Approach to Eye Complaints Flashcards
Diseases that can cause eye problems
DM, Glaucoma, Thyroid Mellitus, ASCD, Collagen Vascular Disease, HIV, IBD
Xanthelasma
high cholesterol can cause build up around the eyes
proptosis/Exophthalmos
Hyperthyroidism
Rash going to the hair line
Herpes Zoster (Singles)
Blepharitis
Flakiness and Crustiness
inflammation of eyelid margin causing eye irritation
Bacteria S. Aureus
causes seborrheic dermatitis
Sx: red swollen itchy eyes, burning with tears , flacking and scaling
lids invert (entropion) and evert (ectropion)
Elderly, patients with surgeries or infecitons,
Chalazion
Inflammation in oil gland on the side of the eye
Icterus
yellow sclera
Hordeolum (stye)
BACTERIAL INFECTION of MEIBOMIAN GLAND
ON LASHLINE
tender and painful
Chalazion
Inflammation in oil gland on the side of the eye
BLOCKED MEIBOMIAN GLAND
IN THE LID
non-tender and nonpainful unless it gets inflamed
Ptosis
- Congential
- Mechanical
- Aponeurotic
- Absent Levator, Marcus Gunn Jaw, Winking Syndrome
- Inflammation, eyelid tumor, dermoid cyts
- Aponeurosis problem going to levator muscle
Ptosis
- Neurologic
- Myogenic
- -CN3 palsy: ptosis, diplopia, ophthalmoplegia DOWN AND OUT
- Horner’s Syndrome: disrupted SNS, anhidrosis, miosis, ptosis
- Myasthenia Gravis, Botulism - Mito disease, dystrophy
Erythema
Purulence
Sunconjunctival Hemmorrage
Pink Eye Conjunctivitis
Conjunctivitis
Viral vs Bacterial
Viral: mild-moderate bilateral gritty burning with clear discharge
eyes sealed closed in the morning
HIGHLY CONTAGIOUS
Bacterial: unilateral a lot of purulent drainage that is yellow
ABS
Cornea colors
Whitish linear = lipid deposition = arcus senilis
should be clear with no brown (blood) or abrasions
Lens, RED REFLEX color
yellow or grey= cataracts
or people with very high melanin
red = normal
Glaucoma
EMERGENCY
Increase in intraocular Pressure
no flow of aqueous from ciliary body to irido-corneal junction
DILATED PUPIL and FIXED
Sclerae
1 White= normal 2 Brown, grey marks= birth marks increased melanin can increase risk of glaucoma 3 Blue= inherited , brittle bine disease 4 Yellow = "Icterus" neonatal, liver disease, pancreatic disease, GB disease
Extraocular Muscles
STRABISMUS “lazy eye” = Amblyopia
Esotropia
Exotropia
COVER/UNCOVER TEST= uncovered eye moves opposite of the tropia side
eye turned in (turns out when other eye is covered)
eye turned out (turns in when other eye is covered)
Optic Disc
Yellow and sharp edges and oval
swollen borders= papilledema
Disc Cupping= glaucoma
Papilledema
increased intracranial pressure = intra-axonal edema along optic nerve = swelling of optic dics
EX: intracranial hemorrhage, meningitis, trauma, huge lesion
Glaucoma
increased intraocular pressure in the eye leads to cupping (backward depression of the optic disc) and atrophy
cup:disc = .4 is normal
= .7 is glaucoma
Cotton Wool Spots
white grey ovoid fluffy looking soft borders lesion
smaller then the disc size, around the disc
due to retinal ganglion cells give out axoplasm due to lesions in the retinal nerve fiber
EX: DIABETES, HIV. others
Drusen Bodies
tellow white round small more sharp and some soft edged specks
many at the posterior pole between the optic dics and macula
due to dead pigment epithelial cells
EX: Macular Degeneration due to aging
Retinal Detachment
painless
vison loss or black dots
curtain over a part of the visual field
INITIAL: Posterior Vitreous Detachment PVD
vision loss- unilateral- painful
vision loss- unilateral - painless
Glaucoma corneal ulcer optic neuritis Trauma hyphema Uveitis
Vitreous Hemorrhage
Macula Degeneration
Retinal Detachment
Retinal Vein occlusion
vision loss- bilateral - painful
vision loss- bilateral- painless
Chemical or radiation exposure
vascular cause: Giant Cell Arteritis
Documentation for the EYE EXAM
Periorbital Region intact with no obvious deficits
Sclera= white
conjunctiva= pink
Visual acuity 20/20
visual fields intact bilaterally
extraocular movements intact bilaterally
pupils constrict to light and equally round
cover-uncover test =- strabismus
disc = sharp margins
no arterial narrowing
no hemorrhage or exudates
PERRLA : Pupils Equally Round and Reactive to Light and Accommodation
Documentation for the EYE EXAM
Periorbital Region intact with no obvious deficits
Sclera= white
conjunctiva= pink
Visual acuity 20/20
visual fields intact bilaterally
extraocular movements intact bilaterally
pupils constrict to light and equally round
cover-uncover test =- strabismus
disc = sharp margins
no arterial narrowing = HTN
no hemorrhage or exudates
PERRLA : Pupils Equally Round and Reactive to Light and Accommodation
