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
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
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
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
5
Q
Jaeger (J) Number Test
A
- tests: near visual acuity to identify need for reading glasses or bifocals
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
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
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
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
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
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
12
Q
External eye portion abnormalities
A
- Blepharitis
- Periorbital Fx
- Ptosis
- Chalazion
- Hordeolum/Stye
- Xanthelasma
13
Q
Blepharitis
A
red inflamed eyelid margins often w/ crusting
14
Q
Ptosis
A
drooping of upper eyelids
15
Q
Chalazion
A
- small, firm lump
- cause: blocked oil gland
- Tx: warm compress over periods of time
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
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
18
Q
Internal aspects of eye abnormalities
A
- Iritis
- Conjunctivitis
- Cataract
- strabismus/heterotropia
- vitreous hemorrhage
- retinal vein occlusion
- central retinal artery occlusion
- glaucoma
19
Q
Iritis
A
- inflammation of iris (major red flag bc… )
- can lead to vision loss
- Tx: steroids, eye drops
20
Q
Conjunctivitis
A
inflammation of conjunctiva (thin, clear membrane covering white of eye and inside of eyelids)
21
Q
Cataracts
A
- clouding of eye lens (white clouds)
- Can lead to slow central vision loss
