Pathologies of eyes and anatomy

Question 1

What are the 7 bones that support/stabilize and protect the eye?

Answer 1

1. Frontal bone
2. Ethmoid bone
3. Lacrimal bone
4. Maxilla
5. Palatine bone
6. Zygomatic bone
7. Sphenoid bone

Question 2

External anatomy for eyelids/eyelashes

Answer 2

1. protection > skin > protect us from external foreign bodies
2. moist> blink 5” > H20, oil
3. exposure> light/heat

Question 3

pupil is known as

Answer 3

the gateway of light

Question 3

iris is known as

Answer 3

controlling the amount of light, controls constriction/dilation

Question 4

cornea is known as

Answer 4

anterior protectionary piece, and the first contact of light

Question 5

There are two types of photoreceptors

Answer 5

1. cones (sharp, central, color vision)
2. rods (night black/white, peripheral vision)
   - these create the optic nerve

Question 6

We have the ability to see due to the ____, which transfers visual information from the retina to the vision centers of the brain via electrical impulses

Answer 6

Optic nerve

Question 7

Anterior cavity

Answer 7

• contains aqueous humor
• going to extend from the cornea, iris and the lens

Question 8

Posterior cavity

Answer 8

• contains vitreous humor

Question 9

Anterior chamber

Answer 9

going to extend from the cornea to the iris

Question 10

Posterior chamber (creates the anterior cavity)

Answer 10

going to extend from the iris to the back of the lens

Question 11

the conjuctiva is

Answer 11

thin covering of the eye and eyelids

Question 12

6 muscles that drive the eye

Answer 12

1. lateral rectus
2. medial rectus
3. superior rectus
4. inferior rectus
5. inferior oblique
6. superior oblique

Question 13

Lateral rectus is

Answer 13

move the eye laterally

Question 14

medial rectus is

Answer 14

move eye medially

Question 15

superior rectus is

Answer 15

move eye up

Question 16

inferior rectus is

Answer 16

move eye down

Question 17

inferior oblique is

Answer 17

move eye up & laterally

Question 18

superior oblique is

Answer 18

move eye down & laterally

Question 19

what are the 3 cranial nerves of the muscular anatomy of the eye?

Answer 19

1. oculomotor
   - medial, superior, inferior rectus & inferior oblique
2. trochlear
   - superior oblique
3. abducens
   - lateral rectus

Question 20

What are the immediate referral when doing inspection of the eye?

Answer 20

Photophobia= tolerate light
Diplopia= double vision
Hyphema= blood in anterior chamber
ROM= limite
Abnormal= pupil Rxn

Question 21

Inspection of the Periorbital area and globe

Answer 21

1. Discoloration
   - hematoma (skin surrounding eye swells easily “black eye”
2. Gross deformity
   - lacerations
   - gross bony deformity (step-off, piano key sign)
3. eyelids
   - swelling, ecchymosis, laceration, stye
4. cornea
   - cloudiness= intraocular pressure (immediate referral) hyphema

Question 22

What is 20/20 vision

Answer 22

patient’s ability to read at 20ft what normal person could read at 20ft (emmertropia)

Question 23

What is 20/40 vision

Answer 23

patient’s ability to read at 40ft what normal could read at 20

Question 24

What is myopia

Answer 24

nearsightedness (light rays focused in front of retina)

Question 25

What is hyperopia

Answer 25

farsightedness (light rays focused behind retina)

Question 26

Conjunctivitis (infection)

Answer 26

Viral or bacterial infection= "pink eye" (viral is most common) - Pain: mild discomfort, not really pain - Vision: temporary mild blurring due to discharge - Discharge: watery (viral), mucoid (bacterial) - Pupil: not affected - Cornea: clear

Question 27

Treatment for conjuctivitis

Answer 27

-bacterial: antibiotic drops, (typically more pain), warm compress - viral: warm or cold compress or artificial tears (found in pharmacies), optometrist may prescribe anti-inflammatory drops, antihistamine if viral

