Eyes and Ears Diseases and Disorders Flashcards
1
Q
What are the etiologies of refractive disorders (hyperopia, myopia, astigmatism, and presbyopia)?
A
possible genetic link, close work, degeneration
1) Hyperopia: abnormally short eyeball
2) Myopia: abnormally long eye
3) Astigmatism: abnormal cornea
4) Presbyopia: stiff lens
2
Q
What are the clinical features of refractive disorders (hyperopia, myopia, astigmatism, presbyopia)?
A
S/S:
- blurry vision, eye fatigue, headaches
DIAGNOSTIC TESTS:
- retinoscopy
3
Q
What’s the treatment and prognosis for refractive disorders?
A
TREATMENT:
- eyeglasses or contact lenses
- laser surgery
PROGNOSIS:
- excellent
4
Q
What are the etiologies of nystagmus?
A
- congenital factors
- (acquired) alcohol abuse, drug abuse, or neoplasm
5
Q
What are the clinical features of nystagmus?
A
S/S:
- repetitve or involuntary movement of eyes, blurry vision
DIAGNOSTIC TESTS:
- external examination
6
Q
What’s the treatment and prognosis for nystagmus?
A
TREATMENT:
- treat underlying cause (tumor, substance abuse)
- Kestenbaum procedure
PROGNOSIS:
- varies on underlying cause
7
Q
What are the etiologies of strabismus?
A
- (if early onset) associated with amblyopia
- (if adult onset) diabetes mellitus, hypertension, intracranial lesion, muscular dystrophy, or trauma -> impaired brain, cranial nerves, or orbital muscles
8
Q
What are the clinical features of strabismus?
A
S/S:
- esotropia (inwards), exotropia, (outwards), and diplopia
DIAGNOSTIC TESTS:
- abnormal opthalmic examination
- abnormal radiographic and blood test readings with late onset causes
9
Q
What’s the treatment and prognosis for strabismus?
A
TREATMENT:
- corrective eyeglasses or surgery
PROGNOSIS:
- good if early onset
- variable if late onset
10
Q
What are the etiologies of blepharitis?
A
- staphyloccal infection (ulcerative), or hypersensitivity, irritants, or meibomian gland dysfunction (nonulcerative) -> eyelid inflammation
11
Q
What are the clinical features of blepharitis?
A
S/S:
- erythema and crusting of eyelids, burning sensation, falling out eyelashes
DIAGNOSTIC TESTS:
- collarettes seen with visual examination
12
Q
What’s the treatment and prognosis of blepharitis?
A
TREATMENT:
- wash with baby shampoo and water solution
- bacitracin or erythromycin
PROGNOSIS:
- if untreated, may progress to keratitis and conjunctivitis
13
Q
What are the etiologies of a hordeolum (or stye)?
A
staphyloccal infection, blepharitis -> abscess of follicule or meibomian gland
14
Q
What are the clinical features of a hordeolum (or stye)?
A
S/S:
- erythema, swelling, pus, pain
DIAGNOSTIC TESTS:
- signs/symptoms present during examination
15
Q
What’s the treatment and prognosis for a hordeolum (or stye)?
A
TREATMENT:
- warm compresses
- topical antibiotics
- surgical drainage of abscess
PROGNOSIS:
- usually self-limiting
16
Q
What’s the etiology of a chalazion?
A
blocked meibomian glands -> subcutaneous nodule
17
Q
What are the clinical features of a chalazion?
A
S/S:
- small/firm nodule, possible erythema, pain, and swelling
DIAGNOSTIC TESTS:
- signs/symptoms present with examination
18
Q
What’s the treatment and prognosis of a chalazion?
A
TREATMENT:
- warm compress
- gentamicin, tobramycin, azithromycin, or quinolone
- corticosteroids
PROGNOSIS:
- usually resolves
19
Q
What are some risk factors and etiologies of keratitis?
