Emergency Eye Care Flashcards
labeled eye structures (external eye)
- lacrimal caruncle
- lacrimal papilla
- plica semilunaris
- sclera
- limbus (corneoscleral junction)
- iris
- pupil
labeled eye structures (diagram)
- cornea
- anterior chamber
- conjunctiva
- lens
- iris
- ciliary muscle
- vitreous humor
- fovea
- optic disk
- choroid
- optic nerve
- retina
- ciliary body
conjunctiva - overview
The conjuctiva is the translucent mucous membrane lining the lids and globe. Inspection should look for injection, purulence or swelling.
cornea - overview
The transparent outer coat of the eyeball forming the anterior wall of the aqueous chamber is termed the cornea. It is avascular and composed of 5 layers.
anterior chamber of eye - overview
This space between the back surface of the cornea to the anterior surface of the iris. It is optically clear and filled with aqueous humor. This area should be examined for blood (hyphema) or inflammatory cells (hypopyon) that layer out and form a meniscus in the lower anterior chamber.
pupils - overview
The central portion of the iris is the pupil. They are normally equal in size, shape and reaction to light. Anisocoria or unequal pupils may be normal but may suggest neurologic disease, if one or both pupils do not react well to light.
key components of HPI for eye complaints
*previous sx similar to current complaints
*previous eye diseases (eg. cataracts, glaucoma)
*previous hx of ocular surgeries (may easily explain anisocoria)
*hx of trauma/injury and details
*allergies
*tetanus status
*occupation (arc welder, sheet metal worker, chemist)
*PMHx
lens - overview
The lens is a biconvex avascular colorless structure behind the pupil and fills the pupillary space. The sole function of the lens is to focus light rays on the retina. The disorders of the lens to consider are opacification and dislocation.
vitreous of eye - overview
The Vitreous - is a clear, avancular gel-like substance that fills the space between the retina and the posterior surface of the lens. it comprises 2/3rds of the volume and weight of the eye. Normal vitreous is not visible by direct or indirect ophthalmoscopy. Opacifications within the vitreous may be secondary hemorrhage, posterior vitreous detachment, white cells or fibrovascular proliferations from adjacent tissues.
retina - overview
The Retina lines the back of the eye and is a multilayered sheet of neural tissue. Its function is to receive visual images, partly analyze then, and dispatch this modified information to the brain. The retina has no pain fibers so that diseases of the retina are painless. it is important to examine the fundus, the optic nerve with its cup and disc. You should examine the arteries and veins from the disc to the periphery.
5 most common presenting eye complaints
- abnormal visual acuity
- pain or discomfort
- change in appearance of lids, orbit, or eye
- diplopia/dizziness
- eye discharge increased
systemic diseases that commonly present with ocular manifestations
- thyroid disease
- hypertension
- diabetes mellitus
- connective tissue disorders
which ocular disease typically causes halos when viewing lights?
glaucoma typically causes halos or rings when viewing lights or bright objects
what toxicity can cause yellow/white vision change?
digoxin toxicity
is the etiology of “spots” or dots that move with the eye considered dangerous?
NO, spots or “floaters” are felt to be secondary to benign vitreous opacities, but should be referred to ophthalmology for further eval
what is another name for sudden, momentary loss of vision? what is the common cause of this?
*amaurosis fugax: the sudden transient monocular loss of vision
*usually secondary to internal carotid artery atherosclerosis
common cause of yellowing of sclera
- jaundice
- meds (antimalarial toxicity [quinacrine], arsenic, Tylenol, amanita mushrooms, tetrachloride)
blue sclerae are characteristic of?
osteogenesis imperfecta
hypopyon - defined
a collection of inflammatory cells in the anterior chamber layering and creating a “fluid level”
acute localized pain, worsened by movement of the eye or lid, is suggestive of ?
- foreign body
- corneal abrasion
itching sensation of the eyes is usually associated with ?
allergic reactions
What methods may be used to remove a corneal foreign body?
The foreign body may be removed with a corneal spur, burr, sterile hypodermic needle or wet q-tip, best done with slit lamp magnification after anesthetizing the eye.
What is the cause of a rust ring on the cornea?
A rust ring is a ring of siderosis that forms in the corneal epithelium as a result of oxidization of an embedded metallic foreign body usually containing iron. This also should be completely removed with the use of a slit lamp as persistence of the ring may cause recurrent irritation and permanent staining.
What disease should be suspected with diffuse corneal edema or haziness, especially if associated with eye pain, nausea and vomiting?
Acute angle closure glaucoma should be suspected with diffuse corneal edema, especially with the associated symptoms. This may be a helpful clue to the diagnosis when glaucoma is suspected.
