Module 1 eye exam 2 Flashcards
exophthalmos
protuberance of one or both eyes
- also called proptosis (the forward movement)
how to check for exophthalmos
pt lift chin up while provider looks from below
visual field defects can be r/t
they eye
optic nerve
optic radiations
visual cortex
Confrontation
visual field testing
- pt has one eye covered
- look at examiners nose
- examiner presents fingers in each quadrant of vision
Periorbital structures
eye lids
eyelashes
lacrimal system
eyelids
contain oil-secreting glands to maintain the tear film
eye lashes
protect the eye from debris
- lash loss: associated with chronic inflammation or neoplastic process
poliosis
whitening of lashes
madarosis
loss of lashes
puntum
opening of the canalicular drainage system, medial aspect of eyelid
ectropion
turning outward of eyelids
entropion
turning inward of eyelids
lagophthalmos
lack of eyelid closure
sclera
firm outer wall of the globe
- dense connective tissue
- white appearance
icterus
when sclera has a yellow hue
- often with jaundice
thin blue sclera
osteogenesis imperfecta
local inflammation
injection
presence of prominent vessels with redness on conjunctiva
- indicative of inflammation
conjunctiva 2 parts
bulbar: overlies sclera
palpebral: lining the eye lids
subconjuctival hemorrage
after trauma or valsalva maneuvers
- conjuctival vessels compromised and bleed
- blood trapped between sclera and conjunctiva
- > deep confluent red appearance
- no ophthalmic problems, resolves within 2 weeks
chemosis
clear balloon-like swelling of the conjunctiva - allergies - mechanical ventilators - trauma - local inflammation Severe: can prevent closure of lids
cornea
curved structure compusedof collagen fibers precisely arranged to achieve optical clarity
- best evaluated with fluorescein dye
clarity of cornea
focal white plaque: infection
edema: decomposition of corneal function or elevated pressure
anterior chamber
space between the iris and cornea
- filled with aqueous humor
- should be deep and clear space
open globe injury
shallow anterior chamber
- violation of the globe
- emergency
- sometimes assoc. with expulsion of intraocular tissue or peaked pupil
hyphema
layering of blood in the anterior chamber
hypopyon
inflammatory debris in the anterior chamber
iris
pigmented structure that forms the posterior aspect of the anterior chamber
- acts as a shutter for the eye, controlling amount of light through the pupil
inconsistency in color of iris
nevi neoplasma hamartomas genetic abnormalities inflammatory nodules
iris neovascularization
ocular ischemia
- proliferative diabetic retinopathy
- central retinal vein occlusion
crystalline lens
transparent, biconcave structure aligned at the center of pupil
- refracts light to achieve fine focus on retina
- can be assessed with a pen light, though best with dilated pupil
cataractous changes assessed
use of a direct ophthalmoscope to observe irregular red flex
posterior segment composed of
vitreous
retina
optic nerve
- can be assessed with a direct ophthalmoscope in a dark room with examiner at same ht as pt
vitreous humor
gelatinous material that fills posterior segment and attaches to the retina
- should be optically clear
vitreous humor and aging
degenerative changes
- eventually detaches from the retinal causing floaters
optic disk
coalescence of the retinal nerve fiber layer as it leaves the globe to form the optic nerve
- slightly oval pink-yellow disc with a small white depression at its center (optic cup)
- should appear flat with distinct margins
