Intro to Ophthalmology Flashcards by Johannah Crumpton

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

Sclera and cornea

outermost layer

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

Iris
Pupil
Ciliary Body
Choroid

middle layer

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

retina and optic nerve

inner

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

outer pigmented layer

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

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Where is the light focused?

light is focused at the back of the eye

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

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

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

anterior chamber and posterior chamber

posterior: vitreous chamber

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

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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Describe how sight works

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

lens becomes thicker and focal length of lens decreases

lens becomes thinner and focal length of lens increases

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

focal point

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_____ 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 ____

Refraction

refract light

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____ is nearsighted

____ is farsighted

myopia: nearsighted

hyperopia: farsighted

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

myopia: Nearsightedness

too long

in front of the retina

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**How do you correct myopia?

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

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

Hyperopia

too short

behind the retina

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**How do you correct for hyperopia?

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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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?

concave

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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?

Convex

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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?

Astigmatism

Corrected with cylindrical lenses that equalize the refraction of light

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When is astigmatism worse?

worse at night and in low light conditions

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

presbyopia

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

correct with reading glasses

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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?

Keratoconus

develops at puberty or early adulthood

pt hx: Corrective lenses, contact lenses, cornea transplant

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_____ 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 ____

Rods Cones

**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 ______

ciliary body cornea and lens supplies nutrients to cornea and lens cornea and lens maintains intraocular pressure

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

Posterior cavity between lens and retina Jelly Like substance Maintains shape of eyeball Holds retina in place

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

closed angle acute angle closure glaucoma Chronic glaucoma

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

Glaucoma cupping

_____ is the second leading cause of blindness next to cataracts

glaucoma

**Where is the lesion?

lesion is BEFORE the optic chiasm blindness in the R eye

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

bitemporal hemianopsia lesion AT the optic chiasm

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

L homonymous hemianopsia after optic chiasm

Pupillary reactions are controlled by what 4 things?

Parasympathetic constriction Sympathetic dilatation Controlled by the sphincter and dilator pupillae muscles Light

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

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

_____ when one pupil is larger than the other

anisocoria

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

sympathetic system

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

parasympathetic system

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?

No direct response but normal consensual response Marcus Gunn Pupil Swinging eye flashlight test inflammation, optic nerve lesion, glaucoma

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

Asymmetric size of pupils Has No, or sluggish pupillary reaction to light Horner's syndrome Adie's syndrome injury lesion

**What is Horner's Syndrome?

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)

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

No or sluggish pupillary reaction to light Direct and consensual Can be associated with diminished DTRs Tonic Pupil women in 30s and 40s

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

Pupils restrict to accommodation, but not light Hallmark of tertiary neurosyphilis usually bilateral

_____ is loss of transparency. Name some additional signs

Cataract blurred vision painless absence of red reflex

When viewing the fundoscopic exam, ____ are thinner than ____

arteries are thinner than veins

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

fovea

___ 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

macula

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

Cotton Wool Spots (AKA soft exudates) retinal surface diabetic retinopathy and hypertensive retinopathy

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

retinal detachment diabetic retinopathy

_____ is swelling of optic nerve. Describe it

Papilledema looks elevated and swollen with ill defined margins

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

Retinal Vein Occlusion blood and thunder fundus

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

Cherry Red Spot on fovea Boxcar Segmentation

_____ 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-V nicking HTN retinopathy

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

HTN retinopathy Both due to atherosclerotic vessel wall thickening and chronic Hypertension

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

Copper wiring

____ is severe vascular wall hyperplasia and thickening. Appears white

silver wiring

____ 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

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

____ 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?

Hard Exudates Diabetic Retinopathy

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

Flame Hemorrhages Diabetic and HTN retinopathy

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

Dot-Blot hemorrhages DM and HTN

____ 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?

Neovascularization DM and wet macular degeneration

____ 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?

Retinal Drusen Bruch’s membrane Age-related macular degeneration

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

slit lamp examination

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

fluorescein staining