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PCMII Final > Eye Exam > Flashcards

Eye Exam Flashcards

1
Q
  • Inspection of the eye
A
  • Position and alignment of the eyes
  • Eyebrows for hair and scaliness
  • Conjunctiva
  • Sclera
  • Cornea
  • Iris
  • Pupil
  • Ask patient to look upward as lower lids are pulled inferior and vice versa
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2
Q
  • Techniques for opthalmoscopy
A
  • Lights off
  • Right eye with opthalmoscope in right hand to examine patient’s right eye and vice versa
  • Patient should focus on distant point in front of them
  • Start 10-15 inches laterally from eye and move in 1-3 inches from the eye
  • Patient should briefly look at light
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3
Q
  • Abbreviated eye exam findings
A
  • PERRLA EOMI

Pupils equal, round and reactive to light, and accomodation. extraocular muscles intact

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4
Q
  • Complete eye exam findings
A
  • Eyes:
    • Orbits
    • Eyelids
    • Conjunctivae
    • Sclera normal
  • PERRLA, EOMI
  • Vision grossly intact and fundoscopic exam is unremarkable
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5
Q
  • How to use Snellen Eye Chart
A
  • Hold 14 inches from patient at eye level
  • Ask them to read smallest line that they can
  • Have them close one eye and test
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6
Q
  • Things to look for during pupillary exam
A
  • Should remain same side regardless to light exposure
  • Monitor both eyes for response to light (direct and consensual)
  • Convergence: pupil constriction when objects become close to eyes
  • Avg pupil size: 4 mm
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7
Q

