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Eye Exam > Eye Exam > Flashcards

Eye Exam Flashcards

1
Q

refractive errors

A

hyperopic

myopic

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2
Q

hyperopia

A

farsightedness?? eye is shorter than normal, or cornea and lens refract too weakly?? the image falls behind the retina

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3
Q

hyperopia correction

A

glasses, contact lens, refractive surgery
use of convex (converging) lens
increase natural refracting power so image is focused on retina

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4
Q

what is required for vision to be clear?

A

image to be projected precisely on the retina
cornea and lens refract light
emmetropia

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5
Q

myopia

A

nearsightedness
when eye is longer than normal or cornea and lens focus too strongly
image falls in front of retina

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6
Q

myopia correction

A

glasses, contact lenses, refractive surgery
use of concave (diverging) lens
decrease natural refracting power so image is focused on retina

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7
Q

astigmatism

A

due to dift corneal or lens curvatures
results in multiple focal points, causing blurry vision
like a footballl?? dift curves ?? require own cylindrical lens to correct refractive error

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8
Q

presbyopia

A

eyes lens become more rigid so its cant change shape as easliy to focus
normal after 40, corrected with focals/reading glasses
or can be corrected with contact lenses or treated surgically to achieve monovision

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9
Q

photoretractive keratoectomy

A

laser sculpts cornea?? either flattens it for myopia or steepens it for hyperopia

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10
Q

LASIK

A

laser assisted in situ kertaomileusis
microkeratome cuts a thin, hinged flap of corneal tissue, folded back, laser is used to reshape cornea, then flap laid back

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11
Q

which defects respect the vertical meridian?

A

defects of visual pathway

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12
Q

features of pituitary tumor

A

bitemptoral hemianopia and diminished libido are common presentign symptoms
when adenomas become large enough, they exert mass effect on optic chiasm
growth hormone secreting pituitary adenomas are slow growing and go undiagnosed for years

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13
Q

defects respecting the horizontal meridian help to localize the pathology to where?

A

retina or optic nerve (glaucoma)

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14
Q

what is glaucoma?

what are 3 major parts?

A

disease of optic nerve
leading cause of blindness in US
leading cause of IRREVERSIBLE vision loss in af ams in US
? visual loss, pressure in eye, optic nerve damage
progression of cupping/damage of optic nerve

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15
Q

risk factors of glaucoma

A

increasing age, african ancestry, family history

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16
Q

what is metamorphopsia?

A

lines on grid are wavy/missing on amsler grid (helps to asses 10 degrees of visual field?? macula function)

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17
Q

age related macular degeneration

A

most common cause of irreversible vision loss over age of 65 in US
macular tissue deteriorates, lead to mild to severe CENTRAL vision loss, NOT TOTAL BLINDNESS

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18
Q

dry from/atrophic age related macular degeneration

A

most common form
IRREVERSIBLE VISION LOSS
vitamin C and E, zinc, copper oxide, and beta carotene may slow progression

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19
Q

why shouldnt you perscirbe beta kerotine to people who smoke?

A

increase risk of lung cancer

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20
Q

AMD: wet form (exudative)

A

occurs when abnormal blood vessels under the retina leak fluid, blurring central vision
IRREVERSIBLE VISION LOSS
new injectable anti?VEGF meds achieve high success in vision preservation

on angiogram, you have ring around macula (shows blood vessels growing where they shouldnt)
can get distortion from scarring

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21
Q

pharmacologic dilation

A

due to scopolamine?? produces mydriasis (dilation) and cyclopegia (paralysis of ciliary muscle, lack of accomodation by blocking muscaranic Ach receptors)

scopolamine patches are used to prevent motion sickness

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22
Q

leukocoria

A

white pupil
importnat clinical finding in children due to potential for amblyopia, blindness, death (unilateral)
sign of retinoblastoma

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23
Q

retinoblastoma
present with 3 signs:
what else are they at risk for?

