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Adv Pathophysiology > Chapter 19: Eyes > Flashcards

Chapter 19: Eyes Flashcards

1
Q

Extraocular Muscles

A

Oculomotor (CN III)
Trochlear (CN IV)
Abducens (CN VI)

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2
Q

Vitamin A

A

Nerve impulses and retinal function
Production of rods and cones
Need for low-light and moisture

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3
Q

Vitamin A Deficiencies

A

Dry eyes

Nyctalopia (night blindness)

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4
Q

Foods high in Vitamin A

A

papaya, cantaloupe, squash, milk, sweet potatoes, dark leafy vegetables, carrots

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5
Q

Vitamin C and E

A

strong antioxidants that protect the eye against damage from free radicals (associated with macular degeneration and cataracts)

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6
Q

Vitamin C rich foods

A

oranges, spinach, strawberries, broccoli/cauliflower, tomatoes, lemons, blackberries

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7
Q

Vitamin E rich foods

A

nuts and seeds, sunflower seeds and oil, spinach/greens, peanuts, pumpkin, red bell pepper

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8
Q

Beta-Carotene

A

precursor of Vitamin A

50% of Vitamin A comes from conversion of beta-cartotene

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9
Q

Foods rich in beta-carotene

A

yellow, green, and orange leafy fruits and vegetables

carrots, spinach, lettuce, tomatoes, sweet potatoes, broccoli, cantaloupe, squash

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10
Q

Lutein

A

protects eye from harm UV rays
may improve dim light vision and prevent glare
may hold off macular degeneration

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11
Q

Foods rich in lutein

A

kale, spinach, broccoli, corn, lettuce, peas, zucchini, tangerines, carrots, celery, tomatoes, oranges

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12
Q

Ptosis

A

eyelid droop - weakness of levator muscle

can be muscular or r/t CN III damage

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13
Q

Entropion

A

turning IN of the lid margins
can normally occur with aging
can cause corneal irritation, abrasion or infection

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14
Q

Ectropion

A

turning OUT of the lid margin
most frequent eyelid condition
usually d/t CN VII weakness
see tearing

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15
Q

Posterior Blepharitis

A

inflammation of the meibomian glands

see frothy, oily tears

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16
Q

Hordeolum (Sty)

A

infection of the sebaceous glands of the eye lid
internal - obstruction of meibomian gland
external - obstruction of hair follicle
painful

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17
Q

Chalazion

A

Meibomian cyst
small, firm, nontender nodules on upper and lower lid
may need to be surgically removed

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18
Q

Dacryocystitis

A

obstruction of the lacrimal duct that causes the nasolacrimal sac to be inflamed
pain, swelling, redness, purulent drainage

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19
Q

Dacryoadenitis

A

inflammation of the lacrimal gland
pain, redness, swelling to upper outer third of eye
Seen in Mumps, Measles, and Mono

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20
Q

Enopthalamos

A

“sunken” posterior displacement of eye

most often caused by atrophy of orbital fat

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21
Q

Exopthalamos

A

“bulging” anterior displacement of eye

seen in hyperthyroidism and Grave’s dx

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22
Q

Hypoglobus

A

inferior displacement of eye

seen in fractures of the orbit

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23
Q

Hyperglobus

A

superior displacement

seen also in fractures

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24
Q

Conjunctivitis

A

“pink eye” - injected conjunctiva (redness)

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25
Q

Allergic Conjunctivitis

A

IgE-mediated hypersensitivity

redness, itching, watery eyes

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26
Q

Bacterial Conjunctivitis

A

Hyperacute (N. gonorrhea) will threaten vision = purulent discharge
Acute (S. aureus, H. influenzae) eyes will be stuck together; foreign body sensation

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27
Q

Viral Conjunctivitis

A

usually self-limiting
caused by adenovirus and herpes simplex
watery drainage, photosensitivity

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28
Q

Keratitis

A

inflammation of the cornea

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29
Q

Bacterial Keratitis

A

can ulcerative (chlamydia, staph, strep) or nonulcerative (lupus, syphilis)

