Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Physical Diagnosis > The Eye Exam > Flashcards

The Eye Exam Flashcards

1
Q

common complaints or concerns

A
  • pain
  • redness
  • discharge
  • photophobia
  • foreign body
  • visual disturbances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

physical exam

A
  • equipment
  • visual acuity
  • visual fields
  • general inspection
  • pupillary responses
  • extraocular muscle movement (EOM)
  • fundoscopic examination
  • slit lamp examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

visual acuity: VS of the eye

A
  • pick a chart (snellen - 20ft, rosenbaum - 14in)
  • test with and without corrective lens
  • cover one eye
  • smallest line read with >50% accuracy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

documentation of eyesight

A
  • top number (distance between patient and chart)
  • bottom number (distance at which a normal eye can read letters)
  • normal vision: 20/20
  • legal blindness: 20/200
  • OS oculus sinister - L eye
  • OD oculus dexter - R eye
  • OU oculus uterque - both eyes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pinhole testing

A
  • Is blurred vision functional or structural?
  • Improvement with pinhole implies functional problem (ex: refractive error)
  • Lack of improvement with pinhole implies structural problem (ex: optic nerve damage)
  • focuses the light waves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

myopia

A
  • nearsightedness

- difficulty seeing far away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

hyperopia

A
  • farsightedness

- difficulty seeing close up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

presbyopia

A

-aging vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

diplopia

A

double vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

scotomas

A

blind spot in visual field

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

visual field cuts

A

loss of vision in part or all of a visual field

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

photophobia

A

pain with vision/light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

visual field

A

entire area seen by an eye when it looks at a central point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

limits of visual fields

A

upper orbital ridge, nose (medially) and cheek bone (inferiorly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

types of hemianopsia

A

-bitemporal hemianopsia (both eyes cant see outer half)
-homonymous hemianopsia (both eyes only see R (or L) half of vision)
Both of these are visual field cuts
-most common cause is pituitary tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

general inspection of the eye

A
  • Position and alignment
  • -Exophthalmos: protruding of eyeball
  • -Enophthalmos: recession of eyeball
  • Eyebrows
  • -Hair distribution
  • Eyelids
  • -Edema, erythema, lesions, position of eyelashes
  • -Adequate opening and closure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

exophthalmos

A

long palpebral fissure and exposure of the superior aspect of the iris - think hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ptosis

A

interruption of CN III nerve supply, older people may be secondary to weight of eyelid, can be congenital (born with it)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

blepharitis

A

inflammation of lid margin with redness, thickening and scales of crust
helpful to wash with baby shampoo - helps to decrease bacteria on skin in the area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

xanthelasma

A

cholesterol deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

entropion

A

lid droops inward

lower lash may irritate conjunctiva and cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ectropion

A

lid droops outward exposing palpebral conjunctiva: poor drainage and tearing occur if punctum blocked
a lot of time its due to loss of connective tissue or elasticity as we age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

chalazion

A

-beady nodule (meibomian (sebaceous) gland) inside otherwise normal eyelid, can become inflamed and tender, points inside lid not on lid margin
fill up with a little debris or pus
treat with washing with baby shampoo and warm compress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

hordeolum

A

acute
sty
painful tender infection around hair follicle lid margin - is usually tender, red infected gland at margin of eyelid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

inspecting lacrimal apparatus

A

-edema, erythema, discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

inspecting conjunctiva and sclera

A

color (icterus), nodules (pterygium), edema (allergies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

inspecting cornea and lens

A

opacities (cataracts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

inspecting iris

A

-color, pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

inspecting pupils

A
  • Size, shape, symmetry
  • Extraocular movements
  • Pupillary reaction to light (direct and consensual)
  • Near reaction (miosis, convergence and accommodation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

dacryostenosis

A
  • stricture/obstruction of gland
  • if you touch it, it will feel hot and tender
  • if you push on those areas, youll get pus coming out of those openings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

dacryocystitis

A

infection of sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what to look for in conjunctiva and sclera

A
  • color
  • injection
  • nodules
  • hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

scleral icterus

A

jaundice in eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

scleritis

A

vasculitis of sclera

lupus and scleritis often times goes together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

pterygium

A

benign growth of the conjunctiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

subconjunctival hemorrhage

A

most common reason is heavy vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

conjunctivitis

A

can be from allergies, virus, bacteria - inflammation of conjunctiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

anterior chamber

A
  • cornea, iris, and lens
  • separates the cornea from the iris and lens
  • transmits light through lens to retina
  • primary reflective element of the eye
  • any disturbance in corneal clarity results in visual impairment
  • avascular - blood vessels should not be present
39
Q

arcus senilis

A

Common in elderly, From cholesterol deposits, may indicate hyperlipidemia

40
Q

cataracts

A

Results from aging process, congenital or result of injury or infection
mature cataract - when the ens is totally opacified. Red reflex cannot be obtained