Question 28

Stye pathology

Answer 28

acute, purulent infection of the oil glands of the eyelid or eyelash follicles due to clogging

Question 29

Stye s/s

Answer 29

-redness, tenderness and pain - irritated or "scratchy" - common to have small, yellowish pus in the area (staph)

Question 30

Treatment for stye

Answer 30

Application of warm compress or washcloth to affected area for 10-15 minutes, 4x/day to assist w/drainage

Question 31

Subconjunctival hematoma etiology

Answer 31

trauma, bleeding disorder, high blood pressure, Vasalva maneuver (sneezing, coughing) - pain: absent - vision: not affected - Discharge: absent - Pupil: not affected - Cornea: clear

Question 32

Referral criteria for subconjunctival hematoma

Answer 32

pain, changes in vision (diplopia), altered pupil

Question 33

Treatment for subconjuctival hematoma

Answer 33

artificial tears 4x daily to irrigate

Question 34

Corneal injury or infection

Answer 34

- Abrasion: trauma from sport, removing contacts - pain: moderate to severe (7-10 scale) - vision: usually decreased - Discharge: watery - Pupil: not affected - Cornea: divot, cloudy (fluorescence swab to detect)

Question 35

Corneal Abrasion typical presentation (s/s)

Answer 35

- photophobia - watering - foreign body sensation - gritty feeling - pain

Question 36

Corneal Abrasion management

Answer 36

- ophthalmologist Rx topical antibiotic and analgesic - do not wear contacts -eye patch PRN

Question 37

Corneal laceration treatment

Answer 37

- cover w/gauze - refer - copious irrigation

Question 38

Orbital "blowout" fracture

Answer 38

s/s: swelling, ecchymosis, diplopia (especially on upward gauze)

Question 39

Orbital socket

Answer 39

with blunt trauma, maxillary bone fractures downward most often and orbital content herniate down into underlying maxillary sinus, creating a "blowout" fracture

Question 40

Orbital socket s/s

Answer 40

enopthalmia, entrapment of inferior rectus muscle (prohibiting superior rectus from upward rotation)

Question 41

Acute iritis pathology

Answer 41

inflammatory reaction in anterior chamber

Question 42

Acute iritis etiology

Answer 42

typically blunt trauma, chemical burn, but also idiopathic

Question 43

Acute iritis

Answer 43

-pain: moderate deep ache, pressure - Vision: decreased - discharge: absent - Pupil: may be small and irregular, sluggish in reacting (may be photophobic) - Cornea: clear or slightly cloudy

Question 44

Acute iritis significance

Answer 44

may be due to ocular or systemic disorder (rheumatoid arthritis)

Question 45

Acute iritis management

Answer 45

typically referral for corticosteroid eyedrops

Question 46

Retinal detachment

Answer 46

- may cause "floaters" (vitreous humor dislodges from retina) - refer to emergency dept for ophthal consult if patient photopsia: starts to see floaters, flashes of light and dark shadows

Question 47

Hyphema

Answer 47

- accumulation of blood in the anterior part of the eye that may cover the iris and pupil - usually result of ruptured iris root vessel - ophthalmologist consult (eye shield)

Question 48

Foreign body (benign)

Answer 48

- do not remove! - copiously irrigate eye with clean, warm water to remove object and relieve symptoms - reassure patient calmly - apply loose bandage and cover object if small -REFER

Question 49

S/s of optic nerve damage

Answer 49

Blurred vision - failure to code impulses for transmission to brain for interpretation Abnormal peripheral vision Interpretation problems - altered information presented to brain Decreased constriction (PEARL= oculomotor mostly; optic is afferent supply) - Photophobia

Question 50

Differential Dx for eyesight loss

Answer 50

Damage to one optic nerve - between eye and chiasm - optic nerves have not converged, so sight loss in only one eye Damage at the optic chiasm - located where two nerves meet, so loss occurs in peripheral vision (pt. can see straight ahead but not to side) Damage closer to the brain - between chiasm and brain - part of visual field will be lost in both eyes