ENT 1 Flashcards by Meg Dolohanty

junction where conjunctiva end and cornea begins

limbus

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what are the 2 types of conjunctiva

palpebral (evert lid)

bulbar (around eye itself)

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what is tortuosity of capillaires of the retina associated with?

hypertension

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uneven pupil size, not necessarily pathological

Anisocoria

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area right underneath the conjunctiva

sclera

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what can you use to numb the eye?

Tetracaine 0.4%

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what is used to check ocular pressure to r/o acute angle glaucoma

tonometry

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reasons to refer to a specialist. Red eye+

eye pain, visual disturbance
corneal damage
acute glaucoma
foreign bodies

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should a nonopthalmologist prescribe a topical steroid or steroid/abx combo drops?

No, could exacerbate the problem

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types of conjunctivitis

allergic
viral
bacterial
chemical

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will people with conjunctivits have normal vision?

Yes (may be transient with crusting)

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will there be photophobia with conjunctivitis

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Mucopurulent discharge, usually unilaterly

bacterial conjunctivitis

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most common cause of bacterial conjuncivitis

Pneumococcus

H. aegytpicus

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Gross purulence with bacterial conjunctivis suggests what?

Neisseria infection

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chronic conjunctivitis is usually due to waht?

Staph aureus or moraxella lacunata

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Usually bilateral, pre auricular nodes, profuse exudate

Chlamydial conjunctivitis

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chronic conjunctivitis from chlamydia trachomatis

Trachoma

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Watery discharge, sometimes mucoid. Unilateral quickly spreading to bilateral. Preauricular adenopathy associated w/ fever, pharyngitis.

Viral conjunctivitis

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most common cause of viral conjunctivitis

adenovirus

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bilateral, pruritus, clear tears. Associated with atopic dermatitis.

allergic conjunctivitis

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what connects the eyes to the nose?

nasolacrimal duct

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what is bilateral sterile conjunctivitis associated with?

reactive arthritis

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What is an example of reactive arthritis

reiter’s syndrome (seronegative spondyloarthropathy)

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who is reiter's syndrome found in/ symptoms

Young men heel pain HLA-B27

what other condition is HLA-B27 associated with?

Ankylosing spondylitis

Reiter's syndrome will other have a prior infection with what?

Klebsiella C. trachomatis abdominal infection

What are the 3 reactive arthritises

Steven Johnson syndrome acne rosacea Reiter's syndrome

what may angioedema of lids bilaterally indicate?

systemic allergen

what does unilateral angioedema of lids

local allergenes (topical chemicals, rhus, insect bites)

What is rhus dermatitis

Poison ivy

what does edema of the eyes w/o erythema suggest?

Allergy

Yellow nodule of the scleral conjunctiva

pinguecula

vascularized "redness"; encroaches on cornea, may interfere w/ vision

Pterygium

What are pinguecula and pterygium associated with?

UV exposure

The solution to pollution is...

Dilution

Usually secondary to trauma. Doesn't cross into iris. Spontaneous with anti-coags. Will include palprebral cojunctiva.

Subconjunctival hemorrhage

massive subconjunctival hemorrhage may be accompanied by what?

proptosis | limited EOMs

What makes eyes stick out with hyperthyroidism

fat pad takes up space

Usually benign inflammation of superficial episceral vessels. Tender, irritated eyes

episcleritis

what is episcleritis associated with?

gout allergic conditions psoriasis collagen disease

underlying ciliary body is inflamed (perilimbal ciliary flush). Photophobia, tearing.

Keratitis

What can cause keratitis

viral bacterial sterile fungal

what common causes corneal limbus infiltrate?

S. aureus

Will have photophobia, concomitant HSV, pain precedes rash. Eyes are sore or painful.

Herpes Simplex Keratoconjunctivitis

blood in the anterior chamber

Hyphema

how long does it take corneal abrasions to heal?

2-3 days as epithelial cells migrate very quickly

what makes up the uveal tract?

Iris ciliary body choroid

Will present with pain, photophobia, redness, ciliary flush. Slightly cloudy anterior chamber. Hypopyon

Uveitis

what are some causes of uveal tract dz

Idiopathic conditions | Ankylosing spondylitis, JRA, granulmoatous colitis, sprue, TB, sarcoidosis, trauma/ inflammation

Inflammation of the structures of the lid margin: redness, scaling, crusting

Blepharitis

what usually causes blepharitis on the anterior lid margin.

