Week 5- The Eyes Flashcards
Causes flashing lights and new vitreous floaters:
Retinal detachment
Advanced open-angle glaucoma causes:
Peripheral vision loss
One-sides vision loss caused by stroke, trauma, or brain tumor. Need to go to ER
Hemianopsia
Degeneration of retina. Can be wet or dry.
Macular degeneration
Farsightedness:
Hyperopia
Aging vision, farsightedness caused by loss of elasticity of the lens d/t again:
Presbyopia
Nearsightedness:
Myopia
Central vision loss caused by:
Nuclear cataract, macular degeneration
Diplopia:
Double vision
Horizontal diplopia caused by:
Palsy of CN III or VI
Vertical diplopia caused by:
palsy of CN III or IV
Leading cause of visual impairment and blindness in the US?
Primary open angle glaucoma
Gradual loss of vision in the peripheral fields that results from loss of retinal ganglion cells axons:
Primary open angle glaucoma
Primary open angle glaucoma exam findings:
Pallor and increasing size of the optic cup ( can be more than half the diameter of the optic disc)
This persists with one eye closed and suggests a problem with the cornea or lens:
Vertical diplopia
Normal double vision:
Physiologic diplopia
Near reaction tests CN?
III
Estropia is:
Inward deviation of the eye.
Exotropia is:
Outward deviation of the eye
Exopthalamus is:
Anterior bulging of the eye found in Graves’ disease
Black numbers on the ophthalmoscope indicate:
Positive diopter- focus on nearer objects.
Red numbers on the ophthalmoscope show:
Negative diopter: focus on objects farther away such as retinal vessels
Bi-convex and is used to focus on objects that are closer to the examiners eye such as anterior structures of the eye:
Plus or positive lens
Bi-concave and is used to focus on objects that are farther away from the examiners eye such as vitreous and retina:
Negative or minus lens
Neither convex nor concave and is used if neither the examiner’s nor the patients eyes have refractive errors (most clear view):
Zero lens (where you start)
What hand to what eye to visualize the right eye when using an ophthalmoscope?
Right hand/right eye
How far from eye with ophthalmoscope to visualize red reflex?
15 inches
What can cause an absent red reflex?
Cataract-lens is opaque
Detached retina
Children: retinoblastoma
Retinal arteries appear:
Light red, smaller, light reflex is bright
Retinal veins look:
Dark red, larger, light reflex is inconspicuous or absent
To inspect the fovea and the macula:
Have the patient look directly into the light
To inspect the anterior structures like the lens:
May need to go up on the diopters to +10 or +20 to focus
Posterior structures start at __ on the diopter.
0
Drooping of the upper eye lid caused by damage to CN III
Ptosis
Damage to sympathetic nerve supply:
Horner syndrome
Subacute, nontender, painless nodule caused by a blocked gland inside the lid:
Chalzion
Venous stasis leads to engorgement and swelling secondary to increased ICP ( meningitis, subarachnoid hemorrhage, trains, mass lesion)
Papilledema
Findings of papilledema:
Color pink, hyperemic Often with loss of venous pulsations Disc vessels more visible, more numerous, curve over borders of the disc Disc swollen with margins blurred Physiologic cup is not visible
An enlarged blind spot present during visual fields by confrontation may indicate:
Affecting optic nerve-glaucoma, optic neuritis, papilledema
To detect strabismus (general term for eso/exotropia):
Cover one eye, if opposite eye deviates inward/outward= strabismus of that eye
If patient is nearsighted rotate diopter:
Counter clockwise (minus diopters)
If patient is farsighted rotate diopter:
Clockwise (plus diopter)
Visual receptive layer of the eye where light waves changed into nerve impulses?
Retina
Retinal structures viewer through ophthalmoscope are:
Optic disc, retinal vessels, general background, and macula
Area in which fibers from retina converge to form optic nerve?
Optic disc
Where is optic disc located?
Located toward nasal side of retina
Located on temporal side of fundus, slightly darker pigmented region surrounding doves centralis (area of sharpest and keenest vision), receives and transduces light from center of visual field?
Macula
Area of keenest vision that is absent at birth but mature by 8 months?
Macula
Lens is ___ at birth, growing ____ throughout life.
Nearly spherical, flatter
Pupil size ___ in the aging adult.
Decreases
Lens opacity resulting from a clumping of proteins in the lens:
Cataract formation
Increased IOP
Glaucoma
Breakdown of cells in macula of retina:
Macular degeneration
When do halos appear around lights?
Acute narrow-angle glaucoma
A blind spot in the visual field surrounded by an area of normal or decreased vision, occurs with glaucoma, with optic nerve and visual pathway disorders:
Scotoma
When does night blindness occur?
Optic atrophy, glaucoma, or vitamin A deficiency
What medication can cause cataracts or increased intraoccular pressure?
Prednisone
What infections have ocular sequelae in the newborn?
Genital herpes and gonorrhea
An undilated eye exam is limited to:
Posterior structures of the retina
Dilated eye exam you can assess:
More peripheral structures, macula, and unexplained vision loss.
Use red lenses on the ophthalmoscope for:
Nearsightedness
Use black lenses on the ophthalmoscope for:
Farsightedness
A small whitish depression in the optic disc, from which retinal vessels appear to emerge
Central physiologic cup
Seen often around the optic disc that is not part of the disc itself and should not be included in estimates of disc diameter:
Rings and crescents
Much less common but a dramatic finding of irregular white patches with feathered margins obscuring the disc edge, no pathologic significance
Medullated nerve fibers
Is the leading cause of irreversible vision loss in the industrialized world:
Age-related macular degeneration
A light beam shining onto one retina causes pupillary construction in both that eye:
Direct reaction to light
A light beam shining into one retina causes pupillary constriction in the contralateral eye:
Consensual reaction
Direct and consensual light reactions indicate which CN are intact?
II and III
When a person shifts gaze from a far object to a near object, the pupils constrict:
The near reaction
The near reaction indicates CN what is intact?
III
Near reaction also tests:
Convergence (medial vectus muscle)
Accommodation (change in the shape of the lens caused by contraction of the ciliary muscles)
CN IV (trochlear) damage due to head trauma, congenital causes, or central lesions, causes dysfunction of the superior oblique muscle leading to:
Diplopia
Visual fields by confrontation is a valuable screening technique for:
Detection of lesions in the anterior and posterior visual pathway
The best results for visual fields by confrontation is these 2 tests:
Static wiggle test
Kinetic red target test
Causes of anterior pathway defects detected by confrontation include:
Glaucoma, optic neuropathy, optic neuritis, and glioma.
Posterior pathway defects detected by confrontation include:
Stroke and chiasmal tumors
