Vision

Question 0

Gradual, chronic, painless loss of peripheral vision. Night glares, cloudiness.

Answer 0

Cataracts

Question 1

Components of eye exam for vision loss? (3)

Answer 1

confrontational visual fields
pupil reactivity
dilated fundus exam

Question 2

vision loss, increased cup to disc ratio

Answer 2

glaucoma

Question 3

which glaucoma is painful?

Answer 3

acute angle closure glaucoma

Question 4

floaters, photopsias, curtain-like loss of vision

Answer 4

retinal detachment

Question 5

on physical exam: raised, whitish retina, rather than yellow

Answer 5

Retinal detachment

Question 6

Retinal detachment can be associated with? 2

Answer 6

myopia

diabetes

Question 7

central vision loss

Answer 7

macular degeneration

Question 8

degeneration of photoreceptors and their supporting structures

Answer 8

macular degeneration

Question 9

painless, gradual/acute blurred vision, wavy/distorted vision, central scotoma

Answer 9

macular degeneration

Question 10

central scotoma with debris upon fundoscopic exam

Answer 10

Dry macular degeneration

Question 11

central scotoma w/ neovascularization

Answer 11

wet macular degeneration

Question 12

characteristic sign of dry macular degeneration

Answer 12

Drusen bodies on funduscopic exam

Question 13

acute, painless, total loss of vision

Answer 13

Central retinal artery occlusion

Question 14

on exam: no light perception, afferent pupillary defect, white retina, cherry red spot in the macular area

Answer 14

Central Retinal Artery Occlusion

Question 15

etiology of central retinal artery occlusion

Answer 15

embolus- originated elsewhere

Question 16

acute, variable painless loss of vision

Answer 16

Central retinal vein occlusion

Question 17

variable vision, +/- afferent pupillary defect, “blood and thunder” retinal appearance

Answer 17

Central retinal vein occlusion

Question 18

No symptoms, hx HTN

Answer 18

Hypertensive retinopathy

Question 19

Hypertensive retinopathy fundoscopic findings (multiple)

Answer 19

copper wiring (arteriolar narrowing), silver wiring (arteriolar sclerosis)
A:V nicking
cotton-wool spots, retinal hemorrhages, other exudates
disc edema

Question 20

Hypertensive retinopathy tx (2)

Answer 20

BP control

refer if vision loss or exudates

Question 21

non-proliferative/proliferative retinopathy
+
macular edema

Answer 21

diabetic retinopathy

Question 22

hemorrhages, exudates/etc and neovascularization

Answer 22

Diabetic retinopathy

Question 23

traction retinal detachment pathophysiology

Answer 23

neovascularization- vessels pull away —> retinal detachment

Question 24

diabetic retinopathy tx

Answer 24

control blood sugar | refer w/ vision loss

Question 25

chronic itching, burning, scratching. Worse in AM. No vision decrease. Erythema, inflammation of the eyelid

Answer 25

Blepharitis

Question 26

Blepharitis txs

Answer 26

Warm compress Baby shampoo wash- clean off crusts Antibiotics/steroids for secondary infection

Question 27

acute onset of pain, swelling. Warm, erythemic, tender. +/- systemic sxs, +/- vision changes

Answer 27

cellulitis

Question 28

cellulitis tx

Answer 28

systemic abx

Question 29

when to refer for cellulitis?

Answer 29

Orbital involvement- EOM involvement, decreased eye movement

Question 30

chronic itching, burning, scratching. "Tired eye". Vision fluctuation

Answer 30

Dry eye

Question 31

dry eye etiology

Answer 31

deficient aqueous tear production

Question 32

dry eye tx

Answer 32

artificial tears/ointments | In severe cases: topical cyclosporin

Question 33

acute onset, bilateral, itching/burning/general irritation, moderate to severe injection, watery discharge, possible URI sxs, preauricular lymphadenopathy

Answer 33

viral conjunctivitis

Question 34

acute onset, unilateral, burning/general irritation, moderate to severe injection, mucopurulent discharge, ~adherent lids

Answer 34

bacterial conjunctivitis

Question 35

chronic/seasonal onset, bilateral, itching, mild-moderate injection, stringy/mucoid discharge, chemosis (edema)

Answer 35

allergic conjunctivitis

Question 36

viral conjunctivitis tx

Answer 36

artificial tears, vasoconstrictors, warm compress

Question 37

bacterial conjunctivitis tx

Answer 37

antibiotic drops

Question 38

allergic conjunctivitis tx

Answer 38

artificial tears | antihistamine drops

Question 39

components of problem-focused Red Eye exam

Answer 39

``` visual acuity tonometry slit lamp (pen light) exam ```

Question 40

painless blood in the conjunctiva, no vision effect

Answer 40

Subconjunctival hemorrhage

Question 41

subacute onset of foreign body sensation, pain, inflammation of episcleral/scleral tissue

Answer 41

Episcleritis

Question 42

acute onset of pain, foreign body sensation

Answer 42

corneal abrasion

Question 43

corneal abrasion tx

Answer 43

topical lubricants topical antibiotics Never topical anesthetics

Question 44

chemical injury tx

Answer 44

Irrigate! and refer quickly

Question 45

acute onset of pain/foreign body sensation w/ associated event. Vision usually unchanged. Foreign body present

Answer 45

Corneal foreign body

Question 46

Corneal foreign body tx

Answer 46

remove if simple- be careful of causing more damage lubricant and/or antibiotic drops refer for follow up

Question 47

acute onset of pain, mucous discharge. Vision decreased. White infiltrate

Answer 47

keratitis/corneal ulcer

Question 48

keratitis/corneal ulcer tx

Answer 48

topical antibiotics | refer

Question 49

keratitis/corneal ulcer pathophysiology

Answer 49

infection of the cornea

Question 50

dendritic pattern on keratitis- etiology & tx

Answer 50

HSV, antivirals | never steroids

Question 51

ciliary flush, acute onset photophobia, +/- vision decrease | inflammation of the uveal tissue

Answer 51

Iritis/Uvetis

Question 52

Iritis/uveitis tx

Answer 52

Refer- never give steroids

Question 53

acute pain, photophobia due to pressure on the iris, +/- vision loss. Layered heme in iris

Answer 53

Hyphema

Question 54

Hyphema etiology

Answer 54

blood in anterior chamber

Question 55

Hyphema tx

Answer 55

eye shield, bed rest. Control intraocular pressure Refer

Question 56

which is better: eye shielding or patching?

Answer 56

Eye shielding- less risk of increased infection/injury due to fibers or scratching

Question 57

acute decrease in peripheral vision, halos around lights. pain.

Answer 57

glaucoma

Question 58

"steamy" cornea, mid-dilated pupil (reacts slowly), circumlimbal injection

Answer 58

Glaucoma

Question 59

glaucoma physical exam findings

Answer 59

shadowing on penlight exam due to loss of anterior chamber

Question 60

more common form of glaucoma, less painful | & tx

Answer 60

open angle glaucoma is less acute, less painful | controlled by medication