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CSS PA Fun Med > Eye > Flashcards

Eye Flashcards

1
Q

Dacrocystitis

Presentation

A

Pain, Swelling, Redness in tear sac area

Usually unilateral

PURULENT (bacterial) discharge may be expressed

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2
Q

Conjunctivitis

A

**The MOST COMMON Eye DISEASE!!**

Inflammation of the conjunctiva

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3
Q

Hordeolum Tx

A

Warm compresses, sometimes incision or drug therapy

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4
Q

Bacterial Conjunctivitis

Tx

A

Clears in 10-14 days w/o tx, but must be isolated to prevents spreading to others

Topical Sulfa or oral ABX will clear in 2-3 days

**If lots of discharge, CULTURE to RULE OUT GYNOCOCCAL conjunctivitis

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5
Q

Gynococcal Conjunctivitis

  • Presentation*
  • Tx*
A

**COPIUS DISCHARGE**

EMERGENCY - may be corneal involvement

Treat Chlamydia + STD Screen

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6
Q

Where?

Internal Hordeolum

A

sty @ Meibomian gland

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7
Q

Lacrimal glands

A

Tear production, removes foreign matter and keeps eye moist

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8
Q

Chronic Blepharitis

Etiology

A

noninfectious, idiopathic inflammation

occurs often with - rosacea, recurrent hordeola/chalazia, ACNE

**SECONDARY DRY EYE**

(aka keratoconjunctivitis sicca)

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9
Q

Bacterial Conjunctivitis

Presentation

A

PURULENT/yellow discharge, - eyes stuck together

mild discomfort

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10
Q

Acute, ulcerative blepharitis often secondary to ….

A

staph or herpes viral infection

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11
Q

DRY EYES

Tx

A

Artificial tears

Lacrimal punctal occlusion (prevent drainage)

(Keratoconjunctivitis Sicca)

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12
Q

Where does light get converted to electrical signals

A

Outer portion of retina - rods (b/w) and cones (color)

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13
Q

Entropion

Tx

A

Refer

Surgery

-OR-

Botox for temp fix (especially for older person)

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14
Q

Presbyopia

A

Loss of accommodation for near vision

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15
Q

Blepharitis

A

Inflammation of the eyelid margins

Acute (ulcerative v nonulcerative)

vs

Chronic

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16
Q

Ectropion

Etiology

A

Age related

CN VII Palsy

Post Trauma Changes

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17
Q

“DRY EYES”

A

Keratoconjunctivitis sicca

Inadequate tear production or excess evaporation

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18
Q

Viral Conjunctivitis

Tx

A

COLD Compress

Sulfa drops to prevent secondary bacterial infection

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19
Q

Where does the outer retina get its blood supply (rods/cones)?

A

Choroid (not the retinal artery!)

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20
Q

Hordeolum Epidemiology

A

More common in children and teens

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21
Q

Chronic blepharitis

Presentation

A

Greasy scales at base of lashes

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22
Q

Pterygium

A

Encroachment of the conjunctiva onto the nasal side fo the cornea

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23
Q

Blood supply for much of the eye

A

Central retinal artery

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24
Q

Gynococcal conjunctivitis

Tx

A

EMERGENCY!! - corneal involvement may lead to rapid perforations

Treat possible Chlamydial Infection + do STD Screening

Uncommon in rural medicine

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25
Q

Chalazion presentation

A

hard, nontender swelling (eyelid redness, pain initially)

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26
Q

Hordeolum Pathophysiology

A

Arises from blocked sebaceous gland

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27
Q

Chalazion

A

COMMON granulomatous (full of immune cells) inflammation of meibomian gland;

may follow internal Hordeolum; noninfectious

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28
Q

Hordeolum Presentation

A

Eyelid redness, swelling, pain, tearing, photophobia, foreign body sensation

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29
Q

Keratoconjunctivitis sicca

Etiology

A

Sjogren’s syndroms, RA, SLE

Result of conditions that scar tear ducts

Affects 50% of older women

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30
Q

Viral Conjunctivitis

Presentation

A

WATERY DISCHARGE, foreign body sensation, bilateral

MOST COMMON FORM OF CONJUNCTIVITIS

Usually Adenovirus

usually d/t direct contact transmission

very contagious

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31
Q

Hordeolum

A

common “sty” - localized infection

(staph abcess) or inflammation

of the eyelid margin involving hair follicles of the eyelashes (ie, external hordeolum) or

meibomian gland (ie internal hordeolum)