A
RISK FACTORS:
- wearing contact lenses
ETIOLOGY:
HSV-1, certain bacteria, certain fungi, corneal trauma, or dry air -> corneal inflammation
20
Q
What are the clinical features of keratitis?
A
S/S:
- irritation, erythema, tearing, decreased visual acuity, and photophobia
DIAGNOSTIC TESTS:
- cultures may identify a pathogen
- slit lamp shows inflamed cornea
21
Q
What’s the treatment and prognosis of keratitis?
A
TREATMENT:
- broad-spectrum antibiotics or antiviral drugs
PROGNOSIS:
- risk of corneal damage
22
Q
What’s the etiology of entropion?
A
degeneration of lower eyelids -> eyelids turn inwards and irritate cornea and conjunctiva
23
Q
What are the clinical features of entropion?
A
S/S:
- redness, itching, tearing, feeling a “foreign body”
DIAGNOSTIC TESTS:
- eyelid inversion present during examination
24
Q
What’s the treatment and prognosis of entropion?
A
TREATMENT:
- surgical correction
PROGNOSIS:
- good with surgery
- risk of corneal damage
25
What are the etiologies of ectropion?
age-related degeneration or scar that pulls eyelid (cicatricial) -> outward bending eyelid
26
What are the clinical features of ectropion?
S/S:
- abnormal tear flow, dry eyes
DIAGNOSTIC TESTS:
- outward bend present during examination
27
What's the treatment and prognosis of ectropion?
TREATMENT:
- surgical correction
PROGNOSIS:
- good with surgery
- risk of corneal damage
28
What are the etiologies of blepharoptosis?
myasthenia gravis, muscular dystrophy -> weakness of CN III or eyelid muscle
29
What are the clinical features of blepharoptosis?
S/S:
- drooping upper eyelid, possible visual obstruction
DIAGNOSTIC TESTS:
- ptosis present during examination
- possible abnormal blood tests
30
What's the treatment and prognosis for blepharoptosis?
TREATMENT:
- surgical correction
- systemic medication, depending on cause\
PROGNOSIS:
- good with treatment
31
What are the etiologies of conjunctivits?
viral infection, bacterial infection, chemical irritants OR hypersensitivity (vernal) -> conjunctival inflammation
32
What are the clinical features of conjunctivitis?
S/S:
- redness, itching, tearing, photophobia, foreign body sensation
- discharge if infectious
- coarse eyelid if vernal
DIAGNOSTIC TESTS:
- conjunctival inflammation present with examination
- (if infectious) postive viral or bacterial culture
33
What's the treatment and prognosis for conjunctivitis?
TREATMENT:
- cool or warm compress
- antibiotics
PROGNOSIS:
- usually good
34
What are some risk factors and etiologies of keratoconjunctivitis sicca (or dry eye syndrome)?
RISK FACTORS:
- being female
- >50yrs old, wearing contact lenses
- vitamin A deficiencies
ETIOLOGY:
degeneration, inflammation, Sjrogen's syndrome, prior radiation therapy, certain drugs -> inadequate tear production
35
What are the clinical features of keratoconjunctivitis sicca?
S/S:
- redness, itching and burning, foreign body sensation, tearing, photophobia
DIAGNOSTIC TESTS:
- dry eyes present during examination
36
What's the treatment and prognosis for keratoconjunctivitis sicca?
TREATMENT:
- eye drops
- cyclosporine and lifitegrast
PROGNOSIS:
- better with treatment
- treatment may be lifelong
37
What are the etiologies of a corneal abrasion? Of a corneal ulcer?
- (corneal abrasion) foreign bodies between eyelid and cornea, direct trauma, and poorly-fitted contacts -> loss of corneal epithelium
- (corneal ulcer) an untreated or undertreated corneal abrasion -> infection of cornea
38
What are the clinical features of a corneal abrasion (and ulcer)?
S/S:
- redness, tearing, pain, foreign body sensation, and blurry vision
DIAGNOSTIC TESTS:
- positive flourescein eye stain
39
What's the treatment and prognosis of a corneal abrasion (and ulcer)?
