Eye Flashcards
What is the medical term for red eye?
Iritis
ptosis
- drooping of eyelid
* week levator palpabrae muscle
diplopia
seeing double
exophthalmos
protrusion of eyeball
arcus senilis
white encircling ring about 1mm from corneal margin, which does not damage vision
astigmatism
- unequal curvature of cornea or lens
* blurred vision for distant and near vision
atonic ectropion
- drooping of lower eyelid due
- flaccid orbicularis oculi, can be from aging
- conjunctival inflammation and weeping
blepharitis
- inflammation of eyelid margins
- FROM: acute bacterial infection (staphylococci), seborrhoeic, allergens, Meibomian gland dysfunction
- itching, burning
- photophobia, excess lacrimation
- margins red, thick, scales, crusts, lash loss
- shallow ulcers
cataract
- gradual increasing opacity of lens, as response to any insult
- common
- From: aging, diabetes, acquired, x-rays, heat (infrared), eye disease, systemic diseases, uveitis, corticosteroids, trauma
- other causes: congenital, chromosomal, intrauterine infection (rubella), metabolic disease (galactosemia), maternal disease during pregnancy
- features: flakes, dots in lens periphery, white opacity in pupil, gradual failure of sight
corneal abrasion
stripping off part of corneal epithelium
episcleritis
- recurrent inflammation of episcleral tissues
- usually localized
- episclera: outermost layer of the sclera
glaucoma
- group of disorders of increase in intra-ocular pressure
- results in damage to eye
- Primary open angle (vasospastic, inflam., trauma, idiopathic)
- Angle closure (anterior chamber reduced)
- Simple (very gradual)
- no symptoms, gradual vision loss (peripheral first), red, pain, headaches, blurred vision
hematoma of the eyelid
- blood oozed into loose subcutaneous tissues
* black eye
hordeolum
correct term for stye
hypermetropia
- short eyeball or flat cornea
- image falls beyond the retina
- long sited
- finds distant and close objects blurred (mostly close)
hyphaema
bleeding into anterior chamber
keratitis
- inflammation of cornea
* herpes simplex, zoster (most common)
myopia
- long eyeball or too curved cornea
- image falls before retina
- short sighted
- finds distant objects blurred
nystagmus
oscillations of eye
optic atrophy
- atrophy of optic nerve fibres
* pallor of optic disc
papillitis
synonym for optic neuritis
papillooedema
- oedema od optic nerve head
- result of high intracranial pressure
- disc appears elevated from retina, margins blurred, engorged veins
pingueculae
- fatty deposits under bulbar conjunctiva
- benign neoplasm
- symptomless appart from visual appearance
presbyopia
decreased range of accommodation
pterygium
wing shaped fold of bulbar conjunctiva that transgresses onto cornea
retinal arteriosclerosis
retinal vessels characterized by spasm, sclerosis, constriction, haemorrhages, and exudates
refractive errors
Group of disorders where refraction of light through eye is abnormal • myopia • hypermetropia • astigmatism • presbyopia
retinal detachment
- separation of neural-visual layer from pigmented layer of retina
- from trauma or disorder
Features:
• sees flashing lights (formation of the hole)
• sees black flies or cobwebs (torn small vessels)
• localized loss of red reflex (where retina is detached)
• significant vision loss
• surgical emergency -or else blindness
retinitis pigmentosa
- slow degeneration or retina
- scarring of black pigment in retina
- FROM: autosomal recessive
- affects rods
- night vision loss
- peripheral ring scotoma (blind spot) -> eventually affects central vision
- fundoscopic appearance
- vascular changes
- areas of abnormal retinal pigmentation
retrobulbar neuritis
- inflammation of the orbital part of optic nerve
- usually unilateral
- FROM: multiple sclerosis, viral, temporal arteritis
