Inner Eye Disorders Flashcards
Thyroid Orbitopathy
occurs in who?
3 disorders
- Hyperthyroid (Graves)
- Euthryoid
- Hypothyroid
Thyroid Orbitopathy
presentation
- bi or unilateral proptosis
Uveitis
describe
emergency inflammation of uveal tract
Uveitis
differentiate:
* anterior
* posterior
* intermediate
* panuveitis
- anterior chamber structures
- retina, choroid
- vitreous body only
- all structures involved
Uveitis
sx
6 components
- blindness, distorted/blurred vision
- painful
- redness
- photophobia
- uni or bi lateral
- acute, < 3 mo, sudden onset
Uveitis
PE Findings
6
- small/constricted pupil
- pupil reacts poorly to light
- iris becomes difficult to see
- redness
- WBCs settled in bottom of anterior chamber
- decreased IOP
Uveitis
tx
3 components
- immediate referral to ophthalmology
- steroids
- exacerbated if give drugs for tx glaucoma
Uveitis
complications
4
- visual loss
- cyst-like formations on macula
- glaucoma
- cataracts
Episcleritis
describe
inflammation of the episclera which is the thin layer of vascular elastic tissue between the sclera and conjunctiva
Episcleritis
PE Findings
3 components
- red, vascular injection of conjunctive w/ enlarged blood vessels beneath the conjunctiva
- mild pain/discomfort
- diffuse/nodular inflammation
Episcleritis
Tx
4 components
- refer to ophthalmology
- warm compress
- steroids (topical)
- NSAIDs (drops/PO)
Nystagmus
describe
2 components
- involuntary rhythmic eye motion/oscillation
- results from dysfunction in the vestibular system, brainstem, cerebellum
Nystagmus
describe vestibular nystagmus
- results from dysfunction of the labryinth (Meinere’s disease), vestibular nerve, or vestibular nucleus in the brainstem
Nystagmus
signs/sx of vestibular nystagmus
5 components
- nausea
- vertigo
- tinnitus
- hearing loss
- sudden head movements worsen sx
Nystagmus
describe jerk nystagmus
- characterized by slow drifting off of a target followed by a quick corrective jerk
- can be downbeat, upbeat, horizontal, or torsional
Nystagmus
signs/sx associated with jerk nystagmus
- some pts are unaware they have it
- others have: blurred vision, oscillopsia (environment oscillates)
Nystagmus
describe up and downbeat nystagmus
- downbeat: occurs from lesions near the craniocervical junction (Chiari malformation, basilar invagination)
- Upbeat: damage to the pontine tegmentum from troke, demyelination, or tumor.
Nystagmus
describe gaze evoked nystagmus
- when the eyes are help eccentrically in the orbits, they tend to drift back to primary position
- the pt will correct this, causing a quick oscillation to continue to target
- normal in many pts in extreme vision fields
Nystagmus
what can exaggerate gaze-evoked nystagmus?
5 components
- drugs (sedatives, anti-convulsants, alcohol)
- muscle paresis
- myasthenia gravis
- demyelinating disease
- cerebellopontine angle, brainstem, cerebellar lesions
Strabismus
pathophys
- problems w/ eye muscles, the nerves that transmit information to the muscles, or the control center in the brain that directs eye movements
Strabismus
describe the misalignment of the eyes
- axis are not aligned
- misaligned may be constant or intermittent
Strabismus
risk factors
3 components
- family hx
- refractive error (farsighted)
- medical conditions (down syndrome, stroke, cerebral palsy)