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adult 1 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Hyperopia

A

Farsightedness, occurs when the eye doesn’t bend light enough

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2
Q

Myopia

A

Nearsightedness, occurs when the eye overbends light

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3
Q

Refraction

A

Bending light rays into the eye to the retina and reflecting back out so you can see an image

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4
Q

Emmetropia

A

Perfect refraction of the eye, 20/20 vision

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5
Q

Astigmatism

A

Refractive error caused by uneven curved surfaces in the eye, usually the cornea. The uneven surfaces distort vision

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6
Q

Miosis

A

Pupillary constriction

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7
Q

Mydriasis

A

Pupillary dilation

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8
Q

Older adults cornea

A

Flattens and blurs vision, worsens astigmatism. Encourage them to wear corrective lenses for best vision

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9
Q

Older adults’ ocular muscles reduce in strength, making it harder to maintain an upward gaze/maintain a single image. What do you tell them?

A

Normal, re-focus your gaze frequently to maintain a single image.

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10
Q

Older adults lens

A
  • Hardens, compacts, forms cataracts, yellows
  • Elasticity is lost, making the point of best vision farther away
  • Encourage wearing glasses and yearly eye exams
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11
Q

Older adults iris

A
  • Decreases in ability to dilate resulting in small pupils and poor adaption to darkness
  • Teach good lighting to avoid falls
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12
Q

Older adults color vision

A
  • Difficulty in discriminating among greens, blues, and violets
  • Don’t use “dipstick” or other color indicator monitors of health status
  • More light is needed to stimulate photoreceptors
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13
Q

Tear production in older adults

A
  • Reduced, resulting in dry eyes, discomfort, increased risk for corneal damage/eye infections (more common in women)
  • Teach pt to use saline eyedrops on a schedule, increase humidity in the home
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14
Q

Arcus senilis

A

An opaque, bluish white ring on the outer edge of cornea, caused by fat deposits. Very common with aging, doesn’t affect vision

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15
Q

Intraocular pressure in older adults

A

Slightly higher

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16
Q

Presbyopia

A

The point at which an object can be can be seen clearly decreases. Objects must be placed farther away. Commonly begins in 40s

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17
Q

Glaucoma

A

Increase intraocular pressure with aging causes hypoxia of photoreceptors and nerve fibers. Extra pressures push on capillaries and nerve fibers, preventing blood flow.

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18
Q

Cataract

A

A lens loses its transparency.

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19
Q

Lens

A

Circular convex structure behind the iris that bends rays of light through the pupil so they focus on the retina

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20
Q

Which drugs tend to dry the eye and increase IOP?

A

Decongestants and antihistamines

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21
Q

Systemic conditions which can affect vision

A

Diabetes, HTN, Lupus erythematosus, thyroid dysfunction, immune deficiency, sarcoidosis, cardia dz, multiple sclerosis, pregnancy

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22
Q

Vitamin A deficiency

A

Can cause dry eye, karatomalacia, blindness

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23
Q

Diet for eye health

A

Rich in fruit and red, orange, and dark green veggies. Lutein and beta carotene maintain retinal function

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24
Q

When do you notify an ophthalmologist immediately?

A

For sudden or persistent loss of vision within the past 48 hours, eye trauma, foreign body in eye, or sudden ocular pain.

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25
Q

What would a pt do with double vision?

A

Cock the head to the side to focus the two images into one or close one eye to see more clearly

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26
Q

Exophthalmos

A

Protrusion of the eye, “bulging”

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27
Q

Enophthalmos

A

Sunken appearance of eye

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28
Q

Anisocoria

A

Unequal pupils

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29
Q

Nystagmus

A

Involuntary rapid twitching of the eyeball. Normal finding for the far lateral gaze

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30
Q

Ishihara Chart

A

Tests color vision by showing numbers composed of dots of one color within a circle of dots of a different color. Test each eye seperately

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31
Q

Slit-Lamp Exam

A

Magnifies the anterior eye structures. Pt leans chin on a rest

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32
Q

Corneal Stain

A

Places fluorescein/topical dye into conjunctival sac. The dye outlines irregularities of corneal surface. Used for problems with contacts, and corneal traumas. Noninvasive, performed under aseptic conditions. Viewed through a blue filter, non intact areas of the cornea stain a bright green color

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33
Q

Tonometry

A

Measures IOP. Indicated for pts over 40, adults w/ family history of glaucoma should test twice a year.

