Internal Eye Flashcards
What age does cataracts occur after?
After age 50
What are cataracts?
Abnormal progressive loss of lens transparency (white-gray opacity) due to degenerative changes. Vision becomes blurry.
What shape are you looking for with funduscopic exam?
Disc-shaped end of the optic nerve with distinct borders
What are some normal variants with the shape of the optic nerve?
Nasal border isn’t as sharp as the rest.
Myopic patients may have areas of dark pigmentation along the border, possible choroidsl crescent.
What color should the optic nerve tissue be?
A shade of yellow or yellow-orange
What does the physiological cup look like
Retinal arteries and veins emerging from it. Small light yellow area. Usually <1/2 the entire disc area
What will the macula and fovea look like?
The macula is a small area of more pigmentation.
Fovea is a pinhole dot of light in the macula
What are SYMPTOMS of Papilledema?
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.
What are Funduscopic SIGNS of Papilledema?
Associated with space occupying lesions. Appears swollen, distorted optic disc with blurry borders. Vessels pushed forward and veins dilated.
What is chronic glaucoma?
Slow, progressive increase of intraocular pressure
SYMPTOMS of chronic glaucoma?
Headaches originating around the eyes, frequent changes of corrective lenses. Tunnel vision.
SIGNS of chronic glaucoma?
Generalized loss of peripheral vision. Increased cup size and atrophy of nerve fibers in the cup.
SYMPTOMS of diabetes mellitus?
Frequent urination, frequent thirst, hunger and weight loss. Bilateral sensory loss in feet. Males- impotence, decreasing firmness of erections.
What is the gold standard lab test for diabetes mellitus?
Glucose tolerance test
What are the 3 non-proliferative diabetic retinopathies?
Micro aneurysms, hard exudates, and soft exudates/cotton-wool patches
What is the 1 proliferative diabetic retinopathy?
Neovasculrization
What do micro aneurysms look like? Mild, moderate or severe?
Small red dots. Mild.
What do hard exudates look like? Mild, moderate, or severe?
Well defined small, yellow, fatty deposits. Moderate.
What do soft exudates/cotton-wool patches look like? Mild, moderate or severe?
Areas of ischemia. Severe
What does neovascularization look like?
New, fragile, irregularly configured vessels.e
Explain the mild stage of hypertension
Retinal arteriole constriction, sclerosis (A-V tapering, nicking and copper wire vessels)
Explain the moderate stage of hypertension.
Hemorrhages (dot, blot & flame shaped), soft cotton-wool patches, and hard exudates
Explain the malignant stage of hypertension.
Papilledema & “silver wiring” from advanced sclerosis
What is age related retinal detachment?
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.
What group of people are most likely to have age related retinal detachment?
Near-sighted people over 50
What are SYMPTOMS of retinal detachment?
Sudden appearance of multiple new vitreous floaters. May perceive flashing lights on head movement. Vision loss starts laterally & moves centrally.
What are SIGNS of retinal detachment?
Diminished peripheral vision corresponding to the area of detachment. Retina may appear hazy.
What are some eye red flags?
Sudden, marked pain. Visible flashes followed by partial, peripheral vision loss. Developing tunnel vision or a central blind spot.
Bacterial conjunctivitis
Kids and elderly. Red burning, itchy eyes. Vision is normal. Purulent discharge. Eyes may stick together during sleep.
Viral conjunctivitis
Red, burning, itchy eyes. Previous or existing URI.
Allergic conjunctivitis
Red, burning, itchy eyes. Coexisting allergies.
Corneal abrasion
Reports of an eye injury, marked pain, photophobia, decreased visual acuity. Perilimbal injection.
Acute iritis
Tearing, marked pain, photophobia in one eye. Secondary to infection of eye injury. Perilimbal injection, swollen iris & the pupil is contracted and sluggish.
Acute glaucoma
Marked pain, photophobia, dimmed vision & halos around lights. Perilimbal injection, dilated pupil, sluggish pupillary responses, increase eyeball tension & disc cupping in that eye.
Chronic glaucoma
Adults 40+. Insidious tunnel vision over the course of many years. Enlarged physiologic cup.
Retinitis pigmentosa
Genetic defect. Night blindness followed by progressive tunnel vision. “Bone spicule” retinopathy.
Optic nerve & tract lesions
Visual field defects dependent on the site of the lesion.
Central cataract
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- Central blurred vision gradually progressing to a central scotoma.
Macular degeneration
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- Slowly progressing central vision loss. Images may be distorted.
Most common opacity of the anterior eye
Cataracts
Nocturia and polydipsia are associated with which eye condition?
Diabetes
Tunnel vision is associated with which eye condition?
Chronic glaucoma
Which condition has microaneurysms as an early retinal sign?
Diabetes