Anisocoria

A

Unequal size of pupils

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8
Q
  • How do you test for red reflex?
A
  • Have patient look directly at light at arm length away
    • Should be equal red color reflection d/l
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9
Q
  • In what patients can there be a lighter red reflex that appears yellow, orange or pink?
A
  • Patients with a lighter colored eyes
  • African American
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10
Q
  • Leukocoria
A
  • “White reflex”
  • Indicates serious pathology, usually congenital cataract
  • May be
    • Retinoblastoma
    • Retinal detachment
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11
Q
  • Fundoscopic exam
    • Structures of posterior chamber to identify
A
  • Optic disc: nasal and inferior
  • Arterioles: 2 laterally, 2 nasally
  • Macula: Temporal
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12
Q
  • Retinoblastoma
A
  • Neuroectoderm malignancy from embryonic retinal cells
  • Most common presenting sign is leukocoria
  • 90% diagnosed before age 5
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13
Q
  • How do you test the cardinal signs of gaze?
  • Which muscles are responsible for each?
A
  • H Test
  • SO4-LR6-AR3
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14
Q
  • Strabismus
    • What is it?
    • What can it lead to?
    • What symptoms are included?
A
  • Misalignment of eyes
  • Can lead to ambylopia (lazy eye)
  • Includes
    • Extropia (lateral)
    • Esotropia (medial)
    • Hypotropia (caudal)
    • Hypertropia (cephalad)
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15
Q
  • Cover uncover test
A
  • Used to identify weakness of EOM
  • Eyes should remain synchronous regardless of being covered
  • Watch for drift as eye is uncovered
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16
Q
  • Nystagmus
    • When is it seen in children
    • When is it seen in adults
A
  • Children
    • Functional or anatomic sensory defect
  • Adults
    • Dysfunctional labyrinth
    • Vestibular system while turning head
    • Intoxication
    • Neurological dysfunction
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17
Q
  • Caloric reflex
A
  • Eyes deviated towards ear when being tested with cold water
  • Eyes deviated to opposite ear when being tested with warm water
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18
Q
  • How to test visual field confrontation
A
  • Static finger wiggle test
  • Kinetic red target test
  • *sensitivity and specificity is best when both are performed together*
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19
Q
  • Fluorescein Stain
A
  • Used to identify epithelial defect (EX: Corneal abrasion)
  • Perform after complete screening exam
20
Q
  • Hordeolum (Stye)
A
  • Painful inflammation of eyelid margins or meibomian glands
  • Commonly caused by S.aureus
  • Internal-caused by gland actually plugged
  • External-caused by eyelash follicle or lid margin tear gland
  • More common on lower eyelid
  • Along eyelash line
21
Q
  • Chalazion
A
  • Painless
  • Caused when Meibomian tear gland becomes obstructed
  • Granulomatous process
  • If persists, may need I+D
  • Often associated with blepharitis and roasacea
  • More common on upper eyelid
  • In the eyelid
22
Q
  • Xanthelasma
A
  • Benign soft yellow plaques filled with cholesterol
  • Most often on medial aspects of eyelids
  • Dyslipidemia in 50% of patients but also classic for primary biliary cholangitis associated with hypercholesterolemia
23
Q
  • Bacterial conjunctivitis
A
  • Spread by direct contact
  • Commonly unilateral
  • Can become matted shut during sleep
  • Purulent discharge throughout day
  • Adults-S aureus
  • Children-S pneumonia, H influenzae, m. catarrhallis (most common)
24
Q
  • Viral conjunctivitis
A
  • Spreads by direct contact
  • Gritty or sandy feeling of eyes
  • Initially unilateral but becomes b/l
  • Clear discharge and may have follicular appearance on tarsal conjunctiva
  • Adenovirus=most common cause
25
Q
  • Pterygium
A
  • Benign growth d/t chronic UV exposure
  • In fibroblastic tissue of eye
  • Usually on medial side
  • More likely if patient has dry eyes
26
Q
  • Hyphema
A
  • Blood in anterior chamber of eye
  • Commonly from trauma
  • Other causes
    • Vascular abnormalities
    • Clotting problems
    • Mass effects from neoplasms
27
Q
  • Orbital compartment syndrome
A
  • Opthalamic emergency
  • Blood collection within bony confines of orbit leads to increased intraocular pressure
  • Presentation
    • Progressive pain
    • Diplopia
    • Diffuse subconjunctival hemorrhage and chemosis
28
Q
  • Associated symptoms with eye complaints
A
  • Pain
  • Drainage
  • Itching/burning
  • Vision change
  • Blurry vision
  • Flashing lights
29
Q
  • Relevant ROS for Eye complaints
A
  • General
    • Fever
    • Weight change
  • Neuro
    • Headache
    • Motor weakness
    • Dizziness
    • Poor balance
  • Cardiovasc
    • Dysrhythmias
    • Chest pain
  • Endocrine
    • Excessive thirst
    • Frequent urination
    • Symptoms with hypoglycemia
  • MSK
    • Joint pain
    • Back pain
  • Skin
    • Frequent infections
    • Dry skin
  • GI
    • Changes in bowel functions
30
Q
  • Relevant PMH
A
  • Glaucoma
  • DM
  • Thyroid disease
  • ASCD (atherosclerotic coronary disease)
  • Collagen Vascular disease
  • HIV
  • IBD
31
Q
  • Relevant medications
A
  • Steroids
  • Plaquenil
  • Antihistamines
  • Antidepressants
  • Antipsychotics
  • Antiarryhtmics
  • Beta Blockers
32
Q
  • Causes of periorbital edema
A
  • Change in elasticity
    • Lipoatrophy or lipohypertrophy from topical meds
  • Bruising
  • Trauma
  • Allergic shiners (Basically bruising/bloated looking eyes)
  • Xanthelasma
    • Check cholesterol levels
  • Proptosis/Exopthalmos
    • Hyperthyroid
  • Dacrocystitis-infection in tear duct common in infants
  • Rash
    • To hairline (herpes zoster-shingles)
    • Pustules-acne, insect bites, other
33
Q
  • What can cause the following
A
  • Staph and strep infections
34
Q
  • What conditions can affect the lacrimal apparatus
A
  • Skin lesions
  • Cancer
  • Auto immune diseases
35
Q
  • When looking at conjunctiva, what is normal and what is abnormal
A
  • Normal-clear
  • Abnormal
    • Erythema-subconjunctival hemorrhage
    • Purulence (Pink eye), conjunctivitis
    • Ptergium
36
Q
  • What nerve is responsible for the sensory portion of the corneal reflex
  • What nerve is responsible for the motor portion of the corneal reflex
A
  • Sensory-Trigeminal
  • Motor-Facial
37
Q
  • Arcus senilis
A
  • Lipid deposition encircling iris
  • Common in people over 60
  • If < 40 years, check cholesterol
38
Q
  • What is icterus and what causes it
A
  • Yellow sclera
  • Causes
    • Neonatal liver disease
    • Pancreatic cancer
    • GB disease
39
Q
  • Blue sclera increased risk of _
  • Don’t confuse with _ which is a birthmark blue sclera and periorbital tissues
A
  • Bone disease
  • Nevus of Ota
40
Q
  • What’s worse, horizontal or vertical nystagmus?
41
Q
  • One thing to do before dilating pupils (mydriasis)
A
  • Make sure patient does not have shallow anterior chamber (acute angle glaucoma)
42
Q
  • Arterioles and venules of the eye
A
  • Arterioles are smaller and brighter
43
Q
  • Papilledema
A
  • Indicative of increased intracranial pressure
44
Q
  • Cotton wool spots are commonly seen in
A
  • patients w/ HTN or DM
45
Q
  • Glaucomatous cupping
46
Q
  • Retinal proliferation is commonly seen (along with cotton wool spots) in patients with _ and _
A
  • HTN and DM
47
Q
  • _ are precursors to macular degeneration
A
  • Drusen bodies

PCMII Final (9 decks)

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