Eye Abnormal Findings Flashcards
symmetrical corneal light reflex - pseudostrabismus
has the appearance of strabismus because of epicanthic fold but is normal for a young child
strabismus
true disparity of the eye axes, constant misalignment is also termed tropia and is likely to cause ambylopia
esotropia
inward turn of the eye
extropia
outward turning of they eyes
phoria
uncovered eye in over-uncover test; mild weakness, apparent only with cover-uncover test, and less likely to cause ambylopia than a tropia
esophpria
inward drift of the eye, as eye is uncovered it jumps to re-establish fixation, weakness exists
exophoria
outward drift of the eye, jumps to re-establish fixation, weakness exists
which CN is affected when site of paralysis is medial rectus and the eye does not turn in straight nasal direction
CN III
which CN is affected when site of paralysis is inferior oblique and the eye does not turn in the direction up and nasal
CN III
which CN is affected when the site of paralysis is superior oblique and the eye does not turn in the direction of up and temporal
CN III
which CN is affected when the site of paralysis is lateral rectus and the eye does not turn in the straight temporal direction
CN VI
which CN is affected when the site of paralysis is inferior rectus and the eye does not turn in the down and temporal direction
CN III
which CN is affected when the site of paralysis is superior oblique and the eye does not turn in the down and nasal direction
CN IV
what is abnormal finding is described as eyelids being swollen and puffy. eyelid tissues are loosely connected, and excess fluid is easily apparent. this occurs with local infections, with crying, and with systemic conditions such as HF, renal failure, allergy, and hypothyroidism
Periorbital edema
what is abnormal finding is described as eyeballs are displaced forward, and palpebral fissures are widened. “lid lag”, upper eyelid rests well above the limbus, and white sclera is visible. Acquired bilateral ________ is associated with thyrotoxicosis
exophthalmos - protruding eyes
what is abnormal finding is described as appearance of narrowed palpebral fissures, in which eyeballs are recessed. Bilateral ______ is caused by loss of fat in the orbits and occurs with dehydration and chronic wasting illnesses.
Enophthalmos - sunked eyes
what is abnormal finding is described as a positional defect that gives pt a sleepy appearance and impairs vision. It is caused by neuromuscular weakness, oculomotor cranial nerve III damage, or sympathetic nerve damage
ptosis (drooping upper eyelid)
what is abnormal finding is described as normal in many children, these slants (when combined with epicanthal folds), hypertelorism, and Brushfields’s spots - indicate down syndrome
upward palpebral slant
what is abnormal finding is described as the lower eyelid is loose, rolls outward, and does not approximate to eyeball. Puncta cannot siphon tears effectively, and excess tearing results. the eyes feel dry and itchy because the tears do not drain correctly over the corner and toward the medial canthus. exposure of the palpebral conjunctiva increases risk for inflammation. this occurs with aging as a result of atrophy of elastic and fibrous tissues, but it may result from trauma.
ectropion
what is abnormal finding is described as lower eyelid rolls inward because of spasm of eyelids or scar tissue contracting. constant rubbing of lashes may irritate cornea. the patient feels a “foreign body” sensation
entropion
what is abnormal finding is described as red, scaly, greasy flakes and thickened, crusted eyelid margins occur with staphylococcal infection or seborrheic dermatitis of the eyelid edge. Symptoms include burning sensation, itching, tearing, foreign body sensation, and some pain.
blepharitis (inflammation of the eyelids)
what is abnormal finding is described as a beady nodule protruding the eyelid, chalazion is an infection or retention cyst of a meibomian gland. It is a nontender, firm, discrete swelling with freely movable skin overlying the nodule. If it becomes inflamed, it points inside and not on eyelid margin.
chalazion
what is abnormal finding is described as localized staphylococcal infection of the hair follices at the eyelid margin. it is painful, red, and swollen - a postule at the eyelid margin. Rubbing the eyes can cause cross-contamination and development of another one.
hordeolum - stye
what is abnormal finding is described as an infection and blockage of sac and duct. Pain, warmth, redness, and swelling occur below the inner canthus toward the nose. tearing is present. pressure on sac yields purulent discharge from puncta.
dacrocystitis - inflammation of the lacrimal sac
what is abnormal finding is described as infection of lacrimal gland. pain, swelling, and redness occur in the outer third of upper eyelid. it occurs with mumps, measels, and infectious mononucleoisis or results from trauma.
dacryoadentitis - inflammation of the lacrimal duct
what is abnormal finding is described as rare, but occurs most often on the lower eyelid and medial canthus. looks like a papule with an ulcerated centre, note the rolled out pearly grey edges. should be referred for removal, although metastasis is rare
basal cell carcinoma
unequal pupil size is known as
anisocoria
when light is directed to the blind eye no response occurs in either eye. when light is directed to normal eye, both pupils constrict as long as the oculomotor nerve is intact.