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32
Q

HSV (Herpes Simplex Virus) Conjunctivitis

  • Differential diagnosis*
  • Tx*
A

UNILATERAL and with lid vesicles

Antivirals - topical or systemic

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33
Q

Acute, nonulcerative blepharitis

Presentation

A

Itchy RASH (normally ALLERGIC reaction)

Swollen “edematous”, red “erythmatous”

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34
Q

Pinguecula

A

Benign, yellow, elevated, nodular growth on the conjunctiva

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35
Q

Where?

External Hordeolum

A

sty @ Eyelid margin involving hair follicles of the eyelashes

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36
Q

Ectropion

A

Outward turning of the eyelid

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37
Q

Myopia

A

NEARSIGHTEDNESS - born with long eyeball; image comes into focus in front of the retina; wear concave lenses to decrease refractive power and lengthen the focal distance

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38
Q

Emmetropia

A

Normal vision

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39
Q

Hyperopia

A

FARSIGHTEDNESS - born with short eyeball; image comes into focus behind the retina; wear convex lenses to increase refractive power and shorten the focal distance

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40
Q

Blepharitis

Tx

A

Warm compresses, clean eyelids

Acute, ulcerative - abx

Acute, nonulcerative - topical corticosteroid

Chronic - ? (noninfectious)

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41
Q

Acute, ulcerative blepharitis

Presentation

A

Bacterial - CRUSTY (lashes “glued shut”), pustules may develop

Viral - Clear

Redness of lid

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42
Q

Astigmatism

A

Curvature of the cornea is uneven

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43
Q

Hordeolum Diagnosis

A

Clinical, Distinguish from chalazion

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44
Q

Ectropion

Tx

A

Eye drops

Surgery to correct

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45
Q

Entropion

Etiology

A

Age (lid fascia degenerates)

-OR-

Post Trauma/Infection scarring

46
Q

Entropion

A

Inward turning of the eyelid,

Eyelashes rubbing cornea

47
Q

General drug class to decrease inflammation/ decreasing activity of the immune system

A

Corticosteroids

48
Q

Allergic Conjunctivitis

Presentation/Diagnosis

A

Itchy, watery eyes

Acute, intermittent or chronic

Seasonal/Perennial

Vernal - spring to fall more common in males

Clinical diagnosis - timing

49
Q

Dacrocystitis

A

Infection of the Lacrimal Sac

d/t congenital or acquired obstruction

50
Q

Most common cause of infectious cause of blindness worldwide

A

Trachoma (eye disease) due to Chlamydia keratoconjunctivitis

51
Q

Chalazion tx

A

Warm compresses;

(alternatively incision an curettage, corticosteroids)

52
Q

Corneal Ulcer

Etiology

A

an open sore to the cornea

associated with contact lens usea, eye trauma, eyelid abnormalities

53
Q

Corneal ulcer

Tx

A

Refer EMERGENTLY

54
Q

Corneal ulcer

most often due to …

A

Infection - Bacterial, viral, fungal, amoebas

Also noninfectious causes - neutrophic, exposure, dry eye, allergic eye disease, other inflammatory

55
Q

Corneal ulcer

  • Symptoms*
  • Exam Findings*
A

Pain, Photophobia, Tearing, Reduced vision

Red eye with predominantly cicumcorneal injection, may be purulent or watery discharge

56
Q

Infectious Keratitis

A

Corneal (keratin) Inflammation

caused by bacteria, virus, fungus, parasites

57
Q

Infectious keratitis may precede

A

Corneal ulcer..

