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HEENT > Intro to Ophthalmology > Flashcards

Intro to Ophthalmology Flashcards

1
Q

What makes up the fibrous layer? Is it in the outer, middle or inner layer?

A

Sclera and cornea

outermost layer

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2
Q

What makes up the vascular layer? Is it in the outer, middle or inner layer?

A

Iris
Pupil
Ciliary Body
Choroid

middle layer

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3
Q

What makes up the neural layer? Is it in the outer, middle or inner layer?

A

retina and optic nerve

inner

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4
Q

What are the two sections of the retina? what is the function?

A

outer pigmented layer

inner neural layer: house the photoreceptors that perceive light and send the neural signals

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5
Q

Where is the light focused?

A

light is focused at the back of the eye

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6
Q

**What are the 3 different chambers of the eye?

A

Anterior chamber: cornea to the iris
posterior chamber: iris and the lens (very narrow)
vitreous chamber: lens to the back of the eye

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7
Q

**What are the two SECTIONS of the eye? What is the job of each section?

A

anterior section: filled with aqueous humor (watery) provides nutrients

posterior section: filled with vitreous humor (jelly like) provides support and structure

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8
Q

**What chambers are in the anterior section? posterior section?

A

anterior chamber and posterior chamber

posterior: vitreous chamber

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9
Q

_______ the pigmented part of the retina located in the very center. _____ is in the center of the macula. Why is this important?

A

macula: responsible for vision straight ahead

fovea

The fovea is the area of best visual acuity. It contains a large amount of cones—nerve cells that are photoreceptors with high acuity.

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10
Q

Describe how sight works

A

-light reflects off an object and enters the eye (as it enters the eye, light is unfocused)
-then hits the cornea, iris, pupil: where the light enters the eye
-lens: focuses the light
-light then falls onto the retina
-optic nerve then carries those signals to you brain where they are decoded into an image

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11
Q

**to see near objects, how does the lens adapt? to see objects far away?

A

lens becomes thicker and focal length of lens decreases

lens becomes thinner and focal length of lens increases

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12
Q

_____ this is where light focuses precisely on the retina
For good vision, the _____ must be on the retina

A

focal point

focal point

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13
Q

_____ The process of bending light to produce a focused image on the retina. Most vision problems occur because of an error in how our eyes ____

A

Refraction

refract light

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14
Q

____ is nearsighted

____ is farsighted

A

myopia: nearsighted

hyperopia: farsighted

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15
Q

____ is too much curvature of the cornea. Eyeball is _____ for the refractive power of the cornea and lens. Focus point is ___ of retina.

A

myopia: Nearsightedness

too long

in front of the retina

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16
Q

**How do you correct myopia?

A

Correct with concave lens
Wide view lens
Diverges light rays
Makes objects look smaller than they are

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17
Q

_____ is too little curvature of the cornea. Eyeball is ____ for the refractive power of the cornea and lens. Image is focused ____ the retina.

A

Hyperopia

too short

behind the retina

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18
Q

**How do you correct for hyperopia?

A

Correct with convex lens
The rays meet at a single point on other side of lens
Magnify objects to make them look larger

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19
Q

Spreads out light rays
divergent
Focal point in front of lens
Parallel rays of light pass through the lens are spread out
Image formed is smaller but clear
Gives wider viewing angle

What type of lens?

A

concave

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20
Q

Focuses the light rays to a specific point
Convergent
Rays of light passing through it get bent in a inward direction towards a single point
Brings light rays together to a focal point behind the lens
Convex lenses hold magnifying abilities

What type of lens?

A

Convex

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21
Q

Irregular shape of the cornea or lens
Not perfectly spherical, kind of like a football
Light reflected to multiple areas of retina = multiple focal points
Retinal image is blurred

What eye condition?
How do you correct it?

A

Astigmatism

Corrected with cylindrical lenses that equalize the refraction of light

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22
Q

When is astigmatism worse?

A

worse at night and in low light conditions

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23
Q

____ is age related farsightedness. Loss of mobility and focusing power of lens. What age do you begin to notice it? until what age?

A

presbyopia

44-46 years old and symptoms increase until about age 55 then stablize

correct with reading glasses

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24
Q

Cornea becomes thin and cone-like
Causes blurred vision
Causes sensitivity to light and glare

What am I?
When does it develop?
What 3 things are sometimes found in the pt hx?

A

Keratoconus

develops at puberty or early adulthood

pt hx: Corrective lenses, contact lenses, cornea transplant

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25
Q

_____ are specialized for dim light (night vision)

_____ are specialized for color perception
Red, green and blue cones
Color blindness results from deficit of one type of ____

A

Rods

Cones

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26
Q

**Aqueous humor is produced in the _____. Anterior cavity between the ___ and ____. What is its job?
_____ and ____ do not have blood vessels
**Aqueous humor also maintains ______

A

ciliary body

cornea and lens

supplies nutrients to cornea and lens

cornea and lens

maintains intraocular pressure

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27
Q

Vitreous humor is found where?
What is the consistency?
What is its job?

A

Posterior cavity between lens and retina

Jelly Like substance

Maintains shape of eyeball
Holds retina in place

28
Q

What are two additional names for narrow angle glaucoma? Open angle?

A

closed angle

acute angle closure glaucoma

Chronic glaucoma

29
Q

_____ A group of eye diseases characterized by neuropathy to the optic nerve. What is a common exam finding?

A

Glaucoma

cupping

30
Q

_____ is the second leading cause of blindness next to cataracts

A

glaucoma

31
Q

**Where is the lesion?

A

lesion is BEFORE the optic chiasm

blindness in the R eye

32
Q

**What is this called? Where is the lesion?

A

bitemporal hemianopsia

lesion AT the optic chiasm

33
Q

**What is this called? Where is the lesion?

A

L homonymous hemianopsia

after optic chiasm

34
Q

Pupillary reactions are controlled by what 4 things?

