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EENT > Eye > Flashcards

Eye Flashcards

1
Q

Flow of Aqueous Humor

A

Ciliary body->Post Chamber->Ant Chamber->Canal of Schlemm

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2
Q

Sensory Innervation of the Eyes

A

CN II, II, IV, VI

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3
Q

Blepharitis

A

-Inflammation of the eyelid (Meibomian gland)
-Leads to: excess tears, flaking, crusting, redness
-Most often occurs in people with rosacea, seborrheic dermatitis…

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4
Q

A patient with blepharitis often awakens with:

A

Crusty, dried mucus in the corner of their eyes

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5
Q

Treatment of blepharitis

A

Moisten a washcloth or cotton-tipped applicator and gently clean lids and lashes

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6
Q

Ectropion

A

Lower eyelid turns outward, and doesn’t completely touch/cover the eye
-Mostly in the elderly or secondary to scars

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7
Q

Ectropion treatment

A

If mild, artificial tears or lubricating ointment will work
-If worse, surgery to reposition lower eyelid

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8
Q

Entropion

A

Eyelid and eyelashed turn inward towards eye, causing the lashes to rub against cornea and conjunctiva

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9
Q

Entropion treatment

A

Soothing eyedrops/artificial tears
-Tape applied to eyelid to pull it down towards the cheek underneath
-Surgery to tighten up the lid

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10
Q

Stye

A

Painful, tender, red, pus-filled infection of the glands
-Often secondary to blepharitis
-Looks like a pimple or boil pointing on lid margin

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11
Q

Stye Treatment

A

Don’t squeeze the stye
-As soon as the stye begins to form, apply clean, warm washcloth compress several times/day until the stye opens

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12
Q

Chalazion

A

Swelling in the eyelid caused by blockage of one of the glands that lubricate the eye
-Larger and less painful than styes

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13
Q

Chalazion: Treatment

A

Small ones go away on their own
-Can speed up process by applying warm water compress 2-4x/day for 5-20 minutes
-If large, or it fails to go away: antibiotics

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14
Q

Xanthelasmas

A

Slightly raised, yellowish, well-circumscribed plaques on the nasal portion of both eyelids
-May accompany lipid disorders as well as diabetes and obesity
-No Treatment necessary

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15
Q

Xanthelasma Treatment

A

None, unless for cosmetic reasons through surgery

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16
Q

Papillomas and Cysts

A

-Papillomas: Slow-growing, fleshy, non-cancerous bumps that are pink or skin-colored
-Cysts: Fluid-filled, almost always non-cancerous, often indistinguishable from chalazion or stye

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17
Q

Ptosis of the eyelid

A

Drooping of the upper eyelid

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18
Q

Trichiasis

A

Inward growth of eye lashes

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19
Q

Trichinosis

A

Roundworm infection that can cause chronic lid edema

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20
Q

Exophthalamos

A

Forward bulging of the eyeballs
-Eye feels dry, gritty due to air exposure

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21
Q

MC cause of Exopthalamos

A

Hyperthyroidism (Grave’s Disease)

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22
Q

Lid lag sign

A

When patient looks down after looking up, lid is slow to move down

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23
Q

Treatment of Exopthalamos

A

Depends on cause:
-Grave’s Disease: Radioactive iodine kills thyroid
-Eyelid surgery

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24
Q

Conjunctivitis

A

Inflammation of the conjunctiva (pink eye)
-Produces yellow or green discharge

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25
Q

How is conjunctivitie commonly caused

A

Bacterial infection (highly contagious)
-Can also be caused by viral infection (highly contagious)
-Can also be caused by allergies (itching)

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26
Q

Treatment of Conjunctivitis

A

-Bacterial: Clean eyelids, antibiotic drops, launder washcloths, keep hands away from eyes
-Viral: Warm compress
-Allergic: Avoid allergens

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27
Q

Subconjunctival Hemorrhage

A

-Leakage of blood b/w conjunctiva and sclera
-Alarming bight red patch in eye-like a “puddle of blood”
-Rarely serious
-Very common: Coughing, sneezing
-See opthamologist if there is pain

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28
Q

Corneal Abrasions, cuts, ulcers

A

-Can blur vision
-May not see without special dye (fluorescein)

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29
Q

Foreign Bodies in Cornea may be difficult to see w/o:

A

Fluorescein dye

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30
Q

How to remove foreign bodies in cornea

A
  1. Removal by irrigation
  2. Hypodermic needle
  3. Surgery
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31
Q

