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Eyes Flashcards

1
Q

Hemianopia

A

Loss of half the visual field. This relates to the brain’s impaired ability to receive the information transmitted to it through both eyes

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2
Q

Visual field loss on the same side in both eyes

A

Homonymous hemianopia

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3
Q

The visual field loss is on the same side that the lesion is on

A

Ipsilateral

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4
Q

The visual field loss is on the opposite side that the lesion is on

A

Contralateral

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5
Q

An area of reduced or absent vision within an otherwise intact visual field (an aura or blind spot that obstructs vision)

A

Scotoma

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6
Q

unequal size of the pupils

A

Anisocoria

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7
Q

etiology & #1 trmnt

“Pink Eye” Viral conjunctivitis

A

Adenovirus
#1 Cold Compress

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8
Q

Allergic Conjunctivitis Mild trmnt

A

Artificial tears

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9
Q

etiology & trmnt

Bacterial conjunctivitis

A

-S. aureus, S. pneumoniae, H. Flu, M. Catarrhalis
- Polymyxin B/Trimethorprim (polytrim), Bleph-10, Erythromycin ointmnet

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10
Q

What is this benign variant called?

A

Conjunctival Nevus = mole on eye

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11
Q

is Pinguecula or Pterygium harmful to your vision?

A

Pterygium

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12
Q

____ vs _____

A

Pinguecula - yellow-white, flat or slightly raised growth on the bublar conjunctiva
Pterygium - wing shaped fold of fibrovascular tissue. invades the cornea

both: degeneration of the deep conjunctival layers 2ndary to sunlight and chronic irritation

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13
Q

What & Trmnt?

A
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14
Q

what and trmnt?

mild pain, foreign body sensation, conjunctival and subconjunctival hemorrhages present. No changes in V/A exam. Hx of BB gun fights

A

Conjunctival Laceration
Fluorescein stain
CT or XR to r/o foreign body
- <1cm in length: erythromycin ointment
- >1cm in length: sx closure

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15
Q

trmnt?

A
  • ABX ointment
  • temporary taping
  • Sx often req
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16
Q

what & trmnt?

obese male with sleep apnea has chronically red irritated eye that is worse in the morning

A

Floppy Eyelid Syndrome
Trmnt: Lubricants, topical ABX, eyelid taping during sleep, Sx

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17
Q

what & trmnt

A

Xanthelasma

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18
Q

Most common eyelid tumor

an asymptomatic or mildly irritated eyelid lump

A

BCC

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19
Q

what & trmnt

painless lump inside the lid

A

internal chalazion
- warm compress, ophthalm ref

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20
Q

what & trmnt

tender nodule on the lid

A

Hordeolum
- Warm compress
- topical ABX: bacitracin, erythromycin ointment, polymyxin B
- refer if no imprvmnt ~2 weeks for Sx I&D

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21
Q

What & trmnt

eyelid margin itchy, burning, crusting, foreign body sensation

A

Blepharitis
- warm compress
- baby shampoo wash
- erythromycin or bacitracin if severe

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22
Q

Hordeolum vs Chalazion

A

Hordeolum is ON THE LID and caused by S. aureus

Chalazion is INSIDE THE LID and caused by noninfectious meibomian gland occlusion

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23
Q

what & trmnt

A

hyphema

bleeding into anterior chamber -> permanent vision loss
- Cycloplegia - Atropine sulfate (mydriatics)
- Analgesia, anti-emetics as needed

