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EYES Flashcards

1
Q

What is the pattern of redness of conjunctivitis?

A

conjunctival injection: diffuse dilation of conjuctival vessels with redness that tends to be maximal peripherally

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2
Q

What is the pattern of redness in subconjuctival hemorrhage?

A

leakage of blood outside of the vessels, producing a homogenous, sharply demarcated, red area that resolves over 2 weeks

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3
Q

What is the pattern of redness of Corneal injury or Infection, Acute Iritis, and Acute Angle Closure Glaucoma?

A

ciliary injection: dilation of deeper vessels that are visible as radiating vessels or a reddish violet flush around the limbus. Ciliary injection is an important sign of these 3 conditions, but may not be apparent.

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4
Q

Is Conjuctivitis painful?

A

mild discomfort rather than pain

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5
Q

is Subconjuctival Hemorrhage painful?

A

NO

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6
Q

is a corneal injury or infection painful?

A

moderate to severe, superficial

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7
Q

is acute iritis painful?

A

moderate, aching, deep

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8
Q

is acute angle closure glaucoma painful?

A

severe, aching, deep

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9
Q

Is your vision impaired with conjunctivitis?

A

not affected, except for temporary mild blurring due to discharge

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10
Q

is ur vision impaired with subconjunctival hemorrhage?

A

no

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11
Q

is your vision affected with corneal injury or infection?

A

usually decreased

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12
Q

is your vision affected by acute iritis?

A

decreased; photophobia

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13
Q

is your vision affected by acute angle closure glaucoma?

A

decreased

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14
Q

is there ocular discharge with conjunctivitis?

A

watery, mucoid, or mucopurulent

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15
Q

is there ocular discharge with subconjuctival hemorrhage?

A

no

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16
Q

is there ocular discharge with a corneal injury or infection?

A

watery or purulent

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17
Q

is there ocular discharge with acute iritis?

A

no

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18
Q

is there ocular discharge with acute angle closure glaucoma?

A

no

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19
Q

is the pupil affected in conjunctivitis or subconjuctival hemorrhage?

A

no

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20
Q

is the pupil affected in a corneal injury or infection?

A

not affected unless iritis develops

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21
Q

is the pupil affected in acute iritis?

A

small and irregular

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22
Q

is the pupil affected in acute angle closure glaucoma?

A

dilated and fixed

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23
Q

T/F the core an is clear in conjunctivitis and subconjuctival hemorrhage?

A

true

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24
Q

How is the core an affected in a corneal injury or infection?

A

changes depends on cause

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25
Q

How is the cornea affected in acute iritis?

A

clear or slightly clouded; injection confined to corneal limbus

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26
Q

how is the cornea affected in acute angle closure glaucoma?

A

steamy and cloudy

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27
Q

What causes conjunctivitis?

A

bacterial, viral, and other infections, highly contagious; allergy; irritation

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28
Q

What causes subconjuctival hemorrhage?

A

often none; may result from trauma, bleeding disorders, or sudden increase in venous pressure as from cough

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29
Q

what is the significance of a corneal injury or infection?

A

abrasions, and other injuries; viral and bacterial infections

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30
Q

what is the significance of acute iritis?

A

associated with systemic infection; Herpes zoster, tuberculosis; refer promptly

31
Q

what is the significance of acute angle glaucoma?

A

acute increase in intraocular pressure constitutes an emergency

32
Q

a drooping of the upper lid

A

ptosis

33
Q

what causes ptosis

A

myasthenia gravis, damage to the oculomotor nerve, and damage to the sympathetic nerve supply (Horner’s syndrome)

  • a weakened muscle, relaxed tissue, and the weight of herniated fat may cause senile ptosis
  • may be congenital
34
Q

an inward turning of the lid margin; the lower lashes, often invisible when turned inward, irritate the conjunctiva and lower cornea

A

entropion; more commonly found in elderly

35
Q

how do you check for an entropion that is not obvious?

A

ask the patient to squeeze the lids together and then open them, then check for the entropion

36
Q

margin of the lower lid is turned outward, exposing the palpebral conductive. when the punctum of the lower lid turns outward, the eye no longer drains well, and tearing occurs.

A

ectropion, more common in elderly

37
Q

wide eyed stare; rim of sclera between the upper lid and the iris.

A

lid retraction

38
Q

Retracted lids and “lid lag” when eyes move from up to down markedly increase the likelihood of _____, especially when accompanied by fine tremor, moist skin, and heart rate > 90 beats per minute

A

hyperthyroidism

39
Q

protrusion of the eyeball; triggered by auto reactive T lymphocytes

A

exophthalmos

40
Q

Exophthalmos is a common feature of _____

A

Graves’ ophthalmopathy

41
Q

In Unilateral exophthalmos what 4 things should be in your differential diagnosis?

A
  1. Graves Disease (usually bilateral)
  2. trauma
  3. orbital tumor
  4. granulomatous disorder
42
Q

a harmless yellowish triangular nodule in the bulbar conductive on either side of the iris. appears frequently with aging, first on the nasal and then on the temporal side

A

pinguecula

43
Q

a localized ocular inflammation of the episcleral vessels. vessels appear movable over the scleral surface. may be nodular or show only redness and dilated vessels

A

Episcleritis

44
Q

What are the 3 diseases associated with episcleritis?