Treatment of Corneal Abrasions, Cuts, and Ulcers

A

-Small Abrasions: Avoid rubbing, they will heal on their own
-Large abrasions: Leave in place; Refer to opthamologist

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32
Q

Scleritis & Episcleritis

A

-Scleritis: Inflammation of sclera (uncommon/30-60 years of age), may cause aching pain, blurred vision

-Episcleritis: Mild inflammation of the episclera (young adults), is rarely harmful

-BOTH: Violet red-patch or small bump on the white of the eye

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33
Q

Blocked nasolacrimal duct is called:

A

Dacryostenosis

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34
Q

Dacryocystitis

A

Infection of the lacrimal sac

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35
Q

Dry eyes is also known as:

A

Ketatoconjunctivitis sicca

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36
Q

What is the most significant cause of dry eyes

A

Aging

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37
Q

Dry eyes, mouth and mucus membranes + RA

A

Sjogren’s syndrome

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38
Q

Treatment of Dry Eyes

A

Tear conservation: Punctal plugs
-Anti-Inflammatory medications: Restasis

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39
Q

Pinguecula

A
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40
Q

Pinguecula

A

-A raised yellowish white mass on the bulbar conjunctiva
-Adjacent to the cornea at 3 and or 9-o’clock position
-Does NOT need to be removed
-Used eye protection to prevent pinguecula from progressing to pterygium

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41
Q

Pterygium

A

Fleshy, triangular growth of bulbar conjunctiva onto cornea at 3 or 9’o clock
-May spread across and distort cornea, causing astigmatism and blurring
-Surgical removal may be necessary

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42
Q

Internal Eye Conditions

A
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43
Q

MC cause of blurred vision

A

Refraction (Focusing) Problems

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44
Q

The _____ does most of the refraction of incoming light

A

Cornea

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45
Q

The _____ fine-tunes focus by changing in thickness

A

Lens

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46
Q

Perfect vision depends on:

A
  1. Perfect eyeball length: Cornea to retina
  2. Cornea bends light coming into the eye
  3. Lens tweaks the focus of the light
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47
Q

Myopia

A

“Nearsightedness”
-Objects in the distance are blurred
-Due to the eyeball being too long: front to back
-Tends to be familial

48
Q

Treatment of Myopia

A

-Corrective lenses
-Bates Exercises
-Orthokeratology (“Ortho-K”)
-Refractive surgery

49
Q

Non-surgical treatments for refraction problems

A

Bates method, glasses, contact lenses, Ortho-K

50
Q

Surgical treatment for refraction problems

A

-RK, PRK, LASIK
-Intrasorneal rings
-Implantable Intra-Ocular lenses
-Clear Lens Replacement (CLR)

51
Q

Bates method

A

Uses eye focussing exercises to attempt correction

52
Q

Orthokeratology

A

Short-term corneal re-shaping using contacts worn at night
-Effects last for a day or two
-Especially helpful in sports

53
Q

Radial Keratotomy (RK)

A

-A tiny knife makes multiple cuts into the cornea
-The worse the nearsightedness, the more cuts are needed

54
Q

Complications of RK

A

-Fluctuating vision (over first few months), -Unpredictable hearing
-Weakened cornea more prone to rupture if hit correctly
-Difficulty fitting/wearing contact lenses
-Glare or haze around lights

55
Q

Photorefractive Keratectomy (PRK)

A

Uses a laser beam to reshape the curve of the cornea

56
Q

LASIK

A

-A more recent version of PRK
-Cornea is sliced from the side; laser beam then reshapes the tissue of the inner layer of the cornea

57
Q

Hyperopia

A

“Farsightedness”
-Far objects are seen more clearly
-Eyeball is shorter than normal front to back
-Eye strain or headache may occur when reading for a long time

58
Q

People with hyperopia are at a greater risk of:

A

Closed-angle glaucoma

59
Q

Astigmatism

A

Blurred or distorted vision due to irregularities in shape of cornea or lens (9/10 times its the cornea)

60
Q

Presbyopia

A

Caused by age-relating stiffening of the lens
-Starts in early 40s and eventually affects everyone
-Main symptom is farsightedness

61
Q

Earliest sign of presbyopia

A

Need to hold reading material at arm’s length

62
Q

Treatment of presbyopia

A

People w/ perfect vision/far-sighted: Reading glasses
-Near-sighted: Bifocals/trifocals, take glasses off when reading, can’t read with contacts well

63
Q

Normal cup: disc ratio

A

<.5 the size
-Disc should always be bigger than the cup

64
Q

A large optic cup can be a possible sign of:

A

Increased pressure, such as in glaucoma

65
Q

A crescent is typically:

A

No big deal

66
Q

Cataracts

A

Gradual clouding of the normal transparent lens, usually due to aging
-Proteins in the lens begin to clump together

67
Q

Cataracts can be accelerated by:

A

Certain medications, DM, Alchoholism, smoking, long-term exposure to sun, Deficiency in anti-oxidants

68
Q

Cataracts are caused by cancer

A

False

69
Q

Inspection of Cataracts

A

-Opthalamoscopic exam: Notice decreased red reflex
-Direct inspection: See a cloudy whiteness when you look through the pupil

70
Q

Diagnosis of Cataracts (History)

A

-Decreased vision
-Blurring
-Bothered by glare when light is bright (snow)
-Difficulty driving at night

71
Q

Diagnosis of Cataracts (Exam)

A

Evaluate visual acuity with Snellen Eye Chart
-Opthalmascope: Check for whiteness in pupil area and/or interrupted red reflex
(Eye doctor would make final diagnosis)

72
Q

Treatment of Cataracts

A

Surgical extraction is the only effective cure
-Lens is removed, replaced with plastic lens implant
-If both eyes have cataracts, the worse one is done first

73
Q

Doctor may recommend cataract removal earlier if patient has:

A

Diabetes mellitus or retinal detachment

74
Q

Recent research indicated that _____may decrease risk of cataract

A

Daily multivitamin

75
Q

Treatment of cataracts: Process

A

-Incision made near the edge of the cornea
-Phacoemulsification: High frequency ultrasound waves are used to emulsify lens to be vacuumed out
-Insertion of new lens

76
Q

Diabetic Retinopathy

A

Deterioration of blood vessels of retina in people w/ DM
-Can progress to advanced stage without symptoms
(Requires regular fundus exam)
-Chiropractors can screen for vision problems: Check visual acuity and central vision fields

77
Q

Diabetic Retinopathy: Proliferative vs. Non-proliferative

A

-Non-proliferative form: BV are narrow, blocked, deteriorating, sometimes hemorraging/ Tiny yellow exudates form on the retina
-Proliferative form: Fragile new vessels form and grow over retina; Scar tissue may be generated pulling on the retina

78
Q

Treatment of Diabetic Retinopathy

A

-Focus: Controlling diabetes-encourage exercise, weight loss, stress reduction, healthy diet, antioxidant supplements
-Control blood pressure
-Laser surgery (photocoagulation)
-Cryotherapy (freezing): To shrink new vessels

79
Q

Amblyopia

A

Partial or complete loss of vision

80
Q

What is the most common cause of monocular blindness

A

Amblyopia

81
Q

Causes of amblyopia

A
  1. Strabismus: crossed eyes or wall-eye (Lazy eye)
    -Weak muscles in one eye/brain only pays attention to strong eye
  2. *Anisometropia: Eyes have unequal refractive power
    -Poorer vision in one eye
82
Q

Diagnosis of Strabismus/Lazy Eye

A

-Check for asymmetry of visual acuity (anisometropia)
-Check eye alignment: Shining pen light and looking to see if pupils are asymmetrical
-Cover/Uncover Test: Cover one eye and see if the patient can follow finger with uncovered eye

83
Q

Treatment of Lazy Eye

A

-Eyeglasses that make the weaker eye work harder
-Patching the stronger eye to make weaker eye work harder
-Surgical correction
-All treatments are most effective if done when the child is very young

84
Q

Strabismus vs. Amblyopia

A

-Strabismus/lazy eye: What you see looking at patient
-Amblyopia: What the patient sees, with loss of vision due to untreated strabismus or anisometropia

85
Q

Papilledema

A

Increased intracranial pressure can push the optic disc out and blur margins
-Almost always bilateral
-Refer for MRI or CT to start determining cause

86
Q

Corneal Arcus (Arcus Senilis)

A

A light colored ring seen at the periphery of the cornea due to lipid infiltration
-Normal in older patients, but should be evaluated in young people

87
Q

Anisocoria

A

Unequal Pupil Size

88
Q

Assessment of Anisocoria

A

PERRLA

89
Q

> 1mm Anisocoria could indicate:

A

Horner’s syndrome, closed glaucoma, Adie’s syndrome, aneurysm, MS, drugs

90
Q

2nd most common cause of blindness in the US

A

Glaucoma

91
Q

Glaucoma can be caused by blocked outflow of:

