Eye Flashcards
1
Q
Dacrocystitis
Presentation
A
Pain, Swelling, Redness in tear sac area
Usually unilateral
PURULENT (bacterial) discharge may be expressed
2
Q
Conjunctivitis
A
**The MOST COMMON Eye DISEASE!!**
Inflammation of the conjunctiva
3
Q
Hordeolum Tx
A
Warm compresses, sometimes incision or drug therapy
4
Q
Bacterial Conjunctivitis
Tx
A
Clears in 10-14 days w/o tx, but must be isolated to prevents spreading to others
Topical Sulfa or oral ABX will clear in 2-3 days
**If lots of discharge, CULTURE to RULE OUT GYNOCOCCAL conjunctivitis
5
Q
Gynococcal Conjunctivitis
- Presentation*
- Tx*
A
**COPIUS DISCHARGE**
EMERGENCY - may be corneal involvement
Treat Chlamydia + STD Screen
6
Q
Where?
Internal Hordeolum
A
sty @ Meibomian gland
7
Q
Lacrimal glands
A
Tear production, removes foreign matter and keeps eye moist
8
Q
Chronic Blepharitis
Etiology
A
noninfectious, idiopathic inflammation
occurs often with - rosacea, recurrent hordeola/chalazia, ACNE
**SECONDARY DRY EYE**
(aka keratoconjunctivitis sicca)
9
Q
Bacterial Conjunctivitis
Presentation
A
PURULENT/yellow discharge, - eyes stuck together
mild discomfort
10
Q
Acute, ulcerative blepharitis often secondary to ….
A
staph or herpes viral infection
11
Q
DRY EYES
Tx
A
Artificial tears
Lacrimal punctal occlusion (prevent drainage)
(Keratoconjunctivitis Sicca)
12
Q
Where does light get converted to electrical signals
A
Outer portion of retina - rods (b/w) and cones (color)
13
Q
Entropion
Tx
A
Refer
Surgery
-OR-
Botox for temp fix (especially for older person)
14
Q
Presbyopia
A
Loss of accommodation for near vision
15
Q
Blepharitis
A
Inflammation of the eyelid margins
Acute (ulcerative v nonulcerative)
vs
Chronic
16
Q
Ectropion
Etiology
A
Age related
CN VII Palsy
Post Trauma Changes
17
Q
“DRY EYES”
A
Keratoconjunctivitis sicca
Inadequate tear production or excess evaporation
18
Q
Viral Conjunctivitis
Tx
A
COLD Compress
Sulfa drops to prevent secondary bacterial infection
19
Q
Where does the outer retina get its blood supply (rods/cones)?
A
Choroid (not the retinal artery!)
20
Q
Hordeolum Epidemiology
A
More common in children and teens
21
Q
Chronic blepharitis
Presentation
A
Greasy scales at base of lashes
22
Q
Pterygium
A
Encroachment of the conjunctiva onto the nasal side fo the cornea
23
Q
Blood supply for much of the eye
A
Central retinal artery
24
Q
Gynococcal conjunctivitis
Tx
A
EMERGENCY!! - corneal involvement may lead to rapid perforations
Treat possible Chlamydial Infection + do STD Screening
Uncommon in rural medicine
25
Chalazion presentation
hard, nontender swelling (eyelid redness, pain initially)
26
Hordeolum Pathophysiology
Arises from blocked sebaceous gland
27
Chalazion
COMMON granulomatous (full of immune cells) inflammation of meibomian gland;
may follow internal Hordeolum; noninfectious
28
Hordeolum Presentation
Eyelid redness, swelling, pain, tearing, photophobia, foreign body sensation
29
Keratoconjunctivitis sicca
## Footnote
*Etiology*
Sjogren's syndroms, RA, SLE
Result of conditions that scar tear ducts
Affects 50% of older women
30
Viral Conjunctivitis
## Footnote
*Presentation*
WATERY DISCHARGE, foreign body sensation, bilateral
MOST COMMON FORM OF CONJUNCTIVITIS
Usually Adenovirus
usually d/t direct contact transmission
very contagious
31
Hordeolum
common “sty” - localized infection
(staph abcess) or inflammation
of the eyelid margin involving hair follicles of the eyelashes (ie, external hordeolum) or
meibomian gland (ie internal hordeolum)
32
HSV (Herpes Simplex Virus) Conjunctivitis
## Footnote
* Differential diagnosis*
* Tx*
UNILATERAL and with lid vesicles
Antivirals - topical or systemic
33
Acute, nonulcerative blepharitis
## Footnote
*Presentation*
Itchy RASH (normally ALLERGIC reaction)
Swollen "edematous", red "erythmatous"