A

Parasympathetic constriction

Sympathetic dilatation

Controlled by the sphincter and dilator pupillae muscles

Light

35
Q

When evaluating pupillary reaction, what are you looking at? Where does the pt need to look?

A

Magnitude
Speed
Symmetry

pt need to focus on a far object NOT your light!

36
Q

_____ when one pupil is larger than the other

A

anisocoria

37
Q

Small pupil is abnormal if anisocoria is greater in dark than light = abnormality in _____

A

sympathetic system

38
Q

Larger pupil is abnormal of anisocoria is greater in light than dark = abnormality in _____

A

parasympathetic system

39
Q

What is a Relative Afferent Pupillary Defect? What is another name for it?
What is the test called?
What are 3 conditions in which it is common?

A

No direct response but normal consensual response

Marcus Gunn Pupil

Swinging eye flashlight test

inflammation, optic nerve lesion, glaucoma

40
Q

What is anisocoria? What will the pupillary reaction to light be? What are some common sources of the problem?

A

Asymmetric size of pupils

Has No, or sluggish pupillary reaction to light

Horner’s syndrome
Adie’s syndrome
injury
lesion

41
Q

**What is Horner’s Syndrome?

A

loss of sympathetic innervation due to a lesion along the sympathetic pathway that causes:
Ptosis (drooping of the eyelid)
Anhidrosis (not sweating)
Miosis (constricted pupils)

42
Q

What is Adie’s pupil? what is another name for it? What age group?

A

No or sluggish pupillary reaction to light
Direct and consensual
Can be associated with diminished DTRs

Tonic Pupil

women in 30s and 40s

43
Q

What is the Argyll-Robertson Pupil? What dz is it the hallmark presentation for?

A

Pupils restrict to accommodation, but not light

Hallmark of tertiary neurosyphilis

usually bilateral

44
Q

_____ is loss of transparency. Name some additional signs

A

Cataract

blurred vision
painless
absence of red reflex

45
Q

When viewing the fundoscopic exam, ____ are thinner than ____

A

arteries are thinner than veins

46
Q

____ necessary for sharp, central vision
Reading, driving, any activity where visual details are needed
Provides greatest visual acuity of all

A

fovea

47
Q

___ is the functional center of the retina
Responsible for the central, high-resolution, color vision that is possible in good light
In your direct line of sight

A

macula

48
Q

_____ are small, yellow-white, slightly elevated lesions, which look like clouds on ______. What 2 dz are they most common with?

A

Cotton Wool Spots (AKA soft exudates)

retinal surface

diabetic retinopathy and hypertensive retinopathy

49
Q

_____ is often described as wall paper falling off a wall. What dz?

A

retinal detachment

diabetic retinopathy

50
Q

_____ is swelling of optic nerve. Describe it

A

Papilledema

looks elevated and swollen with ill defined margins

51
Q

_____ is widespread retinal hemorrhages. Often described with venous dilation and tortuosity. What is the clinical pearl?

A

Retinal Vein Occlusion

blood and thunder fundus

52
Q

Central retinal artery occlusion often has ____ and ____ seen on fundoscopic exam

A

Cherry Red Spot on fovea

Boxcar Segmentation

53
Q

_____ a small artery is seen crossing a small vein. This causes compression on the small vein. Will show bulging on either side. What dz?

A

A-V nicking

HTN retinopathy

54
Q

Copper and silver wiring is seen in what dz? What is it due to??

A

HTN retinopathy

Both due to atherosclerotic vessel wall thickening and chronic Hypertension

55
Q

____ is moderate vascular wall changes and appears orange or yellow instead of red

A

Copper wiring

56
Q

____ is severe vascular wall hyperplasia and thickening. Appears white

A

silver wiring

57
Q

____ is when optic nerve is damaged in ___ these nerve fibers die off and blood flow is diminished. This causes ____ to become larger since the support structure is not there

A

Cupping

Glaucoma

cup

aka the cup takes up a larger portion of the optic disc than it should. See picture

58
Q

____ are smallish, yellowish-whitish distinct spots with sharp borders. Caused by breakdown of blood-retina border, allowing leakage from retinal vessels. See all over the retina. What dz?

A

Hard Exudates

Diabetic Retinopathy

59
Q

____ happen when necrotic vessels bleed into the nerve fiber layer. More superficial layers of the retina. larger. What dz?

A

Flame Hemorrhages

Diabetic and HTN retinopathy

60
Q

_____ Occur as microaneurysms rupture in the deeper layers of the retina. Blood accumulates in the inner nuclear layer. What dz?

A

Dot-Blot hemorrhages

DM and HTN

61
Q

____ are microvascular damage and ischemia cause release of vasoproliferative factors (Vascular Endothelial growth Factor). This results in new vessel from the adjacent retinal vessels in an attempt to revascularize the diseased tissue. What dz?

A

Neovascularization

DM and wet macular degeneration

62
Q

____ are yellow deposits under the retina
Made up of lipids and proteins
Scattered around macular region
“Tombstones” of dead retinal epithelium.
Appear in a layer of the retina called ____.
What dz?

A

Retinal Drusen

Bruch’s membrane

Age-related macular degeneration

63
Q

_____ looks at structures in anterior chamber. Provides greater magnification (10 to 25 times) and illumination

A

slit lamp examination

64
Q

_____ is used to look for foreign bodies, ulcers and corneal abrasions

A

fluorescein staining

65
Q
A

HEENT (12 decks)

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