A

most common primary intraocular malignancy in childhood, fatal without tx
present with leukocoria, strabismus, painful red eye
2 hit hypothesis?? RB tumor suppressor gene
increased lifetime risk for sarcomas, brain tumors, melanoma, lung and bladder CA

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24
Q

retinoblastoma tx:

A

enucleation, multiagent chemo, cryotherapy, laster, plaque brachytherapy, external beam radiation
remisison rate >90%

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25
Q

strabismus

A

constant misalignment of two eyes (object not visualized simultaneously by both fovea)?? cause double vision (binocular diplopia, but if you close 1 eye you see straight)

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26
Q

amblyopia

A

vision loss that is NOT correctable by glasses in an otherwise healthy eye
REVERSIBLE if detected and treated early (before 5)
at least half pts w/ amblyopia have strabismus
can also be caused by asymmetric refractive error and form?deprivation (from ptosis)?? dont stimulate visual pathway

27
Q

tx for amblyopia

A

lazy eye”?? wear a patch to force brain to recognize bad eye”

28
Q

which 4 abnormalities of eye/ eye lid that lead to vision loss?

A

ptosis (eye drooped)
proptosis (pushing forward of eye)
entropion (eye lid rolling inward)
ectropion (eye lid rolling outward)

29
Q

blepharitis
types (3)
symptoms

A

chronic inflammation of lid margin

types: staphylococcal, seborrheic (skin dz that creates flaky/scaly skin), combo
symptoms: decreased vision, foreign body sensation, burning/mattering

30
Q

blepharitis tx

A

lid hygiene: commercially available lid scrub kid, cleanse iwht non irritating shampoo at roots of lashes
AB ointment?? bacitracin or neosporin

31
Q

meibomitis

tx:

A 
inspissated meibomian glands
oily and foamy tear film
commonly seen in ocular rosacea
tx: hot compresses and eyelid massge, DOXYCYCLINE
precursors to styes
32
Q

stye (acute)
types
causes

A

external hordeolum?? staph abscess of lash follice, gland of Zeis or Moll, tender swelling/pustule at lid margin, may discharge through skin

internal hordoleum?? staph abscess of meibomian glands, tender swelling within tarsal plate, may discharge through skin or conjuncitva? if untreated, can get meningitis

33
Q

chronic: chalazion

A

meibomian cyst
painless, roundish, firm lesion within tarsal plate
may rupture through conjunctiva and cause granuloma
usually need to drain them

34
Q

blepharoptosis

due to which eye muscle?

A

upper eyelid margin rests at lower position than is normal
usually due to stretching of levator aponeurosis
can be due to CN 3 palsy
subtle ptosis present on affected side in pts with horners

35
Q

horners syndrome

A

characterized by ptosis, miosis, anhidrosis (no sweating)
only 2mm of ptosis bc muellers muscle (sympathetic) is still working

pancoast tumor: tumor at apex of lung?? can affect cervical sympathetic plexus causing a horners

36
Q

why is it especially important to recognize red eye after surgery?

A

always considered a possible threat for irreversible vision loss!

37
Q

what 8 red eye disorders are a threat for irreversible vision loss?

A 
perforating trauma
corneal infection
scleritis
hyphema (blood in eye)
iritis
acute glaucoma
orbital cellulitis
ednophthalmitis
38
Q

which 8 red eye disorders are non threatening for irrerversible vision loss?

A 
subconjunctival hemorrhage
hordeolum (stye)
chalazion
blepharitis
dry eyes
conjunctivitis
cornea abrasions
allergic rxn
39
Q

how do red eyes from allergy present?

from hordeolum, chalazion?

A

allergies: itching

hordeolum, chalazion?? localized to lid tenderness

40
Q

how do red eyes from lid, conjunctival, corneal disorders, foreign body, trichiasis, dry eye present?

A

scratchiness, burning

41
Q

how do red eye due to corneal abrasions, scleritis, iritis, acute angle closure glaucoma present?

A

deep, intense pain

42
Q

how do red eye due to corneal abrasion, iritis, acute glaucoma present?

A

photophobia

43
Q

what presents with halo vision?

A

corneal edema (acute glaucoma, contact lens overwear)

44
Q

purulent discharge?? cause?
clear watery discharge??
stringy, white mucous??

A

bacterial
viral (periauricular lymphadenopathy)
allergy

45
Q

how do you treat neonatal chlamydial conjunctiva?

