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Flashcards in Eye Abnormalities Deck (38)
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Describe Ptosis

-Inability to close the eye may be seen with CN III problem


What would Yellow sclera indicate?

-Described as scleral icterus
-If jaundice is NOT present, sclera are anicteric


Abnormalities of conjunctivae for color & exudates

-Bulbar (covers the eyeBall)
-Palpebral (lines the eyelids)


How do you look at conjunctivae?

Ask patient to look up while you pull down lower lids to examine


Conjunctiva pallor indicates what?



Red or swollen conjunctiva indicates what?

Injection – caused by dilation of blood vessels secondary to an inflammatory or infectious process


Describe Pinguecula

-Yellowish growth on the sclera, adjacent to cornea, may be a precursor to pterygium
-From sun


Describe Pterygium

-Wedge or wing-shaped growth may grow into cornea
-From sun


Describe Arcus senilis

Ring about the margin of the cornea, common in the elderly, may indicate hyperlipidemia


Opacity of the lens indicated what?



Describe Chalazion

-Meibomian gland lipogranuloma
-Cyst of the inner eyelid due to inflammation of a blocked meibomian gland
-Usu. on upper eyelid
-Chalazion is chronic, usually painless, points to inside of lid


Describe Hordeolum

-External stye
-Due to infection of a sebaceous gland at margin of the eyelid
-Acute, painful, external


What is the best way to distinguish chalazion from hordeolum?

1) History
2) Chalazion is chronic


Describe Xanthelasma

-Sharply demarcated yellowish deposit of cholesterol underneath the skin, usu. around the eyelids
-Hereditary component – more common in people of Asian descent or from Mediterranean region

-May or may not indicate high lipid levels


Describe Periorbital cellulitis

-Infection & inflammation of the eyelid & portions of the skin around the eye
-Must differentiate between orbital cellulitis (a medical emergency)


Describe Orbital cellulitis

-Assoc. with – proptosis (bulging eye), limited movement (ophthalmoplegia), pain with eye movement, or loss of vision


Describe Exopthalmos (proptosis)

-Protrusion of the eyes
-Rim of sclera between upper lid & iris visible
-Produces characteristic stare
-Associated with Graves disease (type of hyperthyroidism)
-Also see lid lag


Describe the differences between Episcleritis vs Scleritis vs conjunctivitis

-Episclera – between the conjunctiva & sclera
-Episcleritis has abrupt onset

-Scleritis – gradual onset, more severe, pain, ↓ vision, commonly assoc. with systemic autoimmune / inflammatory disease

-Episcleritis vs conjunctivitis
-Episcleritis more localized


Describe Uveitis

-Inflammation of the uveal tract (iris, ciliary body, & choroid)
-If limited to iris = iritis
-Painful (with consensual pupillary light reflex)
-Limbic flush (inflammation around the iris)
-Commonly assoc. with systemic autoimmune / inflammatory disease


Describe Subconjunctival hemorrhage

-Painless, small blood vessel breaks
-Can occur with injury, increased pressure (↑BP, cough, sneeze), blood thinning medication


Describe Hyphema

-Bleeding in the ant. chamber
-Usu. due to trauma


Describe Myopia

Impaired far vision


Describe presbyopia

Impaired near vision


What does a crescent shadow on the medial aspect of the iris signify?

-Shadow created if the iris bows abnormally forward –> creates a narrow ACUTE angle with the cornea (a shallow ant. chamber) –> then light casts a crescent shadow

-The narrow angle (shallow chamber) increases risk of acute angle-closure glaucoma (sudden increase in intraocular pressure (IOP) that threatens sight)


What are the different types of glaucoma and what does it cause?

1) Acute angle closure glaucoma (aka narrow angle or closed angle glaucoma)
-Less common form
-Results in sudden increase in Intra Ocular Pressure (IOP) & eye pain
-Crescent shadow present

2) Open angle glaucoma
-Common form
-IOP is increased but angle is normal
-No crescent shadow present


What does an Abnormal, asymmetric corneal light reflection indicate?

-Strabismus (deviation from normal conjugate position)
-Due to imbalance of extraocular eye muscle tone or paralysis of 1 or more extraocular eye muscles


Describe the different Strabismus

-Convergent (internal) strabismus, aka esotropia
-Eye moves inward

-Divergent (external) strabismus, aka exotropia
-Eye moves outward


Describe Pupil inspection

-Inspect size, shape, equality
-Miosis → constriction
-Mydriasis → dilation


Describe Horner’s Syndrome

1) Ptosis
2) Anhidrosis: absent sweating on the affected side
3) Miosis (or “PAM”): unequal pupil size = Anisocria

-Due to dysfunction of the sympathetic nervous system
-May be congenital or assoc. with disease [e.g. Pancoast tumor (lung cancer tumor in apex of the lung)]


Describe Tonic (Adie’s) Pupil

-Affected pupil is larger
-Reduced reaction to light (mydriasis)
-Reduced near reaction
-Due to dysfunction of parasympathetic nervous system
-Most commonly affects young women, cause unknown


What cranial nerves innervate the eye muscles?

-LR6 SO4 AO3
-Lateral rectus CN VI (Abducens)
-Superior oblique CN IV (Trochlear)
-All others CN III


If pupils are normal & react normally to light & accommodation, can document what?

PERRLA: Pupils Equal Round & Reactive to Light & Accommodation


What if red reflex is absent?

-May be due to opacity of the lens (e.g. cataract), retinal detachment, retinoblastoma, other disease, artificial eye

-Retinoblastoma – childhood cancer of the retina
-Will see white light – leukocoria


What is the cup-to-disc ratio used for?

-To assess the progression of glaucoma.
-As glaucoma advances, the cup enlarges until it occupies most of the disc area.


What is Papilledema?

Optic disc swelling assoc. with increased intracrainial pressure


Describe Hypertensive retinopathy

-“dry” retina
-Few hemorrhages, few exudates, multiple cotton wool spots


Describe Diabetic retinopathy

-“wet” retina
-Multiple hemorrhages, multiple exudates, few cotton wool spots


What is the difference between Central retinal vein occlusion vs central retinal artery occlusion

VEIN occlusion: When this fluid collects in the macula
ARTERY occlusion: "Cherry red spot"