Eye Flashcards
what sport is the leading cause of eye injury in the US?
basketball
what proportion of the population may have physiologic anisocoria?
20%
t/f history of cataract or refractive surgery weakens the outer wall of the eye
true
a child is considered functionally one eyed if their vision is worse than what?
20/40
what are the only sports that are absolutely contraindicated for a functionally one eye athlete?
boxing and full contact MMA
what is the single most important physical exam feature in evaluation of the eye?
visual acuity testing
which cranial nerve is responsible for the afferent and efferent pupil response, respectively?
afferent - CN2
efferent - CN3
what is Marcus Gunn pupil?
shining light to the affected pupil causes a paradoxical dilation but the contralateral pupil constricts
explain how to assess the anterior chamber of the eye?
shine light from temporal portion towards medial portion
when evaluating the anterior chamber with a lateral light, you see increased medial shadowing. what might this signify?
narrow anterior chamber
when assessing the anterior chamber, you note a layer of blood forming at the 6 o clock position. what does this signify?
hyphema
t/f suspected acute angle glaucoma is a contraindication to pupillary dilation
true
decreased sensation or numbness along which trigeminal nerve branch can accompany orbital floor fractures?
v2
what topical anesthetic agent can be used for analgesia prior to fluoroscein exam?
proparacaine
explain how to conduct a fluorescein exam
numb with proparacaine, then wet a fluorescein strip with sterile water and touch to the inferior cul de sac, without brushing the cornea. Then use a wood’s lamp to evaluate
what is a normal IOP?
10-21mmHg
in the case of corneal abrasion, when will there be decreased visual acuity?
if abrasion occurs over the central aspect
t/f erythromycin or gentamicin ointment has better lubricating properties compared to drops and are considered first line if antibiotics are used for contaminated corneal abrasion
true
in the case of corneal abrasion in the setting of contact lens wearer, what is the recommended topical antibiotic class?
fluoroquinolone
an ophthalmologist should see a patient who wears contact lenses and sustained a corneal abrasion within how many hours?
24 hours
contact lenses should be discontinued for how long after corneal abrasion?
complete healing has occurred and antibiotics are finished
which topical medication could be used for corneal abrasion symptomatic pain relief to allow a patient to return to play the same day and used for up to 24 hours?
topical tetracaine
t/f patching is recommended for treatment of corneal abrasion
false
most uncomplicated corneal abrasions heal within what time frame?
24-72 hours
a positive Seidel test will result in fluorescein turning what color under blue light?
bright green
t/f cotton tip applicators are appropriate to use to attempt to remove corneal foreign bodies
false
what is the most common sports related eye injury?
blunt trauma to the globe
for a ruptured globe, what should be placed over the eye?
rigid shield
t/f avoid ointments and other topical agents in the case of acute globe rupture
true
explain why restricted upward gaze occurs with orbital floor fractures
inferior rectus muscle entrapment
which nerve root runs through the orbital floor/maxillary sinus roof?
v2 of trigeminal
in an orbital floor fracture, why might there be a lowered globe level on the affected side?
prolapse of large volume of soft tissue into the maxillary sinus
what percentage of hyphema cases will have a comorbid eye injury?
25%
t/f hyphema should warrant immediate referral to specialist
true
how long should bed rest and light activity last after hyphema, respectively?
best rest x 4 days
light activity x 2 weeks
what medication class should be avoided in hyphema?
nsaids
for at least how long after initial cause of hyphema should atropine be used twice daily?
2 weeks
what is the usual duration of uncomplicated hyphema?
5-6 days
what is the major risk of recurrent bleeding in cases of hyphema?
permanent visual acuity loss
t/f retinal detachment produces immediate vision loss
true
why should IOP be measured in the case of lens dislocation?
lens dislocation can lead to secondary glaucoma
with glaucoma, where does visual loss start?
periphery of the visual field
which eye injury is characterized by sudden increase in anterior chamber pressure from blunt trauma to the globe that is transmitted to the lens-iris diaphragm and propelling it backward?
chamber angle recession
what is the primary difference between lens dislocation and chamber angle recession?
in chamber angle recession, the lens position will be normal
chamber angle recession usually requires what treatment?
surgery
