Eye Exam Flashcards
Unilateral vision loss (non-painful): ddx?
Unilateral vision loss (painful): ddx?
Non-painful: vitreous humor hemorrhage, macular degeneration, retinal detachment, retinal vein occlusion, central retinal artery occlusion
Painful: (cornea or anterior chamber involvement)ulcer, uvetitis, traumatic hyphema, acute glaucoma
Define: presbyopia, hyperopia, and myopia
Presbyopia: aging vision, farsightedness
Hyperopia: farsightedness
Myopia: nearsightedness
Causes of diplopia (bilateral vs. unilateral)
Bilateral: brainstem or cerebellum lesion, weakness/paralysis of extraocular muscles
Unilateral: cornea or lens
Definition of “legally blind”
20/200
Causes of visual field defects
Anterior pathway (before optic chiasm): glaucoma, optic neuropathy, optic neuritis, glioma
Posterior pathway: stroke, chiasmal tumors
What can cause an enlarged blindspot?
glaucoma, optic neuritis, papilledema
What can cause Inward or outward deviation of the eyes?
Graves’ disease, ocular tumors
What can lateral sparseness in eyebrows mean? (ddx)
hypothyroidism
What can cause increased or decreased tearing?
Increased: (increased production)conjunctival inflammation, corneal irritation. (impaired drainage) ectropion-turning out of eyelid, nasal lacrimal duct obstrucion
Decreased:
Miosis vs. Myadriasis
Miosis: constriction of the pupils
Myadriasis: dilation
What can cause lid lag?
hyperthyroidism
What can cause poor convergence?
hyperthyroidism
What is the difference between an Afferent Pathway defect (CNII) vs. an Efferent Pathway (CNIII)?
CNII–> loss of direct pupillary reflex, with preservation of indirect pupillary reflex
CNIII–> complete paralysis of ipsilateral pupil
What is an Argyll Robertson pupil? Causes?
Lack of pupillary constriction with preservation of pupillary near accommodation
Causes: syphilis, diabetes, and lupus
What is Adie Tonic Pupil? Cause?
large pupil caused by damage to parasympathetic ciliary ganglion
Facial Motor lesions (UMN vs. LMN)
UMN: Contralateral paralysis of lower face, with forehead sparing
LMN: Ipsilateral paralysis of BOTH lower and upper face
Uveitis
inflammation of the iris, ciliary body, and choroids
can be caused by auto-inflammatory disease or infection
blurry vision
How is Internuclear Ophthalmoplegia distinguished from CN III palsy?
INO: preserves convergence. Most common in Multiple Sclerosis
CNIII: “Down and out”
Marcus Gunn pupil
deficit in afferent light reflex (CN II, retinal detachment)–> affected pupil appears to dilate with light when switched from unaffected eye (but actually returning to baseline from constricted state)
Xerophthalmia
Dry eyes
can be caused by Vit. A deficiency or Sjogren Syndrome
Macular Degeneration
secondary to disruption of retina–> slow-onset of CENTRAL vision loss, w/ preservation of peripheral vision
Amaurosis Fugax (sudden unilateral vision loss) (assoc. with what?)
embolization of ophthalmic artery
Assoc. with carotid bruit and atheroscleosis
Glaucoma
due to increased ICP–> optic nerve atrophy
caused by decreased flow of aqueous humor through canal of Schlemm w/ or w/o narrowing of anterior chamber angle
