Medical Issues Ch. 12 Flashcards Preview

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Flashcards in Medical Issues Ch. 12 Deck (35):
1

History for an eye exam

history of visual acuity
any pre-existing conditions
general health status

2

history of the present condition

location and description of symptoms
injury mechanism

3

inspection techniques

periorbital area
-discoloration
-gross deformity
globe
-general appearance
-eyelids
-conjunctiva
-sclera
-iris
-pupil shape and size

4

how do you examine inside the eye

use your fingers to retract their eyelid and shine a light in to see for foreign objects

5

palpation areas

orbital margin
frontal bone
nasal bones
zygomatic bones

6

functional assessments

vision assessment
-Snellen eye chart
-Rosenbaum
pupillary reaction to light
eye motility
peripheral vision
ophthalmoscope

7

Snellen vs. Rosenbaum

Snellen: 20 feet away
Rosenbaum: 14-16 inches

8

pupillary reaction to light
-PEARL

pupils equal and reactive to light

9

eye motility
-which nerves do they test?
-how to test

occulomotor
tymphatic
abducens
how to test
-follow an object horizontal, vertical, diagonal

10

peripheral vision test

bring fingers in from the sides until they can see them

11

two others recommendations when examining the eye

examine eye ASAP, as swelling will get in the way if too much time is wasted
do not place external pressure on the eye or surrounding structures if there is a high suspicion of trauma that was severe enough to rupture the eyeball

12

red flags for referral

blurred vision
diplopia - double
foreign object protruding into the eye
restricted eye movement
distorted pupil
hyphema
unilateral pupil dilation or constriction
large lacerations of the eyelids
lacerations that involve the margins of the eyelids
persistent floaters

13

refractive errors
--cause
-types

caused by length of eye and shape or curvature of cornea
types
-myopia - hard to see distance
-hyperopia - hard to see close up

14

conjunctivitis
-contagious?
-other S/S

can be contagious
-viral or bacterial
other respiratory problems

15

conjunctivitis bacterial vs. viral

bacterial is more crusty

16

conjunctivitis RTP

48-72 hours after starting antibiotic eyedrops

17

stye
-S/S

inflammation of duct or hair follicle on the eyelid
S/S
-pain
-swelling
-redness

18

glaucoma

increased intraocular pressure
-build up of aqueous humor
-can lead to damage to the optic nerve

19

who is at risk for a glaucoma

anyone over 40
-with myopia
-diabetes
-hypertension
AAs

20

eyelid laceration
-question to ask

bleed profusely
can you approximate the wound?
-harder to do over the eyelid

21

periorbital contusions
-DDx
-RTP

black eye
test the eye early before swelling develops
DDx
-orbital fracture
-concussion
RTP
-as soon as possible if there are not major problems

22

orbital fracture
-S/S

blow to the eye or the bones around the eye
blowout fracture
-fracture to the walls or floor of the orbit
S/S
-pain with eye movement
-possible inability to look up if bottom is fractured
-pain when blowing nose
-diplopia
refer

23

dislocated contact lens

evert eyelid
wash with sterile saline solution
locate lens
replace once the lens is clean or with a new one

24

corneal and conjunctival foreign bodies

may need to evert the upper eyelid to visualize the foreign bodies

25

corneal abrasions

feels with something in the eye
can lead to decreased to vision, pain, tearing

26

how to diagnose a corneal abrasion

fluorescein - dye
shine pen light with attachment
abrasion will be visible
will resolve within a few days to a week

27

corneal laceration

puncture wound to the eye
"open globe"
automatic referral
can use an eye shield

28

subconjunctival hemorrhage

benign
can occur from trauma (straining, high BP)

29

hyphema

bleeding in the anterior chamber of the eye
not benign
shows up over the iris and pupil
S/S
pain, blurred vision
911
-keep them upright
Tx
-bedrest in an elevated position
resolve in about a week
will require eye protection

30

detached retina

high chance of disrupting optic nerve
S/S
-"curtain" over their field of vision
-floaters
-blurred vision
can be caused by a severe jarring force
immediate referral

31

retinal tears

similar S/S to detached retina
immediately refer

32

chemical burns

flush continuously
refer

33

traumatic iritis

blunt trauma
S/S
-photophobia
-sluggish pupil reaction
refer

34

proptosis

direct trauma
bulging of the eye caused by swelling
swelling can damage the optic nerve
S/S
-bulging
-decreased motility
-diplopia
-can't close eyelids fully
-pain
-nausea
immediate referral

35

ruptured globe

blunt trauma directly to the glove
rupture of the cornea or the sclera resulting in the inner contents spilling out
S/S
-pain
-eyeball may look out of place
-marked edema
-hyphema possibly
shield and refer