Staph

Greasy anterior lid scaling | Meibomian gland dysfunction freq.

Seborrheic blepharitis

what is meibomina gland dysfunction associated with?

Seborrheic dermatitis | acne rosacea

Acute staphylococcal infection of the meibomian glands

Internal Hordeolum

Acute staphylococcal infection of the glands of Zeis or Moll around rashes

External hordeolum or sty

Sterile granulomatous inflammation of the meibomian gland Tender, mildly inflamed OR quiet discrete mass Physically disfiguring

Chalazion

Infection of tear duct on lateral nose. | Purulent matter may be expressed

Acute Dacryocystitis

What type organism usually causes orbital cellulitis?

Gram positive organism

swollen, red eyelids with chemosis, painexopthalmos, fever, leukocytosis

Orbital cellulitis

what can orbital cellulitis lead to?

third, fourth, and sixth cranial nerve or ophthalmic division of the fifth cranial nerve. Cavernous sinus thrombosis

Painful, unilateral red eye, ciliary flush. Pupil: mid-dilated, fixed. Cornea: cloudy secondary to edema.

acute glaucoma

What must IOP be above for acute glaucoma?

>20 mm Hg

what will the patient's vision be like with acute glaucoma

cloudy vision halo around lights N/V/Headache

s swelling of the tissue that lines the eyelids and surface of the eye (conjunctiva) (palpebral)

chemosis

what may precipitate acute glaucoma

Mydriatic activity (dark movie theatre) or stress

most common cause of impaired vision?

refractive error

Most common cause of impaired vision?

myopia

what drugs can lead to impaired vision

sulfonamides thiazides anti-cholinergics

with myopia where if the refraction compared to the fovea?

anterior to the fovea

what is "curtain" drawn down over vision

retinal detachment

what are 2 anterior diseases that can impair vision?

Hyphema | iritis

leading cause of blindness in those over age 50. central vision is impaired

macular degeneration

what type disease is macular degeneration

retinal disease

what can cause retinal inflammation

Histoplasmosis, toxoplasmosis, cytomegalovirus, herpes virus. Immunocompromised patients

cherry red spot on macula indicates what

central artery retinal occlusion

what are box car veins?

Veins with skips in them

what is associated with central retinal artery occlusion

cherry red spot | box car veins

most common cause of central artery retinal occlusion

Emboli (a-fib) | vegetations from mitral valve leaflet

Granulomatous inflammation of medium and large arteries in elderly

Giant cell or temporal arteritis

what is giant cell or temporal arteritis associated with

``` polymyalgia rheumatica elevated ESR (sed rate) ```

Inflammation of optic nerve. Loss of color vision. Globe tender and visual field defect.

optic neuritis

Tx for optic neuritis

steroids

exam is normal, objective measurement intact.

psychogenic impaired vision

Autoimmune inflammation w infiltration of the soft tissues of the orbit Lid retraction, lid lag, stare, mild protrusion of the eye (proptosis).

Graves Dz

Risk factors for graves Dz

smoking | hyperthyroid (persistent/ DC ant thyroid drug Rx)

causes of exopthalmos

tumor graves' disease vascular causes

vascular causes of exopthalmos

``` hemangioma aneurysm varices carotid-cavernous sinus fistula cavernous sinus thrombosis ```

Leading cause of blindness under age 65

diabetic retinopathy

2 types of diabetic retinopathy

nonproliferative (generally early form) | proliferative (later stage/ worse prognosis)

have microaneurysms, intraretinal hemorrhages, cotton wool infactions, serious and lipid exudates. Intraretinal vascular damage

non-prolifeative retinopathy

vascular pathology extending from retina into vitreous cavity. Late stage of dz, worse prognosis.

proliferative retinopathy

Fine network of small vessels from optic disc, maj.ret.vessels, or areas adjacent to retinal ischemia.

neovascularization

what is neovascularization seen with?

proliferative retinopathy

if iris is involved in proliferative retinopathy, what is there a higher risk of

glaucoma

presents with flame hemorrhage, AV nicking, arteriolar narrowing, increased vascular tortuosity.

Hypertensive retinopathy

a lesion in the optic chiasm leads to what?

bitemporal hemianopsia

what can bitemporal heminaopsia be a sign of?

pituiatary adenoma