A

caused by chlamydia trachomatis (most commonly STI in US)
newborn colonized during passage through birth canal, develops few days?weeks after birth

all newborns receive erythromycin eye drops prophylactically
MUST TREAT systemically to prevent pneumonia

46
Q

neonatal conjunctiva:
on day 1, due to __
day 2?5:
day 5?14:

A

1: chemical (silver nitrate)
2?5: neisseria gonorrhea
5?14: chlamydia trachomatis

47
Q

what does chalamydia trachoma cause?

A

common source of vision loss in 3rd world areas
causes adult chlamydial keratoconjunctivitis (corneal pannus, cicatricial entropion (eyelid folds inward)
tx: topical tetracycline
MUST treat systemically?? PO tetracycline, azithromycin, erythromycin

48
Q

adenoviral conjunctivitis

A

nonenveloped iscosahedral DNA virus (produce spikes that extend from capsid)
adevnoviral conjunctivitis: vision loss, watery discharge, HIGHLY contagious, usually bilateral, palpable preauricular lymph node
URI, sore throat, fever in prior week
SURFACES MUST BE DISINFECTED WITH BLEACH?? alcohol will not eliminate?? contagious!

49
Q

what can dry eye cause?

A

vision loss (insufficient tear film or inadequate quality of tears)
more common with aging
symptoms: blurry vision, excess tearing, foreign body/gritty feeling
tears have IgA, IgG, lactoferrin, growth factors?? all good

50
Q

sjogrens syndrome

A

women
keratoconjunctivitis sicca, xerostomia (dry mouth), otehr CT or autoimmune disease (RA)
autoimmune destructionof lacrimal and salivary glands
increased lifetime risk for lymphoma

51
Q

what should you NEVER prescribe for corneal abrasion/pain control?

A

topical anesthetics

52
Q

why is it important to recognize corneal infections?

what is a main cause?

A

can cause irreversible vision loss

bacterial keratitis: expanding oval, yellow?white dense stromal infiltrate

53
Q

fungal keratitis

A

frequently preceded by ocular trauma with organic matter (plant or veg)
get greyish white ulcers
slow progression
DO NOT GIVE TOPICAL STEROIDS

54
Q

acanthamoeba keratitis

A

contact lens wearers at risk (ESP in hot tubs!)
perineural infilrate
small, pathcy anterior stroma infiltrate
severe pain
rx: chlorhexidine and or pHMB (pool cleaner!)

55
Q

what should you not give with herpes simplex epithelial keratitis?

A

NO topical steroids!

56
Q

subconjunctival hemorrhage

A

usually asymptomatic or minimal irritaiton
can be from eye rubbing, cough/strain, trauma, HTN, bleeding
check BP and meds, give artificial tears
if TRAUMA?? considered threat for permanent vision loss

57
Q

how do chemicals work in eye?

A

acid precipitates quickly?? battery fluids, chem lab
alkali continues to penetrate and coagulates tissue (can progress)?? lye, household cleaners, fertilizers
immediate irrigation is essential!

58
Q

cataract

A

clouding of lens
vision can look like looking through frosty/fogged window
LEADING cause of vision loss worldwide, but are reversible
aging, diabetes, previous surgery, prolonged steroids cause cataracts

59
Q

symptoms of acute angle closure glaucoma

A 
severe ocular pain
frontal headache
blurred vision with haloes
n/v
mid dilated irregular pupil, cloudy cornea, conjunctival hyperemia
60
Q

optic nerve edema

A

reversible vision loss

papilledema” when bilateral

61
Q

optic nerve cupping

A

loss of retinal nerve fiber layer which results in gradual concentric enlargement and deepenign of cup
irreversible vision loss

62
Q

what does diabetic retinopathy show?

A

precedes development of diabetic neuropathy
LEADING cause of irreversible vision loss in US under 65
tx: panretinal laser tx: laser used to place hundreds of light burns in retina, stimulates new vessels to shrink (reduce metabolic need)

63
Q

central retinal artery occlusion

A

pts present with acute onset of monoocular visual loss
retinal edema (cherry red spot due to lack of nerve fiber layer in fovea)
cause of irreversible vision loss
tx involves lowering IOP

64
Q

big 6 sources of vision loss

A

refractive errors, gluacoma, macular degeneration, amblyopia, cataract, diabetic retinopathy

Eye Exam (1 decks)

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