Vision Abnormalities Flashcards
1
Q
what is the condition in which the eyes are misaligned?
A
strabismus
2
Q
what is the most common cause of strabismus?
A
muscle dysfunction
3
Q
what are 4 common causes of strabismus?
A
- muscle dysfunction
- farsightedness
- trauma
- brain damage
4
Q
what are 2 risk factors of strabismus?
A
- family history
- low birth weight
5
Q
_____ strabismus is when misalignment is seen all the time and the eyes cannot stay together by the fusion mechanism
A
manifest
6
Q
_____ strabismus is when misalignment can only be seen when we cover one eye
A
latent
7
Q
the extraocular muscles are innervated by which 3 cranial nerves?
A
CN 3 (oculomotor)
CN 4 (trochlear)
CN 6 (abducens)
8
Q
_____ muscles in both eyes get equal innervation to ensure the eye movements are coordinated and smooth
A
agonist
9
Q
_____-_____ muscle pairs in the eyes get reciprocal innervation
A
agonist-antagonist
10
Q
the medial rectus muscle is responsible for _____
A
adduction
11
Q
the lateral rectus muscle is responsible for _____
A
abduction
12
Q
superior rectus and inferior oblique muscles are responsible for
A
supraduction
13
Q
inferior rectus and superior oblique muscles are responsible for _____
A
infraduction
14
Q
superior oblique is primarily responsible for _____
A
incyclotorsion - down and in
15
Q
inferior oblique is primarily responsible for _____
A
excyclotorsion
16
Q
which 2 muscles contract when the eyes move to the right?
A
- right lateral rectus
- left medial rectus
17
Q
which 2 muscles contract when the eyes move to the left?
A
- left lateral rectus
- right medial rectus
18
Q
which 2 muscles contract when the eyes move up and to the right?
A
- right superior rectus
- left inferior oblique
19
Q
which 2 muscles contract when the eyes move down and to the right?
A
- right inferior rectus
- left superior oblique
20
Q
which 2 muscle contract when the eyes move up and to the left?
A
- left superior rectus
- right inferior oblique
21
Q
which 2 muscles contract when the eyes move down and to the left?
A
- left inferior rectus
- right superior oblique
22
Q
_____ strabismus is when one eye is misaligned medially
A
esotropia
23
Q
_____ strabismus is when one eye is misaligned laterally
A
exotropia
24
Q
_____ strabismus is when one eye is misaligned upward
A
hypertropia
25
_____ strabismus is when one eye is misaligned downward
hypotropia
26
which is the most common type of strabismus?
esotropia
27
what percentage of patients are born with strabismus?
2-4%
28
_____ strabismus would be more concerning than _____ strabismus due to a concern for a life threatening condition
acquired, congenital
29
during an evaluation, we would ask the patient if the strabismus is _____ or _____
constant, intermittent
30
during an evaluation, we would ask the patient if the strabismus is only present with _____
fatigue
31
a physical examination in which we look at the cornea and see where the light hits
corneal light reflex
32
during a corneal light reflex, if the pen light hits at the same place on each pupil, we would say the patient has ___ _____
no misalignment
33
if, during a corneal light reflex, the light hits the misaligned eye on the outer part of the iris, we would say the patient has _____ strabismus
esotropia
34
if, during a corneal light reflex, the light hits the misaligned eye on the innerpart of the iris, we would say the patient has _____ strabismus
exotropia
35
what kind of strabismus are we trying to diagnose during a cover/uncover test?
latent strabismus
36
during a cover/uncover test, _____ is not present when both eyes are uncovered due to the _____ ________
misalignment; fusion mechanism
37
what will we seen in the uncovered eye during a cover/uncover test?
re-fixation on object
38
what will be seen in the covered eye during a cover/uncover test?
misalignment
39
what is the physical examination in which we are looking at the red light reflex?
bruckner test
40
in a patient with strabismus, the red reflection is more intense from the _____ eye
deviated
41
after what age is intermittent manifest strabismus a concern and should be referred out?
4-6 months
42
putting medication into the strong eye to prevent accomodation
pharmacological penalization
43
spectacle corrections that blur the strong eye to prevent accomodation
optical penalization
44
putting a patch over the strong eye to prevent accommodation and encourage the weaker eye to get stronger
occlusion therapy
45
a functional reduction in visual acuity due to abnormal visual development early in life
amblyopia
46
a functional reduction in visual acuity due to abnormal _____ _________early in life is called amblyopia
visual development
47
amblyopia is predominantly _____
unilateral
48
in bilateral amblyopia, visual acuity is worse than _____ in either eye (> 4 yrs) or worse than _____ in either eye (< 3 yrs)
20/40; 20/50
49
in unilateral amblyopia, there is a _____-line difference in visual acuity between eyes
2
50
between which ages does visual acuity typically reach the adult level?
