Eye Exam

Question 1

What are some things in a patient’s PMH that are relevant to an eye complaint?

Answer 1

Glaucoma, diabetes mellitus, thyroid disease, ASCD, collagen vascular disease, HIV, IBD

Question 2

What are some medications that are relevant to an eye complaint?

Answer 2

Steroids, plaquenil, antihistamines, antidepressants, antipsychotics, antiarrhythmics, beta blockers

Question 3

What is chalazion?

Answer 3

Blocked meibomian gland; generally non-tender and nonpainful unless becomes inflamed; occurs in the eyelid

Question 4

What is hordeolum?

Answer 4

Blocked meibomian gland (inner margin) or tear eyelash follicle or tear gland; tender and painful; occurs along the lash-line

Question 5

What is blepharitis?

Answer 5

Inflammation at base of hair follicles, often from s. aureus or allergies; difficult but not impossible to treat

Question 6

If a patient has conjunctivitis, what might they complain of?

Answer 6

Gritty, irritated feeling, swollen eyelids, discharge, and “red eyes”

Question 7

What is arcus senilis?

Answer 7

Whitish linear (lipid deposition) encircling the colored iris; common over 60 years, if less than 40, consider checking cholesterol level

Question 8

What is esotropia?

Answer 8

Eye turns in

Question 9

What is exotropia?

Answer 9

Eye turns out

Question 10

What is papilledema?

Answer 10

Increased intracranial pressure causes intraaxonal edema along the optic nerve, leading to swelling and engorgement of the optic disc

Question 11

Compare arterioles and venules in the eye

Answer 11

Arterioles are smaller than venules (3:5 to 2:3); arterioles are brighter than venules because oxygenated blood makes them appear red

Question 12

What are cotton wool spots?

Answer 12

White or grayish ovoid lesions with irregular “soft” borders; moderate in size but smaller than the disk; result from extruded axoplasm from retinal ganglion cells caused by microinfarcts of the retinal nerve fiber layer

Question 13

When are cotton wool spots seen?

Answer 13

Hypertension, diabetes, HIV, others

Question 14

What are dursen bodies?

Answer 14

Yellowish, round spots that vary from tiny to small; edges can be soft or hard; randomly distributed but may concentrate 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

Question 15

What is glaucomatous cupping?

Answer 15

Increased intraocular pressure within the eye leads to increased cupping (backward depression of the disc) and atrophy; base of enlarged disc is pale; normal cup to disc ratio is .4, ratios of .7 suggest glaucoma