TREATMENT:
- remove foreign body
- opthalmic antibiotics
- eye dressing
PROGNOSIS:
- usually self-limiting, but possible complication of infection and scarring
40
What are the etiologies of episcleritis and scleritis?
- (episcleritis) currently idiopathic -> superficial sclera inflammation
- (scleritis) link with autoimmune diseases such as rheumatoid arthritis and chron's disease/ulcerative colitis -> deep sclera inflammation
41
What are the clinical features of episcleritis and scleritis?
S/S:
- (epislceritis) redness and irritation
- (scleritis) intense redness, pain, blurry vision
DIAGNOSTIC TESTS:
- blood tests may reveal autoimmune/infectious cause
- ultrasonography, MRI, and/or CT may reveal extent of inflammation
42
What's the treatment and prognosis of episcleritis and scleritis?
TREATMENT:
- opthalmic corticosteroids
- possible immunosupressive drugs
- scleroplasty
PROGNOSIS:
- good
43
What are the etiologies of a cataract?
* being older than 40 -> opacification of lens (risk increases each decade)
- (less commonly) congenital defects, "stamp" trauma, diabetes mellitus, or sunlight -> staining of lens
44
What are the clinical features of a cataract?
S/S:
- progressively impaired vision
- white discoloration of pupil
DIAGNOSTIC TESTS:
- opthalmoscopy and slit-lamp examination reveal cataract
45
What's the treatment and prognosis of a cataract?
TREATMENT:
- phacoemulsification or extracapsular surgery
- eyeglasses
PROGNOSIS:
- surgery usually successful
46
What are the etiologies of open-angle and closed-angle glaucoma?
- (open-angle) ocular trauma, diabetes mellitus, age-related degeneration -> block WITHIN trabecular meshwork -> increased IOP
- (closed-angle) iris root or iris-corneal adhesions blocks trabecular meshwork -> increased IOP
47
What are the clinical features of open-angle and closed-angle glaucoma?
S/S:
- (open-angle, chronic) progressive vision loss
- (closed-angle, acute) eye pain, blurry vision, photophobia, nausea
DIAGNOSTIC TESTS:
- tonometry reveals increased IOP
- goniolens identifies if glaucoma is open-angle or closed-angle
48
What's the treatment and prognosis of open-angle and closed-angle glaucoma?
TREATMENT:
- (open-angle) prostaglandin analogues, laser trabeculoplasty, or trabeculectomy
- (closed-angle) laser iridotomy
PROGNOSIS:
- if left untreated, may cause irreversible blindness
49
What are the etiologies of macular degeneration?
genetic factors, age-related degeneration, and sunlight exposure ->
- (atrophic) dry degeneration of macula lutea
- (exudative) abnormal blood vessels grow and rupture -> macula lutea degeneration
50
What are the clinical features of macular degeneration?
S/S:
- (affects both eyes) progressive worsening of central vision, semiopaque spots in vision
DIAGNOSTIC TESTS:
- opthalmosocope reveals pigmentary changes
- flourescein angiography identifies if atrophic or exudative
51
What's the treatment and prognosis of macular degeneration?
TREATMENT:
- vitamin supplements to slow degeneration
- anti-vascular endothelial growth factor (anti-VEGF) if exudative
- laser photocoagulapathy if exudative
PROGNOSIS:
- no cure is known, central vision may disappear completely
52
What's the pathogenesis of diabetic retinopathy?
(develops around 10 years after diagnosis)
uncontrolled diabetes mellitus -> poor retinal circulation (nonproliferative) -> exudate leakage into vitreous humor -> neovascularization (proliferative) with further leakage
53
What are the clinical features of diabetic retinopathy?
S/S:
- progressive worsening of visual acuity
DIAGNOSTIC TESTS:
- complete opthalmoscopic examination reveals neovascularization and macular edema
54
What's the treatment and the prognosis for diabetic retinopathy?
