Eyes Flashcards
How can you assess depth of the anterior chamber?
stand in front of the pt
shine light from temporal side of patient’s eye
look for a crescent shadow (indicates a shallow anterior chamber) which is abnormal
-increases risk of acute angle closure glaucoma
myopia
impaired far vision
presbyopia
impaired near vision
occurs in middle age and beyond. may see better when card is held further away
How can you test vision with a snellen chart
Snellen chart @20 feet
Patient covers 1 eye and reads lowest line available
Acute angle closure glaucoma
less common form of glaucoma
results in sudden increase in IOP and eye pain
crescent shadow present
open angle glaucoma
common form
IOP is increased but angle is normal
No crescent shadow present
Corneal light reflection
test conjugate gaze by shining light 2 feet in front of pt
normal: symmetric reflection
Abnormal: asymmetric (indicates strabismus)
Strabismus
deviation from normal conjugate position (crossed eye)
- convergent strabismus (esotropia): eyes move inward
- divergent strabismus (exotropia): eyes move outward
If corneal light reflection is abnormal, what should you do?
check cover-uncover test
- to uncover an imbalance of extra ocular eye muscle tone
- cover the normal eye with card
- the abnormal (weak) eye will move to correct position
- uncover the normal eye
- the abnormal eye will deviate
- if you perform the test by covering the abnormal eye, there will be no change
miosis
pupil constriction
mydriasis
pupil dilation
Horner’s Syndrome
- Ptosis
- Anhidrosis
- Miosis
due to dysfunction of the sympathetic nervous system
may be congenital or association with disease
anhidrosis
absent sweating on affected side
anisocria
unequal pupil size >.5mm
Tonic (Adie’s) Pupil
affected pupil is larger
reduced reaction to light
due to dysfunction of parasympathetic nervous system
Most commonly affects young women
How can you check Extraocular eye movements
move fingers through large “H”
Pause at upward gaze to detect nystagmus
how can you test eye acommodation
ask pt to follow finger as you move it towards bridge of their nose, eyes will converge and pupils will constrict
Pupillary light reflex
shine bright light at eyes
Direct pupillary light reflex: pupil on same side constricts
Consensual pupillary light reflex- pupil on opposite side constricts
Ophthalmoscopic exam
1st obtain red reflex (red/orange glow in the pupil)
if absent may be due to: opacity of the lens, retinal detachment, retinoblastoma, artificial eye
retinoblastoma
childhood cancer of the retina
fundus of the eye
interior surface of the eye, opposite the lens, includes: retina, optic disc, macula, fovea, posterior pole
cup to disc ration (CDR)
the measurement used to assess the progression on glaucoma. Glaucoma produces pathological cupping of the optic disc. As glaucoma advances the cup enlarges until it occupies most of the disc area.
optic disc
“blind spot” where the optic nerve and blood vessels enter the retina. can be flat of have a certain amount of normal cupping
papilledema
optic disc swelling associated with increased intracranial pressure
Hypertensive retinopathy
“dry” retina
few hemorrhage, few exudates, multiple cotton wool spots
diabetic retinopathy
“wet” retina
multiple hemorrhages, multiple exudates, few cotton wool spots
central retinal vein occlusion
associated with variable vision loss “blood and thunder”
central retinal artery occlusion
painless loss of monocular vision “cherry red spot”
