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Opthamology rotation > Optho #1 > Flashcards

Optho #1 Flashcards

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1
Q

how does optic nerve toxicity usually present?

A

Bilateral central scotomas with intact peripheral fields.

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2
Q

Optic neuritis vision loss is quick/slow?

A

quick

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3
Q

An intercavernous sinus menigioma will knock out which nerves?

A

3,4,5,6

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4
Q

knocking out the sypathetics and parasympatetics to the eye usually involve which 2 locations?

A 
cavernous sinus (menigioma)
internal carotid (aneurysm)
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5
Q

an aneuysm of the posterior communicating artery usually affects what?

A

CN #3

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6
Q

what is simultagnosia?

A

difficulty with the presentation of multiple stimuli simultaneously.

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7
Q

when does simultagnosia usually present?

A

early dementia

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8
Q

what are the 3 major causes of chronic slow visual loss?

A

Glaucoma, cateract, macular degeneration

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9
Q

T/F The majority of patients with glaucoma experience ocular pain, inflammation and halos?

A

False most of the time its asymptomatic

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10
Q

what is the normal intraocular pressure?

A

10-21 mmHg

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11
Q

what is the number one way to diagnose glaucoma?

A

looking at the optic nerve changes

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12
Q

what is a larger risk factor for glaucoma, parents or siblings with glaucoma?

A

Siblings= 2 points
Parents= 1 point
(Recall 3 points means moderate risk, 4+ points means high risk)

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13
Q

what effect does alpha 1 agonists have on the eye?

A

causes vasoconstriction of the arteries supplying the ciliary body resulting in decreased aqueous humor production.

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14
Q

what commonly causes a red eye, hazy cornea, and a fixed dilated pupil?

A

Acute onset closed angle glaucoma

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15
Q

what are some of the symptoms for chronic angle closure glaucoma?

A

headache and blurred vision

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16
Q

T/F Corneal edema is associated with high intraocular pressure?

A

true

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17
Q

what is Buphthalmos?

A

enlargement of the eye

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18
Q

posterior subcapsular opacity frequently affect what part of the vision?

A

near vision

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19
Q

what usually causes subcapsular types of cataracts?

A

metabolic (diabetes) and corticosteriods

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20
Q

what is metamorphopsia?

A

wavy distortion of central vision

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21
Q

does a severe cataract produce an relative afferent pupillary defect?

A

no

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22
Q

what causes starburst appearance around lights?

A

nuclear cataracts

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23
Q

what is the leading cause of blindness in the USA?

A

age related macular degeneration

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24
Q

T/F the fovea is made of only of cones and is avascular?

