Chapter 9: Ophthamology Flashcards
1
Q
Amblyopia?
A
- vision impairment resulting from interference with processing of images by the brain
- first 6-7 years of life
- most common expression is child with strabismus
- one eye is suppressed (though it is perfectly normal..just can’t process overlapping images from both eyes)–> must fix or can gt permanent cortical blindness of suppressed eye
2
Q
How to verify strabismus?
A
show that reflection from a alight comes from different areas of the cornea in each eye
3
Q
Tw types of strabismus:
A
- true; from birth, does not resolve with glasses spontaneously
- strabismus 2ndary to exaggerated convergence caused by refraction difficulties ( corrective glasses instantly resolve problem
4
Q
White pupil in a baby?
A
Opthalmologic emergency:
- may be caused by retinoblastoma
- could also be a congenital cataract (should attend to it in order to prevent amblyopia)
5
Q
acute angle glaucoma?
A
- very severe eye pain or frontal headache
- typically starts in evening with pupils have been dilated for several hours
- report seeing halos around lights
- pupil is mid-dilated
- pupil doesn’t react to light
- cornea is cloudy w greenish hue
- eye feels hard as rock
6
Q
Tx for acute-angle glaucoma?
A
- emergency!
- drill hole into iris w laser to allow drainage of fluid in anterior chamber
- give systemic carbonic anhydrase inhibitors (i.e. Diamox)
- apply topical beta-blocker/alpha 2 agonist
- give mannitol and pilocarpine
7
Q
Orbital cellulitis?
A
- also ophthalmologic emergency!
- hot, tender, red, swollen eyelid
- pt is febrile
- key finding: when eyelid is pried open–> pupil is dilated and fixed
- very limited motion of eye
- pus in orbit
8
Q
Mgmt of orbital cellulitis?
A
- emergency CT scan
2. drainage
9
Q
Chemical burns of the eye?
A
- need massive irrigation w plain water as soon as possible (even before hospital )
- irrigate for half an hr before transport to ER
- at hospital–> irrigate some more w saline (remove corrosive particles hidden in corners)
- test pH to assure no harmful chemicals in conjunctival sac before sending home
10
Q
Which is worse alkaline or acid burns?
A
alkaline!
11
Q
Retinal detachment: Sx?
A
- emergency!
- see flashes of light and “floaters” in eye (# of floaters correlate with magnitude of problem)
a. 1-2: mild detachment
b. dozens/sno-storm/ big dark cloud at top of visual field: in danger of ripping out the rest of cornea
12
Q
Tx for retinal detachment?
A
- laser “spot welding” to protect remaining retina
13
Q
Embolic occlusion of retinal artery? Sx?
A
- emergency!
- sudden loss of vision from one eye in elderly pt
- damage is irreversible 30 minutes after onset
14
Q
Management for embolic occlusion of retinal artery?
A
- have pt breathe into paper bag
- have someone repeatedly press hard on the eye and release while in transit to the ER ( to vasodilator and shake the clot to a more distal location)
15
Q
Newly diagnosed diabetics what must you do?
A
opthalmologic eval to look for retinal damage that happened over years before diagnosis
-for type II diabetes generally