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34
Q

Ophthalmoscopy

A

Views eye’s external and interior structures. Can be done by a nurse. Start 12-15 inches away. Red reflex is a reflection of the light on the retina. Absent red reflex may indicate a lens opacity or cloudiness of the vitreous. Avoid this test w/ a confused pt and use an interpreter for one who doesn’t speak your language.

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35
Q

Angiography

A

Provides detailed image of eye circulation. Used for assessing problems of retinal circulation or diagnosing intraocular tumors. Instill mydriatic eyedrops to dilate pupils 1 hour before the test. The dye may cause the skin to appear yellow or green for hours after test. IT eliminates through the urine, which will be bright green, drink fluids. Start an IV and inject 5 mL of 10% fluorescein. A digital camera takes pictures, takes only a few minutes. See results immediately.

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36
Q

Perimetry

A

Screens visual fields. Pt looks straight ahead and presses a control button when a light enters peripheral vision. Draws a “map” of peripheral vision.

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37
Q

Gonioscopy

A

Performed when a high IOP is found and determines whether open angle or closed angle glaucoma is present. Uses a special lens that eliminates the corneal curve, is painless, allows visualization of the angle where the iris meets the cornea.

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38
Q

Looks at the bony eye structures and EOM, used for detecting tumors in the orbital space. Not painful, must keep head still. Use contrast dye unless trauma is suspected

A

CT

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39
Q

Examines orbits and optic nerves, evaluates tumors. DO NOT use with metal in the eye

A

MRI

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40
Q

Most common method to measure IOP by an ophthalmologist

A

Goldman’s applanation tonometer with a slit lamp. IOP is usually hight in the morning but may peak at any time of the day. Record the time of procedure and tell pts to measure IOP at the same time each day.

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41
Q

When is easiest to examine the fundus?

A

When the room is dark bc the pupil will dilate.

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42
Q

How many times does a normal person blink per minute?

A

5-10

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43
Q

Inflammation of the eyelid edges

A

Blepharitis

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44
Q

Blepharitis is caused by what in older adults?

A

Dry eye syndrome

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45
Q

Seborrhea

A

Greasy and scaly, draining eye. Occurs with blepharitis

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46
Q

Pt’s eye is itchy, red, and burning.

A

Blepharitis

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47
Q

How to treat blepharitis

A

Warm compress, dilute baby shampoo, don’t rub

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48
Q

Turning inward of eyelid causing lashes to rub against eye. Corneal abrasion may result from constant irritation

A

Entropion

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49
Q

Turning outward and sagging of eyelid, reduces the washing action of tears, leads to cornea drying and ulcers

A

Ectropion

50
Q

Entropion is caused by what?

A

Eyelid muscle spasms or post-trauma

51
Q

Ectropion is caused by what?

A

Muscle relaxation or weakness w/ aging

52
Q

Pt has pain and tears, conjunctiva is red, “feels something in their eye”

A

Entropion

53
Q

Pt has constant tears and a sagging lower eyelid

A

Ectropion

54
Q

How to treat entropion

A

Surgery tightens orbicular muscles and moves eyelid to normal position or prevents inward rotation. The pt wears an eyepatch after surgery until they’re seen by the ophthalmologist. Tell them to report any pain or drainage under the patch.

55
Q

How to treat extropion

A

Surgery restores lid alignment, teaching is same as for entropion

56
Q

Hordeolum

A

“Stye,” infection of sweat glands or sebaceous glands in eyelid, doesn’t affect vision. Caused by staph or strep, affects 1 eye at a time

57
Q

Management of a stye

A

Warm compresses four times a day, antibacterial ointment. When the lesion opens, the pus (purulent material) drains and the pain subsides

58
Q

When more than one topical eye drug is prescribed, pts should wait how long in between instillation of each drug?

