Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

HEENT > Disorders of the Globe > Flashcards

Disorders of the Globe Flashcards

(74 cards)

Start Studying
1
Q

difference between ophthalmologist and optometrist

A

ophthalmologist - eye surgeon and can treat a wide variety of eye related disorders (MD)
optometrist - treats eye related disorders (OD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Global traumas include

A

globe rupture
globe lacerations
intraocular foreign bodies
corneal foreign bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Globe rupture is when

A

full thickness eye injury to sclera/ cornea –> orbital contents spill from the globe
commonly from: penetration/perforation/laceration or rupture due to blunt force trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Globe ruptures have a risk for

A

endophthalmitis - infection of the interior of the eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hx of trauma
sudden moderate to severe eye pain
+/- decreased vision, obvious FB
Hyphema or associated facial trauma
deviated pupil toward the laceration (tear drop shaped)
severe subconjunctival hemorrhage

A

Globe rupture presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Globe rupture workup

A

do not apply pressure to the globe
snellen card - visual acuity
assess conjunctiva, looking for defects, visible FB, lacerations
examine pupil for reactivity and shape
slit lamp exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Globe rupture treatment

A

do NOT remove FB - immediately refer to ophthalmologist
eye shield NOT a patch
analgesia and antiemetics - avoid vomiting b/c increases IOP
update tetanus
abx prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Globe rupture treatment

A

do NOT remove FB - immediately refer to ophthalmologist
eye shield NOT a patch
analgesia and antiemetics - avoid vomiting b/c increases IOP
update tetanus
abx prophylaxis - prevent endophthalmitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Intraocular FB can be due to

A

trauma, sports, occupational injuries
precipitating cause of globe rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Intraocular FB workup

A

slit lamp
+/- fluorescein
CT test of choice, MRI if inconclusive
MRI contraindicated if possibly metallic FB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Intraocular FB treatment

A

maintain high index of suspicion for globe injury
immediate referral to ophthalmologist
should be removed within 24 hours
increased risk of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lacerations usually associated with

A

penetrating trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of laceration

A

minor conjunctival lacerations (<1cm or only partial thickness) - topical abx, patching, close f/u
severe (<1cm) - referral to ophthalmologist, possible suture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

corneal FB - most are

A

superficial and benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Corneal FB commonly include

A

metal, wood, plastic
may see ‘rust ring’ if metal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Corneal FB - FB is usually present on

A

cornea or under upper eyelid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Corneal FB workup

A

Examination with slit lamp +/- fluorescein
eval for corneal abrasion or rupture
improves visualization of FB
visual acuity - get baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment of Corneal FB

A

visual acuity - baseline
local anesthetic then attempt to remove
try saline flush first
can use needle or cotton applicator if doesn’t come out with flush
bacitracin-polymyxin ophthalmic ointment
tetanus
OTC analgesics
don’t need to patch the eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Blowout fractures are associated with

A

periorbital blunt or penetrating trauma (direct - force to bone and indirect - force to globe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Blowout fractures most commonly affects the

A

orbital floor (maxilla)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Blowout fractures may result in

A

entrapment of the orbital tissue and inferior rectus muscle (will have difficult of vertical eye movement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Palpable step-off at the orbital rim
orbital crepitus
limited vertical eye movement (IR entrapment)
periorbital ecchymosis (black eye)
diplopia (during vertical eye movement)
severe pain
paresthesia and numbness in the infraorbital area
enopthalmos and exophthalmos

A

blowout fracture presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Blowout fracture workup

A

CT Head and Orbits test of choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Blowout fracture treatment

