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PE midterm > Eye (UPDATED!) > Flashcards

Eye (UPDATED!) Flashcards

1
Q

What should PAs never prescribe for pts to put int heir eyes withour direction from an opthamologist?

A

steroids

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2
Q

what are the side effects of steroids in the eye?

A

weakened, perforated cornea

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3
Q

True or false: you should always answer “refer to opthamologist” if it is an option

A

TRUE

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4
Q

what are the corners of the eyes called?

A

lateral and medial canthus

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5
Q

what gland is just above the eye?

A

lacrimal gland

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6
Q

what is the part of the eylid that is found under the eyelashes?

A

palpebral fissure

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7
Q

what are the holes on the superior and inferior palpebral fissures near the medial canthus?

A

superior/inferior lacrimal punctum

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8
Q

where is the caruncle located?

A

the red spot in the nasal corner of the eye

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9
Q

what duct empties into the inferior nasal turbinate?

A

the nasolacrimal duct

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10
Q

what is the funciton of tears?

A

protect conjunctiva/cornea from drying, inhibit microbial growth, make surface of cornea smooth

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11
Q

What disease is associated with a lack of tears?

A

Sjogrens

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12
Q

what CN is associated with closing the eye?

A

VII

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13
Q

what CN is associated with opening the eye?

A

III

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14
Q

what are the major CN associated with the eye?

A

3, 4, 6, 7

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15
Q

what CN is associated with changing the shape of the ciliary muscle to focus the lens?

A

III

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16
Q

What is the canal of schlem?

A

drains the vitreous humor of the eye

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17
Q

What can form if the canal of schlem is blocked? How is it treated?

A

glaucoma, vitrectomy to laster through and form the canal again

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18
Q

what parts of the eye are associated with the anterior chamber?

A

cornea, pupil, iris, lens

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19
Q

What parts of the eye are associated with the posterior chamber?

A

retina, vitreous humor, macula, choroid

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20
Q

distinguish the bulbar conjunctiva from the palpebral conjunctiva

A

the bulbar conjunctiva is associated with the eye and the palpebral conjunctiva is associated with the eyelid

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21
Q

what makes up the optic nerve?

A

choroid + retina

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22
Q

what size is the optic cup relative to the optic disc?

A

cup = 1/2 the disc diameter

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23
Q

on eye exam, what is the dark middle region of the eye?

A

macula with the fovea in the middle

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24
Q

what CN are associated with eye muscles?

A

all are asscoiated with CN III except SO4 and LR6

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25
Q

how shoud the pupil respond to light exam with direct light?

A

pupil should become myotic, the other eye should respond consensually

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26
Q

what is accomodation?

A

how the eye focuses on objects coming towards or moving away from them

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27
Q

what CN are associated with accommodation?

A

II and III

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28
Q

how is a normal eye exam documented?

A

PERRLA

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29
Q

Distinguish the Jaeger from the Snellen chart

A

Jeager: hand-held near vision chart; Snellen: distance chart

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30
Q

How close should the snellen and jaeger charts be away from the pt?

A

snellen: 20ft; Jaeger: 14ft

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31
Q

what does 20/200 vision mean?

A

you see at 20ft what someone with normal vision sees at 200ft

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32
Q

what vision is considered legally blind?

A

20/200

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33
Q

what tool is used to determine color blindness?

A

ishihara cards

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34
Q

What constitutes most color blindness?

A

dichromacy (red and green color lost)

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35
Q

What causes color blindness?

A

genetic issues with retinal cones

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36
Q

what population is a higher incidence of color blindness?

A

males (1% of males)

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37
Q

what are the most common types of dichromacy?

A

protanope and dueteranope vision (loss of red, green or yellow combo)

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38
Q

how is the palpebral conjunctiva inspected on exam?

A

have pt look down, using a Qtip place it on the eyelid and evert the eyelids

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39
Q

what is the normal pupil size?

A

3-5mm

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40
Q

what drugs can cause miosis and miodriasis?

A

miosis: opiates, miodriasis: sympathomimetic drugs

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41
Q

what are 3 common APD?

A

marcus gunn, argyll robertson, CNIII palsy

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42
Q

what is the MCC and features of marcus gunn?

A

MCC: optic nerve disease/lesion, eyes react with no accommodation

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43
Q

What is the MCC and features of argyll roberston?

A

MCC: syphilis, accommodation with no reaction

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44
Q

What is the MCC of CN III palsy and features?

A

MCC: DM II, lid lag, big pupils

45
Q

what are causes of absent light relfex of the eye?

A

cataracts, retinoblastoma, retinal detachment

46
Q

when is retinoblastoma usually seen?

A

newborn exam

47
Q

what does an asymmetric light reflex mean?

A

disconjugate gaze (one eye is looking straight in a gaze and the other is looking off)

48
Q

how can you evaluate disconjugate gaze?

A

cover-uncover test, when the normal eye is covered, the one in the gaze with straighten out

49
Q

what is a nasal/temporal disconjugate gaze called?

A

esotropia (adducted) exotropia (abducted)

50
Q

what CN is responsible for the corneal reflex?

A

Sensory: V; Motor: VII (opthalmic branch)

51
Q

how is the cornea reflex performed?

A

touch a Qtip to the pts eye, they should blink

52
Q

what disease causes worsening of visual fields?

A

glaucoma

53
Q

what is nystagmus?

A

beating of the eyes when looking up and down or side to side

54
Q

What does up and down nystagmus indicate?

A

lesion to the brain, MS, doesn’t stop

55
Q

What does nystagmus side to side indicate?

A

vertigo, vetibulocochlear problems, stops

56
Q

when is nystagmus normal?

A

just a few beats side to side

57
Q

what is the uvea of the eye made up of?

