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Flashcards in eye Deck (38):
1

epithelial layer surrounding sclera that produces mucous to lubricate eye

conjuctiva

2

lens attached to

ciliary body/ciliary muscles:
allows for accomodation (focus far/near objects)

3

uvea contents (behind sclera)

iris
cilliary apparatus
choroid (vascular layer posterior to retina)

4

fluid posterior to lens

vitreous humor (body)

5

fluid in anterior chamber + posterior chamber

aqueous humor

6

anterior to iris

anterior chamber

7

posterior to iris, anterior to lens

posterior chamber

8

abrupt onset of eye pain, headache (eyebrow→temporal), nausea, colored halos, rainbows around light
red, teary eye with hazy cornea and fixed, mid-dilated pupil (not reactive to light)
eye firm to palpation

acute angle-closure glaucoma (closed-angle, narrow-angle)

EMERGENCY!

9

insdidious (yrs) - usually bilateral
early: asymptomatic, elevated intraocular pressure
late: ↑ IOP → damages optic nerve → gradual loss of PERIPHERAL vision, permanent blindness if untreated

open-angle glaucoma (wide-angle)

more common

10

treatment of acute angle-closure glaucoma: inhibit aqueous humor production, improve outflow of aqueous humor

laser iridotomy (holes in iris, allow fluid to flow from posterior to anterior chamber→ TM)
if >1 hr before iridotomy:
↓ aqueous humor production: eye drop timolol (DOC - B blocker) or oral acetazolamide (carbonic anhydrase inhibitor diuretic)
↑ outflow of aqueous humor:
PG-F2α (DOC) or apraclonidine (α agonist) or pilocarpine (cholinergic agonist)
↓ IOP rapidly: mannitol
laser trabeculoplasty: holes into TM to improve outflow

11

risk factors for open-angle glaucoma

>40 yo
african american
family hx of glaucoma
myopia
diabetes

12

screening for glaucoma

fundic exam: optic cup:disc ratio
enlarged optic cup: >50% diameter of optic disc

13

fundoscopic exam

yellow circle = optic disc = optic nerve
bright white circle inside optic disc = optic cup
Normal: optic cup

14

loss of CENTRAL vision
peripheral vision intact

age-related macular degeneration

15

drusen accumulates between retina and choroid → gradual loss of vision

dry age-related macular degeneration

16

rapid onset and progression
neovascularization of choroid → vessels bleed and damage photoreceptors

wet age-related macular degeneration

17

risk factors for macular degeneration

smoking

18

treatment of macular degeneration

stop smoking
antioxidant: B carotene, vitamin C, lutein, selenium, zinc
Wet: injection of anti-vascular endothelial growth factor (anti-VEGF) into vitreous humor OR laser therapy

19

cotton wool spots

focal areas of retinal ischemia possibly caused by:
diabetes
HTN

20

well-defined, bright yellow exudates
flame hemorrhages
cotton wool spots

diabetic retinopathy

21

neovascularization (proliferation of new blood vessels) → can rupture, bleed, scar

proliferative diabetic retinopathy

22

causes of retinal detachment

trauma
diabetes

23

sudden onset of flashing lights, floaters → ↓ vision
wrinkled retina

retinal detachment
must surgically reattach

24

loss of red reflex (white reflex instead) in one eye of child or infant

retinoblastoma

25

swelling of optic disc
blurry margins
physical exam finding that suggests ↑ICP from brain tumor or pseudotumor cerebri

papilledema

26

painless vision loss → pale retina (ischemic retina) with "cherry red spot" on macula (retina is thin at macula, able to see choroid behind retina)

central retinal artery (+ vein run through optic nerve) occlusion:
ischemia of eye

27

cherry red spot on retina

central artery occlusion
Tay Sachs disease
Niemann Pick
other lysosomal storage disorders: accumulation in ganglia of macula (gives red color)

28

opacification of lens - usually bilateral
slowly progressive, painless ↓ in vision
first sign: near-sightedness (don't need reading glasses any more)
difficulty driving at night, reading road signs, reading fine print
sun or oncoming headlights at night cause disabling glare

cataracts

29

risk factors for cataracts

age
long-term GC use
tobacco
alcohol
diabetes

30

diabetic complications of eye

retinopathy
glaucoma
retinal detachment
cataracts

31

refractive structures that help to focus light on retina

cornea
lens

32

accumulation of lipid
white/blue ring in periphery of cornea

arcus senillis (in elderly)

33

clouding of cornea

mucopolysaccharidoses (lysosomal storage disease - accumulation in cell of cornea)

34

iris pain and redness
photophobia
pus in anterior chamber (cornea)

anterior uveitis (iritis)

35

seronegative spondyloarthropathies: reactive arthritis or ankylosing spondylitis (HLA-B27)
sarcoidosis
juvenile idiopathic artheritis

anterior uveitis (iritis)

36

associated with CMV, toxoplasma, cat scratch disease (bartonella), psoriatic arthritis, IBD arthritis (HLA-B27)

posterior uveitis (chorioretinitis if retina involved too)
behind retina

37

allergies/infection → inflammation → capillaries of conjuctiva dilate → pink eye

conjunctivitis

38

adenovirus (viral infection usually)
bacterial (unilateral, pus around eye)
allergic (+ allergic rhinitis in spring/fall)

conjunctivitis

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