eyes SM

Question 1

A patient presents with an eye complaint. What should you do first?

Answer 1

Assess visual acuity with Snellen chart

Question 2

What does 20/40 vision mean?

Answer 2

they can see at 20 feet, what a normal person sees at 40 feet

Question 3

What is amblyopia? What causes this?

Answer 3

a lazy eye - a wandering eye or poor depth perception

caused by strabismus (crossed eyes)

Question 4

What vision is considered legally blind?

Answer 4

20/200

Question 5

What test is used to assess for color blindness?

Answer 5

Ishihara color vision test

Question 6

What cranial nerves are related to the eye? What does each one do?

Answer 6

CN 2, 3, 4, 6
Optic - vision acuity
Oculomotor - focus
Trochlear - down and in
Abducens - out

Question 7

Describe a normal fundoscopic exam.

Answer 7

arteries are thin and lighter in color than the veins
sharp disc margins
red reflex

Question 8

Describe what is found on eye exam for hypertension.

Answer 8

Copper wire arteries
AV nicking
flame hemorrhages
papilledema

Question 9

Describe what is found on eye exam for diabetes.

Answer 9

Cotton wool spots
Blot hemorrhages
Microaneurysms
Neovascularization

Question 10

A patient is complaining of sudden eye pain, halos around lights, blurry vision, and eye feels firm to the touch. What diagnostic should be considered? What is this?

Answer 10

Tonometry - increased ICP

Acute angle closure glaucoma - REFER immediately

Question 11

A patient is complain of a feeling of a curtain over the eye, sudden floaters, and flashes of light. What is this?

Answer 11

Retinal detachment - REFER immediately

Question 12

Arcus senilus. Describe, what should be ordered?

Answer 12

grey halo around iris
lipid panel, especially in the young
elder

Question 13

Xanthelasma. Describe, what should be considered?

Answer 13

yellow deposits around the orbitals/eyes
benign in elderly
order a lipid panel in younger

Question 14

Describe pterygium.

Answer 14

benign overgrowth of conjunctiva - encroaches

Causes: surfer’s eye (sun) or from trauma

Question 15

Describe pinguecula.

Answer 15

will NOT cross cornea - piNguecula

Question 16

What is the difference between a hordeolum and chalazion? What treatments are considered?

Answer 16

Hordeolum is a stye - more symptoms/bacterial cause (staph A), consider antibiotics. Warm compress

Chalazion is a blockage of the duct, localized symptoms, warm compress

Question 17

What are the three types of conjunctivitis?

Answer 17

allergic, viral, bacterial

Question 18

Conjunctivitis: starts bilaterally? unilaterally then spreads to bilateral?

Answer 18

Allergic

Viral or bacterial

Question 19

What drainage is typical of allergic conjunctivitis? Viral? Bacterial?

Answer 19

Allergic/Viral - serous. Allergic is MORE stringy and ropy

Bacterial - purulent

Question 20

What medical term is used for pink eye?

Answer 20

adenoviral conjunctivitis

Question 21

What are common lymph nodes are enlarged with allergic conjunctivitis? Viral? Bacterial?

Answer 21

Allergic - cervical chain
Viral - preauricular (in front of ears), submandibular node
Bacterial - unlikely

Question 22

An elderly patient complaining of symptoms at night and an absent red reflex, you suspect?

Answer 22

cataracts

Question 23

A patient complaining of central vision loss. What is a simple lifestyle modification?

Answer 23

macular degeneration

larger print to help with reading

Question 24

A middle age patient complaining of “their arms seem too short.”

Answer 24

Presbyopia - hardening of the lens

glasses

Question 25

What diagnosis is commonly associated with a corneal abrasion? How is this diagnosed? Common complaints?

Answer 25

Bell’s palsy
DX: fluorescein staining
c/o pain, gritty feeling, light sensitivity, redness, tearing

Question 26

A patient complaining of eye pain, sensitive to light, and cannot see as well. Eye is red, inflammed iris. What is this? What should be done?

Answer 26

Iritis or Uveitis
refer to ophthalmology, worried about vision loss
needs slit lamp exam