TREATMENT:
- (if proliferative) laser photocoagulation, vitrectomy to draw out vitreous fluid
PROGNOSIS:
- guarded, but controllable with treatment
55
What are the etiologies of retinal detachment?
severe proliferative diabetic retinopathy, myopia, or ocular trauma -> tear in retina -> exudative fluid pushes section away
56
What are the clinical feature of retinal detachment?
S/S:
- sudden eye floaters, dark "curtain" shadow in vision
DIAGNOSTIC TESTS:
- opthalmoscopy reveals detachment
57
What's the treatment and prognosis of retinal detachment?
TREATMENT:
- photocoagulation
PROGNOSIS:
- resulting blindness is irreversible
58
What are the etiologies of uveitis?
autoimmune disorders (including juvenile rheumatoid arthritis and ankylosing spondylitis) or infections -> inflammation of ciliary body, choroid, and iris
59
What are the clinical features of uveitis?
S/S:
- pain, redness, blurry vision, photophobia
DIAGNOSTIC TESTS
- slit lamp shows uveal inflammation
- blood tests may reveal autoimmune causes
60
What's the treatment and prognosis for uveitis?
TREATMENT:
- opthalmic or systemic steroids
PROGNOSIS
- varies with extent of condition and etiology
61
What's the most common etiology of exopthalmos?
hyperthyroidism -> enlarged extraorbital muscles, increased retrobulbal mass, edema of surrounding tissue -> eyes "pop" out
62
What are the clinical features of exopthalmos?
S/S:
- protruding eyes, dryness, possible double vision
DIAGNOSTIC TESTS:
- CT and blood tests may assess thyroid function
63
What's the treatment and prognosis for exopthalmos?
TREATMENT:
- (if from hyperthroidism) thyroid hormone antagonists or partial thyroidectomy
- surgical intervention
PROGNOSIS:
- usually good with treatment
64
What are the types of eye tumors and their etiologies?
1) Retinoblastoma: usually an inherited mutation on c13
2) Ocular Melanoma: higher prevalence in caucasians
3) Basal Cell Carcinoma: overexposure of sunlight to eyelid
4) Squamous Cell Papilloma: HPV infection
65
What are the clinical features of eye cancer?
S/S:
- possible pain
- visible lesion on eyelid (if BCC/SCC)
- growing pigmentatin on iris (if ocular meloma)
- leukocoria (if retinoblastoma)
DIAGNOSTIC TESTS:
- ultrasound, opthalmoscopy, CT, and MRI may reveal neoplasms
- biopsy may reveal histology
66
What's the treatment and prognosis of eye cancers?
TREATMENT:
- eyeball removal or surgical excision, chemotherapy, radiation therapy, and/or laser therapy
PROGNOSIS:
- 5-year survival rate generally good
- retinoblastoma associated with future malignancies
67
What's the etiology and diagnosis of a color vision impairment?
ETIOLOGY:
- usually inheritance of X-linked recessive genes
DIAGNOSTIC TESTS:
- multicolored eye charts
68
What are the etiologies of impacted cerumen?
abnormally narrow ear canal, excessive hair -> cerumen (earwax) accumulated
69
What are the clinical features of impacted cerumen?
S/S:
- muffled hearing, pressure, tinnitus, earache
DIAGNOSTIC TESTS:
- otologic examination reveals excess earwax
70
What's the treatment and prognosis of impacted cerumen?
TREATMENT:
- irrigation of ear
PROGNOSIS:
- great, but recurrence is likely
71
What are the etiologies of infective otitis externa?
excessive earwax, frequent use of earphones/earplugs -> bacterial or fungal growth
71
What are the etiologies of infective otitis externa?
excessive earwax, frequent use of earphones/earplugs -> bacterial or fungal growth
72
What are the clinical features of infective otitis externa?
S/S:
- hearing loss, severe earache, swollen ear canal, pruritis, fever, ear discharge
DIAGNOSTIC TESTS:
- otoscopy reveals inflammation
- culture may identify pathogen
73
What's the treatment and prognosis of infective otitis externa?
