strabismus
disparity of the eye axis is also termed tropia and is likely cause by ambluopia
estropia
is inward turning of the eye
extropia
is outward turning of theyes
phoria
mild weakness apparent only with the cover test and less likely to cause amblyopia than tropia bust still possible
esphoria
nasal (inward) drift
exophoria
temporal (outward) drift
if eye will not turn ___, ____, ____ and ____ it indicated a dysfunction of cranial nerve III
straight nasal, up and nasal, up and temporal, down and temporal
if eye will not turn ____ and ____ it indicated a dysfunction of cranial nerve IV
straight temporal and down and nasal
periobital edema
lids are swollen and puffy, lids tissues are loosely connected so excess fluid is easily apparent, this occurs with local infections, crying, and systemic conditions such as HF and hypothyroidism
exophthalmos (protruding eyes)
forward displacement of the eyeballs and widened palpebral fissure, note lid lag. bilateral exophthalmos is associated with thyrotoxicosis
enophthalmos (sunken eyes)
bilateral enophthalmos is cause by fat loss, dehydration and wasting .
ptosis
occurs from neuromuscular weakness, oculomotor CN III damage, or sympathetic nerve damage (e.g. horner syndrome or it can be congenital. it can impair vision
upward palperbral slant
although normal in may children, when combine with epicanthal folds, hypertelorism (large space between eyes) and brushfield spots (light-colored areas on the outer iris), it indicates down syndrome
ectropoin
lower lid is loose and rolling out, puncta can not siphon tears effectively thus excess tearing results. it occurs in aging as a result of atrophy of elastic and fibrious tissue but may result from trauma
entropion
lower lid rolls in because of spams of lids or scar tissue contracting. constant rubbing of lashes may irritate cornea. The person feels a “foreign body sensation”
blepharitis (inflammation of the eye)
red scaly greasy flakes and thickened, crusted lid margin a occurs with staph infection or seborrheic dermatitis of the lid. symptoms include burning, itching, tearing foreign body sensation and some paine
chalazion
is a beady nodule protruding on the lid, is an infection retention cyst of a meibomian gland
what is the meibomian gland
are a special kind of sebaceous gland at the rim of the eyelids inside the tarsal plate
hardeolum (stye)
acute localize staph in infection of the hair follicles at the lid margin
is painful red and swollen
rubbing of eyes can cross contaminate and infect other eye
dacryocystitis (inflammation of the lacrimal sac)
pain worth and redness occur
tearing is present
pressure on the sac yields purulent discharge form puncta
dacryoadenitis
in infection of the lacrimal gland
occurs with mumps measles and infection mono or from trauma
basal cell carcinoma
is most often on lower lids and presents as a small painless nodule with central ulceration and sharp, rolled out pearly edges. it occurs in older adults and is associated with uv exposure. it is locally invasive but mtastisis is rare
anisocori
unequal pupil size
occurs normally in 5% of population
although consider cns disease
mydriasis
fixed and dilated pupils
occurs with stimulation of the cns, reaction to sympathomimetic drugs, use of dilating drugs, acute glaucoma, trauma, cns injury, circulatory arrest or deep anesthesia
argyll robertson pupil
no reaction to light
small and irregular bilaterally
occurs with cns system syphilis, brain tumor, meningitis, and chronic alcoholism,
tonic pupil (adies’s pupil)
reaction to light and accommodation is sluggish. tonic pupil is usually unilateral and large regular pupil that does not react, but sluggish after a latent time. No pathologic signifcance
horner syndrome
unilateral small regular pupil that DOES react to light and accommodation
occurs with horner syndrome a lesion of the sympathetic nerve.
also not absence of sweat on same side
CN III damage
unilateral dilated pupil with no reaction to light or accommodation and occurs with oculomotor never damage
ptosis with eye deviating down and laterally may be present
monocular blindness
when light is directed to the blind eye, no response occurs in either eye. when light is directed to the normal eye both pupils constrict as long as oculomotor nerve is intact