Eye Exam Flashcards
What is eyelid inversion or eversion associated with ↑ risk of?
↑risk of infection
What are some relevant associated sx for eye complaints?
–pain –drainage –itching/burning –vision change –blurry vision –flashing lights
Why should you NEVER dilate the pupils if a pt has a shallow anterior chamber?
May represent acute angle glaucoma
What is lipoatrophy or lipohypertrophy?
Change in fat tissue/elasticity in the periorbital area
What movement is associated with the inferior oblique muscle?
Up, in
What movement is associated with the lateral rectus muscle?
Out
What does the cover/uncover test assess? What are possible findings?
–assesses imbalance of corneal light reflex
–when the left eye is covered, the right eye moves outward to pick up the fixation (exotropia)
–estropia: eye turns in
What is a whitish scar in the cornea associated with?
Abrasion or ulcer
What is associated with erythema of the conjunctiva?
Subconjunctival hemorrhage
Identify significant past medical hx that is related to the eye
–glaucoma –DM –thyroid dz –ASCD –collagen vascular dz –HIV –IBD
What is arcus senilis?
Whitish lipid deposition encircling the iris, common in pts>60YO– consider checking cholesterol levels if pt is <40YO
What is proptosis/exophthalmos?
Protruding eyes, associated with hyperthyroidism
What are Drusen bodies?
Precursor to macular degeneration
What is nevus of ota (oculodermal melanocytosis)?
Blue sclera
What movement is associated with the superior rectus muscle?
Up, out
What might be associated with hard sensation or pain upon palpation of the eyelid over the globe?
–hyperthyroidism
–glaucoma
–retrobulbar tumor
What is icterus and what might it be associated with?
Icterus= yellow sclera
–associated with neonatal, liver dz, pancreatic cancer, gallbladder dz
What is erythema of the eyelids/eyelashes associated with?
Contact dermatitis/allergies, blepharitis
What might a blue sclera signify?
Blue sclera is inherited, seen frequently in brittle bone dz
What movement is associated wit the medial rectus muscle?
In
What might brown or gray spots in the sclera signify?
–birthmarks
–↑melanin in sclera
–↑risk for glaucoma
What are xanthomas?
Cholesterol deposits in the periorbital area
What might disc cupping signify?
Glaucoma
What is pterygium?
Pinkish triangular tissue growth on the cornea of the eye due to sun exposure; no sx
How do you test for the direct and consensual constriction?
Darken the room→shine light into one eye→ both eyes should constrict→repeat with other eye
How do you perform a funduscopic exam?
–move in flowing lateral blood vessel centrally
–focus on optic disc (yellow-orange oval)
–examine optic disc to see if margins are sharp
How are arterioles and venules different?
Arterioles are smaller and brighter than venules; oxygenated blood makes them appear more red
What might retina proliferation signify?
HTN or DM
What is entropion?
Eyelid inversion
What might a clear/transparent lens signify?
Normal
How can exotropia/esotropia be treated? What may result if it is not treated?
–patching in young children, surgery if bathing fail
–if not treated, brain will choose to focus with unaffected eye and other eye will lose vision
–cosmetic appearance also has social implications for children
What is “normal” vision and what do these numbers represent?
20/20
First # indicates the distance the pt is from the chart, second # indicates the distance at which a normal eye can read the line of letters
What is papilledema and how might it present?
–↑intracranial pressure
–presents as irregular, “swollen” borders of the optic disc
What are scabs/new skin lesions on the eyelids/eyelashes associated with?
BCC or SCC
What is associated with purulence?
Conjunctivitis
What is mydriasis?
Pupil dilation
What is ptosis?
Dropping eyelids
What might a yellow or gray lens signify?
Cataracts; or can be normal in prisons with ↑melanin
What might cotton wool spots signify?
Vascular dz from HTN or DM
What movement is associated with the inferior rectus muscle?
Down, out
What does the corneal sensitivity with cotton test?
CNV– sensory
CN VII– motor
What are pts at risk for if their eye lids do not close completely?
Corneal abrasions
What is the proper way to use an ophthalmoscope?
–use your right hand for the patient’s right eye and your left hand for the patient’s left eye
–index finger
–use large round white beam
–have pt lok at fixed point on wall behind examiner
–lower the intensity of the light
–start about 15” away and move closer until you are almost cheek to cheek
What is dacrocystitis?
Infection in the tear duct
Which direction of nystagmus is always bad?
Vertical
What is a chalazion?
Painless bump or nodule in the eyelid due to a blocked Meibomian gland; can be tender if it becomes inflamed
What movement is associated with the superior oblique muscle?
Down, in
What dz is a rash from the periorbital area to the hairline associated with?
Herpes Zoster (shingles)
What might brown speckles in the lens signify?
Cataracts
What does PERRLA stand for?
Pupils equal, round, reactive to light and accommodation
What is ectropion?
Eyelid eversion
List some medications that can have ocular side effects
–steroids –plaquenil –antihistamines –antidepressants –antipsychotics –antiarrhythmics –beta blockers
What are some relevant ROS for eye complaints?
–general: fever, weight change
–neuro: headache, motor weakness, speech/swallow, dizziness, poor balance
–CV: dysrhythmias, chest pain
–endo: excessive thirst, frequent urination, sx c/w hypoglycemia
–MSK: back pain, joint pain
–skin: frequent infections, dry skin
–GI: change in bowel function
What is a hordeolum?
Painful bump located along the lash line and associated with a blocked Meibomian gland or tear eyelash follicle of tear gland
What is blepharitis?
Inflammation of the eyelid
What is a brown tint from hyphema in the cornea associated with?
Blood from trauma in the anterior chamber
What does EOMI stand for?
Extraocular muscles intact