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24
Q

what

A

blowout frx

rule out globe fracture
augmentin

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25
# what & trmnt
globe rupture ## Footnote vision test, slit-lamp exam, CT scan, eye shield
26
# trmnt?
rule out globe fracture, eval lacrimal system, CT scan, **eval ptosis**, suture repair, refer to specialist, tetanus shot ## Footnote eval ptosis for levator muscle injury
27
pathogens for preseptal (periorbital) & orbital cellulitis?
- ***S. aureus & strep*** most common - ***H. Flu ***in unimmunized children (Hib)
28
# what & trmnt? inflamed lacrimal gland
Dacryoadenitis ## Footnote most commonly idiopathic -> oral steroids if infx -> Augmentin, Keflex
29
# what, path, trmnt Pain, redness, and swelling over the lacrimal sac
Dacryocystitis ## Footnote staph, strep
30
orbital cellulitis trmnt
- CT scan - IV ABX: unasyn, vanco, zosyn - CBC w/diff - Blood cultures - LP if meningitis suspected
31
preseptal cellulitis trmnt
- CT to r/o cellulitis - Mild Cases: ABX (polytrim, Augmentin, Bactrim) - Severe: Hosp, Ampicillin/subactam (unasyn) IV
32
Pt's with early symptoms of Myasthenia Gravis frequently present with ____
Eyelid Ptosis
33
Vertical nystagmus is a concern for?
CNS tumor
34
Trmnt for chronically blocked tear duct that fails to respond to topical ABX
if not improved by 1 yo old, perform lacrimal probe
35
# what & trmnt Acute onset of localized inflammation of the episcleral vessels. Mild pain, norm V/A exam, no discharge. Manipulation of the conjunctiva demonstrates vessel dilation beneath the conjunctiva affecting the sclera.
Episcleritis Mild: cold compress, artifical tears Mod-Severe: topical steroids, NSAIDs
36
This dendritic or branching fluorescein stain pattern is a classic findings for _____ ## Footnote Copeland may call them "dendritic lesions"
Herpes simplex virus keratits | Aka herpetic corneal ucer,
37
Most common risk factors for Iritis(Uveitis)
Taxoplasmosis, HSV(herpes simplex), VZV(varicella-zoster) ## Footnote 50% idiopathic
38
39
40
Pinguecula & Pterygium trmnt
artificial tears topical steroid drops if symp severe. Severe cases require sx rmvl if you cant see
41
Corneal abrasion trmnt
Non-contacts -> Erythromycin, bacitracin, polysporin ointment, polytrim drops Fingernail injury -> Fluoroquinolone drops Contact lens wearers need pseudomonas coverage -> Ciprofloxacin, Tobramycin
42
Corneal abrasion trmnt for pt who scraped their eye with their dirty fingernails while taking out their contacts.
Ciprofloxacin drops ## Footnote fingernails need fluoroquinolones Contact-lens needs ciprofloxacin or tobramycin
43
A small piece of metal fell into pts eye while they were working under their car. Very superficial and no globe penetration. Trmnt?
Rmvl under topical anesthesia + Topical ABX: Polytrim (polymyxin B/Trimethoprim)
44
After you rmv metal from the cornea, you see it left a rust stain. Wdyd?
Diamond** burr** polishing is performed in office using anesthetic drops. The surface layer of the cornea is removed with a surgical sponge and blade. The diamond-dusted burr is then used to smooth the corneal surface
45
Why are cycloplegics beneficial for intraocular foreign bodies?
Cycloplegics block ACH binding. If there's something deeper in your eye, you want to paralyze the eye to avoid further trauma ## Footnote a piece of metal deep in the eye may be held in place by any layers (ex. cornea). You don't want your pupils to constantly constrict and dilate and cut your iris even further.
46
How to tell if a foreign body is superficially within the cornea or deeper (intraocular)?
Corneal: milder symptoms, foreign body sensation, irritation, and pain Intraocular: irregular pupil, asniscoric, viteous hemorrhage ## Footnote You only have to paralyze the pupil if its deeper (intraocular)l
47
Thing grayish white circle near cornea is concern for
hyperlipoproteinuria
48
red, brown ring, sometimes shades green or blue. Concern for?
Wilson's disease - build up of copper in the body
49
What causes myopia?
point of focus is in front of retina due to cornea being TOO curvy or axial length TOO long
50
What causes hyperopia
Farsightedness is due to flatter cornea or short axial length
51
What causes presbyopia?
with age, the lens becomes more rigid and cant move to focus on objects up close very well
52
Anisometropia
a significant difference b/w the refractive errors of the 2 eyes
53
Emmetropia
normal vision
54
Laser sx opts for refractive errors
Photorefractive keratotomy (PRK) Laser in situ keratomileusis (Lasik) ## Footnote PRK corrects the cornea
55
4 month old child (+) for strabismus on PE. Trmnt?
nothing, normal visual axis alignment is achieved by 6 months
56
Strabismus
misaligned eyes
57
Concomitant Strabismus
Nonparalytic (naturally occurring) misalignment EQUAL in all directions of gaze
58
Incomitant strabismus
paralytic strabismus (not naturally occuring). Misalignment VARIES with direction of gaze ## Footnote nerve dysfunction of mechanical restriction
59
Amblyopia
“lazy eye” defective vision w/o identifiable organic cause. what the PATIENT SEES. Starts off as double vision (diplopia). Eventually, the brain compensates and only chooses one eye to look at
60
Anisometropia
condition that occurs when your eyes have varying refractive powers, which can cause your eyes to focus unevenly
61
How does chronic HTN affect your eyes?
as your arteries constrict more, it increases your risk for atherosclerosis. The build up of plaque looks like silver wire. The arteries look like they're "nicking" the veins. A/V ratio change from 2:3 -> 1:3 or 1:4. ## Footnote Other exam findings: exudates, hemorrhages, cotton-wool spots
62
The most frequent cause of preventable blindness in the world
Cataract
63
Cataract trmnt
Glasses (early dz) Sx lens replacement (late dz)
64
retinopathy is present in ___% of DM pts at initial dx
20
65
Most common cause of adult blindness in USA
Diabetic retinopathy ## Footnote most pts <65yo
66
Proptosis
eyes bulging out
67
a **wing shaped fold of fibrovascular tissue** that extends and invades the cornea resulting in impairment of vision
Pterygium
68
a yellowish elevation extending from the **medial canthus to the nasal cornea**
Pinguecula
69
Which CNs help you open and close your eyelids?
CN 3: Open CN 7: Close
70
ptosis relates to CN ___
CN III Occulomotor
71
Contact lens wearers need pseudomonas coverage when treating bacterial infx. What classes are your go tos?
Topical aminoglycosides or fluoroquinolones ## Footnote Aminoglycosides: gentamycin, tobramycin Fluoroquinolones: ciprofloxacin
72
tear-drop pupil + abnormal red light reflex
globe rupture
73
# what, WU, trmnt? Sudden unilateral vision loss with scalp tenderness and headache
Temporal Arteritis Labs: ESR>50 temporal artery biopsy IV Methylprednisolone
74
What does a high ESR mean?
measures how fast your RBCs sink. if you sink faster than normal, it may mean you have a medical condition causing inflammation.
75
Hypopyon
collection of pus in anterior chamber of eye
76
Cherry red spot
retinal artery occlusion
77
Pale white spot
Retinoblastoma
78
Cotton wool spots
Hypertensive Retinopathy or Diabetic Retinopathy ## Footnote caused by lack of blood flow to small retinal arteries
79
most common cause of blindness in ppl >65yo
Macular degeneration
80
Meds that make glaucoma worse
***Metoclopramide***, Atropine
81
# what, etiology, trmnt painful red eye with ircumcorneal conjunctival injection, blurry vision, light sensitivity,
Acute (anterior) Uveitis ## Footnote toxoplasmosis, HSV, VZV Cycloplegic paralytics (scopalamine, atropine), topical steroid (predisone)

HEENT (9 decks)

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