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Adult/Ped Medicine 2 > Eye Overview and Introduction to the Eye Exam - Graf and Eye Surgeries - Kugler > Flashcards

Eye Overview and Introduction to the Eye Exam - Graf and Eye Surgeries - Kugler Flashcards

1
Q

define: Emmetropia:

A

Visual condition in which an infinitely distant fixated object is imaged sharply on the retina (without an accommodative response)

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2
Q

What vision does this diagram represent?

A

Emmetropia

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3
Q

Refraction:

A

Altering of the pathway of light from its original direction, result of passing from one medium to another

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4
Q

Ametropia:

A

Refractive condition in which parallel rays do not focus on the retina; a deviation from emmetropia (abnormal vision)

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5
Q

define Myopia:

A

Refractive condition in which parallel rays of light entering the eye, focus in front of the retina; nearsightedness

Corrected using LASIK surgery

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6
Q

What vision does this diagram represent?

A

Myopia

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7
Q

Lenses for myopia

A
  • Minus
  • Concave
  • Diverging
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8
Q

define Hyperopia:

A

Refractive condition in which parallel rays of light entering the eye f_ocus behind the retina_; farsightedness

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9
Q

What vision does this diagram represent?

A

Hyperopia

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10
Q

Lenses for hyperopia

A
  • Plus
  • Convex
  • Converging
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11
Q

define: Astigmatism

A

Refractive condition in which rays emanating from a single point are focused as two line images (blurry vision at all distances), generally at right angles to each other; due to unequal refraction of the incident light in different meridians

Eye becomes astigmatic when any of its refracting surfaces assumes a toroidal shape

Eye is not perfectly round (ex: football shaped not basketball shaped)

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12
Q

What type of asitgmatism is this?

A

compound myopic astigmatism

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13
Q

What type of astigmatism is this?

A

Compound hyperopic astigmatism

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14
Q

What type of astigmatism is this?

A

Mixed astigmatism

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15
Q

define Presbyopia:

A

Reduction in accommodative ability occurring normally with age and necessitating a plus lens addition for satisfactory seeing at near
Amplitude decreases from childhood to age 75

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16
Q

Presbyopia

A

affects 100% of people

treat with reading glasses

corrected surgically using: Conductive Keratoplast or Scleral Spacing Procedure (FDA trial)

17
Q

define Accommodation:

A

Ocular adjustment for vision at various distances, by changes in shape (steepening) of the crystalline lens

18
Q

define Diplopia:

A

Condition in which a single object is perceived as two objects rather than as one; double vision

  • usually results from EOM imbalance
  • monocular: persists when fellow eye is covered
19
Q

define: Anisometropia:

A

Condition of unequal refractive state for the two eyes, one eye requiring a different lens correction from the other

20
Q

Six Elements or Major Categories of Eye History

A
  1. chief complaint
  2. medical history
  3. medications/ hypersentitivities
  4. visual and occular history
    • last eye exam
    • galsses or contacts
  5. family eye and medical history
    • cataracts, glaucoma, macular degneration
  6. vocational and recreational demands
21
Q

VISUAL Symptoms of Ocular Discomfort

A
  • Blurred vision
  • Diplopia
  • Distortion
  • Vertigo
  • Glare/light sensitivity
  • Spots before eyes
  • Light flashes
  • Loss of vision
  • Halos around lights
  • Loss of visual field
  • Night blindness
  • Movement of field
22
Q

OCULAR Symptoms of Ocular Discomfort

A
  • Itching or burning
  • Tenderness, soreness
  • Pain, foreign body sensation
  • Excessive lacrimation
  • Change in blink rate
  • Warm, hot, tired feeling
  • Twitching of lids
  • Mattering of eyelids
23
Q

REFERRED Symptoms of Occular Discomfort

A
  • Headache
  • Fatigue
  • Stress
24
Q

Physical Exam

A

Visual Acutiy: Snellen

Pupils: size, shape, equality; reaction to light (PERRLA)

Extra-ocular muscles: movements of eyes into 6 cardinal positions (H test)

Visual field: confrontation testing

Anterior Segment Exam: slit lamp or pen light look at - lids, lashes, lacrimal gland, cornea, conjuntiva, iris, lens

Direct Ophthalmoscopy: media - cornea, lens, vitreous, disc, macula, vessels

25
Q

Physical Exam: Visual Acuity

A
  • Patients will usually get some letters correct and some incorrect as the letter size approaches their threshold
  • Non-conventional methods: Near/Tumbling E/Pictures
  • Pg. 66 Mosby’s Record line in which they miss NO letters….(Evan)
26
Q

Four Cardinal Eye Complaints

A
  1. Changes in Vision
  2. Changes in Appearance
  3. Pain or Discomfort
  4. Trauma
27
Q

Cardinal Changes: Change in Vision

A
  • Painless or Painful
  • Extent of Vision Loss
  • One or Both Eyes:
  • Bilateral: neurologic etiology, not a primary problem

• Flashes or Floaters

  • Multiple – retinal tear, vitreous hemorrhage
  • Single – benign

• Rate of Onset

  • Rapid deterioration: vascular cause
  • Gradual loss: cataracts
28
Q

Cardinal Changes: Pain or Discomfort

A
  • Pain or no pain?
  • Foreign body sensation
  • Excessive tearing
  • Itching or burning
  • Light sensitivity
29
Q

Cardinal Changes: Trauma

A
  • Tetanus immunization state
  • Fluid or chemical exposure
  • Blunt or penetrating injury
30
Q

Special Tests: Sit-Lamp Examination

A

Highly magnified views of: anterior segment and posterior segment

31
Q

Special Tests: Intraocular Pressure

A

Analogous to systemic blood pressure

IOP – 8 to 21 mm Hg

Glaucoma screening

32
Q

Emergent Conditions (immediate referral)

A

o Sudden Vision Loss
o Retinal Artery Occlusion
o Chemical Burns
o Acute Angle-Closure Gluacoma

33
Q

Urgent Conditions

(referal with 1 day or less)

A

o Acute glaucoma
o Orbital cellulitis
o Hyphema
o Corneal Ulcer
o Retinal Detachment

34
Q

Implantable Collamer Lens (ICL)

A

used in patients who cannot have lasik (too nearsighted)

in surgery - cut the limbus, insert the ICL next to the patient’s lens

35
Q

Occular Maturity

A

often occurs at age 18

vision change of less than +or- 0.75 within 1 year

36
Q

Cataract

A

natural clouding (or darkening) of lens

age dependent

typically affects older adults (60+), can occur in infants or children - rarely

Leading cause of preventable blindness world wide

37
Q

Cataract Surgery

A

Entry Incision

Capsulorhexis (cutting the lens)

Phacoemuslification (use ultrasound to destroy lens)

Lens placement (standard, multifocal, accomodative lens types)

Corneal Arcuate Incisions (correct astigmatism if needed)

38
Q

Keratoconus

A

Cone-shaped cornea

Progressive blinding disease

No good treatment - corneal transplant, Collagen Cross-Linking (Clinical Trial)

Adult/Ped Medicine 2 (10 decks)

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