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30
Q

Herpes Simplex Keratitis

A

middle layer of cornea can become scarred leading to corneal blindness
80% from HSV1
neonates are exposed to HSV2

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31
Q

Varicella Zoster Opthalmicus

A

lies dormant and becomes activated at the ophthalmic division of the trigeminal nerve
treated with high dose antivirals

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32
Q

Arcus Senilis

A

bilateral benign corneal degeneration as people age, seen as thin grayish white arc around periphery of cornea
no vision changes
does not indicate hyperlipidemia

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33
Q

Uveitis

A

inflammation of the entire uveal tract (iris, choroid, and ciliary body)
can be bacterial, autoimmune, or malignant

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34
Q

Glaucoma

A

classified as an optic neuropathy vs disease of elevated IOP
can be primary or secondary
can be open-angle or angle-closure

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35
Q

Tonometer

A

measures IOP

normal IOP = 10 - 21

36
Q

Primary Glaucoma

A

occurs w/o evidence of preexisting ocular or systemic disease

37
Q

Secondary Glaucoma

A

results from inflammatory processes that affect the eye

38
Q

Glaucomatous Cupping

A

optic nerve axons atrophy = optic disc pallor and increases depth of the optic cup
can result in transient or permanent vision loss

39
Q

Open-Angle Glaucoma

A

gradual loss of peripheral vision
usually affects both eyes
usually occurs d/t abnormality of flow of aqueous humor in Canal of Schelmm

40
Q

Risk Factors for Open-Angle Glaucoma

A 
>40 years
black
myopia
HTN, Type II DM, hyperthyroidism
migraine HAs
OSA
first-degree family hx
41
Q

Treatment for Open-Angle Glaucoma

A 
topical medications to increase outflow of fluid
Laser trabeculopathy (inner trabecular meshwork is burned to widen the Canal of Sclemm
42
Q

Angle-Closure Glaucoma

Narrow-Angle Glaucoma

A

result of an inherited anatomic defect causing narrow angle of the anterior chamber d/t iris enlargement

43
Q

Risk Factors for Narrow-Angle Glaucoma

A 
Asian (preexisiting shallow anterior chambers)
Older adults (lens thickened and iris becomes anteriorly displaced)
44
Q

Acute Angle-Closure Glaucoma Attack

A

medical emergency

eye pressure rises quickly - often precipitated by pupillary dilation

45
Q

Signs/Symptoms of Acute ACG Attack

A 
sudden eye pain
blurred, halos, iridescent vision
tunnel vision
unilateral HA
pupil may be fixed 
symptoms subside with pupillary constriction
46
Q

Treatment for Narrow-Angle Glaucoma

A

meds to reduce pressure

iridotomy (creates permanent opening between the anterior and posterior chambers)

47
Q

Hyphema

A

blood that collects in the anterior chamber d/t blunt trauma or spontaneous hemorrhage

48
Q

Hypopyon

A

purulent matter in the anterior chamber usually d/t iritis and inflammation of the chamber itself

49
Q

Eye Refraction

A

measurement based on how much the lens of the eye has to bend light rays to process visuall stimuli
how power of eye glasses or contacts is calculated

50
Q

Myopia

A

near-sightedness
objects focus IN FRONT of the retina
(convex)

51
Q

Hyperopia

A

far-sightedness
objects focus BEHIND the retina
(concave)

52
Q

Astigmatism

A 
abnormally shaped cornea or lens
blurry vision (near and/or far)
53
Q

Presbyopia

A

far-sighted due to aging

lens thickens and becomes more rigid = difficulty focusing on near objects (changing shape of lens)

54
Q

Miosis

A

pupillary constriction

improves clarity of vision for near objects

55
Q

Mydriasis

A

pupillary dilation

improves the clarity of vision for far objects

56
Q

Cycloplegia

A

paralysis of the ciliary muscles

loss of accomodation

57
Q

Cataracts

A

clouding of the lens = interferes with the transmission of light
most common cause of age-related vision loss
an absent red reflex may be noticed

