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PCM II: Test 2 > Examination of the Eye > Flashcards

Examination of the Eye Flashcards

1
Q

Sudden loss of vision

A 
retinal detachment
vitreous hemorrhage
central retinal artery occlusion
CVA
trauma
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2
Q

gradual loss of vision

A 
aging
cataracts
glaucoma
HIV
AI disease
diabetes
macular degeneration 
neoplasm
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3
Q

hyperopia

A

farsightedness, diff. seeing near objects

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4
Q

myopia

A

nearsightedness- diff. seeing distant objects

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5
Q

presbyopia

A

aging vision - progressive difficulty seeing near objects

- lens is less pliable due to aging

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6
Q

diplopia

A

double vision

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7
Q

heterophoria

A

failure of the visual axes to remain parallel

  • either esophoria or exophoria
  • use the cover test to evaluate. the good eye will be reflected directly in the pupil, the bad eye will not be focused on the light.
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8
Q

esophoria vs. exophoria

A

esophoria: one eye deviates inward
exophoria: one eye deviates outward

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9
Q

cover test

A

have patient look right at you. cover the good eye, the eye won’t move. when you cover bad eye, and remove it, the bad eye will swing out

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10
Q

look at surface structures of the eye

A

slide #10
limbus = border b/w scler and iris
medial canthus = middle corner
lateral canthus = lateral corner

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11
Q

lacrimal gland

A

produce tears located in upper lateral eyelid

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12
Q

puncta

A

absorbs the tears, they go down the nasolacrimal duct, and are dropped into the nose

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13
Q

want to find the optic disc

A

stay away from fovea and macula: will cause the patient pain. optic disc is where the blood and vessels enter the eye

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14
Q

the examination of the eye

A 
Visual Acuity
Color blindness
Visual field testing
External examination
Conjunctiva and sclera
Cornea, lens and pupil
Extra-ocular movement
The ophthalmoscopic examination
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15
Q

tests for near and far vision

A
  • far vision: snellen eye chart 20 feet away

- near vision: hand held card,

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16
Q

recording visual acuity

A

20/20 normal vision (you can see everything at 20 feet that normal people can)

20/100 what a normal visual (what people can normally see at 100 feet, you can only see at 20 feet)

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17
Q

should always check with and without corrective lenses. how do you document?

A 
oculus dexter (right) O.D.
oculus sinister (left) O.S. 
oculus uterque (both eyes) O.U.
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18
Q

Ishihara color blindness test

A

dots with different colors

- tests for “red blindness”

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19
Q

visual field testing by confrontation

A
  • doctor’s cover her eye, patient covers the eye across from hers. bring fingers in from 4 dxns. n/s/e/west
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20
Q

homonymous hemianopsia

A
  • homonymous hemianopsia: have lost half of visual field on same side
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21
Q

bitemporal hemianopsia

A

have lost vision on opposite sides - lost on right side of right eye and left side of left eye

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22
Q

quadrantic defects

A

lost visual field from 1/4 of the eye

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23
Q

exopthalamos

A

protrusion of the eyes - can see the whites of their eyes. (normally the eyelids should cover the top portion of the iris, and be just below the iris)
- this is happening b/c eye is being pushed forward.

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24
Q

palpebral fissure

A

opening of the eye

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25
Q

blepharitis

A

inflamed lid margins

26
Q

entropion vs ectropion

A

entropion: eyelid turned in
ectropion: eyelid turned out

27
Q

conjunctiva… what are the two types?

A

clear mucus membrane which covers the eye

  • bulbar conjunctiva: covers the anterior eye
  • palpebral conjunctiva- lines the eyelids
28
Q

jaundice

A

will see sclera has turned yellow before skin has

“icterus”

29
Q

osteogenesis imiperfecta

A
  • problem with calcium metabolism: will see blue sclera

- its blue b/c calcium gives the white color in the sclera.

30
Q

anisocoria

A

unequal pupils (greater than 0.5 mm)

31
Q

when looking at anterior chamber what do you use?