A
  1. rheumatoid arthritis
  2. Sjogren’s syndrome
  3. herpes zoster
45
Q

a painful tender red infected in a gland at the margin of the eyelid

A

sty

46
Q

a subacute nontender, usually painless nodule involving a blocked meibomian gland. May become acutely acutely inflamed but unlike a sty usually points inside the lid rather than on the lid margin

A

Chalazion

47
Q

slightly raised yellowish, well circumscribed plaques that appear along the nasal portion of one or both eyelids. may accompany lipid disorders

A

xanthemasma

48
Q

a swelling between the lower eyelid and nose

A

inflammation of the lacrimal sac (dacryocystitis)

49
Q

acute inflammation of the lacrimal sac (Dacryocystitis) description

A

painful red and tender

50
Q

chronic inflammation of the lacrimal sac (Dacryocystitis) discription

A

obstruction of the nasolacrimal duct

tearing is prominent and pressure on the sac produces regurgitation of material through the puncta of the eyelids

51
Q

a thin grayish white arc or cycle not quite at the edge of the cornea. accompanies normal aging but also seen in younger people, especially african american.

A

corneal arcus

52
Q

when corneal arcs in found in young people it suggests possible ________.

A

hyperlipoproteinemia. usually benign

53
Q

a golden to red brown ring, sometimes shading to green or blue, from copper deposition in the periphery of the cornea

A

Kayser-Fleischer Ring

54
Q

What disease is Kayser- Fleischer Ring found in?

A

Wilson’s disease

55
Q

Kayser - Fleischer Ring is due to a rare autosomal recessive mutation of the ATO7B gene on chromosome 13 causing what????

A
  1. abnormal copper transport
  2. reduced biliary copper excretion
  3. abnormal accumulation of copper in the liver and tissue throughout the body
56
Q

What are some symptoms that patients present with who are diagnosed with a Kayser- Fleischer ring?

A
  1. liver disease
  2. renal failure
  3. neurologic symptoms of tremor
  4. dystonia
  5. psychiatric disorders ranging from behavior changes to depression and schizophrenia
57
Q

A superficial grayish white opacity in the cornea, secondary to an old injury or to inflammation. Size and shape are variable.

A

Corneal Scar

**do not confuse with the opaque lens of a cataract, visible on a deeper plane and only through the pupil

58
Q

a triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side

A

Pterygium

59
Q

Will pterygium interfere with vision?

A

may interfere with vision as it encroaches on the pupil

60
Q

opacities of the lenses visible through the pupil.

A

cateracts

61
Q

what are the risk factors of cataracts?

A
  1. old age
  2. smoking
  3. diabetes
  4. corticosteroid use
62
Q

looks gray when seen by a flash light. if the pup is widely dilated, the gray opacity is surrounded by a black rim

A

nuclear cataract

63
Q

produces spokelike shadows that point - gray against black, as seen with a flashlight, or black against red with an opthalmoscope. a dilated pupil, as shown here, facilitates this observation

A

peripheral contact

64
Q

When anisocoria is greater in bright light than in dim light, the pupil ___________.

A

cannot constrict properly

65
Q

What are the cause of unequal pupils (Anisocoria), when anisocoria is greater in bright light than in dim light?

A
  1. blunt trauma to the eye
  2. open angle glaucome
  3. impaired parasympathetic nerve supply to the iris, as in tonic pupil and oculomotor nerve paralysis
66
Q

Unequal pupils - when anisocoria is greater in dim light, the pupil _______.

A

the smaller pupil cannot dilate properly,as in hornet’s syndrome , caused by an interruption of the sympathetic nerve supply

67
Q

pupil is large, regular, and usually unilateral; reaction to light is severely reduced or slowed, or even absent. Near reaction, although very slow, is present. slow accommodation cause blurred vision. deep tendon reflexes are often decreased

A

Tonic Pupil (Adie’s Pupil)

68
Q

The dilated pupil is fixed to light and near effect ; Ptosis of the upper eyelid and lateral deviation of the eye are almost always present

A

Oculomotor Nerve (CN III) Paralysis

69
Q

The affected pupil, though small, reacts briskly to light and near effort. Ptosis of the eyelid is present, perhaps with loss of sweating on the forehead.

A

Horner’s syndrome

70
Q

In congenital Horner’s syndrome , the involved iris is _______.

A

lighter in color than its fellow (heterochromia)

71
Q

small, irregular pupils, that accommodate but do not react to light indicate _________

A

Argyll Robertson Pupils

72
Q

What disease are Argyll Robertson pupils seen in?

A

Central Nervous System Syphilis

73
Q

When does unilateral blindness not cause anisocoria?

A

as long as the sympathetic and parasympathetic innervation to both irises is normal

74
Q

How can you test if unilateral blindness is causing anisocoria?

A

a light directed into the seeing eye produces a direct reaction in that eye and a consensual reaction in the blind eye. A light directed into the blind eye, however, causes no response in either eye.

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