Eye Flashcards
Line between the lateral and medial canthus
Palpebral fissure
Functions of tears include
Protect conjunctiva and cornea from drying
Inhibit microbial growth
Make surface of cornea smooth
Muscle involved in opening the eye lid
Levator palpebrae
The levator palpebrae is controlled by CN #
CN #3
Attached to the lens, pulls on it to change its shape and adjust eye sight
Cilliary muscle
Everything in front of the ciliary body
Anterior chamber
Drains the vitrious humor from the eye
Canal of Schlemm
What is a common problem with canal of schlemm
Common problem in Pts with Glaucoma
Covers the surface of the globe and insides of the eye lids
Conjunctiva
What things are normally seen on a healthy fundus
retina, fovea, macula and optic disc
What #CN controls the lateral rectus
CN #6
What # CN controls the superior oblique
CN #4
What cranial nerve controls all other EOM
CN #3
Both accommodation & light reaction are controlled by what cranial nerves
CN #s 2 & 3
Move light from eye to eye; if you go fast enough both pupils will stay myotic because they won’t have time to react and go back to normal
Swinging flashlight test
Constriction of pupil
Myotic
What vision level is considered legally blind
20/200
Test used to check color blindness
Ishihara cards/test
What is the most common color blindness?
Who is it more common in?
Red-green color blindness
Men > women
Term for most forms of color blindness
Dichromacy
Color blindness is a _______ issue which results in a defect in the _________
Genetic issue
Retinal cones
Normal pupil size is…
3 - 5 mm
Large pupils
Mydriasis (sympathetic)
Irregular/unequal pupils between the 2 eyes
Ansicorcia
Small pupils
Miosis (parasympathetic)
Possible causes or large and small pupils
large = drugs, fight or flight, excitation small = opiods
APD
Afferent pupillary defect
What is the most common cause of APD Marcus Gunn
Optic nerve disease/lesion -> eyes react but don’t accommodate to light
What is APD Argyll Robinson caused by & what does it cause
Syphillis -> eyes accommodate but doesn’t react to light
What is APD CN #3 palsy cuased by & what does it do
DM II -> damage to nerves due to hyperglycemia
What will CN #3 palsy present as
Outward eye d/t tone of CN VI, no direct response, lid lag
Important causes of absent light reflex include
Cataracts
Retinoblastoma
Retinal detachment
What is a retinoblastoma
Congenital eye CA in newborn usually found in newborn exam
Esotropia
Adducted eye
Exotropia
Abducted eye
The corneal reflex (closing the eye) is controlled by what cranial nerve
CN #3
Accommodation, or convergence of the eyes towards the nose to follow the object, is controlled by CN #s
CN #2 & 3
Accommodation is irregular/not intact with what disease/condition
Abnormal with syphilis
Visual field defects are often caused by…
Glaucoma or cranial lesions/abnormalities
Right homonymoushemianopsia due to lesion in the…
L optic tract
Bitemporal hemianopsia due to lesion in the…
Optic Chiasm
Anterior pituitary lesion/tumor often leads to a…
Bitemporal hemianopsia
Can be normal or abnormal; Normal/rhythmical beats of the eye; abnormal may be signs or neurological issue or lesion in the brain
Nystagmus
Normal, abnormal, or both?
Horizontal Nystagmus
Vertical Nystagmus
Horizontal Nystagmus -> may be normal or abnormal; slight while looking laterally is normal
Vertical Nystagmus -> NEVER a normal sign
Lid lag
Ptosis
Ptosis is due to a problem with CN #…
CN #3
Unilateral miosis, anhidrosis (lack of swaeting), ptosis due to lesion that interrupts post-gangionic sympathetic fibers from the Stellate ganglion in the neck or along the carotid is known as…
Horner’s syndrome
Possible cause of Horner’s syndrome is
Pancost tumor
Exversion of the eye lid; more common in elderly; causes excessive tearing
Ectropion
Inversion of the eye lid
Entropion
Red, flacky, itchy, increased production of cebum
Blepharitis
Soft tissues around the eye are affected; often caused by bacteria such as S. aureus; usually treated with a 3rd gen cephalosporin
Periorbital Cellulitis
Pain with EOM movement is usually associated with…
Orbital cellulitis
Swelling around the eyes; consider hypothyroidism, nephrotic syndrome, seasonal allergies
Periorbital Edema
Medical emergency that activates from the trigeminal nerve from a virus that lied dormant; skin lesions on the tip of the nose (Hutchinson sign) can indicate risk of ocular involvement
Herpes Zoster ophthalmicus
Condition due to staph infection of the memolian gland; not threatening/serious in most cases unless left untreated; may be uncomfortable and cause slight pain; common
Hordeolum AKA sty
How do you treat a hordeolum
Tx with warm compress and Abx