A

10-15 minutes

59
Q

Inflammation of a sebaceous gland in the eyelid that protrudes on the inner lid

A

Chalazion

60
Q

Begins with redness and tenderness, followed by a gradual painless swelling. Pt has fatigue, light sensitivity, and excessive tears

A

Chalazion

61
Q

Surgery for removing a chalazion

A

Keep a non pressure eye patch in place for 6 hours and then remove and apply warm compresses. Teach pt to report increasing redness, purulent drainage, or reduced vision to the ophthalmologist

62
Q

Keratoconjunctivitis sicca

A

Dry eye syndrome

63
Q

Results from changes in tear production/composition/distribution or drugs.

A

Dry eye syndrome

64
Q

Injury to which cranial nerve inhibits tears?

A

VII

65
Q

Pt has foreign body sensation in eye, burning and itching, photophobia, tears contain mucus strands and the corneal light reflex is dulled

A

Dry eye syndrome

66
Q

How to treat allergic conjunctivitis

A

Vasoconstrictor or corticosteroid eyedrop

67
Q

Bacterial conjunctivitis

A

“Pink eye,” caused by staph or Haemophilus influenza

68
Q

Inflammation or infection of conjunctiva caused by exposure to allergens, irritants, infection/bacteria/virus and is very contagious

A

Conjunctivitis

69
Q

Allergic conjunctivitis manifestations

A

Edema, sensation of burning, “bloodshot” eye appearance, excessive tears, itching.

70
Q

Bacterial conjunctivitis manifestations

A

Blood vessel dilation, mild edema, tears, watery at first discharge and then it becomes thicker with shreds of mucus

71
Q

Chronic conjunctivitis, similar symptoms of bacterial pink eye

A

Trachoma

72
Q

Trachoma is caused by what

A

Chlamydia trachomatis

73
Q

Scars the conjunctiva and is a common cause of preventable blindness, more often in warm, moist climates where sanitation is poor

A

Trachoma

74
Q

Incubation period of trachoma

A

5-14 days

75
Q

How to treat trachoma

A

“Big Daddy” antibiotics like erythromycin and tetracycline

76
Q

Causes of corneal abrasion

A

Contact lens use, small foreign body, trauma, malnutrition, dry eye syndrome, cancer treatment

77
Q

Why is corneal ulceration a medical emergency?

A

Lack of blood supply and permanent vision impairment

78
Q

S/S of corneal abrasion

A

Pain, vision loss, photophobia, cloudy at injured site, open allowing germs in, can cause ulcerations

79
Q

How to treat corneal abrasions

A

Antibiotic eye drops every hour for 24 hours to prevent vision loss

80
Q

Degeneration of corneal tissue causing abnormal corneal shape, caused by trauma or genetic disorder

A

Keratoconus

81
Q

Treatment for keratoconus when it obscures vision

A

Keratoplasty (corneal transplant) pt wears eye patch until next day when they return to surgeon. Tell pt to lie on the nonoperative side to reduce IOP. Wear shield at night or around kids/pets. DO NOT use ice pack.

82
Q

What do you notify the ophthalmologist of after a keratoplasty?

A

Changes in vitals or drainage on the dressing.

83
Q

Which drugs may need to be d/c before cataract surgery?

A

Drugs that affect blood clotting such as warfarin, aspirin, plavix

84
Q

Opacity of the lens causing blurred vision

A

Cataract

85
Q

Cataract risk factors

A

Aging, smoking, congenital, trauma/injury, poorly controlled diabetes, steroids

86
Q

Senile cataracts

A

Due to aging

87
Q

Immature cataracts

A

Partially cover lens

88
Q

Mature cataracts

A

Cover entire lens

89
Q

Optic neuropathy w/ gradual peripheral vision loss and increased IOP, leading cause of blindness, IOP increases due to problems with aqueous humor

A

Glaucoma

90
Q

Risk factors for primary glaucoma

A

Age, more common in AA and hispanics

91
Q

Risk factors for associated glaucoma

A

W/ another dz, diabetes, HTN, myopia

92
Q

Risk factors for secondary glaucoma

A

Infection, trauma, cataract which pressed against and caused pressure

93
Q

Open-angle glaucoma

A

Most common, normal angle, slow progression, partially obstructed aqueous humor, gradual vision loss. Late sign: night vision decreases, halos

94
Q

Closed-angle glaucoma

A

Aqueous humor outflow blocked, abrupt onset, fast and permanent vision loss, unilateral, worse with pupil dilation. S/S: severe pain, abrupt change in vision, red conjunctiva, pupil fixed and non-reactive

95
Q

Bleeding into vitreous cavity from aging, systemic dz, trauma. Caused by torn vessels bleeding, DM, HTN

A

Vitreous Hemorrhage

96
Q

How to treat Vitreous Hemorrhage

A

Vitrectomy if the hemorrhage is still there weeks to months later and doesn’t absorb without treatment.

