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Physical Diagnosis > Internal Eye > Flashcards

Internal Eye Flashcards

0
Q

What age does cataracts occur after?

A

After age 50

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1
Q

What are cataracts?

A

Abnormal progressive loss of lens transparency (white-gray opacity) due to degenerative changes. Vision becomes blurry.

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2
Q

What shape are you looking for with funduscopic exam?

A

Disc-shaped end of the optic nerve with distinct borders

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3
Q

What are some normal variants with the shape of the optic nerve?

A

Nasal border isn’t as sharp as the rest.

Myopic patients may have areas of dark pigmentation along the border, possible choroidsl crescent.

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4
Q

What color should the optic nerve tissue be?

A

A shade of yellow or yellow-orange

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5
Q

What does the physiological cup look like

A

Retinal arteries and veins emerging from it. Small light yellow area. Usually <1/2 the entire disc area

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6
Q

What will the macula and fovea look like?

A

The macula is a small area of more pigmentation.

Fovea is a pinhole dot of light in the macula

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7
Q

What are SYMPTOMS of Papilledema?

A

Initially vision isn’t altered. Possible atypical, deep, escalating headache. Momentary bouts of blurriest or flickering when rising from sitting. Visual acuity in advanced cases.

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8
Q

What are Funduscopic SIGNS of Papilledema?

A

Associated with space occupying lesions. Appears swollen, distorted optic disc with blurry borders. Vessels pushed forward and veins dilated.

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9
Q

What is chronic glaucoma?

A

Slow, progressive increase of intraocular pressure

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10
Q

SYMPTOMS of chronic glaucoma?

A

Headaches originating around the eyes, frequent changes of corrective lenses. Tunnel vision.

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11
Q

SIGNS of chronic glaucoma?

A

Generalized loss of peripheral vision. Increased cup size and atrophy of nerve fibers in the cup.

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12
Q

SYMPTOMS of diabetes mellitus?

A

Frequent urination, frequent thirst, hunger and weight loss. Bilateral sensory loss in feet. Males- impotence, decreasing firmness of erections.

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13
Q

What is the gold standard lab test for diabetes mellitus?

A

Glucose tolerance test

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14
Q

What are the 3 non-proliferative diabetic retinopathies?

A

Micro aneurysms, hard exudates, and soft exudates/cotton-wool patches

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15
Q

What is the 1 proliferative diabetic retinopathy?

A

Neovasculrization

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16
Q

What do micro aneurysms look like? Mild, moderate or severe?

A

Small red dots. Mild.

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17
Q

What do hard exudates look like? Mild, moderate, or severe?

A

Well defined small, yellow, fatty deposits. Moderate.

18
Q

What do soft exudates/cotton-wool patches look like? Mild, moderate or severe?

A

Areas of ischemia. Severe

19
Q

What does neovascularization look like?

A

New, fragile, irregularly configured vessels.e

20
Q

Explain the mild stage of hypertension

A

Retinal arteriole constriction, sclerosis (A-V tapering, nicking and copper wire vessels)

21
Q

Explain the moderate stage of hypertension.

A

Hemorrhages (dot, blot & flame shaped), soft cotton-wool patches, and hard exudates

22
Q

Explain the malignant stage of hypertension.

A

Papilledema & “silver wiring” from advanced sclerosis

23
Q

What is age related retinal detachment?

A

Shrinkage of the vitreous with age. It pulls away from the retina, tugs too hard and causes a tear. Tear allows vitreous fluid to seep under the retina causing detachment.

24
Q

What group of people are most likely to have age related retinal detachment?

A

Near-sighted people over 50

25
Q

What are SYMPTOMS of retinal detachment?

A

Sudden appearance of multiple new vitreous floaters. May perceive flashing lights on head movement. Vision loss starts laterally & moves centrally.

26
Q

What are SIGNS of retinal detachment?

A

Diminished peripheral vision corresponding to the area of detachment. Retina may appear hazy.

27
Q

What are some eye red flags?

A

Sudden, marked pain. Visible flashes followed by partial, peripheral vision loss. Developing tunnel vision or a central blind spot.

28
Q

Bacterial conjunctivitis

A

Kids and elderly. Red burning, itchy eyes. Vision is normal. Purulent discharge. Eyes may stick together during sleep.

29
Q

Viral conjunctivitis

A

Red, burning, itchy eyes. Previous or existing URI.

30
Q

Allergic conjunctivitis

A

Red, burning, itchy eyes. Coexisting allergies.

31
Q

Corneal abrasion

A

Reports of an eye injury, marked pain, photophobia, decreased visual acuity. Perilimbal injection.

32
Q

Acute iritis

A

Tearing, marked pain, photophobia in one eye. Secondary to infection of eye injury. Perilimbal injection, swollen iris & the pupil is contracted and sluggish.

33
Q

Acute glaucoma

A

Marked pain, photophobia, dimmed vision & halos around lights. Perilimbal injection, dilated pupil, sluggish pupillary responses, increase eyeball tension & disc cupping in that eye.

34
Q

Chronic glaucoma

A

Adults 40+. Insidious tunnel vision over the course of many years. Enlarged physiologic cup.

35
Q

Retinitis pigmentosa

A

Genetic defect. Night blindness followed by progressive tunnel vision. “Bone spicule” retinopathy.

36
Q

Optic nerve & tract lesions

A

Visual field defects dependent on the site of the lesion.

37
Q

Central cataract

A

>

  1. Central blurred vision gradually progressing to a central scotoma.
38
Q

Macular degeneration

A

>

  1. Slowly progressing central vision loss. Images may be distorted.
39
Q

Most common opacity of the anterior eye

A

Cataracts

40
Q

Nocturia and polydipsia are associated with which eye condition?

A

Diabetes

41
Q

Tunnel vision is associated with which eye condition?

A

Chronic glaucoma

42
Q

Which condition has microaneurysms as an early retinal sign?

A

Diabetes

Physical Diagnosis (5 decks)

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