41
Q

nuclear cataract

A

looks gray when seen by a flashlight

42
Q

peripheral cataraact

A

produces spoke-like shadows that point outward

43
Q

acute angle closure glaucoma

A
  • sudden elevation in intraocular pressure that occurs when the iris blocks the eye’s drainage channel—the trabecular meshwork.
  • Treatment consists of making a hole in the peripheral iris (“iridotomy”) with the laser or surgery. This procedure usually unplugs the outflow mechanism. This condition affects middle-aged or elderly patients with anatomically small anterior chambers or altered iris structure.
  • Most angle-closure incidents occur spontaneously. Very few cases are precipitated by topical pupil-dilating parasympatholytics, and virtually none by orally administered parasympatholytics—despite the drug insert warnings.
44
Q

how does acute angle closure glaucoma present?

A
  • severe periocular pain
  • photophobia
  • blurred vision
  • conjunctival vessels are most dilated at the corneal edge (ciliary flush, circumcorneal flush)
  • The cornea is often hazy and the pupil unreactive to direct light
  • Intraocular pressure will be very elevated (above 40 mm Hg).
45
Q

Uveitis (Iritis)

A

-Pain, Red eye, Photophobia, Reduced vision, Tearing, Cells in the aqueous or anterior chamber of the eye (viewed under a slit lamp)
-Build up of pressure in the eye
They get a hazy cornea (from build up of pressure in eye)
Inflammation of iris itself can happen from infection, severe pain, photophobia, etc.

46
Q

Pupils

A
  • Size, shape and symmetry
  • Corneal light reflex: ocular alignment
  • Extraocular Movements: “H”
47
Q

Strabismus

A

deviation of the eyes from the normally conjugate position

“lazy eye”

48
Q

Nystagmus

A

fine, rhythmic oscillations of the eyes, normal for a few beats seen at terminal range of eye movement. Sustained indicates neurological condition.

49
Q

mydriasis

A

dilated pupil size

50
Q

myosis

A

constricted pupil size

51
Q

aniosocoria

A

< 5mm difference between pupils

-common in 20% of population

52
Q

pupillary reaction to light tells us about what nerve

A

tells us about the function of the cranial nerve 2 - optic nerve

53
Q

accommodation

A
  • ability of pupils to constrict when focus shifts from distance to close object
  • pupils constrict to a near object or increased convexity of the lenses caused by contraction of the ciliary muscles to help bring a near object into focus – another test of the oculomotor nerve; reduced accommodation can be a sign of presbyopia (inability to focus on near objects, often age related)
54
Q

convergence

A

ability of eyes to move toward the nose symmetrically when following an object moving toward them

55
Q

near reaction

A

if patient is being tested for convergence, their eyes should come in and pupils should constrict (near reaction)
Near reaction is also tested from accommodation (looking far vs. near)

56
Q

reflex arc and associated nerves

A

initiated by reaction to light: CN II (afferent limb to occipital lobe) and CN III (efferent limb from brain to eye)

57
Q

dilator muscles

A

in iris, dilate pupil

sympathetic innervation

58
Q

oculomotor nerve (CN III)

A

parasympathetic innervation causing sphincter muscles in iris to constrict pupil

59
Q

PERRL(A)

A

Pupils Equal, Round, Reactive to Light and Accommodation

60
Q

Swinging flashlight test

A

-Used to test for impairment of optic nerves
-Swing light beam from one pupil to the other
-Normally each pupil constricts
-Looking for afferent pupillary defect
Looking for pupillary constriction and as the light goes away it dilates
If you have afferent pupilary defect, when you shine the first time, it constricts, but the second time it dilates

61
Q

Nerve innervation of ocular muscles

A
  • Lateral Rectus – Abducens nerve (CN VI)
  • Superior Oblique – Trochlear nerve (CN IV)
  • All others – Oculomotor Nerve (CN III)
62
Q

ocular movements

A

-effected by contraction & relaxation of the EOM -
simultaneous movement of the eyes in tandem up or down, side to side or convergence.
-Convergence is another test of CN III (someone shifts their gaze from a far object to a near one)

