Flashcards in Outcome 3 Ophthalmology Deck (125):
Refractive error, also called farsightedness, where distant objects are clear while near objects are blurry
In hyperopia, light entering the eye is focused ____ the retina rather than ____ the retina
light focused behind the retina rather than on the retina
In hyperopia, the eyeball is abnormally ___ measured from front to back
Hyperopia requires the eye's _____ to reposition the viewed object on the retina, therefore sharpening the image
Refractive error also called nearsightedness where
near objects are clear while distant objects are blurry
In myopia, light entering the eye is focused ___ of the retina causing blurred vision
light is focused in front of the retina
In myopia, the eyeball is abnormally ___ as measured from front to back
In myopia, images viewed cannot be ____ by the eye's internal lens
Refractive error which causes some images to appear clear while other images appear blurred
In astigmatism, ___ focusing of light rays enter the eey
In astigmatism, the cornea is ___ and not ___, causing light rays to be unevenly focused across the retina
egg shaped and not spherical
Refractive error in which the eye's internal lens can't focus on near objects due to loss of _____
Presbyopia is related to ____; usually starts in people in their mid-40s
Involuntary, repetitive and rhythmic movements of one or both eyes and associated with blurred or decreased vision
Type of nystagmus that always necessitates a complete neurologic evaluation
What are the 2 types of nystagmus?
Type of nystagmus that manifests before 6 months to 1 year of age and is the most common type
Type of nystagmus that results when a disease process produces lesions in the brain or inner ear
List some causes for nystagmus
1. brain tumors
2. cerebrovascular lesions
3. abnormal development of the nervous system
4. alcohol/drug use
How is congenital nystagmus treated?
The Kestenbaum procedure is used to treat congenital nystagmus where the eyes are surgically rotated towards the _____ of the eye
How is acquire nystagmus treated?
treating underlying cause
Visual defect of misalignment where eyes fail to look in the same direction at the same time
What are the 2 types of strabismus?
1. convergent strabismus or esotropia
2. divergent strabismus or exotropia
Type of strabismus better known as cross-eye where both eyes turn inward
Type of strabismus better known as wall-eye where both eyes turn outward
What is the main symptom of acquired strabismus?
diplopia or double vision
What disorder is associated with strabismus when present in childhood?
amblyopia or lazy eye
Strabismus is caused by weakness in the ____ stimulating the muscles that control eye position
Strabismus can also be caused by conditions elsewhere in the body in the ___, ___ or ___
brain, cranial nerves, muscles. Ex: HTN, temporal arteritis, muscular dystrophy, aneurysm, intracranial lesions
Strabismus should be treated immediately because early intervention is key. Examples of treatment are corrective glasses, surgery to restore the eye-muscle balance, and covering the ___ eye in order to force the patient to use the ___ eye
fixing eye, deviating eye
Acute, focal inflammatory infections of the sebaceous glands of the eyelids
hordeolum or stye
Which glands of the eyelids are affected by hordeolum
Hordeolum are associated with and secondary to _____
What is the only cause of hordeolum?
Small, firm, non-mobile, painless subcutaneous nodule on the margin or body of the eyelid
In chalazion there is a blockage of fluid originating from one of the ____ glands which lubricate the eyelid margin
Any inflammation or infection of the cornea
Keratitis is diagnosed by examining the cornea using a _____
Keratitis is an infection resulting from the ___ virus, especially likely in people w/ URI and facial cold sores
herpes simplex virus
What are other causes for keratitis
1. certain bacteria/fungi
2. contact lens wear
3. corneal trauma
4. corneal exposure to dry air or intense light
In keratitis, prompt treatment decreases the risk of ulceration which can cause what?
Ulceration can erode the cornea and form of scar tissue
Inflammation of the margins of the eyelids involving hair follicles/glands
Blepharitis is usually secondary to ___ of the eyelid's sebaceous glands
What is the main symptom of blepharitis?
redness, crusting eyelid, itching, burning
What are two types of blepharitis?
Type of blepharitis caused by staphylocococcal infection
Type of blepharitis caused by allergies or exposure to smoke, dust, chemicals
Chronic blepharitis may lead to ___ and ___
corneal and conjunctival inflammation
Lower eyelid margins turn inward
Entropion may cause ___ and ___ defects
conjunctivitis and ephithelial defects
Entropion causes the lashes to rub the ___ and ___
conjunctiva and cornea
How is entropion treated?
minor surgical procedure
Lower eyelid margins evert from the eyeball
Ectropion exposes the ____ lining
conjunctival membrane lining
Type of ectropion that can be caused by scars on the eyelid or cheek that contract and pull the eye down
Ectropion left untreated can cause development of ___ and permanent damage to the ___
corneal ulcers, damage to the cornea
What causes both ectropion and entropion?
2. loss of elasticity
Permanent drooping of the upper eyelid which partially or completely covers the eye
Blepharoptosis can be caused by weakness of the _____ nerve or of the muscle that raises the eyelid
third cranial nerve
Diseases like ___ and ___ can cause blepharoptosis
muscular dystrophy and myasthenia gravis
Blepharoptosis is treated with an operation to elevate the eyelid ___
If patient with blepharoptosis has myasthenia gravis, they are treated with ____
Inflammation of the conjunctiva
What is the layman's term for conjunctivitis
The mucous membrane covering the anterior portion of the eyeball and lines the eyelids
What is present in infectious conjunctivitis?
watery or hyperpurulent discharge
What are 3 causes of pink eye?
