Pestana- 9. Ophthalmology

Question 1

What is the name of the vision impairment resulting from interference with the processing of images by the brain during the first 6 or 7 years of life?

Answer 1

amblyopia

Question 2

What is the most common expression of amblyopia?

Answer 2

strabismus (brain gets two overlapping images and suppresses one of them)

Question 3

What is the consequence if strabismus is not fixed early on?

Answer 3

permanent cortical blindness of the suppressed eye can develop

Question 4

How do you verify that strabismus exists?

Answer 4

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

Question 5

If a child does not have strabismus at first but develops later in infancy, what is most likely the problem and solution?

Answer 5

exaggerated convergence caused by refraction difficulties (fix with corrective glasses)

Question 6

White pupil in a baby means what?

Answer 6

retinoblastoma

Question 7

What should you think about if a patient presetns with severe eye pain or frontal HA starting in the evening after the patient has had dilated pupils for several hours (ex. at the movies)?

Answer 7

acute angle closure glaucoma

Question 8

What is a patient’s sight like with acute angle closure glaucoma?

Answer 8

halos around lights

Question 9

What are the physical exam findings in acute angle closure glaucoma?

Answer 9

• mid-dilated and non-reactive pupil
• cornea cloudy with greenish hue
• eye feels “hard as a rock”

Question 10

What do you give a patient with acute angle closure glaucoma while waiting for the ophthalmologist?

Answer 10

• Systemic carbonic anhydrase inhibitors
• Topical beta-blockers
• Topical alpha2- agonists
• Mannitol
• Pilocarpine

Question 11

What do you think of if a patient has a hot, tender, red and swollen eyelid and a dilated, fixed pupil with limited eye movement when the eye is pried open?

Answer 11

orbital cellulitis

Question 12

What is orbital cellulitis?

Answer 12

pus in the orbit

Question 13

What is the treatment for orbital cellulitis?

Answer 13

emergency CT and drainage

Question 14

How long should you flush out an eye with a chemical burn?

Answer 14

30 minutes before going to ER

Question 15

What must you do before you send a patient with a chemical burn of the eye home from the ER?

Answer 15

check their eye pH

Question 16

.What should you worry about in a patinet who sees flashes of light and “floaters” in their eye?

Answer 16

retinal detachment

Question 17

How long does it take for embolic occlusion of the retinal artery to cause permanent vision loss?

Answer 17

30 minutes

Question 18

What should you do for someone who has embolic occlusion of the retinal artery?

Answer 18

have the patient breathe into a paper bag and have someone repeatedly press hard on the eye and release in transit to the ER