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Physical Diagnosis I Exam Two > External Eye > Flashcards

External Eye Flashcards

1
Q

What are the baseline functional tests?

A

Snellen or Sloan eye charts

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2
Q

What do the Snellen or Sloan eye charts directly test? Indirectly?

A

Directly - visual acuity at a distance

Indirectly - Screening of anterior eye segments, central vision, optic nerve, and visual brain centers

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3
Q

What is the specific distance used for the Snellen chart? Sloan?

A

Snellen - 20 feet

Sloan - 10 feet

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4
Q

In regards to eye tests, what does “OD” stand for? “OS”? “OU”?

A 
OD = oculus dextra (right eye)
OS = oculus sinistra (left eye)
OU = oculus uterque (both eyes)
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5
Q

What does it mean if a person’s vision is considered to be 40/20?

A

At 40 feet, he/she can see what most can see at 20 feet (worse than average vision)

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6
Q

What does it mean if a person’s vision is considered to be 10/20?

A

At 10 feet, he/she can see what most can see at 20 feet (better than average vision)

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7
Q

What is hyperopia?

A

Eye has far sight but poor near sight

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8
Q

What term means the eye has near sight but poor far sight?

A

Myopia

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9
Q

What condition arises around the age of 40 years where the lens loses its elasticity and causes diminished near sight but continued far sight?

A

Presbyopia

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10
Q

What is the term for moving marks like sports or smudges seen by the patient in their field of vision usually in those over 50 years of age?

A

Vitreous floaters

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11
Q

When are vitreous floaters an issue?

A

When new ones or flashes of light appear among those that have been there for a long time and remained unchanged

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12
Q

What chart is used to test for near vision?

A

Rosenbaum chart

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13
Q

What is being tested when the doctor is moving a wiggling finger slowly into the patient’s field of vision from the top, bottom, and both sides of each eye while the patient focuses straight ahead?

A

Peripheral vision

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14
Q

What are the anatomical boundaries of the test for peripheral vision?

A

Surround eye anatomy (eyebrow, cheek, nose, and lateral face)

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15
Q

What kinds of general things can cause visual field deficits?

A

1 anterior eye segment abnormalities (scratching, edema, cataracts, pus/blood in fluid, etc.)
2 chronic glaucoma
3 retinal detachments
4 neural lesions

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16
Q

What cranial nerves can be assessed by testing the cardinal planes of gaze?

A

III, IV, VI

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17
Q

What shapes are made in the air with the doctor’s finger during the cardinal planes of gaze?

A

Either a capital H or an asterisk

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18
Q

What is the term for a fatty deposit seen in the eye region?

A

Xanthoma

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19
Q

When xanthomas are present on a patient, what underlying condition can be assumed?

A

Hyperlipidemia

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20
Q

When a patient presents with xanthomas and hyperlipidemia, they are at risk for what other conditions?

A

Stroke and heart disease

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21
Q

What tests are used to check symmetrical alignment of the eyes and therefore binocular vision?

A

1 corneal light reflex

2 cover-uncover test

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22
Q

What is the clinical term for a lazy eye?

A

Amblyopia

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23
Q

What is implied with an asymmetrical reflection seen in the corneal light reflection test?

A

Acquired or congenital muscle imbalance resulting in strabismus

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24
Q

What is implied with movement of either eye during the cover-uncover test?

A

Acquired or congenital muscle imbalance resulting in strabismus

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25
Q

Strabismus can lead to what big issue?

A

Monocular vision (thus affecting depth perception)

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26
Q

What is the term for when the upper eyelid is slow to react as the eye looks down thus exposing the sclera between the lid margin and iris?

A

Lig (lag) retraction

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27
Q

Lid (lag) retraction suggests what overlying condition?

A

Hyperthyroidism (early exopthlamos)

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28
Q

If unilateral lid lag is observed, what could be the cause?

A

1 damage to cranial nerve VII

2 tumor behind the eye

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29
Q

What is the term for an upper eyelid drooping compared to the opposite eye?

A

Lid (sag) ptosis

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30
Q

What is the cause of ptosis?

A

Congenital or acquired weakness of the levator muscle or paresis of a branch of the 3rd cranial nerve

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31
Q

What is the term for inflammation of the eyelash follicles and Meibomian gland resulting in red, swollen, crusty lid margins?

A

Blephaitis

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32
Q

Blephaitis may be associated with what other conditions?

A

Allergies, seborrheic, dermatitis, and psoriasis

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33
Q

What is the term for a bacterial infection of a gland in an eyelash follicle causing a well circumscribed red, swollen and tender pustule?

