Chapter 12: The eye

Question 1

20/20 vision

Answer 1

• top number = indicates the distance at which the person is standing from the chart
• bottom number = distance at which a normal eye can read that same line
• larger the dominator the poorer the vision

Question 2

Eye muscles

Answer 2

• superior oblique = down & in
• inferior oblique = up & in
• superior rectus = up & out
• medial rectus = medially
• inferior rectus = down & out
• lateral rectus = laterally

Question 3

how to examine the eye

Answer 3

• ophthalmoscope

Question 4

Myopia

Answer 4

nearsightedness, produced by a longer than normal eye

Question 5

Hyperopia

Answer 5

farsightedness, produced by a shorter than normal eye

Question 6

Conjunctivitis

Answer 6

• inflammation of the conductive, transparent, vascular tissue covering the anterior sclera and posterior surface of the eyelids
• caused by bacteria, viruses, allergies, or dry eye as a response to corneal injury or irritation

Question 7

Conjunctivitis S&S

Answer 7

discharge ranging from watery to mucoid to frank purulence (pus)
itchy
very contagious
- viral pink eye presents with pre auricular lymphadenopathy (tender lymph node right in front of tragus in ear)

Question 8

subconjunctival hemorrhage

Answer 8

• bright red blood appearing acutely in a sector of the eye under the clear conductive and in front of the white sclera
• benign condition representing a broken vessel under the conjunctiva

Question 9

Subconjunctival hemorrhage S&S and treatment

Answer 9

• blood surrounding iris
• does not require physician unless there was blunt trauma
• can give artificial tears
• usually clears in 2-3 weeks

Question 10

Hyphema

Answer 10

• blood in the anterior chamber of the eye
• common from blunt trauma, often associated with other orbital or ocular damage (abrasions, fractures, contusions, open globe)
• comes from damaged blood vessel in the iris or ciliary body

Question 11

Hyphema S&S and treatment

Answer 11

• send to eye doctor
• uncomplicated = bed rest and topical steroids
• sleep with head elevated
• can RTP 2-3 weeks after blood is gone

Question 12

Corneal Abrasion

Answer 12

• scratch to the surface of the cornea that causes a defect in the most superficial layers of cells, the epithelium
• most common cause is direct trauma with a foreign object

Question 13

Corneal Abrasion treatment

Answer 13

• patched for 24 to 48 hours

Question 14

Corneal/Scleral Lacerations

Answer 14

• eyeball that has been ruptured after blunt or sharp trauma
• prompt surgical repair
• usually the pre visual acuity of the eye is not retained

Question 15

Preorbital contusion

Answer 15

• direct trauma to eyebrows, lids, and cheeks can result in localized swelling and subcutaneous hemorrhages

Question 16

Orbital Fracture

Answer 16

• thinnest bones of the body
• orbital contents including eyeball are displaced posteriorly
• this can break the thin orbital walls causing a blow-out fracture

Question 17

Proptosis

Answer 17

• deep orbital swelling and hemorrhages, can push the eyeball forward
• can cause compromise the nerve and blood supply
• send to the eye doctor immediately
• ice packs for first 48 hours
• can return after proptosis has completely subsided

Question 18

Retinal Tear and Detachment

Answer 18

• likely to occur in athletes who have had them before
• feels like a curtain falling
• immediately referred to an eye doctor
• RTP is based on how bad it is, usually takes several weeks to heal

Question 19

Chemical burns

Answer 19

• cleaning solutions, solvents, detergents, aerosol hygiene products
• rapid onset of pain, foreign body feeling, loss of vision
• refer
• immediate irrigation
• RTP depends on chemical

Question 20

Red flags for immediate referral

Answer 20

• persistent blurred vision
• diplopia
• restricted eye movement
• hyphema
• distorted pupil
• unilateral pupil dilation or constriction
• foreign body protruding into the eye
• large lacerations of the eye lids
• lacerations that involve the margins of the eyelids
• persistent floaters