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Pt Assess Final > Eye Lecture > Flashcards

Eye Lecture Flashcards

(71 cards)

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1
Q

Emmetropia

A
  • Light rays fall directly on retina

- Normal vision

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2
Q

Myopia

A
  • Light rays fall in FRONT of retina

- Nearsightedness

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3
Q

Hyperopia

A
  • Light rays fall BEHIND retina

- Farsightedness

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4
Q

Astigmatism

A

Varying refraction due to irregular shape of cornea

cylindrical lenses needed as correction

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5
Q

Vital sign of the eye?

A

Visual acuity

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6
Q

Acute painless visual loss could be:

A
  • Vitreous hemorrhage
  • Retinal detachment
  • Retinal artery occlusion
  • Retinal vein occlusion
  • Exudative macular degeneration
  • Ischemic optic neuropathy
  • Stroke
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7
Q

Vitreous hemorrhage

A
  • “Spider webs” clouding vision
  • A/w diabetes, sickle cell anemia
  • Low red reflex, clouding of retina (or not seen at all)
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8
Q

Retinal detachment

A
  • Photopsia/floaters
  • “Curtain” covering vision
  • Pts w/severe myopia
  • Diplopia only goes away when the bad eye is closed
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9
Q

Photopsia

A

Flashes of light

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10
Q

Amaurosis fugax

A
  • Transient painless monocular visual loss

- Occurs when blood clot or plaque blocks artery in eye

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11
Q

Retinal artery occlusion

A
  • Sudden and nearly complete amaurosis fugax
  • A/w carotid artery, valvular disease
  • Vision limited to hand motion/light perception only
  • Cherry red spot in macula, diffusely pale retina
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12
Q

Retinal vein occlusion

A
  • A/w HTN, blood abnormalities (dyscrasias)

- Retinal hemorrhages, veins are tortuous and dilated

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13
Q

Exudative macular degeneration

A
  • 60+ yo
  • Slow, progressive
  • Metamorphosia
  • Retinal hemorrhage may be seen in macular region
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14
Q

Metamorphosia

A

Distortion of straight lines

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15
Q

Ischemic optic neuropathy

A
  • Can be a/w HTN, diabetes
  • Scalp tenderness, neck pain
  • Marcus Gunn pupil, swelling of optic nerve head
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16
Q

Stroke

A

Normal exam of eye

Functional vision loss, painless

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17
Q

Corneal ulcer

A

-Hx of trauma or contact lens wear (esp during sleep)

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18
Q

Uveitis

A
  • Inflammation of uveal tract (iris, ciliary body, choroid)
  • Can be a/w sarcoid, TB, IBD, psoriasis
  • Small pupil, sluggish or non-reactive to light, circumlimbal flush, low red reflex, usually unilateral
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19
Q

Circumlimbal flush

A

Circular reddening around cornea

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20
Q

Acute painful loss of vision could be:

A
  • Corneal ulcer
  • Uveitis
  • Acute angle glaucoma
  • Endophthalmitis
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21
Q

Acute angle glaucoma

A
  • Older farsighted pts
  • Blurry vision, haloes around light, pain
  • Unilateral redy eye, non reactive pupil
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22
Q

Endophthalmitis

A
  • Inflammation/infection of eyeball
  • MC post surgical complication
  • Redness, corneal edema, mucopurulent d/c, low red reflex
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23
Q

Chronic progressive painless vision loss could be:

A
  • Refractive error
  • Cataract
  • Open angle glaucoma
  • Atrophic macular degeneration
  • Brain tumor
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24
Q

Binocular diplopia could be:

A
  • CN 3, 4, 6 palsy
  • Uncompensated strabismus
  • Hyperthyroidism
  • Myasthenia gravis
  • Blow out fracture of orbit
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25
MC cause of gradual visual loss?
Refractive error
26
Cataracts
Common in elderly | Low red reflex, visualization of retina is difficult, normal pupillary response
27
Open angle glaucoma
- MC in pts w/fam hx, myopia, DM, AAs | - Elevated IOP
28
Atrophic macular degeneration
- 60 yo+, may have fam hx | - Drusen (hyaline nodules) in retina
29
CN 3 palsy
- Usually painless diplopia | - A/w aneurysm, diabetes, tumor, trauma, uncal (brain) hernitation
30
CN 3 palsy PE findings
- At rest: eye can only gaze laterally, pupil dilated and may be fixed - With herniation: unconsciousness, contralateral hemiparesis - Droopy eyelid
31
How to confirm binocular diplopia?
Have pt close either eye and diplopia should resolve completely
32
CN 4 palsy
- Vertical diplopia, difficulty looking down | - A/w tumor, aneurysm, diabetes
33
CN 4 palsy PE findings
- Vertical diplopia - Affected eye "sits" higher than other - Head tilt as pt tries to compensate for vertical diplopia
34
CN 6 palsy
- Horizontal diplopia | - Tumor, DM, aneurysm, temporal arteritis
35
CN 6 palsy PE findings
-Eye "sits" with some esotropia (inward gaze)
36
Uncompensated strabismus PE findings
- If horizontal diplopia/deviation, exotropia OR esotropia | - If vertical, one eye will "sit" higher than other
37
Hyperthyroidism PE findings
- Proptosis w/decreased movement - Results in diplopia - Lid lag
38
Myasthenia gravis
- Weakness of facial muscles, upper limbs | - Worsens w/fatigue
39
Blow out fracture of orbits
- May result in CN entrapment | - SC air may be present
40
What can cause itching/burning of the eye?
Conjunctivitis (bacterial or viral)
41
What can cause FB sensation in the eye?
FB Corneal abrasion Dry eyes Entropion
42
What can cause excessive tearing?
Ectropion | Entropion
43
Ectropion
- Outward turning of eyelid | - Tears do not reach drainage points
44
Entropion
- Inward turning of eyelid | - Excessive tear production
45
Visual acuity - distance from wall chart
20 feet
46
Visual acuity - distance from pocket Rosenberg chart
14-16 inches
47
OD OS OU
Right eye Left eye Both eyes
48
Interpret OD = 20/30 + 2
Pt read 20/30 line without mistakes and then got 2 right on the 20/20 line
49
Visual fields test
- Crude - Each eye must be tested separately - May only be possible to pick up significant deficits (not subtle)
50
Visual fields test - distance from patient
18 inches at the SAME level
51
If palpebral conjunctiva is pale, this could indicate:
Anemia
52
Arcus senilis
Whitish arc around edge of cornea in older patients (benign)
53
Pterygium
- Fleshy growth arising from conjunctiva over outer portion of cornea - Usually nasal side
54
Cataract
- Opacity of the lens - Pupil looks cloudy/hazy - Reduced red reflex
55
Anterior depth chamber
- Iris is flat so you should see a small crescent of light on nasal side - If there is a shadow, it would indicate a shallow anterior chamber due to bowing of the iris
56
Anisocoria
Unequal pupils | Normal in about 20% pts
57
Adie's pupil
Large, very sluggish or no reaction to light, slow accommodation
58
CN 3 palsy pupillary reaction
No reaction to light or accommodation
59
Argyll-Robertson pupil
"Whore's pupil" | Small, irregular pupils that accommodate but do not react (to light)
60
Horner's syndrome pupil
- Small, but reactive to light and accommodation - Ptosis is present on affected side - Loss of sweating on affected side forehead
61
Marcus Gunn pupil
- Swinging flashlight sign - 1st light into affected eye shows no reaction - Then light in other eye affected eye constricts - Shine back into affected eye and it dilates
62
How does a CN 3 palsy affect the eye movement?
Paralysis of medial, upward, downward gaze on affected side * CN are not crossed so deficits are on the side of the lesion * Also causes dilated non-reactive pupil and ptosis
63
How does a CN 6 palsy affect the eye movement?
Paralysis of lateral gaze on affected side
64
How does a CN 4 palsy affect eye movement?
Affected eye cannot look downward when turned inward
65
What is a rheostat?
Brightness/dimmer control on opthalmoscope
66
How do you perform the red reflex?
Tilt scope to ~15 degrees about 16 inches from patient
67
Venous pulsations of the eye
Sign of normal intracranial pressure
68
Venous pulsations of the eye are lost when:
ICP increases | Papilledema develops
69
Papilledema
Raised optic disc with blurred margins due to edema
70
T/F: Panoptic allows you to see entire fundus panoramically
True
71
Monocular vs. binocular diplopia
``` Monocular = problem with one of the eyes and it only is resolved when the bad eye is closed Binocular = EOM (should resolve when either eye is closed) ```

Pt Assess Final (7 decks)

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