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Health Assessment LECT | Quiz/Exam 1 > Exam 1 | Eye > Flashcards

Exam 1 | Eye Flashcards

1
Q

S&S to note

A
  • photophobia: light sensitivity from excess light entering eye which may overexcite photoreceptors in retina
  • Flashing lights w/ new vitreous floaters ⇒ consider detachment of vitreous from retina
    • Moving specs or strands ⇒ vitreous floaters
  • Scotomas: area of lost or depressed vision within visual field and is surrounded by area of normal vision
  • Diplopia: double vision
  • Hyperopia (farsightedness): difficulty seeing close objects
  • Myopia (nearsightedness): difficulty seeing far objects
  • Presbyopia (aging vision): difficulty seeing close objects
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2
Q

general external inspection of…

A
  • eyebrows
  • eyelids
    • red inflamed lid margins occur in blepharitis, often w/ crusting
    • failure of eyelids to close exposes cornea to serious damage
    • upward slanting palpebral fissures (space between open eyelids) visible in Down Syndrome
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3
Q

Snellen Chart

A
  • who: for adults and ppl who can read
  • tests: visual acuity
  • numerator: distance of pt from chart (always 20)
  • denominator: # line pt is able to read
  • better than normal vision: when denominator smaller than numerator
  • legally blind: 20/200 = pt at 20 ft can read print that person w/ normal vision can read at 200 ft
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4
Q

E Chart

A
  • who: children or ppl unable to read
  • tests: visual acuity
  • used mostly for myopia (nearsightedness) bc it causes focusing problems for distance vision ppl
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5
Q

Jaeger (J) Number Test

A
  • tests: near visual acuity to identify need for reading glasses or bifocals
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6
Q

EOMs test abnormalities and meanings

A
  • movement deviations ⇒ consider brain tumor or injury
  • Suspecting lid lag or know pt has hyperthyroidism ⇒ ask pt to follow finger again as you slowly move it up/down midline → normally lids should overlap iris slightly
    • If lid doesn’t overlap ⇒ hyperthyroidism creates abnormal protrusion of eye leaving no overlap
  • Poor eye convergence ⇒ common in hyperthyroidism
  • Asymmetry of corneal deviation ⇒ deviation from normal ocular alignment
  • Temporal light reflection on one cornea ⇒ nasal deviation of that eye
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7
Q

Pupil inspection

A
  • PEERLA (tests CN III)
  • direct and consensual responses, accommodation: pupil miosis (constriction) and mydriasis (dilation) should work together and happen at same time
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8
Q

Ophthalmoscopic Examines…

A
  • retina
  • optic nerve (CNII)
  • optic disc
  • vessels
  • macula for…
    • macular degeneration: subretinal hemorrhage or exudate ⇒ can cause poor central vision in elderly
    • drusen: undigested cellular debris that can be found in macula as hard and sharply defined or as soft and confluent w/ altered pigmentation
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9
Q

Peripheral Vision & Visual Fields (how to test and abnormalities + meanings)

A
  • tests confrontation: wiggle fingers → tell pt to tell you when they can see them from temporal to central
    • nurse needs to have normal vision bc wtv you see is what pt should see
  • Defects in peripheral vision can be sign of normal pressure glaucoma ⇒ pt should be referred to ophthalmologist
  • Hemianopsia: when pt is unable to see half of visual field and is generally on one side (can occur after CVA)
    • Bitemporal hemianopsia (optic chiasm): loss of peripheral vision in outer halves of both right and left visual field, caused by lesion
    • Homonymous hemianopsia (right optic tract): loss of visual field in same halves of visual fields of each eye
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10
Q

Eye Alignment (how to test and abnormalities + meanings)

A
  • should be tested w/ correction glasses/lenses
  • If one or both eyes seem to protrude (assess from above)
  • Abnormal protrusion of eye can be inward or outward ⇒ consider Grave’s Disease or ocular tumor
  • Strabismus/Heterotropia: when both eyes aren’t aligned
  • Exotropia (medial shift): one eye drifts away from nose
  • Esotropia (lateral shift): one eye drifts towards nose
  • Hypertropia (down shift): one eye drifts up
  • Hypotropia (up shift): one eye drifts down
  • Eye misalignment can cause amblyopia (lazy eye): reduced vision in one eye
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11
Q