monocular blindness
constricted and fixed pupils; occurs with the use of pilocarpine drops for glaucoma treatment, the use of narcotics, with iritis, and with damage of the pons in the brain
miosis
dilated and fixed pupils; pupils become enlarged with stimulation of the sympathetic nervous system, as a reaction to sympathomimetic medications, with use of dilating drops, and as a result of acute glaucoma and past or recent trauma. enlarged pupils also herald CNS injury, circulatory arrest, or deep anesthesia.
mydriasis
pupils have no reaction to light but do constrict with accomodation. small and irregular bilaterally. occurs with CNS syphilis, brain tumor meningitis, and chronic alcoholism.
agryll robertson pupil
this kind of pupil has a sluggish reaction to light and accommodation. it is usually unilateral, a large regular pupil that does react but sluggishly, after a long latent time. has no pathological significance.
tonic pupil - adie’s pupil
nerve damage causes unilateral pupil dilation with no reaction to light or accommodation. ptosis may also be present, with eye deviating downward and laterally.
CN II damage - oculomotor nerve
a lesion of the sympathetic nerve, cause’s unilateral, small, regular pupil that does not react to light and accomodation. Ptosis and absence of sweat on the same side of the face are also present.
Horner’s Syndrome
central blind area
macula
blind spot (scotoma) corresponding to particular area
localized damage
decrease in peripheral vision, starts with paracentral scotoma
increasing intraocular pressure
pt has shadow or diminished vision in one quadrant or one half of visual field
retinal detachment
injury causes blindness in one eye, or unilateral blindness
lesion in globe or optic nerve
injury to crossing fibres produces only a loss of nasal part of each retina and a loss of both temporal visual fields; bitemporal; hemianopsia
lesion at optic chiasm
injury produces left nasal hemianopsia
lesion of outer uncrossed fibres at optic chiasm
visual field loss in right nasal and left temporal fields; loss of same half visual filed in both eyes homonymous hemianopsia
lesion in right optic tract or right optic radiation
what is abnormal finding is described as infection causing vessles at periphery to appear red, but usually the area around the iris is clearer. common symptom of bacterial or viral infection, allergy, or chemical irritation. Purulent discharge accompanies bacterial infection. Preauricular lymph node is often swollen and painful, and pt have a history of upper respiratory tract infection. Symptoms include itching, burning sensation, foreign body sensation, and eyelids stuck together on awakening. inflammation of the conjunctiva
conjunctivitis - pink eye
what is abnormal finding is described as a red patch on sclera, subconjunctival hemorrhage looks alarming but is usually not serious. the red patch has clear edges. caused by increased intraocular pressure from coughing, sneezing, weight lifting, labour during childbirth, straining at stool, or trauma.
subconjunctival hemorrhage
what is abnormal finding is described as deep, red halo around the iris and cornea. redness is around iris, in contrast to conjunctivitis, in which the redness is more prominent at the periphery. pupil shape may be irregular from swelling of iris. pt alos has marked photophobia, constricted pupil, blurred vision, and throbbing pain. this condiiton warrants immediate referral.
iritis - circumcorneal redness
what is abnormal finding is described as acute, narrow angle glaucoma produces a circumcorneal redness around the iris, with dilation of the pupil. Pupil is oval, dilated, cornea looks :”steamy” and anterior chamber is shallow. acute glaucoma occurs with sudden increase in intraocular pressure caused by blockage of outflow in intraocular pressure caused by blockage of outflow from anterior chamber. pt experiences a sudden clouding of vision and sudden eye pain and sees halos around lights. this necessitates emergency treatment to prevent permanent vision loss.
acute glaucoma
what is abnormal finding is described as a triangular opaque wing of bulbar conjunctiva overgrows toward the centre of the cornea. it looks membranous, translucent, and yellow to white, usually invades from nasal side, and may obstruct vision as it covers pupil. it usually results from chronic exposure to hot, dry, sandy climate, which stimulates the growth of a pingiecula amd development into a ______.
pterygium
what is abnormal finding is described as most common result of a blunt eye injury, but irregular ridges are usually visible only when fluorescein stain reveals yellow-green branching. top layer of corneal or overworn contact lenses, b/c the area is rich in nerve endings, the pt feels intense pain and a foreign body sensation and exhibits lacrimation, redness, and photophobia.
corneal abrasion
what is abnormal finding is described as a light directed across the eye from the temporal side illuminates the entire iris evenly because the normal iris is flat and creates no shadow
normal anterior chamber (for contrast)
what is abnormal finding is described as the iris anteriorly because of increased intraocular pressure. b/c direct light is received from the temporal side, only the temporal part of iris is illuminated, the nasal side is shadowed. this may be a sign of acute angle-closure glaucoma, the iris looks bulging b/c aqueous humor cannot circulate.
shallow anterior chamber
what is abnormal finding is described as blood in anterior chamber is a serious result of blunt trauma or spontaneous hemorrhage. suspect scleral rupture or major intraocular trauma. note that gravity causes blood to settle.
hyphema
purulent matter in anterior chamber occurs with iritis and with inflammation in the anterior chamber
hypopyon
shows an opaque grey surrounded by black background as it forms in the centre of the lens nucleus.
central grey opacity - nuclear cataract
