Ophthalmic History and Examination Lecture Powerpoint Flashcards Preview

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Flashcards in Ophthalmic History and Examination Lecture Powerpoint Deck (25):

Common causes of burning in eyes

Dry eye syndrome
Blepharitis (dandruff of eyelashes)
Chemical splash


Common causes of transient visual loss

Few seconds - papilledema (bilateral)
Few minutes - amaurosis fugax (unilateral) vertebrobasilar insufficiency (bilateral)
10-60 min - migraine (acephalgic visual without headache or classic visual precede headache)
>24 hrs sudden painless - retinal artery or vein occlusion, ischemic optic neuropathy, vitreous hemorrhage, retinal detachment
>24 hrs gradual painless loss - cataracts, refractive error (glasses need), open angle glaucoma, macular degeneration, diabetic retinopathy
>24 hours painful loss - acute angle closure glaucoma, optic neuritis, uveitis


Double vision (diplopia) common associated condition

Due to cranial nerve palsy until proven otherwise


Flashes of light common associated conditions

Indicates posterior vitreous detachment (floaters), retinal detachment, or migraine


Foreign body sensation common associated conditions

Dry eye syndrome, blepharitis, foreign body, contact lens related


Itchy eye comon associated condition

Allergic conjunctivitis, contact dermatitis


Red eye common associated conditions

Discharge presence: conjunctivitis and blepharitis
No discharge: subconjunctival hemorrhage, corneal abrasion, uveitis


Tearing eyes common associated conditions

Pain - corneal abrasion, foreign body, uveitis
Minimal pain - drye eye syndrome, nasolacrimal duct obstruction
Children - nasal lacrimal duct obstruction or congenital glaucoma


Vision physical exam

-Check corrected vision first
-check vision at the correct distance for specific chart you are using
-check one eye at time
-OD is right, OS is left, and OU is both eyes, write as 20/__


Origin of 20/20 vision

Dutch ophthalmologist developed standardized eye chart in 1800's, 20/40 means that a person can see at 20 what a normal eye can see at 40 feet, as bottom number gets larger vision is less acute/more blurry


Pupils physical exam

-Checking pupil size, if >1mm diff called anisocoria
-shape should be round unless previous eye surgery, trauma, or congenital abnormality
-Have patient fixate on distant object, shine bright light source into one eye, pupil should constrict, and other should as well due to consensual light reflex


3rd nerve palsy with fixed or dilated pupil (no indirect acommondation) could indicate...



Relative afferent pupillary defect (marcus gunn pupil)

Occurs upon flashlight testing of eye resulting in abnormal dilation upon exposure to the light indicating pathology of the optic nerve or severe retinal disease


Extraocular muscles testing physical exam

-Have patient follow and object in an H pattern to test both eyes
-test to what %in all directions the eye can move direction in that gaze from 0-100% (100% being best)


Superior oblique allows eye to move ____. Inferior oblique allows eye to move ____

down and nasally, upward and nasally


Visual fields by confrontation physical exam

-have patient look right at nose and cover one eye, hold hand in each of the 4 quadrants using 1,2, or 5 fingers then ask patient to identify, impairmnet may signify a stroke, optic neuropathy, or retinal detachment


What physical exam must be performed on any patient who cmplains of decreased vision

Visual fields by confrontation


Why do eyes bulge in thyroid disease

Muscles constrict squeezing eyes more outwardly?


Assessing clarity of cornea

Stain with fluorescin dye and cobalt blue filter on opthalmoscope to assess iris details for scratched cornea


Angle closure glaucoma finger technique

-Have patient close eyes then push down on it with fingers, if one eye feels much harder closer to a golf ball then that indicates the pressure is markedly elevated


Green lenses on opthalmosope vs red

Green pull the image forward or are positive to focus items that are close
Red push the image backward or are negative to focus items that are far


Optic disk margins

Should be well defined, if no edges and cotton wool spots may be glaucoma or other pathology


Normal cup to disk ratio



AV nicking

Where artery and vein cross, a sign of high blood pressure


Retinal vessel differentiation between arteries and veins

Arteries are narrower than veins