SM Eyes Flashcards by Rachel Reardon

what is the first thing that should be assessed with any eye concern?

visual acuity

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when should visual acuity testing be overlooked with eye concern?

if emergent

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what are emergent eye conditions?

acute angle-closure glaucoma
papilledema
retinal detachment

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what does 20/40 vision mean?

someone else can see something at 40 ft away that you can only see at 20 ft away

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Amblyopia
-def
-common or uncommon?
-what does it impact?
-what leads to amblyopia?

-Lazy eye
-common
-impacts visual acuity
-develops in child d/t strabismus

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what is the visual acuity of a legally blind person?

20/200

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what is the test used for color blindness?

ishihara chart

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what cranial nerves are related to the eye?

CNII
CNIII
CNIV
CNVI

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-name of CNII
-how is CNII related to the eye?

-optic
-responsible for visual acuity

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-name of CNIII
-how is CNIII related to the eye?

-oculomotor
-responsible for eye movement; allows eye to focus

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-name of CNIV
-how is CNIV related to the eye?

-trochlear
-responsible for eye movement; downward and inward eye movement

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-name of CNVI
-how is CNVI related to the eye?

-abducens
-responsible for eye movement; outward or looking to the side movements

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what cranial nerve does the Snellen chart assess?

CNII

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Fundoscopic exam: normal findings
-retinal artery

-should be thinner, lighter in color than veins

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Fundoscopic exam: normal findings
-hemorrhages/cotton wool spots

no hemorrhages or cotton wool spots

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Fundoscopic exam: normal findings
-optic disc

-sharp margins; no swelling

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Fundoscopic exam: normal findings
-arteries in relation to veins

arteries should not cross over vein

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Fundoscopic exam: normal findings
-red reflex

should be present

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what is it called when optic disc is inflamed/swollen?

papilledema; refer immediately to ED (can cause blindness)

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Fundoscopic exam: abnormal findings
-HTN eye

-copper wire arterioles (arteries appear orange/yellow)
-AV nicking (artery crosses vein and causes it to bulge)
-flame hemorrhages (little hemorrhages that on exam look like flame near optic nerve

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Fundoscopic exam: abnormal findings
-HTN eye
*how can these sx by reversed?

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better HTN control

Fundoscopic exam: abnormal findings
-diabetic eye

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-cotton wool spots (white, fluffy patches seen on retina; indicates underlying vascular insufficiency or ischemia)
-neovascularization (formation of new tiny blood vessels in eye)
-microaneurysms
-dot/blot hemorrhages

Fundoscopic exam: abnormal findings
-HTN eye
*phrase to remember sx

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“That AV nicked my copper wire and it burst into flames”

Fundoscopic exam: abnormal findings
-diabetic eye
*phrase to remember sx

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“Blot had a micro amount of new cotton candy”

what two conditions make it very important that the patient receive regular eye exams?

HTN, DM

Clinical Scenario: sudden, severe eye pain, blurry vision, eye feels firm to the touch

Acute angle-closure glaucoma

Acute angle-closure glaucoma -what diagnostic test must be utilized? -manage in primary care?

-tonometry; can determine intraocular pressure -NO; refer immediately to ER or emergent ophthalmologist (can become blind)

Clinical Scenario: feels like a curtain is being pulled over field of vision -sudden, painless appearance of floaters, flashes of light, likely blurred vision

Retinal detachment

Retinal detachment -manage in primary care?

NO; refer immediately to ER or emergent ophthalmologist

-what causes is areus senilis? -what causes xanthelasma? -if seen in young person, what does that indicate? what labs should you order? how does this impact meds? -if seen in older person, what does that indicate?

-high cholesterol -high cholesterol -familial hyperlipidemia; lipid panel = higher doses of statin will be needed to control cholesterol -more benign; doesn't usually require tx

what is pterygium?

benign non-cancerous overgrowth of conjunctiva; may have minor eye redness or irritation; overall pretty asymptomatic

pterygium vs pinguecula

-pterygium: encroaches on actual cornea; will clear on its own w/o tx; benign non-cancerous overgrowth of conjunctiva; may have minor eye redness or irritation; overall pretty asymptomatic -pinguecula: will not go over/into cornea

Hordeolum -another name? -def -what is this usually caused by? -tx

-stye -sudden onset, localized inflamed eyelid; possible purulent eye drainage -usually caused by infection ie staph aureus -warm compress + abx *not chalazion

Chalazion -def -tx

-sudden onset, localized inflamed eyelid; blockage of duct -warm compress *not stye

what is another name for conjunctivitis?

adenoviral conjunctivitis

-what are the three types of conjunctivitis? -what type has bilateral presentation? -what type has unilateral presentation (then spreads to other eye)?

-bacterial, viral, allergic -allergic -viral or bacterial

-type of drainage associated with conjunctivitis *bacterial *viral *allergic

-purulent -serous/watery drainage -serous/watery drainage; more stringy and ropey

lymph node enlargement related to conjunctivitis type *bacterial *viral *allergic

-no lymph node involvement -preauricular or submandibular -cervical

Clinical Scenario: 80YO, many sx night driving; bilateral leukocoria present (white reflex; no RR)

cataracts

what is leukocoria?

white reflex (no RR)

Clinical Scenario: central vision loss

Macular degeneration

-what age group is macular degeneration seen in? -tx?

-seen more commonly as people age -lifestyle modification (once sx start to occur = larger print)

Clinical Scenario: occurs in middle age (older than 40yrs); "suddenly my arms are too short"

Presbyopia (can't see up close objects well)

-What is presbyopia? -tx?

-can't see up close objects well -reading glasses

Clinical Scenario: eye irritation after suffering from Bell's Palsy episode -occurs when eye is not lubricated well

corneal abrasion

-how is a corneal abrasion dx?

dx with fluorescein staining --> abrasion takes up the dye and glows in black light

Clinical Scenario: wears contacts; today has cloudiness and blurry vision concerns -unable to hold eye open (cannot recall eye injury) -cornea is red, inflammed

Keratitis (caused by bacterial infection)

Can keratitis be treated in primary care setting?

NO; refer immediately to ophthalmologist

Clinical Scenario: eye pain; sensitivity to light; not able to see as well as normal -entire eye is red; inflammation/swelling or iris when looking closer

iritis (type of uveitis)

can iritis (type of uveitis) be treated in primary care setting?

NO; refer to ophthalmology (can lead to permanent blindness)

Clinical Scenario: broken blood vessels on sclera of eye -typically occurs after trauma, but could be from no trauma

subconjunctival hemorrhage *asymptomatic outside of red appearance

-tx for subconjunctival hemorrhage? -what can cause subconjunctival henorrhage?

-typically resolves spontaneously; if bothersome, could utilize artificial tears -repetitive sneezing, vomiting, or facial pressure

SM Eyes Flashcards

(52 cards)