Flashcards in Lecture II Deck (52):
True or false: IBD can affect the eye
What is retinitis pigmentosum?
Genetic (or acquired) disease of the rods of the eye that causes them to degenerate slowly over time, with peripheral vision usually being lost first
What are the three major ROS facts that should be obtained with the eye?"
-Disturbances of vision
-Pain or discomfort of the eye
-Abnormal eye secretions
What is amaurosis?
partial or total blindness without visible change in the eye, typically due to disease of the optic nerve, spinal cord, or brain.
What is Amaurosis Fugax?
a temporary loss of vision in one eye caused by ischemia to the retina. It may also be caused by embolization from atherosclerotic plaques in the ipsilateral internal carotid artery.
Floaters and photopsia = ?
What is photopsia?
Flashes of light
What is diplopia?
What is epiphora?
What etiologies do the following secretions usually indicated with the eye:
Purulent = bacterial
Mucous = allergic
Serous = viral
What is iritis?
(anterior uveitis) Inflammation of the anterior chamber and the iris
You should always check the visual acuity of patients except for one instance. What is it?
Chemical burns--irrigate the eye immediately
What is the best way to check for visual acuity-- the (best/worst) (Corrected/uncorrected) (monocular/binocular)
Best corrected monocular vision
What is the order of vision checks you should do if a patient cannot read the top letter/number on an eye chart?
What is cortical blindness?
brain is affected so there is no processing of visual information, but reflexes are intact
What is a scotoma?
What is a hemianopia?
Loss of 1/2 VF
What is homonymous?
Either right or left VF
What are scintillating scotomas?
Jagged lines that appear often with migraine HAs are are not usually accompanied by visual loss
What are the eyebrow findings with hypothyroidism?
What does the swinging flashlight test assess for?
What are the characteristics that should be obtained when inspecting the eye, instead of using PERRLA?
What is anisocoria?
Difference in the size of pupils
How do you perform the swinging light test? What does this assess for?
Swing light between eyes in a dark room--tests for afferent response of each pupil
What happens to the pupils when changing from far to near vision?
When is checking EOMs particularly important?
If there is a complaint of diplopia
From superior to inferior, which muscle is being assessed at each of the three cardinal direction of gaze on the temporal side?
From superior to inferior, which muscle is being assessed at each of the three cardinal direction of gaze on the Nasal side?
Damage to CN III results in what ophthalmologic defects?
Eye looks down and out; ptosis, pupillary dilation, and loss of accommodation
Damage to CN IV results in what defects?
Eye moves upward, particularly with contralateral gaze and head tilt toward the side of the lesion
Damage to CN VI results in what defects?
Medially directed eye that cannot abduct
What is the CN that innervated the sensation to the eye?
What is arcus corneae?
a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris
May be a sign of hypercholesterolemia
What are the two major, general causes of lens subluxation?
What is the classic CT disorder that leads to lens subluxation?
How do you communicate lesions in the retina? (location, size)
Clock position relative to the optic disc
Size relative to the disc diameter
What causes AV nicking?
Increased pressure in the arteries compresses the veins
What are scleral crescents?
lighter area in the optic disc--normal variant
What are pigmented crescents?
Pigmentation around the optic disc--normal variant
What is papilledema?
Optic disc swelling (usually bilateral) d/t increased ICP
Causes an enlarged blind spot and elevated optic disc with blurred margins on fundoscopic exam
True or false: disc edema = papilledema
false--papilledema is 2/2 increased ICP
How do preretinal hemorrhages appear on fundoscopic exam?
Like an air-fluid level on CT (kinda)
How, roughly, do you distinguish between cotton wool spots and hard exudates?
Cotton wool spots are softer than hard exudates
What is the normal eye pressure?
What is the gold standard test for eye pressures?
When should patients with better than 20/20 vision be referred?
If there are visual complaints
When should pts wit worse than 20/20 vision be referred?
Always, even in the absence of complaints
When should pts with VA asymmetry be referred?
Difference of 2 lines or more
True or false: for the most part, any fundus exam abnormality necessitates a referral to an ophthalmologist
Eye pressure of greater than what indicates the need for referral?
More than 22 mmHg
What are the components of AIDET?
-Acknowledge pt with a smile
-Describe what you are going to do