Intro to Ophthalmology Lecture Powerpoint

Question 1

Amaurosis fugax

Answer 1

Transient, acute onset monocular blindness, often described as a “curtain” coming down over eye, high 80% risk of stroke occurring within next 72 hours and thus requires urgent treatment

Question 2

Giant cell arteritis/temporal cell arteritis

Answer 2

Emergency in patients usually over 60 with ipsalateral

Question 3

Central vein occlusion

Answer 3

fuck

Question 4

Scintillating scotoma

Answer 4

Classically associated symptom where patient experiences bilateral flashing visual disturbances seen with migraines due to chemical or vascular interruption of signals (often a migraine causes vasospasm and occlusion of blood flow to the visual cortex causing them)

Question 5

Arcus abnormality (senilus)

Answer 5

Condition causing white ring appearance around iris associated with old age very common in patients of asian heritage, despite unclear association with cardiovascular disease it is linked to deposition of lipids and thus warrants a lipid panel to assess hypercholesterolemia (esp. in patients under 50)

Question 6

Kayser fleischer rings/Wilson’s disease

Answer 6

Copper deposition in a ring around the iris often associated with resting tremors referred for chelation to remove, autosomal recessive disease mapped to chromosome 13 autosomal recessive

Question 7

Pterygium

Answer 7

Nicknamed surfers eye, a condition that causes noncancerous growth of the conjunctiva in a wedge shape that will eventually cover the pupil, common in people who spend time outdoors and requires surgical removal

Question 8

Pinguecula

Answer 8

Yellowish patch or growth on the conjunctiva over the sclera that is a deposit of fat, protein, or calcium, can be associated with pterygium but does not occlude vision and is completely benign.

Question 9

Xanthelasma

Answer 9

Cholesterol buildup causing a plaque or growth that occurs on the eyelid or extensor surfaces of extremities that upon observation indicates a lipid panel for monitoring

Question 10

Ectropion vs Entropion

Answer 10

Entropion eye lid is rolled inward, ectropion is an eyelid rolled outward

Question 11

Exophthalmos

Answer 11

Condition often due to hyperthyroidism (often brought on by graves disease) causing bulging of eyes bilaterally

Question 12

Chalazion

Answer 12

2ndary to or progression of hordeolum, a mass formed in infected (styed) memobian gland

Question 13

Dacroadenitis and what 2 big organisms can be a source of this

Answer 13

lacrimal gland infection by bacterial (most often, typically staph), fungal, or viral (MUMPS is big one for this)

Question 14

Differentiating between conjunctivitis and Uveitis (3 ways)

Answer 14

• Conjunctivits has preserved visual acuity, and uveitis causes loss of visual acuity
• Conjunctivitis is usually infectious in origin while uveitis is often autoimmune
• Uveitis is more diffuse redness while conjunctivitis affects both bulbar and palpebral conjunctiva

Question 15

Glaucoma

Answer 15

Second most common cause of blindness from damage to optic nerve due to increased pressure in eye’s anterior chamber, either near-sighteded (open angle) or farsighted (closed angle)

Question 16

Risk factors of glaucoma (6)

Answer 16

• older than 40
• African american
• familial inheritance
• Diabetes
• High blood pressure
• long term use of corticosteroids

Question 17

Acute closed angle glaucoma (and 2 ways its treated)

Answer 17

Emergency form of glaucoma requiring pharmacologic treatment or laser trabeculoplasty, presents with acute onset pain, blurred vision, nausea and vomiting, halos, and elevated intraocular pressure

Question 18

A normal cup to disk ratio is what according to Walt and what according to Lucas?

Answer 18

.3, 1:2

Question 19

Subconjunctival hemorrhage

Answer 19

Often spontaneous precipitated by cough or sneeze that results in blood accumulation beneath the conjunctiva, is asymptomatic and heals on own as long as patient’s coaguability and BP are normal

Question 20

Hyphema

Answer 20

blood accumulation in anterior chamber usually due to trauma requiring coag studies and referral to ophthalmology

Question 21

Amblyopia

Answer 21

Monocular blindness due to failure of visual cortex to develop due to lack of visual input stimulation derived from children with defect in lens left uncorrected requiring patching of the good eye

Question 22

Ishihara test

Answer 22

Color vision test of all colors using 38 plates used in military/industry/professions when slight variations in shade make a difference

Question 23

DOT physical color test

Answer 23

Simple test that requires differentiation between red, yellow, and green

Question 24

Ipsalateral monocular vision loss

Answer 24

Caused by a lesion at the optic nerve, complete sight loss in one eye

Question 25

Bitemporal hemianopia

Answer 25

Caused by a lesion at the optic chiasm (both temporal visual fields of the patient are located more medially, and cross at the optic chiasm)

Question 26

Ipsalateral nasal hemianoptia

Answer 26

A lesion at the uncrossed optic nerve fibers causing nasal visual field half blindness in one eye due to light entering to the lateral retina and traveling without crossing down the optic nerve, tract, and chiasm but getting cut off somewhere in there

Question 27

Contralateral homonymous hemianoptia

Answer 27

Lesion at optic tract bisecting it completely, removing the nasal view of one eye and temporal view of the other with the lesion being on the side of the tract in the body that can still see

Question 28

Contralateral homonymous hemianoptia with macular sparing

Answer 28

Lesion at the optic tract bisecting it (typically deeper in the lateral geniculate nuclei) causing lack of nasal view of one eye and temporal view of other eye with lesion being on side of the tract in the body that can still see while the macula is spared

Question 29

Ipsalateral central scotoma

Answer 29

Lesion at the eye at a fixed point creating a blind spot

Question 30

Ipsalateral horizontal defect

Answer 30

Vascular occlusion of part of the eye resulting in 1 sided blindness either superiorally or inferiorally, with the occlusion being located at the point that is preserved in visual field

Question 31

Any condition that is monocular in nature indicates…

Binocular indicates…

Answer 31

…condition is anterior to the optic chiasm (anterior circulation)
…condition is posterior to the optic chiasm and much deeper in the brain (geniculate nuclei or visual cortex) (posterior circulation)

Question 32

Proptosis and what causes monocular proptosis

Answer 32

Bulging out of eye, exophthalmos typically refers to bilateral proptosis brought on by Graves disease

Monocular proptosis could occur due to tumor or infection

Question 33

Hordeolum

Answer 33

Classic stye, affects eyelash which is part of memobian glands that becomes occluded and infected often with a staph infection

Question 34

Open angle glaucoma

Answer 34

Occurs when drainage canals of schlemm become plugged in the anterior chamber that has insidious onset typically after 50 with visual symptoms only in late disease, avoided by avid screening of patients

Question 35

Cup to disk ratio

Answer 35

A measure of % of optic disk (the exit point of all vessels and nerves in the retina from the eye) covered by cup (white center of the disk)