Eye

Question 1

what sport is the leading cause of eye injury in the US?

Answer 1

basketball

Question 2

what proportion of the population may have physiologic anisocoria?

Answer 2

20%

Question 3

t/f history of cataract or refractive surgery weakens the outer wall of the eye

Answer 3

true

Question 4

a child is considered functionally one eyed if their vision is worse than what?

Answer 4

20/40

Question 5

what are the only sports that are absolutely contraindicated for a functionally one eye athlete?

Answer 5

boxing and full contact MMA

Question 6

what is the single most important physical exam feature in evaluation of the eye?

Answer 6

visual acuity testing

Question 7

which cranial nerve is responsible for the afferent and efferent pupil response, respectively?

Answer 7

afferent - CN2
efferent - CN3

Question 8

what is Marcus Gunn pupil?

Answer 8

shining light to the affected pupil causes a paradoxical dilation but the contralateral pupil constricts

Question 9

explain how to assess the anterior chamber of the eye?

Answer 9

shine light from temporal portion towards medial portion

Question 10

when evaluating the anterior chamber with a lateral light, you see increased medial shadowing. what might this signify?

Answer 10

narrow anterior chamber

Question 11

when assessing the anterior chamber, you note a layer of blood forming at the 6 o clock position. what does this signify?

Answer 11

hyphema

Question 12

t/f suspected acute angle glaucoma is a contraindication to pupillary dilation

Answer 12

true

Question 13

decreased sensation or numbness along which trigeminal nerve branch can accompany orbital floor fractures?

Answer 13

v2

Question 14

what topical anesthetic agent can be used for analgesia prior to fluoroscein exam?

Answer 14

proparacaine

Question 15

explain how to conduct a fluorescein exam

Answer 15

numb with proparacaine, then wet a fluorescein strip with sterile water and touch to the inferior cul de sac, without brushing the cornea. Then use a wood’s lamp to evaluate

Question 16

what is a normal IOP?

Answer 16

10-21mmHg

Question 17

in the case of corneal abrasion, when will there be decreased visual acuity?

Answer 17

if abrasion occurs over the central aspect

Question 18

t/f erythromycin or gentamicin ointment has better lubricating properties compared to drops and are considered first line if antibiotics are used for contaminated corneal abrasion

Answer 18

true

Question 19

in the case of corneal abrasion in the setting of contact lens wearer, what is the recommended topical antibiotic class?

Answer 19

fluoroquinolone

Question 20

an ophthalmologist should see a patient who wears contact lenses and sustained a corneal abrasion within how many hours?

Answer 20

24 hours

Question 21

contact lenses should be discontinued for how long after corneal abrasion?

Answer 21

complete healing has occurred and antibiotics are finished

Question 22

which topical medication could be used for corneal abrasion symptomatic pain relief to allow a patient to return to play the same day and used for up to 24 hours?

Answer 22

topical tetracaine

Question 23

t/f patching is recommended for treatment of corneal abrasion

Answer 23

false

Question 24

most uncomplicated corneal abrasions heal within what time frame?

Answer 24

24-72 hours

Question 25

a positive Seidel test will result in fluorescein turning what color under blue light?

Answer 25

bright green

Question 26

t/f cotton tip applicators are appropriate to use to attempt to remove corneal foreign bodies

Answer 26

false

Question 27

what is the most common sports related eye injury?

Answer 27

blunt trauma to the globe

Question 28

for a ruptured globe, what should be placed over the eye?

Answer 28

rigid shield

Question 29

t/f avoid ointments and other topical agents in the case of acute globe rupture

Answer 29

true

Question 30

explain why restricted upward gaze occurs with orbital floor fractures

Answer 30

inferior rectus muscle entrapment

Question 31

which nerve root runs through the orbital floor/maxillary sinus roof?

Answer 31

v2 of trigeminal

Question 32

in an orbital floor fracture, why might there be a lowered globe level on the affected side?

Answer 32

prolapse of large volume of soft tissue into the maxillary sinus

Question 33

what percentage of hyphema cases will have a comorbid eye injury?

Answer 33

25%

Question 34

t/f hyphema should warrant immediate referral to specialist

Answer 34

true

Question 35

how long should bed rest and light activity last after hyphema, respectively?

Answer 35

best rest x 4 days light activity x 2 weeks

Question 36

what medication class should be avoided in hyphema?

Answer 36

nsaids

Question 37

for at least how long after initial cause of hyphema should atropine be used twice daily?

Answer 37

2 weeks

Question 38

what is the usual duration of uncomplicated hyphema?

Answer 38

5-6 days

Question 39

what is the major risk of recurrent bleeding in cases of hyphema?

Answer 39

permanent visual acuity loss

Question 40

t/f retinal detachment produces immediate vision loss

Answer 40

true

Question 41

why should IOP be measured in the case of lens dislocation?

Answer 41

lens dislocation can lead to secondary glaucoma

Question 42

with glaucoma, where does visual loss start?

Answer 42

periphery of the visual field

Question 43

which eye injury is characterized by sudden increase in anterior chamber pressure from blunt trauma to the globe that is transmitted to the lens-iris diaphragm and propelling it backward?

Answer 43

chamber angle recession

Question 44

what is the primary difference between lens dislocation and chamber angle recession?

Answer 44

in chamber angle recession, the lens position will be normal

Question 45

chamber angle recession usually requires what treatment?

Answer 45

surgery