1. viral or bacterial infection from contaminated fingers/towels
2. irritation from allergies or chemicals
3. sexual contact with someone with an STI
Infection of the cornea with painful loss of surface epithelium
corneal abrasion or ulcer
Abrasions and ulcerations stain with _____, which make them easily detectable
Characterized by an opaque area on the cornea that represents the infiltrate of immune cells
What causes corneal abrasions and ulcers?
1. foreign bodies trapped between cornea and eyelid
2. ocular trauma
3. poorly fitting contact lenses
How are corneal abrasions treated?
They heal spontaneously
How are corneal ulcers treated?
immediate intensive broad-spectrum antibiotic therapy
Inflammation of the episclera characterized by redness and irritation in ONE portion of the eye
T or F. Episcleritis is usually associated with other concomitant systemic diseases
Inflammation of the deeper sclera (white outermost covering of the eyeball) characterized by intense redness in one or more areas of the sclera
What causes scleritis?
rheumatoid arthritis, Crohns, ulcerative colitis
What happens if scleritis is left untreated?
Perforation of the globe and loss of the eye can occur
How is scleritis treated?
Opacified natural lens of the eye
What causes cataracts?
4. high dose corticosteroid use
How are cataracts treated?
Depends on many factors but usually surgery when they begin to interfere with the lifestyle of the patient
What are the specific surgical procedures to treat cataracts?
1. phacoemulsification (most common: no sutures)
2. extracapsular surgery (removed in one piece)
In extracapsular surgery and phacoemulsification, the ____ is left in place to support an artificial lens
Posterior membrane becomes cloudy after surgery; a laser can be used to make an opening in the center of the cloudy membrane. What is this procedure called?
Damage to the optic nerve in the presence of elevated ocular pressure
Glaucoma is one of the major causes of ____
What are the 2 types of glaucoma
1. Chronic open-angle
2. Acute angle-closure
Most common and most treatable form of glaucoma; obstruction occurs in the trabecular meshwork
chronic open angle
Type of glaucoma that can cause complete blindness; the trabecular meshwork is covered by the root of the iris or adhesions between
the iris and the cornea
What are the 3 risk factors for glaucoma?
1. age older than 60
3. african-american descent
How is glaucoma detected?
1. intraocular pressure readings
2. optic nerve evaluations
List some causes of glaucoma.
1. ocular trauma
2. overuse of tropical steroids
3. family history
5. diabetes mellitus
Medication is given to glaucoma patient to decrease ____ and increased ____
Decrease aqueous humor and increased uveoscleral outflow
What are the 5 procedures used to treat glaucoma?
1. argon laser trabeculopasty (ALT)
2. selective laser trabeculoplasty (SLT)
3. laser iridotomy
5. beta blockers
Progressive deterioration or breakdown of the macula
In macular degeneration, ___ vision may disappear altogether when advance
Macular degeneration does not affect ___ vision
____ macular degeneration is the most common cause of blindness in white people in the US
What are 2 types of macular degeneration?
1. non-exudative (dry)
Type of MD where there are atrophic changes in the macula and drusen deposits are present
non-exudative or dry macular degeneration
Type of MD where there is presence of abnormal blood vessels beneath the retina; can cause hemorrhage
What causes macular degeneration?
degenerative changes in the pigment of the epithelium
T or F. There is no medical cure for MD
How is dry macular degeneration treated?
vitamin supplements especially vitamins C & E
How is wet macular degeneration treated?
1. traditional laser photocoagulation
2. photodynamic therapy
3. injection of antiangiogenic factors
Pathologic alterations of the retinal blood vessels and the pathologic proliferation of retinal vessels
What are the effects on retina associated with dr?
3. dilation of retinal veins
4. neovascularization (formation of abnormal new vessels)
Diabetic retinopathy occurs about __ to __ years after the onset of diabetes mellitus
8 to 10 years
What is the main cause of diabetic retinopathy?
Poor management of diabetes (however, all persons with diabetes are susceptible)
What are the 3 treatments for diabetic retinopathy?
1. laser coagulation
2. vitrectomy (vitreous hemorrhage/proliferative disease)
3. maintaining tight blood glucose control
Retinal detachment is the elevation or separation of the retina from the ___
What are the 2 main symptoms of retinal detachment?
1. light flashes
Retina is associated with which 2 diseases?
2. diabetic retinopathy
What causes retinal detachment?
fluid leaking under the retina through a retinal tear, retinal atrophy, ocular trauma
T or F> Irreversible blindness is likely if left untreated in patients with retinal detachment
How is retinal detachment treated?
1. photocoagulation and cryotherapy if no significant detachment has occurred
Inflammation of the uveal tract including the iris, ciliary body and choroid
Which autoimmune disorders cause uveitis?
1. juvenile rheumatoid arthritis
2. ankylosing spondylitis
Which infections cause uveitis
syphillis, TB, toxoplasmosis, histoplasmosis, IBS
___ agents can reduce uveitis pain associated with ciliary inflammation
Abnormal protrusion of the eyeballs
What are 5 causes of exophthalmos?
1. ENLARGED extraocular muscles
2. RETROBULBAR mass, hemorrhage or inflammation
3. EDEMA of soft tissue that lines the bony orbit of the eye
4. all THYROID conditions