TREATMENT:
- antibiotic eardrops
- steroidal eardrops
PROGNOSIS:
- good with treatment
74
What is the etiology of swimmer's ear?
accumulation of earwax in outer ear canal -> swimming adds water-> serves as medium for bacterial or fungal cultures
75
What are the clinical features of swimmer's ear
S/S:
- severe pain, hearing loss, swollen ear canal, fever, pruritis, discharge
DIAGNOSTIC TESTS:
- otoscopy reveals inflammation
- culture may identify pathogen
76
What's the treatment and prognosis for swimmer's ear
TREATMENT:
- antibiotic eardrops
- steroidal eardrops
- AVOID WATER-RELATED ACTIVITES!!!
PROGNOSIS:
- good with treatment, may recur with swimming
77
What are the etiologies of serous otitis media?
- (if acute) upper respiratory viral infection or hypersensitivity -> inflammation of middle ear
- (if chronic) untreated acute serous otitis media, enlarged adenoid glands -> recurrent inflammation of middle ear
78
What are the etiologies of suppurative otitis media?
dysfunctional estuchian tube, ruptured tympanic membrane -> bacteria breaches middle ear
79
What are the clincial features of otitis media?
S/S:
- (if serous) mild pressure, muffled hearing, watery discharge
- (if suppurative) severe pain, hearing loss, fever, nausea and vomiting, dizziness
DIAGNOSTIC TESTS:
- otoscopy reveals discharge and inflammation
- fluid culture may reveal bacteria and elevated WBCs if suppurative
80
What's the treatment and prognosis of otitis media?
TREATMENT:
- analgesics
- antibiotic ear drops (only if confirmed as suppurative)
- myringotomy
PROGNOSIS:
- good with therapy
81
What are the etiologies of otosclerosis?
possible genetic factors, being female -> abnormal growth of spongy bone around stapes
82
What are the clinical features of otosclerosis?
S/S:
- (onset begins in young adulthood) diminished hearing and tinnitus
DIAGNOSTIC TESTS:
- poor audigram results
- CT scan reveals abnormal bone growth
83
What's the treatment and prognosis of otosclerosis?
TREATMENT:
- stapedectomy with ceramic or plastic prosthesis
PROGNOSIS:
- positive with surgical intervention
84
What are the predisposing factors and physiologic features of Meniere disease?
PREDISPOSING FACTORS:
- being >50 years old, otitis media, head trauma, noise pollution, premenstrual edema
PHYSIOLOGY:
- increased endolymph
- cilial cell destruction
85
What are the clinical features of Meniere disease?
S/S:
recurrent episodes of vertigo (dizziness, nausea, sweating), tinnitus, diminished hearing, and inner ear pressure
DIAGNOSTIC TESTS:
- poor adiogram results
- MRI rules out other pathologies
86
What's the treatment and prognosis of Meniere disease?
TREATMENT:
- salt-free diet with diuretics
- surgical destruction of labyrinth
PROGNOSIS:
- controlled by treatment
- rate of hearing loss greatest during first years of disease, then stablizes afterwards
87
What are the etiologies of benign paroxysmal positional vertigo (or BPPV)?
head trauma, otitis media, or free-floating carbonate crystals in labyrinth -> impaired vestibular system (includes the laybrinth and cochlea, vestibular nerve, brainstem and cerebellum)
88
What are the clinical features of benign paroxysmal positional vertigo (or BPPV)
S/S:
- (occurs with changing position) "spinning" sensation, loss of balance, and nausea lasting for 3-10 seconds
- diminished hearing
DIAGNOSTIC TESTS:
- signs/symptoms present
- CT or MRI rules out CNS pathology
89
What's the treatment and prognosis of benign paroxysmal positional vertigo (or BPPV)?
TREATMENT:
- movement exercises
- antihistamines or antiemetics if highly disruptive
PROGNOSIS:
- controlled by treatment, may resolve with time
90
What are the etiologies of labyrinthitis?
viral/bacterial otitis media or meningitis -> infection of labyrinth
91
What are the clinical features of labyrinthitis?