- rapid lost vision
- pain on movement
- normal fundoycopic exam
scleritis
- inflammation of scleral tissues
- significant pain
- vision affected
senile macular degeneration
- degeneration or atrophy of macula from age
- mottled pigmentation of macula
- FROM: age, familial, smoking
- gradual or sudden loss vision
- central vision
- painless
spastic entropion
- inturning of the eyelashes
- From: aging, scarring of lid
- Causes: irritation of conjunctiva and cornea
strabismus
squint
squint
- deviation of the eyes so that their axes are no longer parallel
- Paralytic or
- Concomitant
stye
- acute local pyogenic infection of glands of lid margin
- staphylococcal infection
- External: lash follicle at lash base
- Internal: Meibomian gland (rarer)
- varying swelling, red, pain, tender
- small pus
- lacrimation, photophobia
trachoma
• scarring of cornea due to infection of cornea with Chlamydia trachomatis
• endemic in many areas of the world, leading cause of blindness
• contagious
• Starts as symptoms and signs of bilateral acute conjunctivitis
-> 7-10 days later, small follicles appear in upper conjunctiva (follicular hyperplasia) -> corneal neovascularisation
• process may last months to years, with exacerbations and remissions
• scarring of the cornea, conjunctiva and eyelids -> visual impairment
uveitis
- Inflammation of the uveal tract (iris, ciliary body, choroid)
- FROM: idiopathic or systemic disease
- pain, red eye, photophobia
- visual impairment
- “floaters”
xanthelasmata
- intradermal plaques of creamy coloured deposits, symmetrical and at medial ends of upper or lower eyelids
- usually indicative of elevated cholesterol, lipoproteins or triglycerides
What is conjunctivitis?
- inflammation of conjunctiva
- virus, bacteria, allergies
- acute, chronic (trachoma), or allergic
All have common symptoms:
• red eye (tarsal, bulbar conjunctiva)
• discomfort (grittiness, exacerbated by eyelid moving)
• photophobia (mild)
Acute conjunctivitis
- staph. aureus (#1), pneumococcus, H. influenza
* purulent, mucopurulent, catarrhal discharge (different from other types)
Allergic conjunctivitis
- acute inflam. from Type 1 hypersensitivity
* hypersensitive to irritants (drugs, atropine, penicillin, cosmetics, allergens)
chalazion
- chronic granulomatous inflam. of Meibomian gland
- results in obstruction of Meibomian duct -> enlargement of gland
- preceded by stye-looking lesion, red, swelling, discomfort
- resolves, then slow growing mass in lid (grey/red madd under conjunctiva)
dacryocystitis
- infection of lacrimal sac
- FROM: infection (pneumococcus from nasopharynx) or congenital lesion -> narrowing of nasolacrimal duct -> infection
- pain, red, swelling of lacrimal sac
- fever
- maybe inflam. of eyelid margin or conjunctiva
Diabetic retinopathy
• pathological changes occurring in retina from long-standing diabetes mellitus
Ophthalmoscopy reveals:
• venous dilations, red dots, dot & blot haemorrhages, oedema, cotton wool spots (micro infarcts), hard exudates (yellow, deep to retinal vessels due to oedema), neovascularisation of vitreous surface and vitreous cavity
• vision gradually diminished -> degrees of blindness
Acute angle closure glaucoma
- acute increase in intra-ocular pressure
- due to closed anterior chamber angle
- more common in middle aged and long sighted
Aetiology:
• primary (most)
• secondary to aqueous drainage issue
What is the pathophysiology of acute angle closure glaucoma?
- bouts of raised tension, precipitated by protrusion of the iris root so that it makes contact with back of the cornea, shuts off peripheral recess of anterior chamber (preventing aqueous humour escaping into canal of Schlemm.
- aggravated by pupillary dilation -> thickening of iris root
What are the clinical features of acute angle closure glaucoma?