97
Q

S/S of Vitreous Hemorrhage

A

Reduced visual acuity is the main sign. A mild hemorrhage may cause pt to see a red haze or floaters. A moderate hemorrhage may cause pt to see black streaks or tiny black dots. Severe hemorrhage may reduce visual acuity to hand motionThe eye has a reduced red reflex bc light rays do not reach the retina

98
Q

Inflammation of iris, ciliary body, or choroid

A

Uveitis

99
Q

Anterior uveitis

A

Can be caused by exposure to allergens, infectious agents, trauma, systemic dz (RA or herpes) and may follow local or systemic bacterial infection

100
Q

Posterior uveitis

A

“Retinitis” or “Chorioretinitis” occurs from TB, syphilis, toxoplasmosis

101
Q

S/S of uveitis

A

Reduced vision in the affected eye results from fluid, fibrin, and cells leaking into the vitreous cavity. The pupil is small, nonreactive, and irregularly shaped. Black dots are visible against the red background of the funds. Lesions appear as grayish yellow patches on the retinal surface.

102
Q

Treatment of uveitis

A

Management: resting ciliary body with a cycloplegia drug to paralyze the ciliary muscles and dilate the pupil. Steroid drops are given hour to reduce inflammation and prevent adhesion of the iris to the cornea and lens.

103
Q

Breakdown of macula that distorts central vision

A

Macular Degeneration

104
Q

Types of Macular Degeneration

A
  1. Nonexudative (dry) no cure. Central vision declines, pts c/o mild luring and distortion
  2. Exudative (wet) Pts have a sudden decrease in vision after a serous detachment of pigment epithelium in the macula. Newly formed blood vessels invade this injured area and cause fluid and blood to collect under the macula like a blister resulting in scar formation and visual distortion
105
Q

Treatment of macular degeneration

A

VEGFI (vascular endothelial growth factor inhibitors) are successful with wet degeneration

106
Q

How to diagnose macular degeneration

A

Amsler

107
Q

Separation of the retina from the pigmented vascular layer

A

Retinal Detachment, medical emergency!

108
Q

Rhegmatogenous retinal detachment

A

Occur following a hole or tear in the retina caused by mechanical force, creating an opening for the vitreous to move under the retina

109
Q

Traction retinal detachment

A

Occur when the retina is pulled away from the support tissue by bands of fibrous tissue in the vitreous

110
Q

Exudative retinal detachment

A

Caused by fluid collecting under the retina. Often occur with a systemic dz or ocular tumors. No retinal break occurs

111
Q

Risk factors for retinal detachment

A

Eye dz, cataract surgery, family hx, retinal detachment of the other eye

112
Q

How to diagnose retinal detachment

A

On ophthalmoscopic examination, detachments are seen as gray bulges or folds in the retina that quiver.

113
Q

Treatment for retinal detachment

A

Create an inflammatory response using a freezing probe (cryotherapy), a laser (photocoagulation) or a high-frequency current (diathermy) that will bind the retina and choroid together around the break. Surgery: scleral buckling

114
Q

Hemorrhage in anterior chamber when force is applied to eye and breaks blood vessels

A

Hyphema

115
Q

Traumatic contact from blunt object with eye pushed back into socket

A

Contusion

116
Q

Most common malignant eye tumor in adults age 30-40

A

Ocular Melanoma

117
Q

Ocular Melanoma is caused by what?

A

Exposure to UV light

118
Q

Where can ocular melanomas spread?

A

Surrounding tissue and brain

119
Q

S/S of ocular melanoma

A

Blurred vision may occur if the macular area is invaded. Visual acuity is reduced if the tumor grows inward toward the center of the eye from the choroid and alters the visual pathway. Increased IOP, iris color changed when the tumor infiltrates the iris.

120
Q

Enucleation

A

Usually for ocular melanoma, surgical eye removal. A ball implant is inserted as a base for the socket prosthesis.

adult 1 (8 decks)

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