A

Aqueous humor; increases internal eye pressure

92
Q

Types of glaucoma

A

Open angle (chronic): 80%
Closed angle (acute): 20%

93
Q

Responsibilities of the aqueous humor

A

-Continuously produced by ciliary body
-Circulates between anterior/posterior chambers
-Nourishes the lens and cornea
-Maintains appropriate pressure within the eyeball
-Drains into the angle in the front of the iris, though trabecular meshwork (reticulum) and then through the Canal of Schlemm

94
Q

Retinal changes in glaucoma

A

Physiologic cup gets bigger, deeper
-Cup to disc ratio >0.5

95
Q

Open-angle glaucoma

A

60-90% of cases (mostly older population)
-Gets worse over time, but with few or no symptoms

96
Q

Open angle glaucoma: Diagnosis

A

-MC type of glaucoma
-No symptoms in most patients
-Screen for pressure: Tonometry is done by eye doctor (normal pressure: <20mm Hg)
-Opthalmoscopy revels cup; disc ratio > 0.5
-Exam reveals loss of peripheral vision

97
Q

Treatment of Open-angle Glaucoma

A

-Topical medications: eye drops
-Oral medications
-Surgery: Laser trabeculoplasty
-Trabeculectomy may be required

98
Q

Closed Angle Glaucoma

A

AKA Acute or Narrow-angle glaucoma
-Develops quickly
-Pressure causes pain, blurred vision, rainbow halos around lights, headache
-An emergency!

99
Q

Closed-angle Treatment

A

Iridectomy

100
Q

Leading cause of vision loss in people >60

A

Macular degeneration

101
Q

Macular degeneration

A

Gradual development of blurred central vision, difficulty reading, and blind spots in central area of vision (peripheral vision is retained)

102
Q

Risk factors of macular degeneration

A

-AGE: greatest risk factor
-Family history
-Cardiovascular risk
-Exposure to UV light
-Light-colored eyes/lighter skin

103
Q

Dry Macular Degeneration

A

-MC Type
-Tissues of retina thicken and cells decay
-Yellow deposits (drusen) form on retina

104
Q

Wet Macular Degeneration

A

-Less common but more severe
-Progresses faster
-Abnormal new blood vessels that leak blood and fluids
-Distorted vision: Straight lines appear wavy, shapes look deformed

105
Q

Diagnosis of Macular Degeneration

A

-Snellen Chart: Decreased visual acuity
-Amsler grid: Blurred or wavy lines
-Color testing: Decreased color vision
-Fundoscopic exam: Drusen bodies, hemorrhage in the macular area
-Visual field exam: Central field defects

106
Q

Managing Macular Degeneration

A

-Nutrition: Vitamin C, Vitamin E, Betacarotene, Zinc, Copper, Lutein
-Diet: Dark leafy green vegetables, fish, red grapes, oranges, cantaloupe, peppers, almonds
-Lifestyle: Exercise, stop smoking, lose weight, control hypertension

107
Q

TX of MD (Dry/Wet)

A

Dry MD: None; nutrition may help slow symptoms

Wet MD: Laser surgery, photodynamic therapy, injections (VEGF)

All patients: Stop smoking, eat right, manage BP

108
Q

Retinal Detachment: Signs/Symptoms

A

-Sensation of flashing lights
-Many floaters in field of vision
-Blurred vision
-Shadow or part of field of vision

109
Q

In RD, the Retina detaches from the ______

A

Choroid

110
Q

Rhegmatogenous (Primary) Retinal Detachment

A

-MC type of retinal detachment
-Almost always leads to blindness unless it is surgically repaired

111
Q

Risks of primary retinal detachment

A

Being near sighted, family history of retinal detachment, previous eye injury, serious eye injury, age

112
Q

Secondary types of retinal detachment

A

-Exudates/fluid accomodates behind retina without a tear or hole
-Inflammatory disease in posterior eye
-Tumor in posterior eye

113
Q

Treatment of Retinal Tear or hole

A

-Photocoagulation: Laser beam is directed around the defect, forming a scar that holds retina to choroid
-Cryopexy: Uses intense cold to freeze the area around defect, causing a scar that holds retina to choroid

114
Q

Treatment of Retinal Detachment

A
  1. Laser and cryopexy photocoagulation
  2. Pneumatic retinopexy: After freezing, injects bubble of gas into vitreous cavity, reattaches
  3. Scleral buckling: Use cryopexy first then a piece of silicone is sutured to the sclera
  4. Vitrectomy: Bloody or cloudy vitreous is removed
115
Q

Shingles

A

Herpes Zoster in Opthalamic Branch of CN 5
-Refer to doctor immediately!

EENT (7 decks)

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