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Otolaryngology > Vision Abnormalities > Flashcards

Vision Abnormalities Flashcards

1
Q

what is the condition in which the eyes are misaligned?

A

strabismus

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2
Q

what is the most common cause of strabismus?

A

muscle dysfunction

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3
Q

what are 4 common causes of strabismus?

A
  1. muscle dysfunction
  2. farsightedness
  3. trauma
  4. brain damage
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4
Q

what are 2 risk factors of strabismus?

A
  1. family history
  2. low birth weight
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5
Q

_____ strabismus is when misalignment is seen all the time and the eyes cannot stay together by the fusion mechanism

A

manifest

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6
Q

_____ strabismus is when misalignment can only be seen when we cover one eye

A

latent

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7
Q

the extraocular muscles are innervated by which 3 cranial nerves?

A

CN 3 (oculomotor)
CN 4 (trochlear)
CN 6 (abducens)

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8
Q

_____ muscles in both eyes get equal innervation to ensure the eye movements are coordinated and smooth

A

agonist

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9
Q

_____-_____ muscle pairs in the eyes get reciprocal innervation

A

agonist-antagonist

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10
Q

the medial rectus muscle is responsible for _____

A

adduction

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11
Q

the lateral rectus muscle is responsible for _____

A

abduction

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12
Q

superior rectus and inferior oblique muscles are responsible for

A

supraduction

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13
Q

inferior rectus and superior oblique muscles are responsible for _____

A

infraduction

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14
Q

superior oblique is primarily responsible for _____

A

incyclotorsion - down and in

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15
Q

inferior oblique is primarily responsible for _____

A

excyclotorsion

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16
Q

which 2 muscles contract when the eyes move to the right?

A
  1. right lateral rectus
  2. left medial rectus
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17
Q

which 2 muscles contract when the eyes move to the left?

A
  1. left lateral rectus
  2. right medial rectus
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18
Q

which 2 muscles contract when the eyes move up and to the right?

A
  1. right superior rectus
  2. left inferior oblique
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19
Q

which 2 muscles contract when the eyes move down and to the right?

A
  1. right inferior rectus
  2. left superior oblique
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20
Q

which 2 muscle contract when the eyes move up and to the left?

A
  1. left superior rectus
  2. right inferior oblique
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21
Q

which 2 muscles contract when the eyes move down and to the left?

A
  1. left inferior rectus
  2. right superior oblique
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22
Q

_____ strabismus is when one eye is misaligned medially

A

esotropia

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23
Q

_____ strabismus is when one eye is misaligned laterally

A

exotropia

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24
Q

_____ strabismus is when one eye is misaligned upward

A

hypertropia

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25
Q

_____ strabismus is when one eye is misaligned downward

A

hypotropia

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26
Q

which is the most common type of strabismus?

A

esotropia

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27
Q

what percentage of patients are born with strabismus?

A

2-4%

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28
Q

_____ strabismus would be more concerning than _____ strabismus due to a concern for a life threatening condition

A

acquired, congenital

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29
Q

during an evaluation, we would ask the patient if the strabismus is _____ or _____

A

constant, intermittent

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30
Q

during an evaluation, we would ask the patient if the strabismus is only present with _____

A

fatigue

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31
Q

a physical examination in which we look at the cornea and see where the light hits

A

corneal light reflex

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32
Q

during a corneal light reflex, if the pen light hits at the same place on each pupil, we would say the patient has ___ _____

A

no misalignment

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33
Q

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

A

esotropia

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34
Q

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

A

exotropia

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35
Q

what kind of strabismus are we trying to diagnose during a cover/uncover test?

A

latent strabismus

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36
Q

during a cover/uncover test, _____ is not present when both eyes are uncovered due to the _____ ________

A

misalignment; fusion mechanism

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37
Q

what will we seen in the uncovered eye during a cover/uncover test?

A

re-fixation on object

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38
Q

what will be seen in the covered eye during a cover/uncover test?

A

misalignment

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39
Q

what is the physical examination in which we are looking at the red light reflex?

A

bruckner test

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40
Q

in a patient with strabismus, the red reflection is more intense from the _____ eye

A

deviated

41
Q

after what age is intermittent manifest strabismus a concern and should be referred out?

A

4-6 months

42
Q

putting medication into the strong eye to prevent accomodation

A

pharmacological penalization

43
Q

spectacle corrections that blur the strong eye to prevent accomodation

A

optical penalization

44
Q

putting a patch over the strong eye to prevent accommodation and encourage the weaker eye to get stronger

A

occlusion therapy

45
Q

a functional reduction in visual acuity due to abnormal visual development early in life

A

amblyopia

46
Q

a functional reduction in visual acuity due to abnormal _____ _________early in life is called amblyopia

A

visual development

47
Q

amblyopia is predominantly _____

A

unilateral

48
Q

in bilateral amblyopia, visual acuity is worse than _____ in either eye (> 4 yrs) or worse than _____ in either eye (< 3 yrs)

A

20/40; 20/50

49
Q

in unilateral amblyopia, there is a _____-line difference in visual acuity between eyes

A

2

50
Q

between which ages does visual acuity typically reach the adult level?