A

all get prophylactic broad spectrum abx
if non-displacement and no globe injury – pain control, ice, decongestants, avoid nose blowing, +/- oral steroids, no operative treatment needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Indications for surgery in a blowout fracture
severe pain and or autonomic disturbance (entrapment of muscle) diplopia due to limited eye movement persistent/severe enopthalmos fractures involving more than 50% of the orbital floor
26
goal of surgery in a blowout fracture is
to restore herniated structures into orbital cavity
27
Corneal abrasion is a
scratched cornea - scratched eye scratching or scraping away of some of the corneal epithelium one of the most common ophthalmic injuries
28
Corneal abrasions are most commonly from
rubbing eyes, FB, contacts, etc
29
Corneal abrasion presentation
FB sensation pain and photophobia difficulty opening eye blurred vision redness in the affected eye excessive lacrimation
30
Corneal abrasion workup
measure and record visual acuity slit lamp exam with fluorescein
31
Corneal abrasion treatment
most will heal on their own in 24 to 48 hrs try to remove FB if visible Administration of topical anesthetic (NOT to go home with) topical broad spectrum abx x 3 days - contact lens wearers need coverage for pseudomonas (cipro) cold compresses oral NSAIDs discontinue lens wear - glasses instead
32
What can a corneal abrasion lead to
corneal ulcer
33
Corneal ulcer is a
keratitis = inflammation of the cornea
34
most common cause of a corneal abrasion
infection (bacterial, viral, fungi, amoeba) major complication of contact lens wearers, esp overnight
35
What other causes can lead to a corneal ulcer besides infection
severe dry eye severe allergic eye disease inflammatory disorders that involve the eye
36
Corneal ulcer presentation
eye pain photophobia lacrimation reduced vision circumcorneal injection +/- purulent or water discharge cornea appears hazy, with visible ulcer hypopyon - layering of WBC in anterior chamber
37
Corneal Ulcer workup
measure and record visual acuity slit lamp with fluorescein ulcer scraping for gram stain and culture urgent referral to ophthalmologist - risk of permanent corneal scarring and or intraocular infection
38
Corneal ulcer treatment infectious vs non-infectious
topical abx - levofloxacin, ciprofloxacin (vanco is MRSA is present) oral or topical antivirals should heal within days to weeks - heals more slowly in people who smoke
39
What is the main retinal blood supply
central retinal artery
40
retinal detachment is when
there is separation of the neurosensory layer from the retinal pigmented epithelium and choroid most common over the age of 50
41
What can happen in a retinal tear with vitreous fluid
the vitreous fluid leaks through the retinal tear, behind the retina, pulling it away from the epithelium and choroid
42
Risk factors to retinal detachments
nearsightedness (myopia) cataract surgery diabetic retinopathy penetrating or blunt ocular trauma older age +FHx of retinal detachment
43
Retinal detachment presentation
painless vision changes unilateral photopsia (flashers) increasing number of floaters in affected eye (move in and out of central vision) decreased visual acuity metamorphopsia (wavy distortion of an object)
44
Retinal detachment workup
primarily clinical dx +/- retinal tear on fundoscopic if trouble visualizing retina --> ocular US
45
Retina detachment treatment
emergent referral to ophthalmology usually surgical intervention - retinopexy
46
Central Retinal Artery Occlusion (CRAO) aka
ocular stroke
47
CRAO mean age presentation
early 60s
48
risk factors of CRAO
similar to other thromboembolic diseases (Atherosclerosis, hypertension, DM, smoking, hyperlipidemia, hypercoagulable states, male gender, migraine, OCPs)
49
1/3 of pts with CRAO have ______ carotid artery _____
ipsilateral stenosis
50
most common etiology of CRAO
embolism -- retinal hypoperfusion, rapidly progressive ischemic damage visual loss can be partial or total
51
CRAO presentation
sudden, painless, transient monocular vision loss lasts 20 - 30 min (never more than 30 min) described as a 'curtain coming down' normal IOP, anterior chamber exam and extraocular movements Likely carotid bruit
52
CRAO presentation
sudden, painless, transient monocular vision loss lasts 20 - 30 min (never more than 30 min) described as a 'curtain coming down' normal IOP, anterior chamber exam and extraocular movements Likely carotid bruit cherry red spot on the fovea*
53
CRAO workup
fundoscopic exam - pallor swelling of the retina, cherry red spot at the fovea, retinal arteries with 'box-car' segmentation, +/- clot in the central retinal artery or its branches if sx onset < 6 hrs - CT head without contrast to r/o intracranial hemorrhage - possible thrombolytics stroke workup, cardiac assessment, GCA workup if less than 50
54
CRAO treatment
emergent referral to ophthalmology - irreversible vision loss begins in the first 90-120 min lysis of clot and restoration of retinal perfusion (vasodilators, meds to reduce IOP, early intra-arterial or intravenous thrombolysis - tPA)
55
Central Retinal Vein Occlusion (CRVO) main risk
arteriosclerosis also glaucoma
56
CRVO is
venous thrombosis --> venous stasis, retinal edema, hemorrhage retinal ischemia - increased vascular endothelial growth factor - edema and neovascularization - prone to bleeding
57
endothelial injury stasis hypercoag =
virchows triad
58
CRVO presentation
sudden onset unilateral blurry or distorted vision - decreased visual acuity fundoscopic exam : dilated and tortuous retinal veins, blood streaked retina or flame shaped hemorrhages radiating from optic disc cotton wool spots esp w/ hypertension
59
CRVO treatment
urgent referral to ophthalmologist no totally effective prevention or tx management of neovascularization and macular edema - intravitreal injection of anti-VEGF agent, intravitreal steroid injections optimize risk factors
60
Macular degeneration affects mostly
the elderly idiopathic
61
macular degeneration is a degenerative process that leads to
atrophy of retinal pigment epithelium which causes geographical atrophy and gradual decline of vision
62
two types of macular degeneration
wet and dry
63
wet macular degeneration on fundoscopic exam
revealing scarring and hemorrhaging on the retina
64
dry macular degeneration on fundoscopic exam
deposits of lipids (drusen) beneath the retinal pigment epithelium
65
size of drusen effects the
amount of vision lost
66
macular degeneration presentation
painless vision changes NO redness usually bilateral slow, insidious central vision loss distorted images
67
macular degeneration treatment
goal to prevent further degeneration ocuvite - "eye multivitamin" smoking cessation lifestyle modifications laser photocoagulation anti-VEGF agents
68
Diabetic retinopathy two types
non-proliferative (just hemorrhage or exudate, no abnormal blood vessels) and proliferative (abnormal blood vessels on fundoscopic exam plus others)
69
Diabetic retinopathy treatment
annual dilated eye exam for all at risk patients risk factor modifications without sx - monitor closely without treatment with sx - intravitreal injections of an anti-VEGF
70
Iritis is
inflammation of anterior or posterior chamber and iris - not a true ocular emergency
71
most cases of iritis is from
idiopathic blunt for trauma - 20% other immune, traumatic or infectious mechanisms
72
acute iritis presentation
pain redness photophobia tearing decreased vision with pain developing over a few hours or days
73
chronic iritis presentation
blurred vision mild redness with little pain or photophobia except during an acute episode
74
Iritis treatment
aimed at reducing inflammation and pain/ preventing complications atropine - 1st line topical cycloplegic (paralyze the ciliary bodies) refer to ophthalmologist within 24-48 hours

HEENT (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions