Eyes Flashcards
What is physiological anisocoria?
Difference in muscle tone between right and left pupil
20%
One pupil larger than other and stays that way throughout dilation/contraction
Horners syndrome
Pupil of affected eye is smaller
Also have ptosis, anhidrosis
Argyll robertson pupils
Constrict only in response to accommodation
Do not constrict in response to light
What might you find argyll Robertson pupils in response to?
Syphilis, diabetics, alcoholics
ALWAYS PATHOLOGICAL
Adies pupil
Doesn’t constrict in response to light and accommodation
May constrict after a bit but sluggish
ALWAYS BENIGN
Is argyll Robertson pupils benign or pathological?
Pathological
Are adies pupil always benign or pathological?
Benign
Marcus Gunn pupil
Abnormal afferent pathways. Will dilate in response to light but poorly constricts.
What is Marcus Gunn pupil usually caused by?
Optic neuritis
What are the common cause of optic neuritis
- demyelinating diseases
- infections: TB, HIV, Lyme, Hep etc
- sinus infections
- drugs
- radiator therapy
What is the red free filter used to detect?
Hemorrhages
What is the cobalt filter used to detect?
With flourescein dye to evaluate small lesions, corneal abrasions and foreign bodies
What is another word for near-sighted?
Myoptic
What is another name for far-sighted?
Hyperopic
What are a few of the things that you can evaluate the disc for?
Clarity of the outline, color, elevation and condition of vessels
Arcus cornealis
Opaque, grayish ring at the periphery of the cornea within the sclerocorneal junction
-common in the elderly
-from fatty granules or hyaline degeneration of lamellae and cells of the cornea
Hordeolum
Aka: style
Inflammation of the lash follicle
Chalazion
Plugged meibomian gland
Usually not tender
Blepharitis
Inflammation of the eyelids
Anterior: affects outer lid caused by bacteria and scalp dandruff
Posterior: affects inner lid caused by problems with oil/meibomian glands
Xanthelasma
Yellow, flat plaques that occur near inner canthus
Commonly occur in people with hyperlipidemia
Milia
Firm collection of oil/skin cells that get walled off. Not associated with a pore
Ectropion
Outward turning of the eyelid
Conjunctivitis
Viral MC
Bacterial: yellow sticky pus
Allergies and mechanical irritation may cause
Pinguecula
Abnormal growth on the eye
- thickening lateral to the iris
- does not interfere with sight
Pterygium
Abnormal growth on the surface of the eye
- may grow large enough to cover the iris and pupil
- wedge growth lateral to the iris
Coloboma
Anomaly with the iris
“Keyhole” shape
Leukocoria
“White reflex”
Indicates that something is changing color of retina or something obstructing normal reflex
MC cause is congenital cataract
Retinoblastoma most serious causes
Amblyopia
Anything that affects normal use of the eyes and visual development
3 major causes:
- Strabismus
- Unequal focus
- Cloudiness
3 things that cause amblyopia
- Strabismus
- Unequal focus
- Cloudiness of of the eye tissues
Nonproliferative diabetic retinopathy (NDR)
MC form of diabetic
-20 years of diabetes almost 100% of Type 1 patients have some degree
Features: microaneurysm, cotton wool spots, exudates
What are the main features seen in nonproliferative diabetic retinopathy?
- Cotton wool spots
- Microaneurysms
- Exudates
Proliferation diabetic retinopathy (PDR)
- growth of new vessels on the retina
- loss of vision
- neovascularization of the disc (NVD)
Cotton wool spots
Small, yellowish areas in retina
-due to swelling of the retina due to impaired blood flow
-MC with high BP and diabetes
May become exudates
Microaneurysms
- earliest sign of diabetic retinopathy
- transition to hemorrhages
Hemorrahages
Resemble ischemic retina
-usually cause damage and visual issues
Exudates
- accumulations of lipid and protein
- bright reflective white lesions
- represent increased vessel permeability and increased risk of edema
Hypertensive retinopathy findings
Cotton wool spots Flame shaped hemorrhages Macular edema Disc edema Cholesterol laid down into the tunica intima and medium that lead to hemorrhage and cotton wool spots
AV ration
Arteriovenous ratio
3:5 to 2:3
AV nicking
Cause of vascular sclerosis
Where vein and artery overlap
MC cause of AV nicking
Prolonged systemic HTN
Drusen bodies
Round yellow deposits that form under retina
Form in the periphery
What are factors in formation of drusen bodies?
Atherosclerosis, amount of pigmentation, heredity, and exposure to sun
Glaucoma
Increased pressure within the eye due to obstruction of aqueous humor outflow
Causes “cupping” of optic disc
What can glaucoma lead to?
Destruction of optic fibers and visual field deficit
Retinal tears
Due to traction on retina by vitreous gel
Over time vitreous becomes thinner and separates from the retina —> posterior vitreous detachment (PVD) which cause “floaters”
Floaters
Created as vitreous pulls free from the retina
-gel that cast shadows on the retina
Retinal detachment
When sensory and pigmented layer separate
MC in middle-aged and elderly
3 types of retinal detachments
- Break in sensory layer of retina and fluid seeps in causing separation
Near-sighted more at risk - Strands of vitreous scar tissue traction retina pulling it loose
Diabetes most at risk - Fluid collects under retina and cause it to separate
In conjunction with another disease of the eye
Signs and symptoms of retinal detachment
- light flashes
- “watery” vision
- veil obstructing vision
- many floaters
Papilledema
Optic disc swelling secondary to increased intracranial pressure
- vision well preserved
- bilateral and onset is between hours and weeks
Signs and symptoms of papilledema
headache that is exacerbated with coughing/valsalva manouver
Nausea/vomiting