58
Q

Traumatic Cataracts

A

caused by injury from a foreign body, blunt trauma to the eyes, or overexposure to UV radiation

59
Q

Congenital Cataracts

A

present at birth

caused by genetics, toxins, viruses (rubella), or maternal diabetes

60
Q

Senile Cataracts (Nuclear)

A

central opacity

61
Q

Senile Cataracts (Peripheral Cortical)

A

white, wedge-like opacities that start in the periphery and work their way to the center of the lens in a spoke-like fashion
little effect on vision initially

62
Q

Senile Cataracts (Subcapsular Cataracts)

A

opacities occur in front of the posterior capsule
associated with prolonged, steroid use, DM, obesity, or trauma
near vision is affected w/ inc sensitivity to glare

63
Q

Color Blindness

A

inherited X-linked disorder of the cones (green, red, and blue vision) - photopigment missing or deficient
not considered a clinical disease

64
Q

Ishihara cards

A

polychromatic pictures/figures used to screen for color blindness

65
Q

Papilledema

A

edema of the optic papilla caused by increased IOP = collapse retinal artery/veins = back flow and inc capillary permeability

66
Q

Causes of Papilledema

A

cerebral tumor
subdural hematoma
hydroecephalus
malignant HTN

67
Q

Hypertensive Retinopathy

A

longstanding HTN = thickened arteriole walls
appear pale and more opaque (copper wiring)
MICH - microaneurysms, intraretinal hemorrhages (flame-like), hard exudates, cotton wool spots
optic disc swelling

68
Q

Diabetic Retionopathy

A

most common cause of blindness

can be proliferative or non-proliferative

69
Q

Nonproliferative Diabetic Retinopathy

background retinopathy

A

confined to the retina
see microaneurysms, cotton wool spots, exudates
macular edema = dec vision and sensation of glare

70
Q

Proliferative Diabetic Retinopathy

A

more several retinal changes

characterized by the neovacularization and can result in retinal detachment

71
Q

Retinal Detachment

A

Retina becomes separated from nerve tissues and blood supply
emergency that will result in permanent vision loss if untreated

72
Q

Clinical Manifestations of Retinal Detachment

A

painless
sudden appearance of floaters/flashes of light
“curtain” across vision
altered red reflex

73
Q

Exudative (Serous) Retinal Detachment

A

caused by accumulation of fluid in the subretinal space
HTN, neoplasm, inflammation
usually resolves well

74
Q

Traction Retinal Detachment

A

detachment due to pulling force

scar, fibrous tissue, or inflammation

75
Q

Rhegmatogenous Retinal Detachment

A

most common form

vitreous humor leaks through hole or tear, separating the receptors from their blood supplier (choroid) = vision loss

76
Q

Macular Degeneration

A

degenerative changes in the central portion of the retina (macula)
age-related (AMD) most common cause of reduced vision worldwide

77
Q

Risk Factors for Macular Degeneration

A 
>50 years
female
caucasian
smoking
CVD
poor nutrition
genetics
78
Q

Atrophic Macular Degeneration

“Dry Form”

A

Drusen (yellow fatty deposits) develop beneath the retina
slow onset with mild vision loss
no established treatment

79
Q

Exudative Macular Degeneration

“Wet Form”

A

neovascularization occurs and vessels leak and bleed = edema, fibrosis and scarring
loss of central vision occurs
Treatment: photodynamic therapy, corticosteroids or VEGF

80
Q

Amsler Grid

A

screening tool for macular degeneration
identify visual distortions
used with early diagnosis

81
Q

Anopia

A

blindness in one eye

82
Q

Hemianopia

A

half of the visual field in one eye is lost

can be homonymous (same side) or heteronymous (different)

83
Q

Homonymous Quadrantic Defect

A

quarter of the visual field is lost

usually caused by a partial lesion of the optic tract

84
Q

Bitemporal Anopia

A

loss of temporal vision

central (nasal) vision maintained

85
Q

Amblyopia

A

decrease in visual acuity resulting from abnormal visual development in infancy or early childhood

Adv Pathophysiology (22 decks)

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