A

Sty(e) aka hordeolum

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34
Q

What is a chalazion?

A

Hard, painless papule on the eyelid due to an obstruction of a Meibowmian (oil) gland

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35
Q

A chalazion is just like what other kind of growth elsewhere on the body?

A

Sebaceous cyst

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36
Q

What is the term for a loss of muscle tone with aging causing the lower lid to turn OUTWARD interfering with proper tear drainage?

A

ECtropion (turning out)

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37
Q

What muscle is affected with ectropion?

A

Orbicularis oculi

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38
Q

What overlying condition can be another cause of ectropion?

A

Facial nerve palsy (Bell’s palsy)

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39
Q

What is the term for the INVERSION of the lower eyelid allowing the eyelashes to irritate the conjunctive and cornea?

A

ENtropion (turning in)

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40
Q

What is the cause of entropion?

A

Scar tissue formation on the inner surface of the lid

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41
Q

What is dacryocystitis?

A

Inflammation of the tear sac secondary to dacryostenosis

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42
Q

What is dacryostenosis?

A

Chronic obstruction or narrowing of the nasolacrimal duct

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43
Q

What population is usually affected by dacryocystitis?

A

Infants

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44
Q

What is dacryoadenitis?

A

Inflammation of the lacrimal gland

45
Q

What develops with dacryocystitis?

A

Painful, swollen nodule between nose and eye with accompanying tearing and discharge

46
Q

Tears come out of which anatomical structure?

A

Lacrimal punctum

47
Q

When the inside of the eyelid appears pale, what condition can be expected?

A

Anemia

48
Q

What is the term for the mucous membrane that lines the inside of the eyelids and the visible part of the sclera?

A

Conjunctiva

49
Q

What is the clinical term for pink eye?

A

Contagious conjunctivitis

50
Q

What can cause contagious conjunctivitis?

A

Bacteria, virus, or allergies

51
Q

What is unique about the symptoms of contagious conjunctivitis?

A

1 pain is minimal

2 vision is unaffected

52
Q

What is the appearance of blood vessels involved in contagious conjunctivitis?

A

Dilate from periphery to the center of the eye SPARING the area around the cornea (limbus)

53
Q

What is the difference between the symptoms of contagious conjunctivitis and allergic or chemical conjunctivitis?

A

Same signs and symptoms but less thick discharge with allergic/chemical

54
Q

What is the term for a plaque formed from yellow elastic fibers on either side of the cornea?

A

Pinguecula

55
Q

What causes a pinguecula?

A

Chronic irritation to the bulbar conjunctiva

56
Q

What is the term for when growth of a pinguecula is stimulated to form a vascular membrane that extends over the cornea?

A

Pterygium

57
Q

What kinds of things can cause a pterygium?

A

Windy, sunny, or dusty conditions that stimulate the growth of the pinguecula

58
Q

What things can cause a subconjunctival hemorrhage?

A

Sneezing, straining, or coughing

59
Q

Where does the blood get trapped following a subconjunctival hemorrhage?

A

Between the clear mucous membrane and the sclera

60
Q

What is the tough, white outer coat of the eye?

A

Sclera

61
Q

What condition involves uniform yellowing of the sclera?

A

Jaundice

62
Q

Where is jaundice usually seen first?

A

Eyes (natural light reveals it best)

63
Q

What substance has been known to produce harmless yellowing of the sclera in dark-complected people?

A

Antimalarial drugs

64
Q

Blue sclera is indicative of what condition?

A

Osteogenesis imperfecta

65
Q

Why is a blue sclera associated with osteogenesis imperfect?

A

Sclera thins allowing the choroid to show through as blue

66
Q

When do we seen brown sclera, and what is it?

A

Common in people with dark complexions; occur due to patches of melanin

67
Q

The cornea is a transparent extension of what structure?

A

Sclera

68
Q

Following a corneal abrasion, the vessels dilate and radiate outward from around what structure?

A

Limbus (edge of the cornea)

69
Q

What does it mean when a corneal arcus/ring is seen in a patient?

A

Above 60 years old: clinically insignificant

Under 40 years old: indicative of hyperlipidemia

70
Q

What is the term for the golden-brown band seen around the limbus of the cornea in a patient with Wilson’s disease?

A

Kayser-Fleischer ring

71
Q

What is Wilson’s disease?

A

Inherited disease where copper accumulates in the liver and throughout the body resulting in neurologic symptoms

72
Q

Iritis can be secondary to what condition?

A

Ankylosing spondylitis

73
Q

Which is more painful: conjunctivitis or iritis?

A

Iritis

74
Q

What are the signs and symptoms of iritis?

