Clinical Eye Exam - Parrott Flashcards
Exotropia definition
Dx how?
lateral eye drift when the good eye is covered
Dx with rapid cover/uncover test
Esotropia definition
Dx how?
medial eye drift when the good eye is covered
Dx with rapid cover/uncover test
Sclera
White of eye
Limbus
border between cornea and sclera. Often site of neoplasm
Pterygium
Tx?
A BENIGN overgrowth of the cornea due to excess sun exposure.
Tx? None if it does not affect vision
Five things to inspect in eye.
- Symmetry
- Orbits
- Lids/lid margins
- Sclera
- Conjuctiva
Cardinal signs of gaze
SO4, LR6, R3 (SR, IO, IR, MR)
What is the goal of the Cover/Uncover test? What does it show?
- REVEALS WEAKNESS OF EOM
- Eyes should remain synchronous regardless of being covered.
- Watch for DRIFT of the covered eye is uncovered (EXOTROPIA, ESOTROPIA)
Define strabismus.
What conditions can it result in?
What age group is it especially important in?
- Misalignment of eyes.
- Can result in AMBLYOPIA, exotropia, esotropia.
- Especially important in children.
What is amblyopia?
Permanent lazy eye with permanently reduced visual acuity.
Nystagmus definition
Especially important to test in what age group and why…?
- Ocular ataxia or rhythmical oscillation of the eyes, associated with turning the head.
- Esp important in infants - may indicate ocular weakness.
What action is nystagmus associated with?
Hornizontal movement (Testing) and TURNING HEAD - Implications for evaluation of labyrinth/vestibular or central NS.
What is the coaloric reflex test?
Checks for brain activity - shoot COLD water into one (L ear)»_space; eye goes to L, nystagmus goes R.
WARM water into L ear»_space; eye goes R, nystagmus goes L
*COWS - COLD=nystagmus (away) Opposite; WARM=nystagmus Same
3 things that should be looked for in pupillary exam
- Both pupils remain same size
- Convergence
- Anisocoria
Define convergence
near point constriction of pupil
Define anisocoria
unequal size of pupils
What 2 things are involved in visual field confrontation?
PERIPHERAL VISION
- Temporal fields can be tested simultaneously (peripheral eye field) or independently (nasal eye field)
- Uses same six cardinal fields.
What is Confrontation testing used for and how is it done?
Assesses visual field, one eye at a time. Doc brings fingers peripherally to centrally.
Fundoscopic exam procedures - what should you see?
- Start lateral of midline and ID red reflex (retina)
- Move forward and ID posterior chamber structures: optic disc is nasal and inferior, arterioles (2 laterally, 2 nasally), macula is temporal
What is blepharitis?
Bacterial infection of the eyelids.
What is scleral icterus indicative of?
Bilirubin of at least 3 (high)»_space; do LIVER WORKUP
Difference in appearance between conjuctivitis:
- Allergic
- Viral
- Bacteral
See slide 15 of ppt.
Allergic-watery
Viral-red
Bacterial-GROSS
Bacterial conjuctivitis:
- Most common causes
- Method of spread
- Uni/bilateral
- Discharge
- Most common causes - S. aureus, S. pneumo, H. flu, M. catarrhalis
- Method of spread - direct contact
- Unilateral
- Discharge - purulent thru the day, mattes shut during sleep
Most common cause of Bacterial conjuctivitis in adults v. children.
Adults - S. aureus
Children - M. catarrhalis
