EYES

Question 1

What is the pattern of redness of conjunctivitis?

Answer 1

conjunctival injection: diffuse dilation of conjuctival vessels with redness that tends to be maximal peripherally

Question 2

What is the pattern of redness in subconjuctival hemorrhage?

Answer 2

leakage of blood outside of the vessels, producing a homogenous, sharply demarcated, red area that resolves over 2 weeks

Question 3

What is the pattern of redness of Corneal injury or Infection, Acute Iritis, and Acute Angle Closure Glaucoma?

Answer 3

ciliary injection: dilation of deeper vessels that are visible as radiating vessels or a reddish violet flush around the limbus. Ciliary injection is an important sign of these 3 conditions, but may not be apparent.

Question 4

Is Conjuctivitis painful?

Answer 4

mild discomfort rather than pain

Question 5

is Subconjuctival Hemorrhage painful?

Answer 5

NO

Question 6

is a corneal injury or infection painful?

Answer 6

moderate to severe, superficial

Question 7

is acute iritis painful?

Answer 7

moderate, aching, deep

Question 8

is acute angle closure glaucoma painful?

Answer 8

severe, aching, deep

Question 9

Is your vision impaired with conjunctivitis?

Answer 9

not affected, except for temporary mild blurring due to discharge

Question 10

is ur vision impaired with subconjunctival hemorrhage?

Answer 10

no

Question 11

is your vision affected with corneal injury or infection?

Answer 11

usually decreased

Question 12

is your vision affected by acute iritis?

Answer 12

decreased; photophobia

Question 13

is your vision affected by acute angle closure glaucoma?

Answer 13

decreased

Question 14

is there ocular discharge with conjunctivitis?

Answer 14

watery, mucoid, or mucopurulent

Question 15

is there ocular discharge with subconjuctival hemorrhage?

Answer 15

no

Question 16

is there ocular discharge with a corneal injury or infection?

Answer 16

watery or purulent

Question 17

is there ocular discharge with acute iritis?

Answer 17

no

Question 18

is there ocular discharge with acute angle closure glaucoma?

Answer 18

no

Question 19

is the pupil affected in conjunctivitis or subconjuctival hemorrhage?

Answer 19

no

Question 20

is the pupil affected in a corneal injury or infection?

Answer 20

not affected unless iritis develops

Question 21

is the pupil affected in acute iritis?

Answer 21

small and irregular

Question 22

is the pupil affected in acute angle closure glaucoma?

Answer 22

dilated and fixed

Question 23

T/F the core an is clear in conjunctivitis and subconjuctival hemorrhage?

Answer 23

true

Question 24

How is the core an affected in a corneal injury or infection?

Answer 24

changes depends on cause

Question 25

How is the cornea affected in acute iritis?

Answer 25

clear or slightly clouded; injection confined to corneal limbus

Question 26

how is the cornea affected in acute angle closure glaucoma?

Answer 26

steamy and cloudy

Question 27

What causes conjunctivitis?

Answer 27

bacterial, viral, and other infections, highly contagious; allergy; irritation

Question 28

What causes subconjuctival hemorrhage?

Answer 28

often none; may result from trauma, bleeding disorders, or sudden increase in venous pressure as from cough

Question 29

what is the significance of a corneal injury or infection?

Answer 29

abrasions, and other injuries; viral and bacterial infections

Question 30

what is the significance of acute iritis?

Answer 30

associated with systemic infection; Herpes zoster, tuberculosis; refer promptly

Question 31

what is the significance of acute angle glaucoma?

Answer 31

acute increase in intraocular pressure constitutes an emergency

Question 32

a drooping of the upper lid

Answer 32

ptosis

Question 33

what causes ptosis

Answer 33

myasthenia gravis, damage to the oculomotor nerve, and damage to the sympathetic nerve supply (Horner's syndrome) * a weakened muscle, relaxed tissue, and the weight of herniated fat may cause senile ptosis * may be congenital

Question 34

an inward turning of the lid margin; the lower lashes, often invisible when turned inward, irritate the conjunctiva and lower cornea

Answer 34

entropion; more commonly found in elderly

Question 35

how do you check for an entropion that is not obvious?

Answer 35

ask the patient to squeeze the lids together and then open them, then check for the entropion

Question 36

margin of the lower lid is turned outward, exposing the palpebral conductive. when the punctum of the lower lid turns outward, the eye no longer drains well, and tearing occurs.

Answer 36

ectropion, more common in elderly

Question 37

wide eyed stare; rim of sclera between the upper lid and the iris.

Answer 37

lid retraction

Question 38

Retracted lids and "lid lag" when eyes move from up to down markedly increase the likelihood of _____, especially when accompanied by fine tremor, moist skin, and heart rate > 90 beats per minute

Answer 38

hyperthyroidism

Question 39

protrusion of the eyeball; triggered by auto reactive T lymphocytes

Answer 39

exophthalmos

Question 40

Exophthalmos is a common feature of _____

Answer 40

Graves' ophthalmopathy

Question 41

In Unilateral exophthalmos what 4 things should be in your differential diagnosis?

Answer 41

1. Graves Disease (usually bilateral) 2. trauma 3. orbital tumor 4. granulomatous disorder

Question 42

a harmless yellowish triangular nodule in the bulbar conductive on either side of the iris. appears frequently with aging, first on the nasal and then on the temporal side

Answer 42

pinguecula

Question 43

a localized ocular inflammation of the episcleral vessels. vessels appear movable over the scleral surface. may be nodular or show only redness and dilated vessels

Answer 43

Episcleritis

Question 44

What are the 3 diseases associated with episcleritis?