3-5 years
51
what is the most common cause of pediatric visual impairment?
amblyopia
52
50% of the amblyopia cases also have _____
strabismus
53
in strabismus amblyopia, the foveas see two _____ and _____ images
different; unfusable
54
long-term _____ of _____ eye results in strabismus amblyopia
suppression; one
55
amblyopia classification where one eye sees things more clearly than the other
refractive amblyopia
56
amblyopia classification in which something is in the way of getting the visual image to the retina
deprivational
57
what are 4 risk factors of amblyopia?
1. prematurity
2. small birth weight
3. family history
4. neurodevelopmental delay
58
amblyopia screening is recommended in all children younger than _____ years of age
5
59
amblyopia screening includes _____ risk assessment at all health visits and vision screening at _____, _____, and _____ years old
vision; 3; 4; 5
60
what is the goal of amblyopia treatment?
decrease the brain's ability of not using the weaker eye
61
what is the first step for amblyopia treatment?
eliminate visual obstructions
62
what is the second step in amblyopia treatment?
corrective lenses
63
what is the third step in amblyopia treatment?
patch or penalization
64
there is an improved long-term outcome when amblyopia treatment is started before _____ years old
7
65
what is the upper age limit for optimal amblyopia therapy?
9-10 years
66
half of children between ___-___ years with previously untreated amblyopia respond to treatment
7-17
67
what is the condition in which opacity of the lens causes blurred vision to total blindness?
cataracts
68
what is the leading cause of blindness in the world?
cataracts
69
what is the standard of blindness in the US?
20/200
70
in the US, blind patients can _____ and some can read print with appropriate ____-_____ aids
ambulate; low-vision
71
the lens of the eyes contain cells that are what kind of epithelia?
stratified
72
the cells of the lens contain a high content of what?
cytoplasmic protein
73
cataracts are formed because the lens is not able to ____ its _____ _____
shed; nonviable cells
74
a clinical presentation of cataracts is _____ vision loss
painless
75
what is the most common risk factor for cataracts?
formation of toxins
76
the clinical presentation of cataracts is highly _____
variable
77
cataracts are typically _____, although it is often _____
bilateral; asymmetrical
78
what are 3 things patients with cataracts will have difficulty with?
1. night driving
2. reading road signs
3. reading fine print
79
what physical evaluation would we perform in a patient with suspected cataracts?
nondilated fundus exam with ophthalmoscope
80
what would a ophthalmologist perform to rule out other potential pathology that can affect vision?
dilated fundus exam
81
what treatment for cataracts is indicated when symptoms interfere with ADLs and has few major complications?
surgical removal of opacified lens and replacement with synthetic lens
82
surgical intervention for cataracts is not based on _____ _____
visual acuity
83
there is no proven therapy to _____ cataract formation or _____ _____of lens opacity once it develops
prevent; slow progression
84
what is the best way to prevent cataracts?
avoid risk factors
85
a transient loss of vision in one or both eyes
amaurosis fugax
86
amaurosis fugax is due to ocular _____
ischemia
87
amaurosis fugax is also called ____ _____ _____ _____
ocular transient ischemic attack
88
amaurosis fugax is usually caused by a ___ ____ from ipsilateral carotid diseases of the heart
retinal embolus
89
how might a patient describe amaurosis fugax?
curtain passing vertically across visual field to cause complete darkness for a few minutes and curtain effect as episode passes
90
a physical examination in a patient with amaurosis fugax would present with ____ _____
no abnormalities
91
inflammation of arteries that can cause amaurosis fugax
giant cell arteritis
92
what 2 evaluations would we perform in a patient with suspected amaurosis fugax to look for inflammation and exclude giant cell arteritis?
1. erythrocyte sedimentation rate
2. C-reactive protein
93
what evaluation would we perform in a patient with suspected amaurosis fugax to potentially see a thrombus?
carotid imaging
94
what evaluation would we perform in a patient with suspected amaurosis fugax to seek a cardiogenic source of embolism?
cardiac evaluation
95
what evaluation would we perform in a patient with suspected amaurosis fugax to note activity of heart?
ECG
96
what evaluation would we perform in a patient with suspected amaurosis fugax to exclude occlusion disease of the posterior circulation?
brain MRI
97
in a patient with suspected amaurosis fugax, we would perform _____ testing to test for clotting
hypercoagulable
98
what is our management for amaurosis fugax to decrease a potential hypercoagulable state and decrease the risk for another thrombus or emboli to form?
81 mg oral aspirin daily
