Eyes Flashcards
What are common problems related to eyes?
Focusing problems Cataracts Diabetes Macular degeneration Glaucoma Transient loss of vision Flashes of light Diplopia Itching Headache Red eye
What is macular degeneration?
central vision loss
What is glaucoma?
elevated pressure - peripheral vision is lost first
Diplopia
double vision
If diplopia occurs in one eye, what could be the problem?
optical
If diplopia occurs in both eyes, what could be the problem?
alignment
What disease is the most common cause of exophthalmos?
thyroid disease
exophthalmos
bulging eyes
When patient has diabetes, what sort of eye problems are of most concern?
large changes in vision correction
cause of CN paralysis (CN III, IV, VI)
Retinopathy
Common HPI and PROS questions
sudden or gradual persistent or transitory recent trauma time spent on computer screens new medications past medical and surgical history recent URI one or both eyes last eye exam
What to inspect during the physical eye exam
periorbital skin eyebrows eyelashes eyelids lacrimal apparatus conjunctiva and sclera
What do you look for when inspecting periorbital skin?
swelling, redness, lesions, rash
What do you look for when inspecting eyebrows?
amount of hair, scaliness
What do you look for when inspecting eyelashes?
crusting, amount of lashes
What do you look for when inspecting eyelids?
edema, color, width of palpebral fissures, adequacy of eyelid closure
What do you look for when inspecting lacrimal apparatus?
swelling, tearing or drying
What do you look for when inspecting conjunctiva and sclera?
color, vascular pattern, nodules, swelling, presence of foreign bodies in conjunctiva
When using the Snellen eye chart, how far does the patient need to stand from the chart?
20 feet
What and how do you record when using the Snellen eye chart?
Record as fraction
Numerator - distance from the chart (20 feet)
Denominator - distance the average eye can read the chart
What does using the hand held card (Rosenbaum chart) help identify?
need for reading glasses or bifocals
How far away should the patient hold the hand-held card?
14 inches from the patient’s face
What does visual fields by confrontation test for?
defect in any quadrant of the field of vision
How far away do you stand from the patient when performing visual fields by confrontation?
3 feet. at patient’s eye level
Nystagmus
jerking or drifting of the eyes
Convergence
bringing your finger towards their nose
Under what condition(s) should you be in while performing pupillary responses?
normal light and with light shining in eye
Looking at patient’s right eye and you shine a light into it, you see constriction, what kind of response is this?
direct
Looking at the left eye, you shine a light in the right eye and you observe constriction in the left eye, what kind of response is this?
consensual
What does the swinging light test for?
test for functional impairment in the optic nerves
What does the lateral penlight test for?
estimate the depth of the anterior chamber of the eye
What do you always want to do prior to instilling mydriatic drops to the eye?
lateral penlight test
What does the corneal light reflex test?
ocular alignment by reflecting light off patient’s pupils
What is a normal result for the corneal light reflex?
The light reflects from center of both pupils
What test is used to detect tropia?
cover test
What is phoria?
movement of the eyes during binocular fixation on a given object in the absence of adequate fusion stimulus
How is phoria detected?
By observing the covered eye just as it is uncovered
What does the corneal sensitivity test?
CN V
When do you use a small light source?
When the room lights are not dimmed or for small pupils
When do you use a large light source?
when pupils are dilated
When do you use the green light on the ophthalmoscope?
used to see drusen bodies, nerve fibers and blood
When do you use the slit on the ophthalmoscope?
used to examine anterior chamber, corneal injuries
What do you use the GRID pattern for?
identify size of lesion
What is myopic and what color lens should you use?
near-sighted, red
What is hyperopic and what color lens should you use?
far-sighted, black
What are common pathologies pertaining to the eye?
corneal abrasion corneal opacification conjunctivitis pterygium hyphema cataracts papilledema diabetic retinopathy drusen
What is esotropia?
crossed eyes, eyes turn inward
What is exotropia?
eyes that turn outward
In esodeviation, how is the reflex displaced on the deviated eye?
reflex is displaced laterally
In exodeviation, how is the reflex displaced on the deviated eye?
reflex is displaced medially
What test is used to detect phoria?
cover-uncover test
When a patient complains of flashes of light, what could be the cause?
retinal detachment
When a patient has a red eye, what could it be indicative of?
Allergies
Trauma
Broken red vessel
What test allows you to detect afferent defect (Marcus Gunn pupil)?
swinging light test, also indicative of tertiary syphilis
What test is important to perform to prevent blindness in children?
pupillary response test
A shallow anterior chamber is indicative of what?
risk of acute-angle glaucoma