A

true

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25
where does Drussen deposit in the retina?
in Bruches membrane (separates RPE and choroidal vessels)
26
what percentage of macular degeneration is wet?
20% (AKA neovascular)
27
what does fluoroscein angiography do?
identifies neovascularization of the retina and choroid.
28
how do you tell if the vessels are newely formed from neovascularizaiton?
the new vessels are very leaky
29
what is Ocular Coherance Tomography (OCT)?
shows the layers of the retina and thickness
30
what part of the vision is affected first in macular degeneration?
central because it affects the fovea
31
what are 2 major signs of early macuar degeneration?
absence of foveal reflex | mottled appearance of RPE
32
what is hyperemia?
injection of the eye (red eye)
33
T/F chronic open anle glaucoma causes eye redness?
False, it is caused by acute closed angle glaucoma
34
ciliary flush is dilated episcleral vessels adjacent and circumferential to the limbus. what causes this?
Iritis or Iridiocyclitis | acute glaucoma
35
what problem that causes eye redness usually spares the area around the limbus?
conjunctivitis
36
what is the difference between scleritis and episcleritis? (besides the layer location)
Scleritis= raised hyperemic lesion on eye and associated with collagen and rheumatoid diseases Episcleritis=flattened but hyperemic lesion on eye and often associated with allergies
37
what is dacrocystitis?
inflammation of the lacrimal sac
38
what are the layers of the retina?
``` Innternal limiting membrane Nerve fiber layer – axons of the ganglion cell nuclei Ganglion cell layer Inner plexiform layer Inner nuclear layer Outer plexiform layer Outer nuclear layer – cell bodies of rods and cones External limiting membrane Photo-receptor layer Retinal pigment epithelium ```
39
T/F patients with conjunctivitis have normal light sensitivity?
true
40
what happens to the cornea with glaucoma?
corneal edema that results in halos
41
what is mattering of the eye?
Exudate from the eye. This often causes the eylids to be stuck together in the mornings.
42
Does conjunctivitis cause decreased visual acuity?
No
43
what often causes low IOP?
iridocyclitis
44
what is iridocyclitis?
inflammation of the iris and ciliary body
45
in viral conjunctivitis, where do you expect the lymph nodes to be enlarged/inflamed?
preauricular lymph nodes (note in bacterial conjunctivitis, this enlargement usually does not happen)
46
which virus is known for causing conjunctivitis every year?
adenovirus
47
what is erythema multiforme?
bulls eye target lesions on skin that can also affect eyes causing scarring and blindness. Steven Johnson syndrome is a form of erythema multiforme that can affect the eyes.
48
what is seborrheic blepharitis?
dandruff of the eyelid seen in the eye lashes
49
what is the real name for a stye?
Hordeolum (inflammation of the glands or hair follicles of eyelid)
50
what is the difference between a hordolum and a chalazion?
In general, hordeola are acute, infected, and painful lesions at the rim of the eyelid. Chalazia are subacute or chronic, noninfected, and generally less painful lesions on the conjunctival side of the eyelid.
51
T/F steroids are effective in the treatment of infectious conjunctivitis?
False almost never are they needed
52
what are 4 major side effects of using topical eye numbing drops?
1) slows growth/healing of the cornea 2) allergic reaction to drops 3) decreases blinking rate=dries out cornea 4) increased risk for further injury because of numbness
53
what 3 adverse things do corticosteroids do to the eye?
1) predispose to herpes and fungal infections 2) cataract formation 3) increase IOP
54
T/F Flourescein should always be instilled in a red eye to test for integrity of the corneal epithelium?
True
55
which two major eye conditions cause irregularities in the pupils?
acute angle closure glaucoma | iridocyclitis
56
what is epiphoria?
chronic tearing of the eye
57
how do you usually treat hyphema of the anterior chamber?
watch and wait because they usually resolve spontaneously.
58
what color does the retina turn when edematous?
white
59
after ocular trauma and there is vertical restriction and vertical diplopia, what should you be thinking?
blowout fracture of the orbit
60
If you have a penetrating eye injury, what should you do as a PCP?
place and eye shield and send for immediate optho referral. Order a CT Do not put on a pressure patch or add ointment to eye.
61
orbital fractures and subconjunctival hemorrhages should be referred to an opthamologist how quickly?
semi-urgently (1-2 days)
62
what are 2 common short acting cycloplegics used in opthomology?
homatropine and cyclopentolate | atropine is usually not used because of its long duration
63
which 2 topical eye antibiotics are associated with allergic reaction when used longer than 7 days?
gentamycin and neomycin
64
when do you add a pressure eye patch?
when there is damage to the cornea such as with foreign bodies or abrasions.
65
PCP can suture eyelid injuries except for those that?
involve eyelid margin | involve the canaliculi
66
what should you assume with a teardrop shaped pupil and a flat anterior chamber?
globe penetration or rupture
67
what is Bells phenomenon?
eyes rotate superiorly on lid closure so many traumatic abrasions to the eye are often located in the central or inferior cornea.
68
How do you treat a corneal abrasion?
antibiotic ointment, cycloplegic drops, pressure patch, follow up in a few days
69
How do you treat Hyphema without trauma?
Steroid drops and cycloplegic drops and tell patient to keep head elevated at all times.
70
what is the first thing that you do when treating someone after facial/ocular trauma?
carefully open eye lids and examine for a ruptured globe, if present place shield and send for immediate treatment.
71
T/F orbital fractures are emergencies?
False, you can treat them 1-2 weeks afterwards
72
what should you instruct patients to do with orbital fractures?
1) ice packs to the orbit 2) avoid blowing the nose 3) oral antibiotics
73
what do alpha 2 agonists do to the eye?
located on the ciliary epithelium cause decreased aqueous humor production
74
Beta 2 agonists do what?
increase aqueous humor production, therefore beta blockers are helpful in glaucoma
75
which receptors cause iris dilatation? constriction?
dilation=alpha 1 | constriction=M3 (just like ciliary body)
76
T1 MRI is better for seeing what?
Anatomy but usually has fat supression
77
T2 is better for seeing what?
Pathology (eyes glow)
78
T/F cellulitis of the eye often causes proptosis?
True
79
Why does proptosis happen with thyroid disease?
Because the antibodies that are stimulating the thyroid gland also stimulates the the fibroblasts of the eye muscles
80
what is the most common orbital tumor in kids?
Dermoid cysts
81
what is the most common benign tumor in adults?
cavernous tumor
82
what is the most common primary orbital malignancy in kids?
rhabdomyosarcoma
83
which tumor is frequently found in the lacrimal gland fossa?
lymphoma (50%) soft and molds
84
when do you usually get the trap door fracture of the inferior orbit?
younger kids
85
what is the most common cause of eye lid cancer?
basal cell carcinoma
86
what can sebacious adenocarcinoma mimick?
blepharitis usually on upper lid because of so many glands
87
what is the most common cause of ptosis?
aponeurotic (muscles slip off of tarsel plate)
88
when do you usually see pseudotumor cerbri (which population)?
overweight individuals
89
what is the big danger of orbital cellulitis?
cavernous sinus thrombosis
90
what is the only way to prevent glaucoma?
by decreasing the IOP (this is the only way)
91
What are the common acute optic neuropathies?
``` Older = ischemic optic neuropathy Young = optic neuritis ```

Opthamology rotation (2 decks)

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