63
Q

lateral rectus and medial rectus

A

move eyes left and right

64
Q

superior rectus and inferior rectus

A

move eye up and down

65
Q

paralysis of left lateral rectus

A

cranial nerve VI palsy

pt cant look to the left with L eye

66
Q

nystagmus

A

Rhythmic oscillation of the eyes, many causes

Direction of components, plane of movements

67
Q

fundus

A

posterior aspect of the eye seen through the ophthalmoscope

68
Q

retina

A

Retina – visual screen and inner layer of the eye

69
Q

optic disc

A

Optic disc: contain optic nerve (CN II), retinal vein and arteries

70
Q

fovea

A

Fovea: lateral and slightly inferior to the disc, a small depression in the retinal surface where largest concentration of cones are contained therefore the central point of vision

71
Q

macula

A

Macula: yellow oval around the fovea– acts as a natural blocker of UV light or sunblock for the fovea

72
Q

physiologic cup

A

Physiologic cup: depression in the optic disc

73
Q

red reflex

A
  • light reflecting off retina

- absent in cataract and sometimes in vitreous hemorrhage

74
Q

papilledema

A
  • From swelling of the optic disc and bulging of the cup.
  • Disc vessels are more visible, disc is swollen with blurred margins, cup is absent.
  • Seen in hypertension, increased intracranial pressure from brain hemorrhage, trauma, meningitis.
75
Q

optic disc cupping

A

normal ratio of disc to cup is 2:1
in cupping, cup gets bigger
indication of optic nerve damage which may be associated with loss of peripheral vision
usually presents without symptoms

76
Q

glaucoma

A

disease that causes damage to the optic nerve. There are two types. Open angle glaucoma and acute closed angle glaucoma

77
Q

open angle glaucoma

A
  • second leading cause of blindness in Americans.
  • painless, gradual and irreversible vision loss, usually starting with peripheral vision loss, pallor and increasing size of the optic cup.
  • some associated with increased intraocular pressures but some arent
  • risk factors: DM, age, family hx, myopia
78
Q

acute closed angle glaucoma

A

sudden increased in intraocular pressure that is a medical emergency.

79
Q

A-V tapering

A

The vein appears to taper on either side of the artery – seen in hypertensive retinopathy. From decreased transparency of the retina and arterial walls.

80
Q

A-V nicking

A

vein abruptly stops on either side of the artery

81
Q

copperwiring

A

increased light reflection off of artery, commonly seen as vessels close to the disc.
happens because of the pressure

82
Q

A-V crossing

A

Arterial wall is transparent – what is seen is the column of blood passing through it and a reflection of the light, thus when an artery crosses over top of a vein, you can see the vein right up to the column of blood in the artery – AV crossing
-types = AV-nicking and AV-tapering

83
Q

fovea

A

lateral and slightly inferior to the disc, a small depression in the retinal surface where largest concentration of cones are contained therefore the central point of vision

84
Q

macula

A

yellow oval around the fovea– acts as a natural blocker of UV light or sunblock for the fovea

85
Q

macular degeneration

A

cause of poor central vision in the elderly

Two kinds wet and dry

86
Q

diabetic retinopathy

A

Hard exudates
Cotton wool patches
Deep hemorrhages

87
Q

hypertensive retinopathy

A

AV tapering, banking and nicking
Copper wiring
Hard exudates
Papilledema

88
Q

cotton wool patches

A

soft exudates - white or grayish, irregular shaped lesions – result from infarcted nerve fibers – seen in hypertension and diabetes

89
Q

neovascularization

A

happens because of diabetes or hypertention to try to get more nutrients and blood supply to the eye
Form due to cotton wool patches (infarcted nerve fibers)

90
Q

hard exudates

A

Creamy or yellow in color, bright with well defined borders, often occur in clusters. Seen in diabetes and hypertension – hard deposits of lipids or proteins – leak from surrounding capillaries
Exudates = damage to the retina vision loss due to exudates

91
Q

slit lamp examination

A
  • Magnifying device to examine anterior portion of eye: Cornea, Anterior chamber, Iris, Lens
  • Used primarily in ED and by Ophthalmologists/Optometrists
92
Q

eye exam checklist

A
  • visual acuity bilaterally
  • inspect external eye
  • inspect pupils
  • pupillary reaction to light and accommodation
  • assess visual fields by confrontation bilaterally
  • assess extraocular movements, convergence
  • fundoscopic examination
93
Q

acute narrow-angle glaucoma

A

crescentic shadow on iris

94
Q

Binocular vision muscles

A
  • Depends on 3 pairs of muscles
    1. Medial & Lateral rectus
    2. Superior & Inferior Rectus
    3. Superior & Inferior Obliques

Physical Diagnosis (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions