Basic Ophtho

Question 1

Hyperemia

Answer 1

Injection of superficially visible vessels of the conjunctiva, episclera, or sclera

Question 2

Iritis

Answer 2

inflammation of iris alone or iris and ciliary body, manifested as CILIARY FLUSH

Question 3

Ciliary flush

Answer 3

dilated deep conjunctival and episcleral vessels adjacent and circumferential to the corneal limbus.

Question 4

Episcleritis

Answer 4

Inflammation often sectorial of the episclera, vascular layer between the conjunctiva and sclera; uncommon, not serious, possibly allergic.

Question 5

Scleritis

Answer 5

Inflammation of sclera, often protracted, painful, may indicate systemic dz

Question 6

Adnexal disease

Answer 6

eyelids, lacrimal apparatus, orbit, includes dacrocystitis, stye, blepharitis.

Question 7

Pterygium

Answer 7

Abnormal growth consisting of triangular fold of tissue that advances progressively over cornea, usually from nasal side. Not serious.

Question 8

Keratoconjunctivitis sicca

Answer 8

Dry eyes,

Question 9

mattering

Answer 9

Mucus secretions in the eye

Question 10

Lagophthalmos

Answer 10

Poor lid clsure

Question 11

Severe pain in eye

Answer 11

Keratitis, ulcer, iridocyclitis, acute glaucoma

Question 12

Hypopyon

Answer 12

the presence of visibly layered leukocytes in the anterior chamber of the eye

Question 13

Mattering

Answer 13

exudation

Question 14

Ciliary flush

Answer 14

injection of deep conjunctival and episcleral vessels surrounding cornea. Danger sign seen in corneal inflammations, iridocyclitis, acute glaucoma.

Question 15

Blepharitis

Answer 15

inflammation of the eyelid

Question 16

Stye

Answer 16

hordeolum - acute usually sterile inflammation of the glands of hair follicles in the eyelid. External or internal.

Question 17

Chalazion

Answer 17

Chronic granulomatous inflammation of a meibomian gland in the eyelid that may develop spontaneously or may follow a hordeolum.

Question 18

23 year old woman red eye irritated, moderate injection, larger conjunctival vessels, watery discharge, palpable preauricular lymph node

Answer 18

serous nature of discharge plus preauricular adenopathy indicate viral conjunctivitis. Rx Cool complexes and stay home

Question 19

Irregular pupil, pain, redness

Answer 19

Angle-closure glaucoma and iridocyclitis

Question 20

Entropion

Answer 20

Inward turning of the eyelid and lashes

Question 21

Conjunctival hyperemia

Answer 21

engorgement of the larger and more superficial bulbar conjunctival vessels. Nonspecific, may be seen in almost any condition causing red eye.

Question 22

45 y/o M 2 day history of redness, severe pain, and photophobia of his left eye. He denies trauma. Which convince you that it’s not conjunctivitis?

Answer 22

Reduced visual acuity, ciliary flush

Question 23

88 yo has had red, irritated eyes for months. Feels like she has “sand in her eyes” Exam all four eyelid margins are inflamed and edematous wih debris on lashes.

Answer 23

Blepharitis, Rx Cleansing of eyelids daily, antibiotic ointment to alleviate any staphylococcal infection

Question 24

What causes a pterygium to form?

Answer 24

chronic UV exposure

Question 25

Cycloplegics

Answer 25

Homatropine hydrobomide 5% or cyclopentolate hydrochloride 1% mayt be used to relax the iris and ciliary body to relive pain and discomfort of most forms of nonpenetrating ocular injuries.

Question 26

teardrop-shaped pupil and flat anterior chamber

Answer 26

perforating injury of cornea or limbal area. Look for prolapse of dark tissue either iris or ciliary body at point of teardrop

Question 27

What signs might you see if you suspect a perforation of the eye?

Answer 27

Irregular shape to pupil, shallow anterior chamber, uveal tissue prolapsing, hyphema

Question 28

buphthalmos

Answer 28

enlarged eyes

Question 29

DDx for pupil sparing third nerve palsy

Answer 29

Diabetes, GCA, syphilis, other vascular disease.

Question 30

Cholinergic blocking drugs

Answer 30

Tropicamide 0.5% or 1%, Cyclopentolate hydrochloride 0.5%, 1% or 2% or homatropine hydrobromide 2% or 5% (all paralyze the iris sphincter)

Question 31

Adrenergic stimulating drugs (mydriatic)

Answer 31

Phenylephrine hydrochloride 2.5 or 10%. Dilation by stimulating the pupillary dilator muscle.

Question 32

MOA Pilocarpine

Answer 32

Cholinergic stimulating drug, increases aqueous outflow through the trabecular meshwork

Question 33

SE Pilocarpine

Answer 33

diminished vision pupillary constriction and headaches from ciliary muscle spasm

Question 34

Beta adrenergic blockers

Answer 34

Timolol, Levobunolol, Metipranolol, Cartelol, Betaxolol

Question 35

Prostaglandin analogs

Answer 35

Latanoprost (Xalatan), Bimatoprost (lumigan), Travoprost (Travatan), Unoprostone (Rescula)

Question 36

Topical Brimonidine (Alphagan-P)

Answer 36

selective alpha-2 agonist lowers intraocular pressure via decreased aqueous produciton and increased uveoscleral aqueous outflow (nontrabecular meshwork)

Question 37

Topical apraclonidine (lopidine)

Answer 37

derivative of clonidine, decreases aqueous formation and increases uveoscleral outflow. Used for temporary intraocular pressure in critical situations