S/S:
- fever, extreme vertigo, nausea, tinnitus
DIAGNOSTIC TESTS:
- signs/symptoms present
- poor adiometry results
92
What's the treatment and prognosis of labyrinthitis?
TREATMENT:
- antihistamines, antiemetics, tranquilizers
- antibiotics if bacterial
- possoble corticosteroids if autoimmune
PROGNOSIS:
- resolves after 1-3 weeks
- risk of permanent hearing loss or balance problems
93
What are the etiologies of a ruptured tympanic membrane?
extremely loud noise, foreign objects, or severe otitis media -> ruptured eardrum
94
What are the clinical features of a ruptured tympanic membrane?
S/S:
- slight pain, diminished hearing, possible bleeding from ear
DIAGNOSTIC TESTS:
- otoscopy reveals hole in tympanic membrane
95
What's the treatment and prognosis of a ruptured eardrum?
TREATMENT:
- tympanoplasty
- prophylactic antiobiotics and analgesics
PROGNOSIS:
- eardrum usually heals within 1-2 weeks
96
What are the etiologies of a cholesteatoma?
chronic otitis media -> inflammed and occluded estuchian tube -> negative middle ear pressure -> skin cells accumulate (cholesteatoma) and become infected
97
What are the clinical features of a cholesteatoma?
S/S:
- diminished hearing, earache, headache, possible purulent discharge
DIAGNOSTIC TESTS:
- otoscopy reveals eardrum retraction
- radiographic studies show extent of cholesteatoma
- fluid culture identifies pathogen
98
What's the treatment and prognosis of a cholesteatoma?
TREATMENT:
- surgical destruction of cholesteatoma with estuchian tube inflation
PROGNOSIS:
- best with early surgical intervention
- complications may include deafness, labyrinthitis, and Bell's palsy
99
What are the etiologies of mastoiditis?
untreated acute otitis media, extensive cholesteatoma -> Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella cattarhalis infection of mastoid bone
100
What are the clinical features of mastoiditis?
S/S:
- pain, headache, diminished hearing, fever, discharge
DIAGNOSTIC TESTS:
- CT reveals mastoid deformities
- blood tests reveal elevated WBCs
- positive culture study
101
What's the treatment and prognosis of mastoiditis?
TREATMENT:
- antibiotic therapy
- simple mastoidectomy
PROGNOSIS:
- varies with extent of infection and response to antibiotics
- complications may include permanent deafness, facial paralysis, and meningitis or encephalitis
102
What are the etiologies of sensironeural hearing loss?
age-related degeneration, loud noises, certain drugs, inner ear infections, or trauma -> damage to basilar membrane or auditory nerve
103
What are the clinical features of sensironeural hearing loss?
S/S:
- partial to severe hearing loss, tinnitus
DIAGNOSTIC TESTS:
- audiometry reveals poor hearing
104
What's the treatment and prognosis of sensironeural hearing loss?
TREATMENT:
- prevent further damage through reducing noise
PROGNOSIS:
- sensironeural hearing loss is irreversible
105
What are the types of benign ear tumors?
- (if external) glomus tumor or ceruminal gland neoplasm
| - (if inner) acoustic neruoma or facial neuroma
106
What are the types of malignant ear tumors?
BCC, SCC, or ceruminal gland neoplasm
*middle ear malignancy uncommon
107
What are the clinical features of ear tumors?
S/S:
- progressive hearing loss, tinnitus, dizziness, discharge
- (if glomus neoplasm) pulsitate tinnitus
DIAGNOSTIC TESTS:
- otoscopy may reveal lesion
- MRI/CT may reveal extent of neoplasm
- biopsy may reveal histology
108
What's the treatment and prognosis of ear tumors?
TREATMENT:
- surgical excision
- nerve graft if CN affected
PROGNOSIS:
- generally good with treatment, but poor if SCC
