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Physical Diagnosis > Gradual Onset Vision Loss > Flashcards

Gradual Onset Vision Loss Flashcards

1
Q

what conditions cause optic atrophy

A

MS
glaucoma
cranial arteritis

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2
Q

what is normal cup to disc ratio

A

30%

cup/disc

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3
Q

what does increase cup to disc ratio indicate

A

> 50%

chronic glaucoma

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4
Q

flame shaped or splinter/linear hemorrhages indicate what

A

HTN

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5
Q

punctate or blot/dot hemorrhages indicate what

A

Diabetes Mellitus

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6
Q

hard exudates are seen in what condition

A

yellow or macular star

DM, HTN, VHL disease, radiation

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7
Q

soft exudates are seen in what condition

A

cotton wool spot

DM, HTN, HIV, connective tissue disease

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8
Q

what is the grading scale for arteriosclerosis

A

grade 1 - widening of arteriole light reflex
grade 2 - above plus AV crossing defects
grade 3 - above plus COPPER WIRE APPEARANCE
grade 4 - above plus SILVER WIRE APPEREANCE

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9
Q

what is the grading scale for hypertensive retinopathy

A

grade 1 - mild narrowing of vessels
grade 2 - severe narrowing of vessels and AV crossing defects
grade 3 - above plus cotton spots and flame shaped hemorrhages
grade 4 - above plus malignant plus optic disc and macular swelling

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10
Q

What are the characteristics of non proliferative and proliferative diabetes

A

background diabetes or non proliferative

  • hard and cotton wool exudates
  • punctate/blot dot hemorrhages
  • microaneurysms

proliferative diabetes

  • neovascularization
  • preretinal hemorrhages
  • virteous hemorrhages
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11
Q

what are the symptoms of cataracts

A 
clouded and blurred vision 
difficult to see at night 
sensitivity to light and glare 
halos around lights 
changes in eyeglass or contact lens 
fading or yellowing of colors
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12
Q

what type of cataracts is described as opacities in various locations that are separated by areas of clear lens

A

immature cataracts

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13
Q

what type of cataracts is described as total opacity of the lens

A

mature cataracts

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14
Q

what type of cataracts is described as swollen lens encroaches on the anterior chamber where it could displace the iris forward so that it blocks flow to the eye

A

intumescent cataracts

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15
Q

what type of cataracts is described as wrinkling of the lens leading to liquefaction of the lens cortex which causes fluid to leak out through the lens capsule

A

hypermature cataracts

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16
Q

what are the 3 locations that cataracts could occur at

A

nuclear or lenticular - lens nucleus becomes dense - yellow or brown

cortical - opacities localized to lens cortex - may form radial spikes or progress to complete opacification of the cortex

posterior capsular - opacification of anterior or posterior capsule - POSTERIOR MC

17
Q

what are clinical features of chronic glaucoma

A 
cup/disc = 50% 
PAINLESS 
HALOS
mid peripheral vision loss 
increase IOP
18
Q

what are the clinical features of DRY age related macular

A 
blurry vision 
distorted vision 
metamorphosia - straight lines appear and object may appear wrong shape or size 
loss of correct color 
difficulty reading 
dark empty area in the center of vision 
DRUSEN bodies
19
Q

what are the clinical features of retinitis pigementosa

A

rare hereditary disorder
rods located in the periphery degenerate - night vision and peripheral vision lost
mild vision loss to blind

20
Q

the pinhole testing for the eye will correct what issue

A

refractive errors

21
Q

what is another term for marcus gunn pupil

A

relative afferent pupillary light response

22
Q

what is the relative afferent pupillary light response

A

intact consensual response

paradoxical pupil dilation to direct light

swing light test used

23
Q

what does marcus gunn pupil suggest

A

optic nerve lesion

extensive retinal disorder

24
Q

what conditions have RAPD or marcus gunn pupil

A 
optic neuritis 
chronic glaucoma 
optic nerve tumor 
retinal detachment 
severe macular degen
25
Q

what conditions do NOT have RAPD or macus gunn pupil

A

refractive errors
horners syndrome
third cranial nerve palsy
mild macular degen

26
Q

what is esotropia, exotropia, hypertropia, and hypotropia

A

eso - eye adducted
exo - abducted
hyper - eye superior
hypo - inferior

27
Q

what is tropia

A

strabismus

deviation ALWAYS present
tropia is the resting position of the eyes when covered
deviation of eyes NOT corrected by fusion

COVER UNCOVER TEST

28
Q

strabismus is MC when

A

18 months - 2 years

29
Q

what is phoria

A

latent strabismus

deviation in eyes corrected by fusion
deviation SOMETIMES present when binocular vision is broken or tired eyes

COVER UNCOVER TEST

30
Q

what is amblyopia

A

visual impairment in normal eye

Physical Diagnosis (18 decks)

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