58
Q

Infectious keratitis

Risk Factors

A

Contact lens use, corneal trauma

59
Q

Infectious keratitis often shows

Hypopyon, which are..

A

inflammatory cells in the anterior chamber

60
Q

Most common cause of infectious blindness in the western world

A

Herpes Simplex Keratitis

61
Q

Herpes Simplex Keratitis

Symptoms

A

**Dendritic branching

62
Q

Fungal Keratitis

Etiology

A

Occurrance after corneal injury involving contact with plants - gardening/agriculture

Contact lens wearers - high risk

63
Q

Fungal Keratitis

  • Exam*
  • Tx*
A

Multiple stromal abcesses

Refer for Culture, treat with antifungals

64
Q

Herpes Zoster Opthalmicus

Symptoms

A

**MALAISE, FEVER, HEADACHE

+

*Vesicular RASH becoming pustular, then crusting

(if involvement of tip of nose or lid margins

  • concern for eye involvement)
65
Q

Herpes Zoster Opthalmicus

Risk Factor

A

**HIV infection

66
Q

Herpes Zoster Opthalmicus

A

Refer EMERGENTLY -

Trigeminal nerve involvement

Antivirals if within 72 hours of rash appearing/

corticosteroids

67
Q

Acute Angle Closure Glaucoma

Presentation

A

Rapid onset, Extreme Pain +NAUSEA/abdominal

Blurred, profound vision loss with “HALOS AROUND LIGHTS”

Pupil dilated, not reactive to light, high IOP

*Permanent if not treated within days

68
Q

Acute Angle Closure Glaucoma

Etiology

A

Primary - pre-existing narrow anterior chamber angle (Asian, inuit)

Secondary - hemodialysis, anterior uveitis, punched

69
Q

Uveitis

A

General term for inlammation of the eye

Uvea - Iris, Ciliary Body, Choroid

70
Q

Ocular Motor Palsies

CN 3,4,6

Symptoms

A
  • Pain on movement
  • double vision
  • ptosis (eyelid droop)
  • headache
  • nausea
71
Q

Ocular Motor Palsies

Etiology

A

MS, DM, Guillan Barre

72
Q

3rd CN Palsy

A

Complete ptosis - Eye down and out

Dilated pupil, not responsive to light

If acute - Emergent, could be aneurysm

73
Q

4th CN Palsy

A

Double vision going down stairs or reading books

Vertical hypertropia

74
Q

6th CN Palsy

A

Failure of lateral movements,

Nystagmus

75
Q

Strabismus

A

Misalignment of the eyes

76
Q

Strabismus

Etiology

A

Muscle imbalance

Refractive error

Down Syndrome, congenital eye defects

77
Q

Tropia

A

Manifest with both eyes open

78
Q

Phoria

A

latent, seen when one eye is covered

79
Q

Nystagmus

A

Involuntary eye movement

Treat underlying abnormalitites

congenital

acquired - associated with serious medical conditions

80
Q

Acanthamoeba Keratitis

A
  1. Perineural ring and ring infiltrates into corneal stroma
  2. Severe pain
81
Q

Cataract

A

1 cause of WW blindness

Opacity of the lens

82
Q

Cataract

  • Presentation*
  • Tx*
A

Glare with night driving

Surgery

83
Q

Cataract

Etiology

A

Age Related

-or-

Congenital

84
Q

Retinal Detachment

Presentation

A

Sudden flashes, floaters, CURTAIN across vision

85
Q

Retinal Detachment

A

Traction from PVD (Posterior Vitreous Detachment)

Possible surgical correction

86
Q

Chronic angle closure glaucoma

Etiology

A

Common in Asian/inuit

87
Q

Chronic angle closure glaucoma

A

Flow of aqueous fluid to anterior chamber angle obstructed

Chronic, progressive, ..

