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ECOS I Exam 2 > Approach To Eye Exam > Flashcards

Approach To Eye Exam Flashcards

1
Q

What is some relevant history during an eye complaint?

A

Age, pregnancy, glasses/contacts, injuries/trauma, surgeries, eye infections, recent travel/activities, current eye issue

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2
Q

What are some associated sx for eye complaints?

A

Pain, drainage, vision change, burry vision, flashing lights

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3
Q

What is some relevant past medical history?

A

Glaucoma, DM, thyroid disease, ASCD, collagen vascular disease, HIV and IBD

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4
Q

What should you check if you observe xanthelasma?

A

Cholesterol levels

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5
Q

Proptosis/exophthalmos is indicative of what?

A

Hyperthyroidism

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6
Q

Do the lids invert/evert?

A

Entropion

Ectotropion (elderly, prior surgeries, previous infection, genetic disorders)

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7
Q

A hard sensation or pain upon palpation of the eyelid over the globe may represent what?

A

Hyperthyroidism, glaucoma, retrobulbar tumor

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8
Q

What are the 5 causes of ptosis?

A

Congenital (absent levator), mechanical (inflammation, eyelid tumors, cysts), aponeurotic (dehiscence of aponeurosis connecting levator M to eyelid), neurologic and myogenic (rare muscle disorders)

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9
Q

Explain the neurologic cause of ptosis

A

CN III palsy (down and out)
Horner’s syndrome (disruption of sympathetic pathway leading to triad of anhydrosis, miosis, ptosis
Other causes such as Botox and myasthenia gravis

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10
Q

What is chalazion?

A

Blocked meibomian gland
Generally non tender and non painful unless becomes inflamed
In the lid

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11
Q

What is hordeolum (stye)?

A

Bacterial infection of the meibomian gland (inner margin)
Tender/painful
Along the lash line

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12
Q

What is blepharitis?

A

Inflammation at eyelid margin resulting in eye irritation
Causes include bacterial (s. Aureus, most common) inflammatory skin conditions (psoriasis, seborrheic dermatitis) or allergens

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13
Q

What are sx of belpharitis?

A

Red, swollen itchy eyes
Gritty/burning sensation
May have excessive tearing
May have blurred vision that improves with blinking (will have signs of flaking/scaling eyelids)

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14
Q

What is the tx for blepharitis?

A

Warm compress, eyelid washing, artificial tears, topical Abx (reserved for pts who dont respond to initial Tx)

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15
Q

What is a clogged tear duct?

A

Transient very common in infants
Keep eye clean, use warm compress 2-3x daily
Most infants grow out of it
Issue of the lacrimal apparatus

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16
Q

What is dacrostenosis?

A

Issue of the lacrimal apparatus
Stenosis (narrowing) of nasolacrimal duct
Can be treated by milking the duct

17
Q

What is dacrocystitis?

A

Issue of the lacrimal apparatus
Most commonly occurs in newborns vs older folks
Requires system Abx

18
Q

What are common abnormal findings of the conjunctiva?

A

Erythema (subconjuctival hemorrhage)
Purulence (pink eye, conjunctivitis)
Pterygium (tissue growth on the conjunctiva)

19
Q

What are the causes of conjunctivitis?

A

Allergic, viral and bacterial

20
Q

Describe allergic conjunctivitis

A

Mild bilateral sx of gritty, pruritic, irritated eyes with clear discharge
Tx: olopatidine

21
Q

Describe viral conjunctivitis

A

Mild to moderate bilateral sx, gritty, burning, irritated eyes with clear discharge
Eyes will be matted shut in the morning
Tx: supportive care, isolation from school, highly contagious

22
Q

Describe bacterial conjunctivitis

A

Usually unilateral with copious amounts of purulent drainage throughout the entire day
Purulent drainage will reaccumulate minutes after cleaning

23
Q

A brown tint of the cornea represents what?

A

From hyphema

Blood from trauma in anterior chamber

24
Q

How can corneal abrasions be visualized?

A

Fluorescent stain and a blue light to visualize

25
Q

What is the leading cause of blindness worldwide?

A

Herpes simplex keratitis
Pathognomonic dendritic lesion
(Can be visualized during corneal abrasion visuals)

26
Q

A whitish linear (lipid deposition) encircling the iris indicative of?

A

Arcus senilis
Common over 60 y/o
Consider checking cholesterol levels

27
Q

What is acute angle closure glaucoma?

A

Medical emergency
Sudden increase in intraocular pressure
-failure of aqueous to flow from ciliary body into the irido-corneal junction resulting in increased pressure
Acute severe pain associated with decreased vision
Pupil will be dilated and fixed

28
Q

What are brown or gray spots of the sclera?

A

Can be birthmarks
Increased melanin in sclera
Can be associated with increased risk for glaucoma, rarely melanoma

29
Q

A yellow sclera can be caused by what?

A

Neonatal, liver disease, pancreatic cancer, GB disease

30
Q

What is the cover/uncover test?

A

Stare straight ahead at a near fixed point
Cover one eye and observe uncovered eye as it focuses on point
Movement in the uncovered eye means tropia is present (eye moves opposite direction of tropia)
Repeat on other side

31
Q

How is a tropia named?

A

Where it likes to live
Esotropia = eye turned in
Exotropia = eye turned out
Forms of strabismus and commonly called lazy eye referring to weak extraocular muscles

32
Q

Describe a lazy eye

A

When ID’ed in children patching sometimes helps
When patching fails, surgery
If not treated brain will choose to focus with unaffected eye and other eye will lose vision (also cosmetic appearance makes kids different, social issues may result)
This loss of vision is ambylopia also called lazy eye by some but now referred to as weak vision

33
Q

Irregular swollen borers of the optic disc during an ophthalmoscope exam means what?

A

Papilledema

34
Q

What is disc cupping during opthalamoscpe (fundosopic) exam indicative of?

A

Glaucoma

35
Q

What is papilledema?

A

Indicates increased intracranial pressure that results in intra axonal edema along the optic nerve leading to swelling and engorgment of the optic disc
Think intracranial hemorrhage, meningitis, trauma, mass lesion

36
Q

What is glaucomatous cupping?

A

Increased intraocular pressure within the eye leads to increased cupping (backward depression of the disc) and atrophy
Base of the enlarged cup is pale
Normal cup to disc ration is 0.4
Ratios of 0.7 suggest possible glaucoma

37
Q

What are cotton wool spots?

A

White or gray ovoid lesions with irregular soft borders
Moderate in size but smaller than the disc
Result from extruded axoplasm from retinal ganglion cells caused by microinfarcts of the retinal nerve fiber layer
Seen in HTN, diabetes*, HIV and others

38
Q

What are drusen bodies?

A

Yellowish round spots that vary from tiny to small
Edges may be soft or hard
consist of dead pigment epithelial cells
Seen in normal aging and age related macular degeneration*

39
Q

What is retinal detachment?

A

Painless vision loss
Initial warning signs of posterior vitreous detachment (PVD) - transient floaters/flashes of light
Persistent sx of vision loss or black dots are more concerning
Curtain over portion of the visual field is the classic/ominous sign of retinal detachment

ECOS I Exam 2 (9 decks)

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