PE Eyes Flashcards
What is composed of the eyelid, conjunctiva, lacrimal gland, eye muscles, and bony skull orbit.
External eye
What part of the outer eye also contains fat, blood vessels, nerves, and connective tissue that support the eye.
Orbit
What is composed of skin, striated muscle, the tarsal plate, and conjunctiva
a) Meibomian glands in the eyelid provide oils to the tear film.
b) The tarsus provides a skeleton for the eyelid.
Eyelids
What distributes tears, limit light, and protect the eyes
Eyelids
What is the thin and clear mucous membrane covering most of the anterior surface of the
eye and eyelid.
Conjunctiva
What is the Palpebral conjunctiva?
It coats the inside of the eyelids
______ glands in the eyelid provide oils to the tear film
Meibomian
What protects the anterior surface of the eye (except the cornea) and the surface of the eyelid in contact with the globe.
Bulbar (or ocular) conjunctiva
What is located in the temporal region of the superior eyelid and Produces tears that moisten the eye.
Lacrimal gland
True/False
Tears flow over the cornea, drain via the canaliculi to the lacrimal sac and duct, and then into the nasal meatus.
True
If someone is tearing chronically then were is the problem?
The canal that drains the tears
The eye muscles are innervated by what?
CN 3, 4 and 6
What CN
(1 Controls the levator palpebrae superior is (which elevates and retracts the upper eyelid).
(2 Controls superior, inferior, medial rectus muscles and the inferior oblique muscles.
CN 3
What CN
Controls the superior oblique muscle.
CN IV
What CN
Controls the lateral rectus muscle
CN VI
Internal structures of the eye are composed of what three separate coats?
1) Outer layer - sclera (posteriorly) and the cornea (anteriorly).
2) Middle layer (uvea) - choroid (posteriorly) and the ciliary body and iris (anteriorly).
3) Inner layer - retina.
What is the posterior 5/6 of the globe, dense, avascular white portion of the eye and supports the internal structure of the eye.
The sclera
What is this?
1) Anterior 1/6 of the globe and is continuous with the sclera.
2) Optically clear, has rich sensory innervation, and is avascular.
3) Major refractive power of the eye.
The cornea
What is composed by the iris, ciliary body, and choroids.
Uvea
What part of the uvea produces the aqueous humor
Ciliary body
What part of the uvea Contains pigment cells that produce the color of the eye and controls light by dilating or contracting the pupil?
Iris
What part of the uvea is Pigmented, richly vascular layer that supplies oxygen to the outer layerof the retina?
Choroid
What is the biconcave, transparent, elastic structure that changes its thickness to focus images on retina (refraction)?
Lens
What is the sensory network of the eye
Retina
The macula, or fovea do what?
allows for color perception and central vision
Past Medical History questions for eye issues
Past eye trauma, treatment and results, previous eye surgery and outcome, any chronic illnesses affecting vision, and medications used
History of Present Illness questions to ask?
-Present problem data focused on recent injury or foreign bodies, eye pain, swelling, infections, surgery, allergies, secretions, recent illness, or medications used.
-Visual perception and related symptoms such as double vision, near or distant vision acuity problem, central or peripheral vision problem, cataracts, adequacy of color vision, sudden loss of vision or portion of visual field, trauma or eyelid drooping should be investigated.
Personal and Social History to ask for eyes
(1) Employment, activities, allergies, medications, eye lenses, and protective device use.
(2) Exposure to irritants, activity risks, routine care of eyes and eye devices.
(3) Date of last eye examination, corrective surgery.
(4) Cigarette smoking (a risk factor for cataract formation, glaucoma, macular degeneration, thyroid eye disease).
Cigarette smoking is a risk factor for what?
ataract formation, glaucoma, macular degeneration,
thyroid eye disease
Rosenbaum pocket screener is used for? At what distance?
-Near visual acuity (NVA)
-Comfortable distance (about 35cm, or 14 inches) from the eyes
How do you test peripheral vision
confrontation test
When inspecting the external eyes and the patient’s eyebrows are coarse (or do not extend beyond the temporal canthus), What does this mean?