A

iris, choroid, ciliary body

58
Q

anisocoria

A

pupils are unequal size - slight variation is normal in 35% of people who have it

59
Q

What can cause exopthalmos

A

bilateral: Grave’s, unilateral: tumor, orbital cellulitis

60
Q

Xanthelasma

A

lipid deposits on the outside of the eye due to severe hyperlipidemia

61
Q

pterygium

A

Visual disturbance caused by bulbar conjunctive invading the pupil

62
Q

Kayser-fleischer rings

A

wilson’s disease, Copper deposits

63
Q

corneal (Senile) arcus

A

grey hue around cornea - in young people it is due to hyperlipidemia

64
Q

Key points of funduscopic exam

A

Dilate pupils, use lowest brightness, start at 0 diopters, start 12 inches away at 15 degrees and move in

65
Q

What is a cataract?

A

thickening of the cornea

66
Q

General order of funduscopic exam

A

red reflex first, cornea, lens, background, arteries and veins, optic disc, macula

67
Q

what is the fovea?

A

high concentration of cones, found in the macula

68
Q

True or false: arteries are more transparent than veins

A

TRUE

69
Q

choroid crescent

A

hyperpigmentation around the optic disc

70
Q

What can cause AV nicking?

A

HTN

71
Q

What can cause hemorrhages on fundus exam?

A

HTN, swelling, occlusion of retinal veins, DM

72
Q

differentiate deep from superficial hemorrhages

A

superficial: obscure margins, deep: redder, rounder

73
Q

what can cause preretinal hemorrhage?

A

increased ICP

74
Q

What does neovascularity look like on fundus exam?

A

tortuous, fragile

75
Q

What can cause neovascularity?

A

DM retinopathy

76
Q

What can cause soft exudates? What do they look like?

A

soft edges; HTN, DM

77
Q

What can cause hard exudates and what do they look like?

A

sharp edges; HTN, DM

78
Q

What is drusen and what is it a sign of?

A

tiny yellow or white accumulations of extracellular material, sign of macular degeneration

79
Q

What are signs of DM retiopathy?

A

neovascularity, AV nicking, hard exudates

80
Q

how can hypertensive retinopathy be diagnosed on fundus exam?

A

hemorrhages, soft/hard exudates

81
Q

What is papilledema?

A

swelling of the optic disc due to increased ICP causing hemorrhages

82
Q

where is the lesion in right homonymous hemianopsia?

A

L optic tract: missing vision on right side of both eyes

83
Q

where is the lesion for bitemporal hemianopsia?

A

optic chiasm, can only see nasal side of both eyes

84
Q

where is the lesion for homonyous right quadrantic defect?

A

L optic radiation, missing vision in right upper quadrant of both eyes

85
Q

where is the lesion responsible for Horner’s syndrome?

A

stellate ganglion in neck caused by carotid dissection or pancoast tumor

86
Q

characteristics of horner’s syndrome?

A

myosis, ptosis, anhidrosis

87
Q

Causes of ectropion?

A

older pts, excessive tearing

88
Q

causes of entropion?

A

older pts, tearing issues

89
Q

What is Blepharitis

A

inflammation of the eyelid caused by staph or seborrheic blepharitis - increase in cebum blocks glands leading to itchiness, can alos be fungal

90
Q

What is periorbital cellulitis?

A

due to URI, fever, staph/strep - pain with EOM and proptosis

91
Q

how is blepharitis treated?

A

cleansing, topical abx

92
Q

how is periorbital cellulitis treated?

A

augmentin, 3rd gen cephalosporin

93
Q

What can cause periorbital edema?

A

allergies, hypothyroidism, nephrotic syndrome

94
Q

What causes herpes zoster opthalmicus?

A

varicella infection of the trigeminal nerve (V, opthalmic branch)

95
Q

Signs of herpes zoster opthalmicus?

A

deutritic lesions, hutchinson’s sign (lesion on top of nose causing occular involvement, keratosis, and blindness)

96
Q

What causes hordeolum (stys)?

A

staph infection of meibomian gland in tarsal plates

97
Q

how are stys treated?

A

warm compress, abx

98
Q

What is a chelazion?

A

chronic inflammation of meibomian gland following hordeolum, not infectious (tx: steroids)

99
Q

What is dacrocystitis?

A

bacterial superinfection of lactrimal tract due to strep/staph - treated with cephalosporin

100
Q

What causes conjunctivitis?

A

srep, adenovirus, chlamydia

101
Q

Signs of bacterial conjunctivitis?

A

unilateral, discharge, purulent, adenopathy - treat with abx

102
Q

signs of viral conjunctivitis?

A

bilateral, not as red, less discharge, periocular adenopathy - treat with abx

103
Q

signs of allergic conjunctivitis?

A

stringy discharge, less red

104
Q

what is a subconjunctival hemorrhage?

A

rupture of small vessels of sclera due to valsalva, HTN, coagulopathy - BENIGN, well-demarcated, no tx

105
Q

what is iritis?

A

medical emergency, autoimmune disease (SLE, sarcoid, ankylosing sponydlitis

106
Q

Signs of iritis?

A

pain with EOM, ciliary injection, cells in flare, photophobia, blurred vision, myotic pupil

107
Q

What is acute glaucoma?

A

painful red eye, vision loss, emergency, steamy cornea, ciliary injection, N/V, HA - Tx: BB, carbonic anhydrase inhibitors, psychoplegics contraindicated

108
Q

What is a hyphema

A

blood in the anterior chamber due to a blow to the eye - pain, red, vision loss - tx: drain, tPa, F/u in 5 days

109
Q

what is pinguecula?

A

overgrowth of sclera in the bulbar conjunctiva due to age, sun, wind - yellow spot on sclera

PE midterm (10 decks)

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