A

1 perilimbal and conjunctival injection
2 red, teary eyes with constricted and slow pupil
3 significant pain
4 decreased visual acuity

75
Q

Is visual acuity decreased with conjunctivitis?

A

NO; vision is unaffected

76
Q

What does PERRLA stand for in regards to the pupil?

A 
Pupils (should be)
Equal
Round (and)
Reactive (to)
Light (and)
Accommodation
77
Q

What is the expected response from the direct light reflex?

A

Pupil (one having light shined into it) should constrict briskly

78
Q

What is a sluggish or no response to the direct light reflex indicative of?

A

Problem along neural path from sensory receptor through C.N. II to brain center and back through C.N. III to the circular iris muscles

79
Q

What is the expected response from the consensual (indirect) light reflex?

A

Contralateral pupil should constrict briskly

80
Q

What does a sluggish or absent response to the consensual (indirect) light reflex indicate?

A

Problem along neural reflex path

81
Q

During which test is constriction seen at a greater level: direct or indirect light reflex?

A

Direct

82
Q

According to the accommodation reflex, what happens to the eyes?

A

Constriction and convergence as object moves from distant to near point

83
Q

What kinds of general things can cause the pupils to constrict or dilate?

A

1 brain injury
2 prescription
3 illegal drug use

84
Q

Which two pupil condition discussed are bilateral findings?

A

1 coloboma

2 argyll robertson pupil

85
Q

What is the clinical term for inequality of pupil size?

A

Anisocoria

86
Q

What is the clinical term for congenital anisocoria?

A

Physiologic anisocoria

87
Q

What can cause anisocoria?

A

Congenital, head trauma, nervous system diseases

88
Q

What condition involves a fixed dilated pupil with poor response to the pupillary reflexes?

A

Adie’s tonic pupil

89
Q

What condition involves a failure of the iris to close during fetal development resulting in a keyhole-shaped pupil?

A

Coloboma

90
Q

What condition involves an irregularly shaped pupil due to an adhesion of part of the iris to the cornea in front of it or the lens behind it?

A

Synechia

91
Q

What conditions is synechia secondary to?

A

Trauma, surgery, cataracts, glaucoma, iritis, etc.

92
Q

What is the result of synechia?

A

Flow of aqueous fluid blocked and may lead to acute glaucoma and potential blindness

93
Q

Argyll Robertson pupil can be caused from a CNS defect from what overlying disease?

A

Syphilis

94
Q

What is the condition where there is decreased or absent response to the light reflexes yet the pupils respond to accommodation?

A

Argyll Robertson pupil

95
Q

What four things can cause red eyes?

A

1 conjunctivitis
2 corneal abrasion
3 iritis
4 acute glaucoma

96
Q

What causes Horner syndrome?

A

Interruption of sympathetic nerve supply to the eye

97
Q

What are the results of Horner syndrome?

A 
1 miosis (constricted pupil)
2 ptosis
98
Q

What conditions can cause cervical sympathetic trunk damage that is associated with Horner syndrome?

A

Mediastinal tumors, bronchogenic or metastatic cancer

99
Q

Pancoast tumors are associated with which eye condition?

A

Horner syndrome

100
Q

People with a shallow anterior chamber are prone to which eye condition?

A

Acute glaucoma

101
Q

What structure in acute glaucoma becomes blocked and allows aqueous fluid to build up rapidly in the eye produces severe eye pain, blurred vision, corneal edema, conjunctival and perilimbal injection, and a fixed dilated pupil?

A

Canal of Schlemm

102
Q

In pressure in the eye following acute glaucoma is not reduced, how long does it take blindness to occur?

A

2-5 days only

103
Q

What is the most common form of glaucoma?

A

Chronic

104
Q

Which has more abrupt and dramatic signs: acute or chronic glaucoma?

A

Acute

105
Q

What kinds of tools are used by the optometrist and ophthalmologist to routinely assess people at risk of glaucoma?

A

“Puff test”, tonometry, and perimetry

106
Q

What kind of vessel injection is seen with conjunctivitis that differentiates it from other conditions?

A

Vessels radiate from periphery toward limbus of the corner but don’t directly touch the limbus

107
Q

In which condition is the burning/itching relatively mild: iritis, conjunctivitis, or corneal abrasion?

A

Conjunctivitis

108
Q

What kind of vessel injection is seen with corneal abrasions and iritis?

A

Perilimbal (aka circumcorneal/ciliary)

109
Q

What kind of eye condition presents with BOTH conjunctival and perilimbal injection?

A

Acute glaucoma

Physical Diagnosis I Exam Two (2 decks)

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