Quiz eye part 2

Question 1

Recording visual acuity

Answer 1

cornea and conjunctiva examined to rule out FB, use fluorescien to examine with the light and the abrasian will be seen as a darker green area

Question 2

ocular trauma tx

Answer 2

polymyxin- bacitracin opthalmic ointment, mydriatic and analgesiac

Question 3

corneal abrasion

Answer 3

surface epithelium sloughed off and is stained with fluorescein
-caused by trauma, pain, tearing and red eye

Question 4

corneal laceration

Answer 4

-significant ocular trauma
-metallic object
-fingernail scratch does not have enough force to lacerate the cornea
-intense pain

Question 5

s and s corneal laceration

Answer 5

photophobia and profuse lacrimation with significant uvetis
-the anterior chamber will be shallow or flat in a full thickness laceration
-bubbles in the anterior chamber
-reduced visual acuity
-lens dislocation, iridodialysis and hyphema

Question 6

is a hyphema visible when the pt is lying down

Answer 6

not always

Question 7

hyphema tx (blood in front of the eye)

Answer 7

-refer, reduce manipulation, shield from the light, pain meds, xray and ct

Question 8

bacterial causes of corneal ulcer

Answer 8

adnexal infection, lid malposition, dry eye, Clamydia

Question 9

viral causes of corneal ulcer

Answer 9

hsv, h zoster oticus
-ramsey hunt and shingles

Question 10

blow out fracture

Answer 10

large high velocity object causes intense swelling of the eye
-nose blowing may also be common
-sports related

Question 11

s and s blow out fracture

Answer 11

-pain, local tenderness, double vision
-some pt ignore initially treating
-s and s may present after the inflammatory has subsided

Question 12

relative enopthalmos and motility restriction with gazing up and a possible infraorbital hypoesthesia will be caused by

Answer 12

orbital blow out fracture

Question 13

orbital blowout will be visible due to

Answer 13

edema, ecchymosis of the lid tissue, low motility and orbital crepitus (bone has air so it feels crunchy) and hypoesthesia of the ipsilateral cheek (entrapment of the infraorbital nerve), proptotic eye, enopthalmic and droopy

Question 14

what is orbital blowout caused by

Answer 14

traumatic uveitis and or hyphema

Question 15

managing orbital blowout fracture

Answer 15

if there is resultant crepitus or a motility restriction you need orbital imaging studie, ct is the choice procedure bc it is better at imaging the bony structures of the orbit than x ray or MRI

Question 16

crepitus

Answer 16

cracking popping crunching

Question 17

what if there is a floor fracture with associated herniation of the orbital contents

Answer 17

consider surgical intervention especially if there is unacceptable enophthalmos or diplopia

Question 18

what is an orbital globe rupture

Answer 18

a medical emergency with a history of trauma, the eye must be covered

Question 19

what is a cataract

Answer 19

an opacity of the lens, can be localized or diffuse causing problems with vision normally develops slowly, can be unilateral or bilateral

Question 20

why do cataracts get worse with age

Answer 20

because the lens worsens with age

Question 21

other causes of cataracts

Answer 21

congenital, traumatic, metabolic, toxic, secondary to another disorder

Question 22

what can long term steroids cause

Answer 22

cataracts

Question 23

early symp cataracts

Answer 23

loss of contract and glare, need more light to see, cant distinguish dark blue from black

Question 24

later symptoms cataracts

Answer 24

progressive, painless blurring of vision, cataract can swell occluding drainage
-pain is rare

Question 25

nuclear cataract

Answer 25

in central lens nucleus
-myopia may develop in the early stages and changes the refractive index of the lens so that a presbyopic patient may be temporarily able to read without glasses

Question 26

Posterior subscapular cataract

Answer 26

-cataract beneath the posterior lens capsule
-reduces visual acuity more twhen the pupil constricts (bright light or reading)
-most likley to produce glare
-loss of contrast

Question 27

cataract diagnosis

Answer 27

best with the pupil dilated
-well developed cataract will have gray or yellow opacities in the lens
-examination of the ref reflex through the dilated pupil discloses subtle opacities

Question 28

small cataracts

Answer 28

stand out as dark defects in the red reflrex
-slit lamp examination provides more details about the character, location, and extent of the opacity

Question 29

cataract prevention

Answer 29

UV coated eyeglasses or sunglasses
-reducing risk factors, polarized vision
something can indicate surgery intervention, vision prevents driving, reading etc

Question 30

retinal detachment

Answer 30

posterior vitreous detachment with age, vitreous gel collapses and retina will detach
-vitreous fluid will seep into or underneath the retina
-web or veil in front of the eye

Question 31

what causes the detachment

Answer 31

pigmented epithelium underneath

Question 32

shower of floaters

Answer 32

thousands of blood cells being liberated from a tiny blood vessel which has been broken due to the tear

Question 33

macular degeneration

Answer 33

loss of central vision bc the retina is damaged, leading cause irreversible blindness in the western world
-can be age related

Question 34

can debris accumulate in the eye from ARMD

Answer 34

yes bc it will accumulate in the cells in the back of the eye

Question 35

dry macular degeneration

Answer 35

thinning of the maculas layers and vision loss is typically gradual

Question 36

wet macular deeneration

Answer 36

tiny fragile blood vessel develop underneath the macula, results from the blood vessels hemorrhage and destroy macular tissue

Question 37

what happens if one bv is damages

Answer 37

vision loss can be rapid over months and weeks, if one is damages the others will compensate

Question 38

earliest sx of macular degeneration

Answer 38

persistent blurred vision then the objects will become distorted (straight lines get crooked)
-after time a small blind spot will grow in size creating a “doughnut”
-cant recognize ppl face

Question 39

visual loss not due to refrctive error

Answer 39

medical emergency especially if there is pain, redness, retinal artery occlusion, detachment or giant cell arthritis

Question 40

emergencies:

Answer 40

-redness, vitreous hemorrhage, retinal detachment, branch retinal artery occlusion, diabetic maculopathy, ischemic optic neuropathy, optic neuritis, onset of macular degeneration, thyroid disease