Answer 44

1. rheumatoid arthritis 2. Sjogren's syndrome 3. herpes zoster

Question 45

a painful tender red infected in a gland at the margin of the eyelid

Answer 45

sty

Question 46

a subacute nontender, usually painless nodule involving a blocked meibomian gland. May become acutely acutely inflamed but unlike a sty usually points inside the lid rather than on the lid margin

Answer 46

Chalazion

Question 47

slightly raised yellowish, well circumscribed plaques that appear along the nasal portion of one or both eyelids. may accompany lipid disorders

Answer 47

xanthemasma

Question 48

a swelling between the lower eyelid and nose

Answer 48

inflammation of the lacrimal sac (dacryocystitis)

Question 49

acute inflammation of the lacrimal sac (Dacryocystitis) description

Answer 49

painful red and tender

Question 50

chronic inflammation of the lacrimal sac (Dacryocystitis) discription

Answer 50

obstruction of the nasolacrimal duct | tearing is prominent and pressure on the sac produces regurgitation of material through the puncta of the eyelids

Question 51

a thin grayish white arc or cycle not quite at the edge of the cornea. accompanies normal aging but also seen in younger people, especially african american.

Answer 51

corneal arcus

Question 52

when corneal arcs in found in young people it suggests possible ________.

Answer 52

hyperlipoproteinemia. usually benign

Question 53

a golden to red brown ring, sometimes shading to green or blue, from copper deposition in the periphery of the cornea

Answer 53

Kayser-Fleischer Ring

Question 54

What disease is Kayser- Fleischer Ring found in?

Answer 54

Wilson's disease

Question 55

Kayser - Fleischer Ring is due to a rare autosomal recessive mutation of the ATO7B gene on chromosome 13 causing what????

Answer 55

1. abnormal copper transport 2. reduced biliary copper excretion 3. abnormal accumulation of copper in the liver and tissue throughout the body

Question 56

What are some symptoms that patients present with who are diagnosed with a Kayser- Fleischer ring?

Answer 56

1. liver disease 2. renal failure 3. neurologic symptoms of tremor 4. dystonia 5. psychiatric disorders ranging from behavior changes to depression and schizophrenia

Question 57

A superficial grayish white opacity in the cornea, secondary to an old injury or to inflammation. Size and shape are variable.

Answer 57

Corneal Scar | **do not confuse with the opaque lens of a cataract, visible on a deeper plane and only through the pupil

Question 58

a triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side

Answer 58

Pterygium

Question 59

Will pterygium interfere with vision?

Answer 59

may interfere with vision as it encroaches on the pupil

Question 60

opacities of the lenses visible through the pupil.

Answer 60

cateracts

Question 61

what are the risk factors of cataracts?

Answer 61

1. old age 2. smoking 3. diabetes 4. corticosteroid use

Question 62

looks gray when seen by a flash light. if the pup is widely dilated, the gray opacity is surrounded by a black rim

Answer 62

nuclear cataract

Question 63

produces spokelike shadows that point - gray against black, as seen with a flashlight, or black against red with an opthalmoscope. a dilated pupil, as shown here, facilitates this observation

Answer 63

peripheral contact

Question 64

When anisocoria is greater in bright light than in dim light, the pupil ___________.

Answer 64

cannot constrict properly

Question 65

What are the cause of unequal pupils (Anisocoria), when anisocoria is greater in bright light than in dim light?

Answer 65

1. blunt trauma to the eye 2. open angle glaucome 3. impaired parasympathetic nerve supply to the iris, as in tonic pupil and oculomotor nerve paralysis

Question 66

Unequal pupils - when anisocoria is greater in dim light, the pupil _______.

Answer 66

the smaller pupil cannot dilate properly,as in hornet's syndrome , caused by an interruption of the sympathetic nerve supply

Question 67

pupil is large, regular, and usually unilateral; reaction to light is severely reduced or slowed, or even absent. Near reaction, although very slow, is present. slow accommodation cause blurred vision. deep tendon reflexes are often decreased

Answer 67

Tonic Pupil (Adie's Pupil)

Question 68

The dilated pupil is fixed to light and near effect ; Ptosis of the upper eyelid and lateral deviation of the eye are almost always present

Answer 68

Oculomotor Nerve (CN III) Paralysis

Question 69

The affected pupil, though small, reacts briskly to light and near effort. Ptosis of the eyelid is present, perhaps with loss of sweating on the forehead.

Answer 69

Horner's syndrome

Question 70

In congenital Horner's syndrome , the involved iris is _______.

Answer 70

lighter in color than its fellow (heterochromia)

Question 71

small, irregular pupils, that accommodate but do not react to light indicate _________

Answer 71

Argyll Robertson Pupils

Question 72

What disease are Argyll Robertson pupils seen in?

Answer 72

Central Nervous System Syphilis

Question 73

When does unilateral blindness not cause anisocoria?

Answer 73

as long as the sympathetic and parasympathetic innervation to both irises is normal

Question 74

How can you test if unilateral blindness is causing anisocoria?

Answer 74

a light directed into the seeing eye produces a direct reaction in that eye and a consensual reaction in the blind eye. A light directed into the blind eye, however, causes no response in either eye.