Ophthalmology Flashcards

1
Q

What is the most common vision impairment in children?

A

Ambylopia (lazy eye); strabismus is the most common expression of this phenomenon in children (though congenital cataracts also cause it)

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2
Q

_________ is verified by showing that the reflection from a light comes from different areas of the cornea in each eye.

A

Strabismus

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3
Q

Strabismus should be surgically corrected, unless it developed later in infancy, in which case _____________ instantly resolves the problem.

A

corrective glasses

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4
Q

What might a white pupil in a baby represent?

A

Retinoblastoma

Congenital cataract

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5
Q

How might acute angle closure glaucoma present?

A

Very severe eye pain or frontal headache, typically starting in the evening when the pupils have been dilated for several hours (watching a double feature at the movies, watching TV in a dark room). Patient may report seeing halos around lights.

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6
Q

What might be seen on physical exam in acute angle closure glaucoma?

A

pupil is mid-dilated, does not react to light, cornea is cloudy with a greenish hue, and eye feels “hard as a rock”

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7
Q

What is the management of acute angle glaucoma?

A

Emergency surgery! drill hole in the iris with a laser beam to provide drainage route for fluid building up in the anterior chamber

Until then:

  • -carbonic anhydrase inhibitors (Diamox)
  • -apply topical beta blockers and alpha-2-selective adrenergic agonists
    • pilocarpine or mannitol
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8
Q

How do alpha 2 agonists treat glaucoma?

A

Decrease production of fluid, improve outflow

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9
Q

How do beta blockers treat glaucoma?

A

Decrease aqueous humor production

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10
Q

How does pilocarpine treat glaucoma?

A

causes ciliary muscle to contract. When the ciliary muscle contracts, it opens the trabecular meshwork through increased tension on the scleral spur. This action facilitates the rate that aqueous humor leaves the eye to decrease intraocular pressure.

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11
Q

What are the physical findings in orbital cellulitis?

A

eyelids are hot, tender, red, and swollen and the patient is febrile. Key finding is that when eyelid is pried open the pupil is dilated and fixed, and the eye has very limited motion.

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12
Q

T/F: In the case of chemical burn of the eye, irrigation with water should be started when the patient gets to the hospital.

A

FALSE! IT must be started immediately. The eye should be washed under running water for at least 30 minutes before transportation to the hospital is arranged. (At the hospital, irrigation with saline continues)

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13
Q

Following irrigation of patient with chemical burn of eye, what is tested before the patient home?

A

pH is tested to make sure that no harmful chemicals remain in the conjunctival sac

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14
Q

A patient describing dozens of floaters (or a snow storm within their eye), or a big dark cloud at the top of the visual field…
Next step?

A

RETINAL DETACHMENT!!! Emergency intervention with laser “spot welding” to save the remaining retina

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15
Q

What is happening in a patient who reports seeing flashes of light and having “floaters” in the eye?

A

Patient may have vitreous tugging at the retina, with little actual detachment

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16
Q

What do you do for an elderly person who has sudden loss of vision from one eye?

A

This is likely embolic occlusion of the retinal artery! Have patient breathe into a paper bag and have someone repeatedly press hard on the eye and release (hope to vasodilate and shake the clot into a more distal location so a smaller area is ischemic…but really not much can be done :(

17
Q

Why do newly diagnosed diabetics need a opthalmologic evaluation upon diagnosis?

A

They may have actually had diabetes for years before diagnosis. Retinal damage may have already occurred, and proper treatment may prevent its progression.

18
Q

People diagnosed with type 1 diabetes are about ___ years away from getting eye problems.

A

20