Ophthalmology general Flashcards
(53 cards)
Chemosis?
Accumulation of fluid under conjunctiva, the conjunctiva looks like a raised blister.
Ophthalmoplegia?
Paralysis of the extraocular muscles that control the movements of the eye.
Preseptal cellulitis is a clinical Dx once cellulitis has been excluded. Exclusion of orbital cellulitis is dependent on the absence of:
- proptosis
- ophthalmoplegia
- pain on eye movement
- impairment of visual acuity
Epiphora?
Watery eyes, excessive tearing.
Xerosis?
Conjunctival Dryness
Anisocoria?
Pupils of different sizes
PERRLA?
Pupils
Equal
Round
Reactive to
Light
Accomodation
Diagnostic position test?
Straight nasal = III = Medial rectus
Up and nasal = III = inferior oblique
Up and temporal = III = superior rectus
Straight temporal = VI (6) = lateral rectus
Down and temporal = III = inferior rectus
Down and nasal = IV (4) = Superior oblique
Exophthalmos?
Protruding eyes. AKA Proptosis (however proptosis can indicate any organ pushed foward)
Enophthalmos?
Sunken eyes.
Ectropion?
The lower eyelid is loose and rolling out.
Entropion?
Lower eye lid rolls in because of spams of lids or scar tissue. Scratching the cornea.
Blepharitis?
Inflammation of the eyelids.
Chalazion?
Inflammation of Meibomian gland.
Often painless and less erythematous than Stye
Hordeolum (stye)?
Painful!
External = infection of the glands in lid-margin (Gland of Zeis or gland of Moll)
Internal = Inflammation of meibomian gland
Dacryocystitis?
Dx: Nasolacrimal duct obstruction/inflammation.
Xanthelasma?
Dx: Soft, yellow plaques usually appearing symmetrically on medial aspect of eye lid.
Milia?
Dx: Pin-point multiple, firm, withe lesions.
Moderate to severe ocular pain DDX (Wills)?
- Corneal disorders
- Trauma
- Scleritis
- Anterior uveitis
- Endophthalmitis
- Acute angle closure glaucoma
Orbital pain DDX?
- Sinusitis
- Trauma
- orbital cellulitis
- Idiopathic orbital inflammatory syndrome
- Orbital tumor or mass
- Optic neuritis
- Acute dacryoadenitis
- diabetic cranial nerve palsy
- Cluster headache or migraine
- POst-infectious neuralgia (herpetic)
Episcleritis definition?
Episcleritis is inflammation of the tissue lying between the sclera (the tough, white, fiber layer covering the eye) and the conjunctiva (the membrane that lines the eyelid and covers the white of the eye).
Episcleritis diagnosis?
The diagnosis of episcleritis should be strongly suspected in a patient with a history of the abrupt onset of:
redness,
irritation, and
watering of the eye,
often without pain or mild pain (except in more chronic disease or with nodular episcleritis),
and with normal vision.
More common in women.
Sign: Sectoral (and, less commonly, diffuse) redness of one or both eyes, mostly due to engorgement of the episcleral vessels. These vessels are large, run in a radial direction beneath the conjunctiva, and can be moved with a cotton-tip applicator.
Scleritis definition?
Scleritis is severe, destructive inflammation of the sclera (the tough, white, fiber layer covering the eye) that may threaten vision.
Scleritis diagnosis?
Symptoms:
1. Severe and boring eye pain (most prominent feature),
2. which may radiate to the forehead, brow, jaw, or sinuses, and classically awakens the patient at night.
3. Pain worsens with eye movement and with touch.
4. Gradual or acute onset with red eye.
5. May have tearing, photophobia, or decrease in vision.
6. Recurrent episodes are common. Scleromalacia perforans (necrotizing scleritis without inflammation) may have minimal symptoms.
Signs: Critical.
1. Inflammation of scleral, episcleral, and conjunctival vessels (scleral vessels are large, deep vessels that cannot be moved with a cotton swab and do not blanch with topical 2.5% or 10% phenylephrine).
2. Can be sectoral, nodular, or diffuse with associated scleral edema. Characteristic violaceous scleral hue (best seen in natural light by gross inspection). Areas of scleral thinning or remodeling may appear with recurrent episodes, allowing underlying uvea to become visible or even bulge outward.