Early - asymptomatic

88
Q

Vitreous hemorrhage

A

Blood leakage into vitreous

Retinal tear prone to bleeding - refer for laser tx to correct tear

89
Q

Age-Related Macular Degeneration

Etiology

A

White female, age

*Leading cause of blindness in patients > 65yo in developed countries

90
Q

Dry ARMD

A

Degeneration of the macula/retina causing..

progressive, CENTRAL vision loss

85% this milder type

91
Q

Wet ARMD

A

NEOVASCULARIZATION - leaky “exudative”

Hemorrhage, fibrosis

See crooked lines/visual disturbances

15% ACUTELY become this more severe type

92
Q

Central and Branch Retinal Vein Occlusions

A

PAINLESS, SUDDEN VL often upon WAKING

exam - widespread retinal hemorrhages,

Veins dilated, torturous

Optic Disc Swelling

cotton-wool spots

caused by THROMBUS (hx cardiovascular disease)

93
Q

Central and Branch Arterial Occusion

A

SUDDEN, PROFOUND, Painless, VL

Cherry Red Fovea, RAFD

caused by THROMBUS (commonly from giant cell arteritis)

94
Q

Transient Monocular Vision Loss

A

Ocular TIA -aka- Amaurosis Fugax

Retinal EMBOLUS from Carotid disease or the heart

(identify underlying cause to treat source)

PAINLESS, TEMP,

COMPLETE MONOCULAR - VLCurtain VERTICALLY

Crescendo TIA - multiple in a week - EMERGENCY

95
Q

Diabetic Retinopathy

A

A leading cause of blindness

Retinal capillary closure and MICROANEURYSMS,

macular edema,

dot and blot

cotton-wool spots

96
Q

Nonproliferative Diabetic Retinopathy

A

Mild/moderate (to severe), Very common

Often Asymptomatic

Tx- Control Blood Glucose

97
Q

Proliferative Diabetic Retinopathy

A

Less common, more severe

NEOVASCULARIZATION

leads to Vitreous hemorrhage & traction retinal detachment

SEVERE, SUDDEN, PAINLESS VL, FLASHES & FLOATERS

98
Q

Hypertensive Retinochoroidopathy

A

Retinal or Choroidal Damage d/t HTN

Acute - reversible

Chronic - arteriovenous nicking

Copper, Silver Wiring

99
Q

Optic Neuritis

A

Inflammation of the Optic Nerve - associated with MS

Abrupt, monocular VL, RAPD

DIFFERENTIATE FROM OCULAR TIA:

LASTS HOURS TO DAYS + PAIN

100
Q

Papilledema

A

Optic Disk Swelling d/t raised intracranial pressure

101
Q

Optic Disk Druzen

A

Optic disk ELEVATION - PSEUDOPAPILLEDEMA,

associated with Farsightedness

102
Q

Grave’s Opthalmyopathy

(Thyroid Eye Disease)

A

Inflammatory cell deposits into muscle

Diplopia, PROPTOSIS

103
Q

Orbital Cellulitis

A

Infection of orbital tissues surrounding eye

Usually from sinuses

Serious - could spread to brain

Pain on eye movement

104
Q

Perioribital cellulitis

A

Local infection of eyelid and surrounding skin

From bug bite/etc

105
Q

Blow out Fracture

A

Blunt trauma Fractures Orbital Bone

106
Q

Conjunctival and corneal foreign bodies

A

Know source - Hx

107
Q

Corneal Abrasions

A

Hx of trauma to eye

Severe pain, tearing, foreign body sensation

108
Q

Hyphema

A

Anterior chamber angle hemorrhage

Danger of Secondary hemorrhage, increased ocular pressure and glaucoma

109
Q

Ecchymosis

A

“Black eye” - generally cosmetic

Ice pack 24-48 hours, then hot pack

110
Q

Subconjunctival Hemorrhage

A

Bleeding under conjunctiva

Not painful

From straining, blood thinners

111
Q

Lens Dislocation

A

Supporting ligaments broken - Marfan’s susceptible to this

Blurry vision, iris may quiver

Lens off center, permanent

112
Q

Lacerations

A

Refer to Opthalmologist for repair

CSS PA Fun Med (4 decks)

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