- severe pain in and around eye
- prostrated, nauseated, vomiting
- severe reduced vision
- dusky ciliary congestion
- steamy looking cornea (oedema under epithelium)
- dull grey-green iris
- dilated vertically oval pupil
- stony hard ocular tension
Simple glaucoma
- very gradual rise of intra-ocular pressure over many months
- obscure aetiology
- white eye
- painless
- sight gradually lost (more cure -> eventual blindness)
Iritis
- often with inflam. of uveal tract (ciliary body, choroid)
- unknown aetiology (endogenous, collagen disorder)
Features:
• circumcorneal injection (brick red colour)
• pupil contraction
• blurred vision (exudate in anterior chamber)
• tender, painful eye, photophobia
brick red colour
iritis
What are the complications of iritis?
- secondary glaucoma
- secondary cataract
Exudate may form:
• hypopyon (fluid in anterior chamber)
• in back of cornea
• posterior synéchies (adhesions between iris and anterior surface of lens)
What are the aetiologies of keratitis?
- microorganisms (stap/strep. pneumonia, pseudomonas, herpes simples/zoster)
- eyelid abnormalities
- trauma
- connective tissue disorder
- systemic allergy
- toxins
- low tear volume
- low vitamin A
What are the clinical features of keratitis?
- ulcers on cornea
- photophobia
- lacrimation or dryness
- discomfort (itchy, gritty, burning, pulling)
- red eye
- decreased vision
Retinal vessel occlusion
• causes visual impairment
Central artery:
• emboli or thrombi
• sudden lost vision in one eye
• NO pain
Central vein:
• hypertension, diabetes mellitus, glaucoma
• slow lost vision in one eye
• oedomatus and conjested fundus
• distension of retinal veins and vessels
Paralytic squint
Damage to motor apparatus:
• muscles
• cranial nerves: oculomotor, trochlear, abducens
-trauma, vascular disease, neuritis
Features:
• limited eye movement in direction of affected muscle
• greatest deviation in that direction
• no diplopia in other directions
• patient compensates with head and neck posture
Concomitant squint
Damage to reflex arc:
• sensory component
• central component
- before reflex binocular vision established
- constant deviation
- common in ling sighted, hereditary
Features:
• asymmetrical bright corneal light reflections
• cover each eye in turn, note whether either eye assumes fixation
• deviation remains same in all directions or gaze
amblyopia
permanently lazy eye
What is the consequence of untreated concomitant squint?
- infant suppresses vision of squinty eye
- eye remains permanently lazy
- neural circuits for binocular vision fails to develop
Toxic amblyopia
- reduced visual acuity
- from toxins affecting orbital portion of optic nerve
- toxins, alcohol, tobacco, malnutrition
- eye discomfort, photophobia
What is the relationship between Chalazion and Hordeolum?
Chalazion is a chronic version of hordeolum
Compare the pathology and clinical features of Atonic ectropion and Spastic entropion
spastic = hypertonicity atonic = hypotonicity
Atonic ectropion:
-upper lid drooping
Spastic entropion:
-inturning lid
Same clinical features BUT spastic has lashes scratching cornea
How does Trachoma lead to blindness?
Trachoma causes infective conjunctivitis
- > ulceration of cornea
- > scar tissue (can lead to spastic entropion)
- > more damage and scarring
- > blocks light going into lens
- > blindness
What is the most common cause of blindness?
Chlamydia -> Trachoma
Why does glaucoma impair vision?
compression of the optic nerve
What are the clinical differences between Senile macular degeneration and Retinitis pigmentosa?
Senile macular degeneration:
• macula is cones (in middle)
• central vision loss
• older demographic
Retinitis pigmentosa:
• retina is rods (peripheral)
• rods do night vision
• younger demographic
Why does conjunctivitis cause a red eye?
dilation and inflammation of arteries of superficial surface of eyes
What questions might you ask a patient with vision problems?
- Family Hx of eye disorders
- Sensitivity to light?
- Headache?
- Describe the vision: spot, both eyes, blurred, cloudy
- Other symptoms: discharge, dry, crust, grittiness
