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(PA school) CAM I > Ophthalmology I highlights > Flashcards

Ophthalmology I highlights Flashcards

1
Q

1) What is important to do if a pt comes in with anisocoria (unequal pupils)?
2) What is important to include during PE?
3) Name a common cause

A

1) Thorough Hx taking
2) Light and dark
3) Scopolamine patch

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2
Q

What is Holmes-Adie syndrome?

A

Tonic pupil (Adie’s tonic pupil) and hyporeflexia

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3
Q

What condition constricts both pupils?

A

Argyll Robertson pupil

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4
Q

1) What abnormal pupil finding is benign, idiopathic, & primarily found in young women?
2) What makes this finding unique?
3) What would a weak cholinergic agent do to an eye with this? Why?

A

1) Adie’s tonic pupil
2) Reaction to accommodation remains intact
3) Involved pupil will constrict, indicating denervation hypersensitivity

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5
Q

1) What is the most common cause of ‘red eye’?
2) Is this more commonly viral or bacterial? How long does this form last?

A

1) Conjunctivitis
2) Most often viral in nature (approx. 80-85%). Most resolve in 1-2 weeks. Self-limiting.

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6
Q

1) What helps distinguish bacterial conjunctivitis from viral?
2) What helps differentiate allergic conjunctivitis?

A

1) Bacterial often has purulent discharge
2) Allergic is more often bilateral, watery discharge

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7
Q

Unilateral thick purulent discharge is characteristic of what kind of conjunctivitis?

A

Bacterial

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8
Q

“Second eye usually becomes involved within 24-48 hours. Usually, profuse tearing rather than discharge” describes what kind of conjunctivitis?

A

Viral conjunctivitis

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9
Q

True or false: Most pts with conjunctivitis do not require antibiotics

A

True

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10
Q

For bacterial conjunctivitis, what is recommended? Be specific

A

Antibiotic therapy:
1) Polymyxin B/trimethoprim or
2) Erythromycin or
3) Levofloxacin/Moxifloxacin/Gatifloxacin

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11
Q

1) What is the hallmark sign of iritis?
2) List 3 more Sx

A

1) Ciliary flush
2) Eye pain, redness, and constricted pupil

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12
Q

Describe allergic conjunctivitis and give its cardinal symptom

A

1) Generally bilateral redness. Watery discharge + itching.
2) Itching

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13
Q

1) What are two key Sx of corneal abrasion?
2) What testing is done?

A

1) Reluctance to open eye with photophobia and Rx of recent trauma to eye
2) Fluorescein staining with Wood’s lamp exam

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14
Q

What should you tell contact wearers with a corneal abrasion?

A

No contact lenses x 2 weeks

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15
Q

True or false: Corneal abrasion pts always get antibiotics

A

True

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16
Q

Foreign body sensation is a primary Sx of what?

A

Foreign body

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17
Q

When should you refer a corneal FB pt to an opthalmologist?

A

If severe or unable to remove FB

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18
Q

What should you not dispense for prolonged or home use?

A

Topical anesthesia (ophthalmic)

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19
Q

Can you use topical ocular corticosteroids as a PCP?

A

Should not be used by primary care unless in consultation with ophthalmology.

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20
Q

Calcium deposits in the cornea in a band shape are a Sx of what condition?

A

Band keratopathy

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21
Q

1) What is the name for blood in the anterior chamber of the eye?
2) What can it result in?

A

1) Traumatic hyphema
2) Permanent vision loss

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22
Q

How is a retinal artery occlusion treated?

A

Medical emergency to save vision; reduction of IOP is the goal

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23
Q

How do you treat subconjunctival hemorrhage?

A

Resolves spontaneously.

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24
Q

What condition is commonly seen with Graves’ disease – hyperthyroidism?

A

Exophthalmos

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25
Q

What are the 2 types of retinal vascular occlusion?

A

Central and branch

26
Q

1) What is misalignment of the eyes called?
2) Who is more likely to have it?

A

1) Strabismus; “cross eyes”
2) Strong correlation with family history

27
Q

What are the two main onsets of nystagmus?

A

Congenital and acquired

28
Q

When a pt has a retinal artery occlusion, dilated fundoscopic exam reveals what?

A

Pale retina, cherry red spot in the fovea

29
Q

Retinal Artery Occlusion
1) What is it usually attributed to?
2) What is a common visual symptom?
3) What are 3 potential causes?

A

1) Ischemia from thromboembolism of the retinal artery
2) Amaurosis fugax
3) PMHx of HTN, cardiovascular disease (CVD), Hollenhorst plaque (cholesterol emboli)

30
Q

Subacute, painless, vision loss in one eye is characteristic of what?

A

Retinal vein occlusion

31
Q

What are the two primary categories of red eyes?

A

Painless and painful

32
Q

One or both eyes turning outward is called?

A

Exotropia

33
Q

1) Most common cause of pediatric visual impairment (1-4% of children) is what? What is it also called?
2) When is screening recommended for this?

