Ophthomology Flashcards
All 6 EOM attach to the ___ and orginate at the ___.
- sclera
- common tendinous ring (except superior oblique - sphenoid)
What is the name of the dilator muscle of the pupil?
Is it part of the SNS or PSNS?
- dilator pupillae
- SNS
What is the name of the constrictor muscle of the pupil? Is it part of the SNS or PSNS?
- sphincter pupillae
- PSNS, CN3
Excessive dilation of the pupil is called ____. Excessive constriction is called _____.
- mydriasis
- miosis
Aqueous humor is produced in the ____ and reabsorbed by ____ in the canal of ____.
- ciliary body
- trabeculae
- Schlemm
Cones are responsible for ____ & ____ vision, while Rods are responsible for ____ & _____ vision.
- Cones: central & colored
- Rods: night & peripheral
True or False: There are more cones than rods.
FALSE
____ is near the center of the retina and contains millions of tightly packed cones.
Macula
____ is the center of the macula and is rod-free.
Fovea
The Cup:Disc ratio should not exceed ___.
0.5 or 1:2
Inward turning of the eyelid is known as ___.
Entropion
Outward turning of the eyelid is known as ___.
Ectropion
___ is the acute inflammation of the lacrimal sac.
Dacryoadenitis
___ is an infection of the lacrimal sac, usually d/t congenital or acquired obstruction of the nasolacrimal system.
Dacryocystitis
Tearing or excessive water in the eye is known as ___.
Epiphora
Central retina artery occlusion presentation
- optic disc pallor
- cherry red fovea
- constricted arterioles (boxcar segmented)
Central retina artery occlusion treatment
- call ophtho
- Attempt to dislodge (ballotment, hemodilution, rebreathe CO2)
- reduce IOP (acetazolamide or beta blockers)
Central retina vein occlusion presentation
- retinal hemorrhage
- cotton wool spots
- dilated tortuous retinal veins
Central retina vein occlusion treatment
- call ophtho
- hemodilution
- manage HTN
Retinal detachment presentation
- “curtain pulling down”
- abnormal light reflex
Retinal detachment treatment
call optho for surgical repair
know onset time
- hazy reddish vision
- red debris floating
- obscured retina and optic disc
…Diagnosis?
Vitreous hemorrhage
Vitreous hemorrhage treatment
- stop thinners
- sleep upright, no strenuous activities
- continue to reexamine for inc bleeding
- proptosis, chemosis, recent infection
- decreased EOMs, absent pupillary reflex
…Diagnosis?
Cavernous sinus thrombosis
Cavernous sinus thrombosis treatment
- broad spectrum abx (rocephin, vanco, nafcillin)
- consider steroid and anticoags
What deficiencies can cause destruction of the optic nerve
Vit B1, Vit B12, copper
- mid-dilated, fixed pupil
- IOP >40 mmHg
- photophobia, halos, HA
…Diagnosis?
Acute angle closure glaucoma
Acute angle closure glaucoma treatment
- IV analgesics & antiemetics
- constrict pupils
- shift aqueous fluid
- decrease Aq humor production
- tunnel vision
- bilat increased IOP >21
- cupping of optic disc
…Diagnosis?
Open angle glaucoma
Open angle glaucoma treatment
- decrease Aq Humor
- Increase Aq outflow
- ciliary flush, small irregular pupils
- floating debris in anterior chamber
- eye redness, photophobia, blurry vision
…Diagnosis?
Uveitis
Uveitis treatment
- ophtho in 24 hours
- cyclopegics
- steroid if optho requests
- central loss of vision
- pain with EOM
- red desaturation test, optic disc edema
…Diagnosis?
optic neuritis
optic neuritis treatment
steroids, if optho recommends
optic neuritis may be the first presentation of ___ in up to 65% of patients
MS
orbital blowout fracture treatment
- if <50% displaced with no entrapment = no surgical intervention
- if >50% displaced, surgical intervention
- analgesics
- Augmentin if open Fx
- decreased EOM, periorbital ecchymosis/edema, facial bone crepitus
- diplopia
- Hx trauma
…Diagnosis?
orbital blowout fracture
- Hx trauma
- Seidel’s sign on fluoro stain
…Diagnosis?
ruptured globe
- blood in anterior chamber
- decreased vision with pain
…Diagnosis?
Hyphema
Hyphema Tx
- Optho in 2-3 days if less than 1/3 and normal IOP
- reduce Aq humor prod (dec IOP)
- d/c thinners and nsaid
With fluorescein staining, a dendritic appearance is indicative of ____
corneal ulceration secondary to HSV
periorbital cellulitis Tx vs. orbital cellulitis Tx
- peri = Augmentin or Clinda
- orbital = Broad spectrum Abx
- decreased vision, systemically ill
- hypopyon, chemosis, absent red reflex
…Diagnosis?
Endophthalmitis
Endophthalmitis Tx
- emergent ophtho consult - possible paracentesis
- Broad spectrum Abx
Anterior vs Posterior blepharitis
- Anterior = greasy scales (remove with wash cloth and shampoo)
- Posterior = dry flakes and inflamed Meibomian glands (can express)
Stye Tx
- warm compress
- wash QID
- bacitracin or erythromycin
conjunctivitis Tx
- COLD compress
- DO NOT patch
- gradual blurry vision, excess glare, fixed spots
- whitish lens
…Diagnosis?
cataracts
- retinal hemorrhage and edema
- venous dilation
- exudates on fundoscopy
…Diagnosis?
Diabetic retinopathy
- AV nicking, tortuous arterioles
- cotton wool spot
…Diagnosis?
Hypertensive retinopathy
- loss of central vision
- atrophy/degeneration of outer retina
…Diagnosis?
Dry macular degeneration
- loss of central vision
- new vessels, fluid accumulation, hemorrhage
…Diagnosis?
Wet macular degeneration
____ is when an eye deviates inward when covered and resumes straight ahead position. ____ is when the eye deviates outward
- Esophoria
- Exophoria
- central loss of vision
- dyschromatopsia
…Dx?
optic neuritis
