Introduction to ophthalmology history and examination Flashcards
What are the common causes of gradual loss of vision?
Cataract, glaucoma, and macular degeneration.
What are the common causes of sudden loss of vision?
Retinal detachment, vascular occlusion, or optic neuritis.
What are the potential symptoms of eye diseases?
Change in appearance, discharge, pain, discomfort, loss of vision, double vision, or no symptoms.
When is severe pain in the eye most concerning?
When associated with acute glaucoma or scleritis.
What types of pain are associated with eye conditions like dry eyes or allergies?
Burning sensations (lid disease), itching (allergy), and gritty sensations (dry eyes).
Why is pain accompanying vision loss a significant concern?
It may indicate a serious underlying eye condition.
How should loss of vision be described by patients?
By factors such as transient/continuous, profound/mild, and rapid/slow onset.
Which serious eye diseases are often asymptomatic in early stages?
Chronic glaucoma, diabetic retinopathy, hypertension, and papilloedema.
What steps are included in a basic eye examination?
Assess function (VA, visual fields, color vision), check pupil reactions, inspection, test eye movements, and fundus examination
What is the significance of color vision assessment?
It helps detect and monitor optic nerve diseases.
What is a scotoma in visual field terminology?
A circumscribed area of vision loss.
A circumscribed area of vision loss.
Loss of half of the visual field with a vertical border.
What is quadrantinopia?
Loss of a quarter of the visual field with a vertical border.
What visual field defect is shaped like an arc?
Arcuate defect.
What is an altitudinal defect in visual fields?
Loss of half of the visual field with a horizontal border.
What is the difference between homonymous and bitemporal visual field defects?
Homonymous affects the same side of both eyes, while bitemporal affects the temporal fields of both eyes.
How are visual field defects tested?
Using confrontation testing, Goldmann, or Humphrey automated techniques.
What is the hallmark of a left homonymous hemianopia?
Loss of vision in the same side of the visual field in both eyes.
How does macular disease affect vision?
Causes central scotomas and loss of central visual acuity.
What type of visual field defect is caused by optic neuritis?
Central scotoma.
What causes altitudinal defects in anterior ischemic optic neuropathy (AION)?
Infarction of the optic disc.
Describe the progression of field loss in glaucoma.
Nasal step → arcuate → altitudinal → peripheral loss.
What is a bitemporal hemianopia commonly caused by?
Chiasmal compression.
How does a pituitary tumor affect visual fields?
Causes bitemporal defects, initially affecting the superior field.
What is a characteristic defect caused by craniopharyngiomas?
Inferior bitemporal hemianopia.
What visual defect is caused by retinal detachment?
Uniocular defects mirroring the detachment.
What visual field defect results from a superior retinal artery occlusion?
Inferior altitudinal defect.
What is the characteristic field defect of macular degeneration?
Bilateral central scotomas.
How are optic tract lesions typically described?
As incongruous homonymous hemianopias.
What causes incongruous homonymous hemianopias?
Lesions in the optic tract, usually vascular in origin.
How do temporal lobe lesions affect visual fields?
They affect the superior visual field.
What visual field defect is caused by parietal lobe lesions?
Inferior visual field defects
Define “congruous visual field defect.”
Defects that are identical in size and location in both eyes.
What is a hallmark feature of occipital lobe infarcts?
Macular sparing homonymous hemianopia.
What causes macular sparing in occipital strokes?
Collateral flow from the middle cerebral artery.
Which visual field defect is produced by damage below the calcarine sulcus?
Superior homonymous quadrantinopia
What visual defect occurs with optic disc infarction?
Sectoral or altitudinal defects.
What is a nasal step in glaucoma?
An early visual field defect near the horizontal midline.
What visual field pattern is indicative of advanced glaucoma?
Tunnel vision.
What anatomical structure is compressed in chiasmal compression?
The crossing nasal fibers at the optic chiasm.
How does the visual pathway differ before and after the chiasm?
Pre-chiasmal defects affect one eye; post-chiasmal defects are homonymous.
What field defect results from right parietal lobe lesions?
Left inferior homonymous quadrantinopia.
How is a retinal artery occlusion detected on fundus examination?
Whitening of the retina in the affected area.
What causes pie-shaped (sectoral) field defects?
Damage to specific optic nerve fibers or areas.
What is the visual field defect from a left occipital lobe infarct?
Right homonymous hemianopia with macular sparing.
How are visual radiations distributed in the brain?
Through the parietal (inferior fields) and temporal (superior fields) lobes.
What does a left superior homonymous quadrantinopia indicate?
A lesion in the right temporal lobe.
What are the early symptoms of diabetic retinopathy?
Often asymptomatic until advanced stages.
What condition presents as a bitemporal hemianopia with superior defects?
Pituitary tumor.
Why is visual field testing critical in glaucoma management?
To track progression and assess treatment efficacy.