Retina-Specific Inspection Using Ophthalmoscope

A
  • Glaucoma: increase intraocular pressure ⇒ damages optic nerve ⇒ impacts vision
    • Open-angle: gradual, painless increase in intraocular pressure ⇒ peripheral vision loss/tunnel vision (can progress to central vision loss too)
    • Closed-angle: sudden, dramatic, painful increase in intraocular pressure ⇒ quick vision loss starting peripheral then quickly to central
  • Papilledema: gradual swelling of optic disc and anterior bulging of cup (can be sign of serious brain disorder– subarachnoid hemorrhage, meningitis, trauma, mass lesions)
  • Retinopathy: gradual vision loss and blindness from damaged retinal blood vessels
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12
Q

External eye portion abnormalities

A
  • Blepharitis
  • Periorbital Fx
  • Ptosis
  • Chalazion
  • Hordeolum/Stye
  • Xanthelasma
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13
Q

Blepharitis

A

red inflamed eyelid margins often w/ crusting

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14
Q

Ptosis

A

drooping of upper eyelids

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15
Q

Chalazion

A
  • small, firm lump
  • cause: blocked oil gland
  • Tx: warm compress over periods of time
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16
Q

Hordeolum/Stye

A
  • painful, red, pus-filled bump that occurs on edges of eyelid
  • cause: bacterial infection of oil gland in eyelid
  • Tx: warm compress over periods of time
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17
Q

Xanthelasma

A
  • harmless bump near eyelid
  • Chronic and benign disease
  • Fat appears
  • High risk of stroke bc it can be sign of high cholesterol, thyroid issues, or diabetes
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18
Q

Internal aspects of eye abnormalities

A
  • Iritis
  • Conjunctivitis
  • Cataract
  • strabismus/heterotropia
  • vitreous hemorrhage
  • retinal vein occlusion
  • central retinal artery occlusion
  • glaucoma
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19
Q

Iritis

A
  • inflammation of iris (major red flag bc… )
  • can lead to vision loss
  • Tx: steroids, eye drops
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20
Q

Conjunctivitis

A

inflammation of conjunctiva (thin, clear membrane covering white of eye and inside of eyelids)

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21
Q

Cataracts

A
  • clouding of eye lens (white clouds)
  • Can lead to slow central vision loss
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22
Q

Strabismus/Heterotropia (definition, causes, types)

A
  • when both eyes aren’t aligned
  • causes: neurological problems, genes, issue of extraocular muscles or nerve issues
  • Exotropia (medial shift): one eye drifts away from nose
  • Esotropia (lateral shift): one eye drifts towards nose
  • Hypertropia (down shift): one eye drifts up
  • Hypotropia (up shift): one eye drifts down
23
Q

Vitreous hemorrhage

A
  • blood floating in vitreous ⇒ occludes view or retina
  • Can lead to unilateral and painless, sudden vision loss
24
Q

Retinal vein occlusion

A
  • blockage in vein that drains blood from retina
  • Can lead to unilateral and painless, sudden vision loss
25
Q

Central retinal artery occlusion

A
  • blockage of retinal artery carrying oxygen to nerve cells in retina at back of eye
  • Can lead to unilateral and painless, sudden vision loss
26
Q

Red Flags for Eyes

A
  • Iritis: inflammation of iris ⇒ can read to vision loss
  • Sudden eye pain
  • White reflection instead of red reflex ⇒ cataracts
27
Q

Open-angle glaucoma S&S

A
  • Usually asymptomatic bc of gradual progression ⇒ any Sxs felt means it’s severe
  • Peripheral vision loss / Tunnel vision
  • Enlarged central cup
  • Increased cup-to-disk ratio
28
Q

Glaucoma (open and closed angle) Risk Factors

A
  • Aging
  • Diabetes mellitus I, II
  • FHx / Genes
  • Eye injury
  • Corticosteroid use
  • Smoking
29
Q