A

look at iris with oblique lighting - gives better perspective of anterior chamber.
- slit lamp used to look at anterior chamber

32
Q

direct reaction

A

constriction of the same pupil

33
Q

consensual reaction

A

constriction of the opposite pupil

34
Q

accommodation

A

change in pupil and lens for near and far objects
- can see the pupil change looking close and far distance (far distance, pupil opens up wide, close distance, pupil constricts)

35
Q

convergence

A

eyes look inward to focus on a near object

36
Q

PERRLA

A

pupils equal, round, react to light, accommodation.

37
Q

nystagmus

A

fine rhythmic oscillations of the eyes at the extreme lateral gaze

38
Q

6 cardinal dxns. of gaze

A

shows if all extraocc. eye muscles are working (see slide)

39
Q

first landmbark you need to look at is?

A

the optic disc. located 25 degree angle toward the nose. don’t shine light at the macula or fovea, or strait back. blood vessels can be seen entering optic disc

40
Q

how to use opthalmoscope

A
  1. Darken the room.
  2. Turn the lens disc to 0 diopter.
  3. Hold the ophthalmoscope in your right hand to examine the right eye and vice versa.
  4. Brace the scope against your eye and about 15-20 degrees lateral to the patient.
  5. Shine the light into the pupil and find the red reflex.
  6. Place your thumb of your other hand on the patient’s eyebrow, keeping the light focused on the red reflex, move in with the scope maintaining the 10-20 degree angle.
41
Q

how to examine the optic disc and retina

A
  1. Locate the optic disc. It is medial.
  2. Bring the optic disc into sharp focus with the lens diopter adjustment.
  3. Identify the following:
    a. Clarity of the disc margin
    b. Color of the disc
    c. Central physiologic cup
    A small whitish depression within the optic disc.
  • once find cup and disc, look inward, and lastly go to the macula (last, because it is so sensitive to light)
42
Q

blind sport

A

the optic disc

43
Q

bitemporal hemianopsia… think about…..

A

think about pituitary tumor pushing on optic chiasm

44
Q

pinguecula

A

small nodule on the bulbar conjunctiva, does not cross the limbus over the cornea

45
Q

pterygium

A

thickening of the bulbar conjunctiva which grows accross the cornea

46
Q

sty

A

infection at the margin of the eyelid

47
Q

chalazion

A
  • painless nodule involving the Meibomian gland
  • nodule that is seen underneath the lower eyelid
  • may need to be surgically removed
48
Q

xanthelasma

A

flat yellow plaques, found under the eye. associated with hyperlipidemias, no treatment. inestigate lipids and cholesterol.
- seen on the eyelids

49
Q

ptosisd

A

drooping of eye

50
Q

horner’s syndrom

A

ptosis, miosis and anhydrosis - lack of sympathetic innervation

51
Q

bells palsy

A

CN VII lesion, causes drooping of eye

52
Q

graves disease

A

see exopthalamos due to hyperthyroidism

53
Q

conjunctivitis

A

infection or inflammation of the conjunctiva. discomfort and discharge are seen. vessels go from eyelid towards the pupil.

54
Q

subconjunctival hemorrhage

A

blood leaks between the sclera and conjunctiva. see blood under the conjunctiva. painless, sharply demarcated, resolves on its own. does not cross into cornea.

55
Q

see a sunburst of vessels coming out from eye

A
  • corneal injury or infection
  • acute iritis
  • glaucoma
  • ** this is occular emergency
  • inflammation of the radiating vessels around the limbus, very painful, vision affected
56
Q

hyphema

A

blood in anterior chamber due to trauma, seen in iris

57
Q

papilledema

A

when looking at fundoscopic exam - disc is swollen with blurred margins and physiologic cup not visible = increased intracranial pressure

58
Q

gaucomatous cupping

A

increased intraocc. pressure causes increased disc cupping. the physiologic cup is enlarged occupying more than half of the discs diameter. the bowl is enlarged.

59
Q

A-V nicking

A

arterial walls become thickened and lose transparency, atherosclerotic changes. the vv. appear to taper as the artery crosses.

*** indicates hypertensive changes

60
Q

cotton wool patches, coper or silver wiring, A-V nicking

A

indicative of hypertensive retinopathy

PCM II: Test 2 (5 decks)

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