Scarring infection; granulomatous inflammation of a meibomian gland that may follow an internal hordeolum
Chalazion
Sign of severe hyperlipidemia
Xanthelasma
Bacterial superinfection of the lacrimal sac due to staph or strep; backing up of the drainage that leads to infection
Dacrocystitis
Type of conjunctivitis; usually unilateral, redness with more yellow/pussy discharge with adenopathy
Bacterial conjunctivitis
Type of conjunctivitis; usually bilateral due to touching of eyes, not as red and less discharge, accompanied by preauricular adenopathy
Viral conjunctivitis
Type of conjunctivitis; less redness, stringy discharge
Allergic conjunctivitis
Painless, no visual disturbance; caused by rupture of small subconjunctival vessles due to cough, sneeze, valsalva, trauma; associated with HTN or coagulopathy if recurrent
Subconjunctival hemorrhage
Medical emergency caused by inflammation of the uvea (iris, choroid, ciliary body); pain with eye movements, photophobia, blurring, myosis, ciliary injection,inflammatory cells and flare on slit lamp observation
Iritis
Acute medical emergency; acute pain, vision loss, steaming cornea, circumlimbal/ciliary injection, dilated pupil, nausea/vomiting
Acute Glaucoma
Most common cause of acute glaucoma
Impeded aqueous outflow through the canal of schlemm
Actual blood in the anterior chamber of the eye
Hyphema
How do you treat hyphema
Immediate drainage of the blood from the chamber
Bulging of the eyeballs
Exophthalmos
Bilateral Exophthalmos is seen in…
Grave’s disease
Unilateral Exophthalmos is seen in…
Tumor, granulomatous disease, trauma
Differences in the size of the pupils
Anisocoria
Dysconjugate gaze; imbalance in ocular muscle tone; causes include hereditary, orbital disease, tumor, CNS infarct or hemorrhage
Stabismus
Harmless age related lesion on bulbar conjunctiva – not associated with vision loss
Associated with sun, wind, dry air exposure
Pinguecula
Thickening of the bulbar conjunctiva that encroaches on the cornea; accommpanied by vision loss; needs to be removed
Pterygium
Copper deposition into cornea
Kayser-Fleischer rings
What disease causes Kayser-Fleischer rings
Wilson’s disease
Wilson’s disease is an ____________ genetic disease leading to ______________
Autosomal recessive; dysfunctional copper transport leads to multisystemically abnormal copper deposition into tissues
Common in elderly Pts; grayish hue around the cornea
Corneal (senile) arcus
Corneal (senile) arcus seen in younger pts could be a sign of…
Hyperlipidemia
No red reflex can be problem due to…
Retinal tear/detachment or retinal blastoma
Area of retina responsible for detailed central vision (i.e reading print), high acuity vision
Macula
Found within the macula; high density of cones (photoreceptors) for high acuity vision
Fovea
On a normal fundoscopic exam the optic cup should be ______ the diameter of the disc
Cup should be ½ the diameter of the disc
On a normal fundoscopic exam arteries should be _________ than the veins
Arteries more transparent than the veins
Area of deeper pigmentation around the optic disc – developmental variation
Choroid crescent
On fundoscopic exam, vein appears to stop abruptly on either side of the artery
AV nicking
AV nicking is commonly seen due to
HTN
Occular hemorrhages are often seen in _______ Pts
HTN
Hemorrhages can be caused by….
Papilledema, retinal vein occlusion, DM
Type of hemorrhages that are more obscure and the in margins
Superficial
Type of hemorrhages that are a little redder and more discrete
Deep
Type of hemorrhage that occurs between the retina and vitreous space
Pre-retinal hemorrhages
What do pre-retinal hemorrhages indicate
Indicates increased ICP which directly impacts the retina and the optic nerve and optic vessels
New vessels that are more torturous, numerous, and fragile
Neovascularity
Neovascularity is commonly seen in…
Commonly see in diabetic retinopathy and may bleed and lead to retinal detachment
White/gray lesions; due to optic nerve infarcts; again seen in HTN and DM Pts
Soft exudates
Similar to soft exudates except more sharp in appearance and creamy or yellow with hard borders; seen in DM and HTN
Hard exudates
Look like hard exudates; May lead to macular degeneration
Drusen bodies
Condition accompanied by neovascularity, AV nicking, and exudates
Diabetic retinopathy
Condition with no neovascularity; hard (and soft) exudates, retinal hemorrhages, and microaneurysms
Hypertensive retinopathy
Engorgement and edema of the optic disc due to elevated ICP
Papilledema
Cherry red spot on fovea goes along with 2 conditions:
If seen in an infant it is…
If seen in others it is…
Infant = taysachs disease Others = central retinal artery occlusion
