Eye Complaint Flashcards
What are important history findings to obtain for someone with an eye complaints?
Age, Pregnancy?, Glasses/contact wearer? Injuries/trauma to head/eye? Surgeries? Hx of eye infection? Recent travel?
Common associated sx for eye complaint?
Pain, drainage, itching/burning, vision change, blurry vision, flashing lights
Relevant PMH?
Glaucoma, DM, Thyroid disease, Collagen Vascular Disease, HIV, IBS
Relevant medications?
Steroids, Plaquenil, Antihistamines, Antidepressants, Antipsychotics, Antiarrhythmics, Beta Blockers all have ocular side effects
What is xanthelasma?
Fatty yellow deposits around the eye caused by HLD
What is proptosis/exopthalmos?
Pronouced bulging of the eyes, often a symptom of Graves Disease
What is dacryocystitis?
Inflammation/infection of the lacrimal sac (NOT the gland)
What is looked for when palpating the upper eyelid over the globe?
Chalazion can sometimes be felt, A hard sensation or pain may indicate hyprthyroidism, glaucoma, or retrobulbar tumor (increased pressure in or around the eye)
What is a chalazion? What is a Hordeolum?
Chalazion: Blocked meibomian gland, nontender and nonpainful in the eyelid
Hordeolum: blocked meiobian gland (on the inner margin), or tear eyelash follicle, or tear gland that is tender and painful. Only along the lash line
What is blepharitis?
Inflammation at the base of the eyelash hair follicles often from S. aureus or from allergies. Difficult to treat
What is a pterygium?
Tissue growth over the cornea of the eye that sometimes starts to impinge over the iris caused by chronic UV exposure
Sx of conjunctivitis?
Gritty/irritated sensation in the eye, swollen eyelids, discharge and purulence, conjunctival erythema/injection
Hyphema vs. Subconjunctival Hemorrhage
Hyphema- blood pooling in the anterior chamber, looks like small pool at bottom of iris
Subconjunctival Hemorrhage - bleeding in the sclera
How to detect corneal abrasions?
Fluoresciene stain and blue light to visualize abrasions and potential foreign body
What is arcus senilis?
Whitish linear lipid deposition encircing the colored iris
Common in those >60yo, if seen in someone younger than 40y.o., consider checking cholesterol levels
What does blue sclera indicate?
What about yellow?
Blue sclera- indicates brittle bone disease (Osteogenesis imperfect)
Yellow sclera (called sceral ictarus)- due to liver disease, pancreatic cancer, or gallbladder disease (yellow b/c of bilirubin)
Oculodermal melanocystosis (Nevus of Ota)
Increased pigment deposition in the sclera sometimes including the eyelids
What can happen when esotropia or exotropia is untreated or not successfully treated?
The brain will choose to focus with the unaffected eye and the affected eye will lose vision (amblyopia)
When examining the right eye, which hand do you hold the opthalmoscope with and what eye do you use to examine?
Right hand and right eye
Papilledema
Increased intrcranial pressure that causes intraxonal edema along the optic nerve, leading to swelling and enlargement of the optic disc (appears to have blurry margins)
Cottom wool spots
Describe them
Causes?
Associated illnesses?
White or grayish ovoid lesions with irregular soft borders that are moderate in size but smaller than the optic disc
Caused by extruded exoplasm from retinal ganglion cells caused by microinfarcts of the retinal nerve fiber layer
Seen in HTN, DM, HIV, and other issues
Drusen Bodies
yellowish round spots that vary from tiny to small and are haphazarly discributed but may be concentrated at the posterior pole between the optic disc and macula
Consist of dead pigment epithelial cells
Seen in normal aging and age-related macular degeneration
Glaucomatous Cupping
Increased intraocular pressure within the eye leading to backward depression of the disc and atrophy
Looks like a ring around the disc
Normal cup to disc ratio is 0.4. A Ratio of 0.7 suggests possible glaucoma
Leukocoria
“White reflex” that indicates a serious pathology of the eye, commonly a congenital cataract or be an indicator of retinoblastoma or retinal detachement
Anisocoria
Unequal pupil size
Retinoblastoma -arising from embryonic retinal cells
90% of tumors are diagnosed before age of 5. Most common presenting sign is leukocoria
Hypotropia and Hypertropia are both types of..?
Strabismus
Hypotropia is downward deviation of one eye
Hypertropia is upward deviation of one eye
Caloric Reflex test normal findings
Eyes deviate towards the ear tested with cold water and away from the ear tested with warm water