Glaucoma (open and closed angle) Prevention

A
  • Monitor BP
  • Monitor blood sugar lvls
30
Q

Cataracts S&S

A
  • Gradual, bilateral vision loss
  • Cloudy lenses
  • Monocular diplopia
  • No red reflex / Dark light reflex
31
Q

Cataracts Risk Factors

A
  • Aging
  • Diabetes mellitus I, II
  • FHx / Genes
  • Smoking
32
Q

Cataracts Prevention

A
  • Stop smoking
  • Monitor blood sugar lvls
33
Q

Macular Degeneration S&S

A
  • Gradual, central vision loss
  • Bilateral
  • Painless
  • Blurred vision
34
Q

Macular Degeneration Risk Factors

A
  • Aging
  • FHx / Genes
35
Q

Macular Degeneration Prevention

A
  • Sunglasses
36
Q

Gradual + Painless Eye Conditions

A
  • Macular degeneration
  • open-angle glaucoma
  • cataracts
  • Retinal vein occlusion (can be both sudden or gradual)
37
Q

Sudden + Painful Eye Conditions

A
  • closed-angle glaucoma
38
Q

Sudden + Painless Eye Conditions

A
  • Vitreous hemorrhage
  • Retinal vein occlusion (can be both sudden or gradual)
  • Central retinal artery occlusion
39
Q

DM impact on eyes (can lead to…)

A
  • leading cause of preventable blindness in US
  • Retinopathy: retina damage
  • Cataracts: cloudy lenses
  • Glaucoma
  • Vitreous hemorrhage
40
Q

Hypertension (HTN) can lead to…

A
  • A-V nicking: narrowing venule bc arteriole crosses over and compresses it
  • Retinopathy: retina damage
41
Q

Atherosclerosis impact on eyes + can lead to…

A
  • Bilateral or unilateral, gradual effect on eye
  • Leads to central retinal artery occlusion (eye stroke) ⇒ vision loss
42
Q

Brain injury can lead to…

A
  • papilledema (swelling of optic disc)
43
Q

Grave’s Disease (cause of hyperthyroidism) can lead to…

A
  • Bilateral, gradual effect on eye
  • Exophthalmos
  • Corneal ulceration
  • Loss of vision (rare)
44
Q

AIDS can lead to…

A
  • Retinopathy
  • Detached Retina
  • Squamous cell carcinoma of eye
  • Increased risk of eye infection
45
Q

Sickle Cell can lead to…

A
  • Bilateral, gradual effect on eye
  • Subconjunctival hemorrhage
  • Retinal vessel occlusion (eye stroke)
  • Retinal neovascularization: creation of new, poor quality eye blood vessels
  • Retinal detachment
46
Q

Multiple sclerosis can lead to…

A
  • Unilateral or bilateral, gradual effect on eye
  • Optic neuritis: inflammation of optic nerves
  • Diplopia
  • Nystagmus: involuntary eye movement
47
Q

Children considerations

A
  • Strabismus starts often in childhood 3-5 yrs
  • Failure to correct amblyopia during early childhood can result in poor vision for life
48
Q

Geriatrics/Older Adults considerations

A
  • Poor central vision in elderly is caused by macular degeneration
    • Types of macular degeneration: Dry atrophic, Wet exudate, Wet neovascular
  • More at risk for glaucoma, cataracts, and macular degeneration
49
Q

General Population health education and prevention

A

Eye protection– sunglasses
Contact lens care

50
Q

Infants health education and prevention

A
  • Should see Red Reflex from ophthalmoscopy
  • No prescriptions bc eyesight still developing
51
Q

Geriatrics health education and prevention

A
  • Screening for glaucoma, cataracts, macular degeneration
  • Near vision testing for presbyopia
52
Q

Ppl w/ DM I health education and prevention

A

eye exam within 5 yrs of DM I diagnosis and yearly following

53
Q

Ppl w/ DM II health education and prevention

A

eye exam at same time as DM II diagnosis and at least every 2 yrs following

Health Assessment LECT | Quiz/Exam 1 (4 decks)

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