A

3-5 years

51
Q

what is the most common cause of pediatric visual impairment?

A

amblyopia

52
Q

50% of the amblyopia cases also have _____

A

strabismus

53
Q

in strabismus amblyopia, the foveas see two _____ and _____ images

A

different; unfusable

54
Q

long-term _____ of _____ eye results in strabismus amblyopia

A

suppression; one

55
Q

amblyopia classification where one eye sees things more clearly than the other

A

refractive amblyopia

56
Q

amblyopia classification in which something is in the way of getting the visual image to the retina

A

deprivational

57
Q

what are 4 risk factors of amblyopia?

A
  1. prematurity
  2. small birth weight
  3. family history
  4. neurodevelopmental delay
58
Q

amblyopia screening is recommended in all children younger than _____ years of age

A

5

59
Q

amblyopia screening includes _____ risk assessment at all health visits and vision screening at _____, _____, and _____ years old

A

vision; 3; 4; 5

60
Q

what is the goal of amblyopia treatment?

A

decrease the brain’s ability of not using the weaker eye

61
Q

what is the first step for amblyopia treatment?

A

eliminate visual obstructions

62
Q

what is the second step in amblyopia treatment?

A

corrective lenses

63
Q

what is the third step in amblyopia treatment?

A

patch or penalization

64
Q

there is an improved long-term outcome when amblyopia treatment is started before _____ years old

A

7

65
Q

what is the upper age limit for optimal amblyopia therapy?

A

9-10 years

66
Q

half of children between ___-___ years with previously untreated amblyopia respond to treatment

A

7-17

67
Q

what is the condition in which opacity of the lens causes blurred vision to total blindness?

A

cataracts

68
Q

what is the leading cause of blindness in the world?

A

cataracts

69
Q

what is the standard of blindness in the US?

A

20/200

70
Q

in the US, blind patients can _____ and some can read print with appropriate ____-_____ aids

A

ambulate; low-vision

71
Q

the lens of the eyes contain cells that are what kind of epithelia?

A

stratified

72
Q

the cells of the lens contain a high content of what?

A

cytoplasmic protein

73
Q

cataracts are formed because the lens is not able to ____ its _____ _____

A

shed; nonviable cells

74
Q

a clinical presentation of cataracts is _____ vision loss

A

painless

75
Q

what is the most common risk factor for cataracts?

A

formation of toxins

76
Q

the clinical presentation of cataracts is highly _____

A

variable

77
Q

cataracts are typically _____, although it is often _____

A

bilateral; asymmetrical

78
Q

what are 3 things patients with cataracts will have difficulty with?

A
  1. night driving
  2. reading road signs
  3. reading fine print
79
Q

what physical evaluation would we perform in a patient with suspected cataracts?

A

nondilated fundus exam with ophthalmoscope

80
Q

what would a ophthalmologist perform to rule out other potential pathology that can affect vision?

A

dilated fundus exam

81
Q

what treatment for cataracts is indicated when symptoms interfere with ADLs and has few major complications?

A

surgical removal of opacified lens and replacement with synthetic lens

82
Q

surgical intervention for cataracts is not based on _____ _____

A

visual acuity

83
Q

there is no proven therapy to _____ cataract formation or _____ _____of lens opacity once it develops

A

prevent; slow progression

84
Q

what is the best way to prevent cataracts?

A

avoid risk factors

85
Q

a transient loss of vision in one or both eyes

A

amaurosis fugax

86
Q

amaurosis fugax is due to ocular _____

A

ischemia

87
Q

amaurosis fugax is also called ____ _____ _____ _____

A

ocular transient ischemic attack

88
Q

amaurosis fugax is usually caused by a ___ ____ from ipsilateral carotid diseases of the heart

A

retinal embolus

89
Q

how might a patient describe amaurosis fugax?

A

curtain passing vertically across visual field to cause complete darkness for a few minutes and curtain effect as episode passes

90
Q

a physical examination in a patient with amaurosis fugax would present with ____ _____

A

no abnormalities

91
Q

inflammation of arteries that can cause amaurosis fugax

A

giant cell arteritis

92
Q

what 2 evaluations would we perform in a patient with suspected amaurosis fugax to look for inflammation and exclude giant cell arteritis?

A
  1. erythrocyte sedimentation rate
  2. C-reactive protein
93
Q

what evaluation would we perform in a patient with suspected amaurosis fugax to potentially see a thrombus?

A

carotid imaging

94
Q

what evaluation would we perform in a patient with suspected amaurosis fugax to seek a cardiogenic source of embolism?

A

cardiac evaluation

95
Q

what evaluation would we perform in a patient with suspected amaurosis fugax to note activity of heart?

A

ECG

96
Q

what evaluation would we perform in a patient with suspected amaurosis fugax to exclude occlusion disease of the posterior circulation?

A

brain MRI

97
Q

in a patient with suspected amaurosis fugax, we would perform _____ testing to test for clotting

A

hypercoagulable

98
Q

what is our management for amaurosis fugax to decrease a potential hypercoagulable state and decrease the risk for another thrombus or emboli to form?

A

81 mg oral aspirin daily

Otolaryngology (19 decks)

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