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EENT Exam 1 > Visial exam and disorders of vision > Flashcards

Visial exam and disorders of vision Flashcards

1
Q

What is shown here?

A

Superficial flame-shaped hemorrhages,
dot hemorrhages, & microaneurysms in a patient with nonproliferative diabetic
retinopathy

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2
Q

_____ is optic disk swelling caused by increased intracranial pressure

A

Papilledema

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3
Q

Causes of papilledema

A
  • Space occupying lesion
  • Pseudotumor cerebri
  • Addison’s disease
  • Hypoparathyroidism
  • Sleep apnea
  • Obesity hypoventilation
    syndrome
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4
Q

8 point eye exam includes:

A
  1. Visual Acuity (Snellen chart)
  2. Pupillary exam
  3. Ocular motility
  4. Intraocular Pressure
  5. Visual fields
  6. External Exam
  7. Slit-lamp examination
  8. Fundoscopic exam
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5
Q

What does 20/XX mean anyway?

A
  • Clarity of vision measured at 20 feet
  • Eg: 20/100 vision
  • Patient must stand as close as 20
    feet to see what a person with
    normal vision can see at 100 feet
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6
Q

Pupillary Exam

A
  • Swinging flashlight test
  • Dim room lights (if possible)
  • Patient should focus on an object 15 feet away to avoid the pupil constriction normally seen with accommodation.
    A. Pupils are normal & equal before light testing.
    B. Both pupils constrict when light is shined into the normal (right) eye.
    C. Afferent pupillary defect (Marcus-Gunn pupil) of the left eye when compared with
    D. Unaffected right eye
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7
Q

IOP ____ due to ↓ fluid production or loss of globe integrity

A

↓

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8
Q

IOP ↑ when fluid production > outflow, causing

A

glaucoma, hyphema

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9
Q

Normal IOP =

A

10 to 20 mm Hg

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10
Q

Factors that determine depth perception

A
  1. Size of the image of a known object on the retina
  2. Moving parallax phenomenon
  3. Stereopsis
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11
Q

objects moving at a constant speed across the frame will appear to move a greater amount if they are closer to an
observer (or camera) than they would if they were at a greater distance

A

Moving parallax phenomenon

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12
Q

The perception of depth produced by the reception in the brain of visual stimuli from both eyes in combination;
binocular vision

A

Stereopsis

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13
Q

Normal eye or _____

A

“emmetropic”

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14
Q

Farsighted eye or Hyperopia

A
  • Usually the eyeball is too short or, occasionally, the lens system is too weak
  • Parallel light rays are not bent sufficiently by the relaxed lens system to come to focus by the time they reach the retina (capable of focusing distant objects on the retina).
  • To compensate, the ciliary muscle contracts to ↑ the strength of the lens
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15
Q

Objects close-up appear blurry, out of focus

A

Farsightedness

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16
Q

In Farsightedness, Light focuses ____ the retina

A

behind

17
Q

Age-related worsening of vision

A

Presbyopia

18
Q

Nearsightedness or Myopia

A
  • Ciliary muscle is relaxed & light from distant objects is focused in FRONT of the retina.
  • Usually eyeball is too long
  • Can result from ↑ refractive power in the lens system of the eye.
  • The eye cannot ↓ the strength of its lens less than a relaxed ciliary muscle.
  • No mechanism to focus distant objects sharply on the retina.
  • As an object moves nearer, the eye can focus the image
19
Q

Objects in the distance appear blurry, out of focus

A

Nearsightedness or Myopia

20
Q

Astigmatism

A
  • Refractive error of the eye causing the visual image in one plane to focus at
    a different distance from that of the plane at right angles.
  • Most often results from ↑ curvature of the cornea in one plane of the eye
21
Q

Abnormal curvature of the cornea

A

Astigmatism

22
Q

T/F Astigmatism causes Blurred vision at any distance

A

T

23
Q

Strabismus

A

Cross-eyed
One eye is turned
* Inward → esotropia
* Outward → exotropia
* Upward → hypertropia
* Downward → hypotropia

24
Q

Children with strabismus often develop
_____ (lazy eye) & impaired depth
perception

A

amblyopia

25
Q

Strabismus Clinical Presentation

A
  • Diplopia (double vision)
  • Eye strain
  • Headache
  • Decreased depth perception
26
Q

Strabismus diagnosis

A
  • Visual acuity (Snellen Chart)
  • Corneal light reflex test
  • Cover/Uncover test (1st video-link)
  • Retinal bifringence scanning (2nd video-link)
27
Q

Strabismus Treatment

A
  • Referral to Ophthalmology
  • Eyeglasses
  • Prism lenses
  • Vision therapy
28
Q

Leading cause of decreased vision among children

A

Amblyopia “lazy eye”

29
Q

Strabismic amblyopia

A
  • Foveas of the eyes are presented with two different &
    unfusible images.
  • Visual cortex suppresses the image from one eye in
    order to avoid having diplopia
  • Long-term suppression of one eye → strabismic
    amblyopia
30
Q

Refractive amblyopia

A
  • Foveas of the eyes are presented with different image clarity asymmetric refractive error (anisometropia)
  • Often dx’d later, eye abnormalities are less obvious & discovered when children start learning to read
31
Q

Deprivational amblyopia

A
  • Less common & is the result of visual axis interruption
  • Cataracts, ptosis, vitreous hemorrhage, corneal opacities
32
Q

Treatment for amblyopia involves patching of the ____ eye

A

unaffected

33
Q

Keratoconus

A

Progressive, thinning, cone-shaped protrusion of the cornea → visual impairment

34
Q

Keratoconus etiology: association with ___

A
  • Down’s syndrome
  • Atopic dermatitis
  • Retinitis pigmentosa
  • Aniridia
  • Marfan’s syndrome
  • Ehlers– Danlos syndrome
35
Q

Keratoconus presentation

A
  • ↓ vision: Distortions, glare/flare, & monocular diplopia or ghost images
  • Unsatisfactory spectacle correction
  • Corneal sensitivity
  • Decreased tear secretion
  • Bilateral but asymmetric
36
Q

Deposition of iron in the basal epithelial cells in a (often
partial) ring shape at the base of the conical protrusion

A

Fleischer ring

37
Q

What are Vogt striae and when will you see it?

A

(fine-stress lines) in the deep stroma fluorescein
seen with keratoconus

38
Q

Keratoconus Tx

A
  • Rigid contact lenses
  • Scleral lenses
  • Surgical correction
  • Referral to opthalmology

EENT Exam 1 (5 decks)

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