithelial cells are seen in?
Age-related macular degeneration
While normal cup to disc ratio is 0.4, a ratio of 0.7 would suggest possible?
Glaucoma
What is the term for the pupillary reflex when one pupil is exposed to a light source and the other eye constricts?
Consensual reflex