34
Pinguecula
Benign, yellow, elevated, nodular growth on the conjunctiva
35
# Where?
External Hordeolum
sty @ Eyelid margin involving hair follicles of the eyelashes
36
Ectropion
Outward turning of the eyelid
37
Myopia
NEARSIGHTEDNESS - born with long eyeball; image comes into focus in front of the retina; wear concave lenses to decrease refractive power and lengthen the focal distance
38
Emmetropia
Normal vision
39
Hyperopia
FARSIGHTEDNESS - born with short eyeball; image comes into focus behind the retina; wear convex lenses to increase refractive power and shorten the focal distance
40
Blepharitis
## Footnote
*Tx*
Warm compresses, clean eyelids
Acute, ulcerative - abx
Acute, nonulcerative - topical corticosteroid
Chronic - ? (noninfectious)
41
Acute, ulcerative blepharitis
## Footnote
*Presentation*
Bacterial - CRUSTY (lashes "glued shut"), pustules may develop
Viral - Clear
Redness of lid
42
Astigmatism
Curvature of the cornea is uneven
43
Hordeolum Diagnosis
Clinical, Distinguish from chalazion
44
Ectropion
## Footnote
*Tx*
Eye drops
Surgery to correct
45
Entropion
## Footnote
*Etiology*
Age (lid fascia degenerates)
-OR-
Post Trauma/Infection scarring
46
Entropion
Inward turning of the eyelid,
Eyelashes rubbing cornea
47
General drug class to decrease inflammation/ decreasing activity of the immune system
Corticosteroids
48
Allergic Conjunctivitis
## Footnote
*Presentation/Diagnosis*
Itchy, watery eyes
Acute, intermittent or chronic
Seasonal/Perennial
Vernal - spring to fall more common in males
Clinical diagnosis - timing
49
Dacrocystitis
Infection of the Lacrimal Sac
d/t congenital or acquired obstruction
50
Most common cause of infectious cause of blindness worldwide
Trachoma (eye disease) due to Chlamydia keratoconjunctivitis
51
Chalazion tx
Warm compresses;
(alternatively incision an curettage, corticosteroids)
52
Corneal Ulcer
## Footnote
*Etiology*
an open sore to the cornea
associated with contact lens usea, eye trauma, eyelid abnormalities
53
Corneal ulcer
## Footnote
*Tx*
Refer EMERGENTLY
54
Corneal ulcer
most often due to ...
Infection - Bacterial, viral, fungal, amoebas
Also noninfectious causes - neutrophic, exposure, dry eye, allergic eye disease, other inflammatory
55
Corneal ulcer
## Footnote
* Symptoms*
* Exam Findings*
Pain, Photophobia, Tearing, Reduced vision
Red eye with predominantly cicumcorneal injection, may be purulent or watery discharge
56
Infectious Keratitis
Corneal (keratin) Inflammation
caused by bacteria, virus, fungus, parasites
57
Infectious keratitis may precede
Corneal ulcer..
58
Infectious keratitis
## Footnote
*Risk Factors*
Contact lens use, corneal trauma
59
Infectious keratitis often shows
_Hypopyon_, which are..
inflammatory cells in the anterior chamber
60
Most common cause of infectious blindness in the western world
Herpes Simplex Keratitis
61
Herpes Simplex Keratitis
Symptoms
\*\*Dendritic branching
62
Fungal Keratitis
## Footnote
*Etiology*
Occurrance after corneal injury involving contact with plants - gardening/agriculture
Contact lens wearers - high risk
63
Fungal Keratitis
## Footnote
* Exam*
* Tx*
Multiple stromal abcesses
Refer for Culture, treat with antifungals
64
Herpes Zoster Opthalmicus
## Footnote
*Symptoms*
\*\*MALAISE, FEVER, HEADACHE
+
\*Vesicular RASH becoming pustular, then crusting
(if involvement of tip of nose or lid margins
- concern for eye involvement)
65
Herpes Zoster Opthalmicus
## Footnote
*Risk Factor*
\*\*HIV infection
66
Herpes Zoster Opthalmicus
Refer EMERGENTLY -
Trigeminal nerve involvement
Antivirals if within 72 hours of rash appearing/
corticosteroids
67
Acute Angle Closure Glaucoma
## Footnote
*Presentation*
Rapid onset, Extreme Pain +NAUSEA/abdominal
Blurred, profound vision loss with "HALOS AROUND LIGHTS"
Pupil dilated, not reactive to light, high IOP
\*Permanent if not treated within days
68
Acute Angle Closure Glaucoma
## Footnote
*Etiology*
Primary - pre-existing narrow anterior chamber angle (Asian, inuit)
Secondary - hemodialysis, anterior uveitis, punched
69
Uveitis
General term for inlammation of the eye
Uvea - Iris, Ciliary Body, Choroid
70
Ocular Motor Palsies
CN 3,4,6
*Symptoms*
* Pain on movement
* double vision
* ptosis (eyelid droop)
* headache
* nausea
71
Ocular Motor Palsies
## Footnote
*Etiology*
MS, DM, Guillan Barre
72
3rd CN Palsy
Complete ptosis - Eye down and out
Dilated pupil, not responsive to light
If acute - Emergent, could be aneurysm
73
4th CN Palsy
Double vision going down stairs or reading books
Vertical hypertropia
74
6th CN Palsy
Failure of lateral movements,
Nystagmus
75
Strabismus
Misalignment of the eyes
76
Strabismus
## Footnote
*Etiology*
Muscle imbalance
Refractive error
Down Syndrome, congenital eye defects
77
Tropia
Manifest with both eyes open
78
Phoria
latent, seen when one eye is covered
79
Nystagmus
Involuntary eye movement
Treat underlying abnormalitites
congenital
acquired - associated with serious medical conditions
80
Acanthamoeba Keratitis
1. Perineural ring and ring infiltrates into corneal stroma
2. Severe pain
81
Cataract
Opacity of the lens
#1 cause of WW blindness
82
Cataract
## Footnote
* Presentation*
* Tx*
Glare with night driving
Surgery
83
Cataract
## Footnote
*Etiology*
Age Related
-or-
Congenital
84
Retinal Detachment
## Footnote
*Presentation*
Sudden flashes, floaters, CURTAIN across vision
85
Retinal Detachment
Traction from PVD (Posterior Vitreous Detachment)
Possible surgical correction
86
Chronic angle closure glaucoma
## Footnote
*Etiology*
Common in Asian/inuit
87
Chronic angle closure glaucoma
Flow of aqueous fluid to anterior chamber angle obstructed
Chronic, progressive, ..