May have hypothyroidism
When inspecting the external eyes and the eyebrows appear unusually thin, what should you ask?
if the patient waxes or plucks them
What is the MIDNIT mnemonic
Metabolic
Inflammation
Degenerative
Neoplastic
Infection
Trauma
True/False
Periorbital edema is usually normal
FALSE
always abnormal.
Periorbital edema may represent what?
(1 May represent thyroid eye disease.
(2 Allergies.
(3 Renal disease (nephrotic syndrome).
(4 Xanthelasma lesion
when inspecting the closed eyelids Fasciculation’s and tremors may represent what?
hyperthyroidism
Lids do not completely close is called what and what is a complication of this
Lagophthalmos - cornea may become dried and be
at increased risk of infection.
What are some common causes of lagophthalmos?
Thyroid eye disease, Bell palsy, overaggressive ptosis or blepharoplasty surgical repair
True/False
Eyelashes should be present on both lids and should curve away from the globe
True
What is this issue?
If one superior eyelid covers more of the iris than the other, or extends over the pupil
Ptosis
What is an indication for weakness of the levator muscle (congenital or acquired) or a paresis
of a branch of CN III
Ptosis
Definition of what?
Lid is turned away from the eye (may result in excessive tearing)
Ectropion
What is Entropion
lid is turned inward toward the globe (may cause irritation, increasing the risk of infection)
What is an acute supportive inflammation (staphylococcal) of the follicle of an eyelash that forms an erythematous or yellow lump.
Hordeolum (stye)
What is crusting along the eyelashes caused by bacterial infection?
(seborrhea, psoriasis, rosacea, or allergic response).
Blepharitis
When do you inspect the upper conjunctiva?
only when there is a suggestion that a foreign body may be present
How would you inspect the upper conjunctiva?
Evert the lid on a small cotton covered applicator by pulling the eyelashes gently downward and forward
Erythematous or cobblestone appearance of the conjunctiva might suggest what?
Allergic or infectious conjunctivitis
Bright red blood in a sharply defined area surrounded by healthy-appearing conjunctiva
subconjunctival hemorrhage
What is an abnormal growth of conjunctiva that extends over the cornea from the limbus.
Common with heavily exposure to ultraviolet light
Pterygium
What can cause subconjunctival hemorrhage
Straining or pressure
(violent coughing, sneezing, straining, vomiting,
pregnancy labor, trauma, foreign objects, and aggressive rubbing of the eye.)
True/False
Subconjunctival hemorrhage resolve spontaneously?
True
How do you inspect the cornea?
shining a light tangentially (from the side) on it.
Normally the cornea on inspection will be what?
clear/transparent
when testing Corneal sensitivity (CN V) your patient has decreased sensation what could this mean?
diabetes, viral infections (herpes simplex or zoster), neuralgia or ocular surgery
What is lipids deposited in the periphery of the cornea.
Complete circle is called what?.
Corneal arcus (arcus senilis)
circus senilis
What is pupillary constriction to less than 2 mm
Miosis
What is pupillary dilation of more than 6 mm and failure of the pupils to constrict with light
Myadriasis
True/False
Myadriasis may indicate coma, or may be caused the use of eye drops
True
What is inequality of pupillary size
Anisocoria
Either yellow or green Sclera may indicate what?
liver or a hemolytic disease is present
Dark or slate gray pigment in the Sclera may indicate what?
senile hyaline plaque
If the temporal aspect of the upper lid feels full how would you inspect?
evert the lid and inspect the gland.
Enlargement of the lacrimal gland may indicate what?
tumors, lymphoid infiltration, sarcoid disease, or
Sjogren syndrome
patient may report dry eyes or a gritty feeling in
the eyes. what would you suspect?
Inadequate tear production
Corneal light reflex reflected asymmetrically, what is the next step?
perform the cover-uncover test to evaluate
Cover-uncover test can identify what?
identifies strabismic eye (crossed eye)
For a strabismic eye what does exotropic mean
is outward (away from the midline)
For a strabismic eye what does Esotropic mean?
is inward (toward the nose)
When doing an Ophthalmoscopy Examination and you visualize narrowing of the blood vessels and it looks like copper wiring what would you suspect?
Hypertension
True/False
Vessels always branch Towards from the optic disc, you can use these landmarks to find the optic disc
FALSE
Vessels always branch away
Where does the retina converge to the optic nerve?
Optic disk