A

1) Amblyopia; a “lazy eye” (does not have normal visual acuity)
2) In all children under 5 years of age

34
Q

Differentiate the 2 categories of unilateral vision loss

A

1) Sudden, unilateral, and painless (often vascular)
2) Sudden, unilateral, and painful

35
Q

List 3 causes of gradual vision loss

A

Cataracts
Glaucoma
Macular degeneration

36
Q

What are two primary locations of vision loss?

A

1) Central (cataracts, macular degeneration)
2) Peripheral (chronic open-angle glaucoma)

37
Q

1) List a common presenting ocular symptom in primary care
2) Will a large of small % of these need urgent ophthalmological referral/treatment?

A

1) Red eyes
2) Small %

38
Q

List an important ocular Hx question to ask

A

Is there pain?

39
Q

The human eye has four refractive media, list them

A

1) Cornea
2) Vitreous body
3) Lens
4) Aqueous humor.

40
Q

The small depression within the neurosensory retina where visual acuity is the highest is called what?

A

fovea

41
Q

1) Who’s most at risk for entropion? Where is it most likely?
2) What abt ectropion?

A

1) Often due to aging; lower lid
1) Associated with obstructive sleep apnea (OSA) (also often due to aging)
-Floppy eyelid syndrome

42
Q

1) What is entropion?
2) What is ectropion?

A

1) Entropion: eyelid margin (eyelashes) rotated inwar and rubbing against the eye.
2) Ectropion: eyelid margin rotated outward, away from the eyeball.

43
Q

1) Describe entropion Sx
2) Describe ectropion Sx

A

1) Traumatizes the conjunctiva and cornea, causing tearing, irritation, redness, FB sensation, photophobia.
2) Exposes conjunctiva and cornea, which results in tearing, irritation, and redness.

44
Q

1) Entropion Tx?
2) Ectropion Tx?

A

1) Artificial tears, lubricants until corrective oculoplastic surgery (or Botox injections).
2) Surgical repair

45
Q

Hordeolum/Stye:
1) Main symptom?
2) What would you see on exam?
3) What is the general Tx?
4) What is it most often associated with?

A

1) Tender lump in the eyelid
2) Tender, localized swelling of eyelid.
3) Antibiotics generally not indicated
4) Staphylococcus aureus.

46
Q

Chalazion:
1) Main symptom?
2) What would you see on an exam?

A

1) Painless swelling/ bump of eyelid
2) Nontender rubbery nodule of eyelid

47
Q

Blepharitis:
1) What would you see on exam?
2) What is the main component of Tx?
3) What abt if due to staph?

A

1) Crust and debris within lashes
2) Lid hygiene
3) Erythromycin ointment or bacitracin

48
Q

List 3 organisms that often cause orbital cellulitis

A

1) Staphylococcus aureus
2) Streptococcus
3) Haemophilus influenzae

49
Q

What is a primary characteristic of pingueculas?

A

Generally, does not encroach on visual field

50
Q

Pterygium
1) What would you see on an exam?
2) Where is it usually?

A

1) Superficial, fleshy, triangular-shaped growing fibrovascular mass
2) On the nasal side of eye

51
Q

1) It is important to distinguish Dacryocystitis from what?
2) Who is it most common in?
3) How should you treat?

A

1) Distinguish from periorbital cellulitis
2) Pediatrics.
3) Refer to ophthalmologist and start PO antibiotics

52
Q

What are some orbital cellulitis Sx?

A

1) Redness
2) Localized soft tissue swelling
3) Warmth, pain, fever
-I.e. more systemic Sx than dacrocystitis

53
Q

1) What testing should you do for orbital cellulitis?
2) Most common Tx?

A

1) CT imaging (with contrast)
2) Cephalexin

54
Q

What is an ocular condition often associated with hyperlipidemia?

A

Xanthelasma

55
Q

What two conditions can be related to cholesterol issues?

A

Xanthelasma and Arcus Senilis (Corneal Arcus)

56
Q

Arcus Senilis (Corneal Arcus):
1) What is this ring made of?
2) Who’s it most common in?

A

1) Cholesterol
2) Older adults

57
Q

1) What pt of the body does Horner’s syndrome affect?
2) What generally causes it?

A

1) Face and eye on one side of the body
2) Another medical condition

58
Q

What is an indication for urgent evaluation if the pt also has ptosis? Why?

A

Ipsilateral pupil dilation; could be aneurysm (affecting CNIII)

59
Q

A brown ring around the iris is called what? What can it be caused by?

A

Kayser-Fleischer Ring; Wilson’s disease

60
Q

Amblyopia belongs to what group of causes of ptosis?

A

Myogenic

61
Q

1) Define ptosis
2) What are two types of underlying causes?
3) Is it reversable?

A

1) Drooping of the upper eyelid
2) Myogenic or neurogenic
3) Generally yes

62
Q

Triad of Sx for Horner’s syndrome is what?

A

1) Ipsilateral ptosis (drooping eye)
2) Miosis (pupil constriction)
3) Anhidrosis (sweat glands do not produce sweat)

(PA school) CAM I (29 decks)

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