Early - asymptomatic
88
Vitreous hemorrhage
Blood leakage into vitreous
Retinal tear prone to bleeding - refer for laser tx to correct tear
89
Age-Related Macular Degeneration
## Footnote
*Etiology*
White female, age
\*Leading cause of blindness in patients \> 65yo in developed countries
90
Dry ARMD
Degeneration of the macula/retina causing..
progressive, CENTRAL vision loss
85% this milder type
91
Wet ARMD
NEOVASCULARIZATION - leaky "exudative"
Hemorrhage, fibrosis
See crooked lines/visual disturbances
15% ACUTELY become this more severe type
92
Central and Branch Retinal Vein Occlusions
PAINLESS, SUDDEN VL often upon WAKING
exam - widespread retinal hemorrhages,
Veins dilated, torturous
Optic Disc Swelling
cotton-wool spots
caused by THROMBUS (hx cardiovascular disease)
93
Central and Branch Arterial Occusion
SUDDEN, PROFOUND, Painless, VL
Cherry Red Fovea, RAFD
caused by THROMBUS (commonly from giant cell arteritis)
94
Transient Monocular Vision Loss
Ocular TIA -aka- Amaurosis Fugax
Retinal EMBOLUS from Carotid disease or the heart
(identify underlying cause to treat source)
PAINLESS, TEMP,
COMPLETE MONOCULAR - VLCurtain VERTICALLY
Crescendo TIA - multiple in a week - EMERGENCY
95
Diabetic Retinopathy
A leading cause of blindness
Retinal capillary closure and MICROANEURYSMS,
macular edema,
dot and blot
cotton-wool spots
96
Nonproliferative Diabetic Retinopathy
Mild/moderate (to severe), Very common
Often Asymptomatic
Tx- Control Blood Glucose
97
Proliferative Diabetic Retinopathy
Less common, more severe
NEOVASCULARIZATION
leads to Vitreous hemorrhage & traction retinal detachment
SEVERE, SUDDEN, PAINLESS VL, FLASHES & FLOATERS
98
Hypertensive Retinochoroidopathy
Retinal or Choroidal Damage d/t HTN
Acute - reversible
Chronic - arteriovenous nicking
Copper, Silver Wiring
99
Optic Neuritis
Inflammation of the Optic Nerve - associated with _MS_
Abrupt, monocular VL, RAPD
**DIFFERENTIATE FROM OCULAR TIA:**
LASTS HOURS TO DAYS + PAIN
100
Papilledema
Optic Disk Swelling d/t raised intracranial pressure
101
Optic Disk Druzen
Optic disk ELEVATION - PSEUDOPAPILLEDEMA,
associated with Farsightedness
102
Grave's Opthalmyopathy
| (Thyroid Eye Disease)
Inflammatory cell deposits into muscle
Diplopia, PROPTOSIS
103
Orbital Cellulitis
Infection of orbital tissues surrounding eye
Usually from sinuses
Serious - could spread to brain
Pain on eye movement
104
Perioribital cellulitis
Local infection of eyelid and surrounding skin
From bug bite/etc
105
Blow out Fracture
Blunt trauma Fractures Orbital Bone
106
Conjunctival and corneal foreign bodies
Know source - Hx
107
Corneal Abrasions
Hx of trauma to eye
Severe pain, tearing, foreign body sensation
108
Hyphema
Anterior chamber angle hemorrhage
Danger of Secondary hemorrhage, increased ocular pressure and glaucoma
109
Ecchymosis
"Black eye" - generally cosmetic
Ice pack 24-48 hours, then hot pack
110
Subconjunctival Hemorrhage
Bleeding under conjunctiva
Not painful
From straining, blood thinners
111
Lens Dislocation
Supporting ligaments broken - Marfan's susceptible to this
Blurry vision, iris may quiver
Lens off center, permanent
112
Lacerations
Refer to Opthalmologist for repair
