HEENT QUIZ 3- EYES Flashcards
causes of arterial occlusion
atherosclerosis, emboli, inflammation
sx of arterial occlusion
amarousis fugax: Aarterial spasm that lasts seconds to minutes
as if a dark shade is being lowered in the field of vision
what would the retina look like in some with arterial occlusion
-cherry red spots in the macula
-pale and edematous retina
-if occlusion last greater than 1 hour, then optic nerve may atrophy
incidence of venous occlusion
more common than arterial occlusion
-2nd most common cause of blindness due to retinal vascular disease `
causes of venous occlusion
increased blood viscosity, HTN, COPD, diabetes
retinal findings in venous occlusion
-flame hemes
-pale and swollen ONH
-engorged retinal vessels
-stormy retina
-CRVO: blood and thunder
which type of vein occlusion is more common
BRVO is more common than CVRO
who is more likely to have a vitreous hemorrhage?
diabetics and hx of floaters
how would a vitreous hemorrhage show up in retinal exam?
unable to see retina due to blood in vitreous humor
incidence of retinal detachment
-DM
-Trauma
-ROP
sx of retinal detachment
floaters, flashing lights and descending curtain
PE findings in retinal detachment
retina becomes pearly grey and retinal folds
retinal findings in a patient with cataracts
decreased red reflex; hard to see through the cataract
how will a child with cataracts present
squinting and amblyopia (Crossing of the eyes)
what is the usual cause of cupping?
chronic glaucoma
Sx of chronic open angle glaucoma
- blind spots in vision (negative scotomas)
-usually have normal VA until later in the z
retinal findings in chronic glaucoma
-atrophic changes to optic nerve : pale optic disc with cupping
retinal findings in stage 1 diabetic retinopathy
-cotton wool spots
-superficial flame hemes, deep blot hemes
-retinal sichemia
-soft exudates: proteinous material that leaks from vessels
-hard exudates: fatty deposits
-macular edema: leads to decreased VA
what is the #1 cause of preventable blindness
diabetic retinopathy
how often should diabetics have an eye exam
type 2 at the time of dx and yearly
type 1 within 5 years
retinal findings in proliferative stage diabetic retinopathy
same findings as stage 1 but with neovacularization near optic disc
retinal findings in hypertensive retinopathy
-cooper-silver wiring
-a/v nicking
-soft exudates
-flame hemes
-papilledema
sx of senile macular degeneration
loss of central field of vision
usually bilteral
retinal findings in senile macular degeneration
macular drusen
pigmented macula, exudates
Hyphema
hemorrhage in anterior chamber caused by trauma
negative scotomas
dark spot in field of vision
positive scotomas
moving luminous patches
usually in one eye only
usually bening
causes of keratitis
non-infectious or infectious causes
symptoms of keratitis
-severe and persistent pain
-photophobia
-little to no D/C
-(+) f/o stain for damaged epithelium
-hypopyon may be seen
should a referal be given form keratitis ?
yes, refer to opthalmologist immediately
what type of ulcers will be seen in a slit lamp exam of a patient with herpetic eye dz (HSV-1)
dentritic ulcers with terminal bulbs
(HSV1) sx of herpetic eye dz
- begins on cornea with keratitis
-pain may or may not be present
-decreased v/a
chance of recurrence for herpetic eye dz (hsv 1)
25% chance of recurrence
what is the name for anterior uveitis that involves the cilliary body too
iridocyclitis
causes of anterior uveitis
-granulomatous: infections like TB, syphillis, sarcoidosis
-non-granulomatous: CT disoders
sx of anterior uveitis
-dull, aching pain in temple, periorbital area, worse with accomodation
-tearing with no d/c
-decreased V/A
-decreased IOP
-photophobia
-redness
pathophysiology of anterior uveitis
breakdown in blood/ocular barrier with causes an influx of WBCs and protein into aqueous humor
physical exam findings in anterior uveitis
-ciliary flush
- f/o stain: cells, flares, hypopyon
-small pupil initially , irregular later
-decreased IOP
What is a possible complication for anterior uveitis
can lead to cataracts and glaucoma
what is the most common cause of acute closed angle glaucoma
pupillary block: anterior iris becomes stuck to the trabecular meshwork and the angle closes: causes impared drainage of aqueous humor and increased IOP
other causes of acute closed angle glaucoma
-meds: sulfa, bronchodialators
-plateau iris: genetically narrow angle that becomes occluded with pupil dilation
-lesions of the brain
sx of acute closed angle glaucoma
-severe pain with nausea and vomitting
-unilateral vision loss or halo vision
physical exam findings in acute closed angle glaucoma
-hazy cornea and diffuse redness
- large and fixed pupils- not reactive to light and accomodation
-eye feels hard
-iop:40-80
