Eent

Front 1

the eye consists of three concentric layers called:

Back 1

tunics

Front 2

The ________ layer is a tough, fibrous layer consisting of the sclera and the cornea

Back 2

external tunic

Front 3

The ________ layer is the vascular layer consisting of the choroid, the ciliary body, and the iris.

Back 3

middle tunic

Front 4

The ______ layer is the nerve tissue layer making up the retina.

Back 4

inner tunic

Front 5

the opaque, white portion of the globe

Back 5

sclera

Front 6

The corneal-scleral junction is the area where the transparent collagen bundles of the cornea transition to the white opaque fibers of the sclera.

In this region, the ___________ drains fluid from the anterior chamber of the eye and communicates with the venous system

Back 6

Canal of Schlemm

Front 7

The __________ consists of three bundles of smooth muscle fibers called the ________ muscles which provide visual accommodation (changing the curvature of the lens to permit focus adjustments for near and far objects).

Back 7

ciliary body, ciliary

Front 8

When the eye is at rest or focused on distant objects, the lens is _________.

Back 8

stretched

Front 9

To focus on near objects, the ciliary muscles contract and the lens becomes __________ thus keeping the object in focus.

Back 9

thicker

Front 10

The ____consists of pigment to prevent the passage of light except through the _____, which is the opening in the center of the iris.

Back 10

iris, pupil

Front 11

The optic disc is where the optic nerve enters the eyeball, and is about _____ mm in diameter.

Back 11

1.5 mm

Front 12

The anterior chamber is the space between the cornea, iris, and lens.

It contains a protein-rich, blood plasma filtrate called the _________which nourishes the lens.

It drains through the Canal of ___________.

Back 12

aqueous humor, Canal of Schlema

Front 13

Glaucoma results from increased intraocular pressure due to obstruction of the outflow of _______

Back 13

aqueous humor

Front 14

The posterior chamber is the space behind the lens, surrounded by the retina.

It is filled with a gelatinous substance called the _________________

Back 14

vitreous humor (or vitreous body).

Front 15

The ______are the receptors utilized when low levels of light are present, and are responsible for night vision and peripheral vision.

The ________ permit better visual acuity than do the _____, and also permit color vision.

Back 15

rods, cones, rods

Front 16

The __________ is the outer corner of the eye.

The __________ is the inner corner of the eye.

Back 16

lateral canthus, medial canthus

Front 17

The _______ is the outer edge of the iris, where the cornea stops.

Back 17

limbus

Front 18

The opening between the eyelids is called the ________.

Back 18

palpebral fissure

Front 19

The ________________ covers the inner aspect of the lid.

Back 19

palpebral conjunctiva

Front 20

The _____________ covers the sclera over the globe.

Back 20

bulbar conjunctiva

Front 21

The ___________ is the site of central vision and color perception. It lies lateral to the optic disc.

Back 21

macula or fovea

Front 22

_____________ occurs when the patient shifts focus from a distant object to a near object and the pupils constrict and the curvature of the lens is changed to adjust.

Back 22

Accomadation

Front 23

Convergence refers to the slight coming together of the eyes when the focus is shifted from far to near.

Back 23

Convergence

Front 24

__________ is excessive tearing of the eye.

Back 24

Epiphora

Front 25

___________ is inflammation of the cornea.

Back 25

Keratitis

Front 26

____________ is a thin, gray-white arc or circle, not quite at the edge of the cornea, caused by lipid deposits.

Back 26

Arcus senilis

Front 27

__________ occurs when the eye returns to midline from the medial side when uncovered.

Back 27

Esotropia

Front 28

___________ occurs when the eye returns to midline from the lateral side when uncovered.

Back 28

Exotropia

Front 29

_________ (crossed-eyes) is a manifest lack of parallelism of the visual axis of the eyes, resulting in the absence of binocular fixation.

Back 29

Strabismus

Front 30

__________ (“lazy eye”) is caused by a disruption of the normal development of vision, that results in reduced visual acuity not correctable by refractive means.

It may develop in children when visual information from one eye is blurred or conflicts with the information from the other eye.

The information from the ________ eye is ignored by the brain, which selects the better image and suppresses the blurred image, resulting in faulty development of vision in the affected eye.

Back 30

Amblyopia, amblyopic

Front 31

____________ measures intraocular pressure
There are two commonly used types:
1. Shioetz Tonometer
2. Tonopen

Back 31

tonometry

Front 32

Normal intraocular pressure (IOP) is:

Back 32

10 to 24 mm Hg

Front 33

A ___________ is an instrument consisting of a microscope combined with a rectangular light source that can be narrowed into a slit.

Back 33

slitlamp

Front 34

_____________ is a flat, slightly raised, irregularly shaped, yellow tinted lesion on the periorbital tissues that represents depositions of lipids.

Back 34

xanthelasma

Front 35

___________ is swelling of the bulbar conjunctiva, forming a swelling around the cornea.

Back 35

Chemosis

Front 36

O.D. = “oculus dexter” = _____
O.S. = “oculus sinister” =__ O.U. = “oculus uterque” = __

Back 36

right eye, left eye, each eye

Front 37

_________ is the most frequently encountered symptom of ocular disorders.

It is due to hyperemia of the conjunctival, episcleral, or ciliary vessels; erythema of the eyelids; or subconjunctival hemorrhage.
The major differential diagnoses are conjunctivitis, corneal disorders, acute glaucoma, and acute uveitis

Back 37

Redness

Front 38

________ pain may be caused by trauma, (chemical, mechanical, or physical), infection, inflammation, or sudden increase in intraocular pressure.

Back 38

ocular

Front 39

_____________ is most commonly due to corneal or conjunctival foreign bodies.

Back 39

foreign body sensation

Front 40

Other causes are disturbances of the corneal epithelium and rubbing of eyelashes against the cornea. (This is referred to as ___________.)

Back 40

trichiasis

Front 41

___________ is eye pain or sensitivity to light, and is commonly due to corneal inflammation or iritis.

A less common cause is fever associated with various systemic infections

Back 41

photophobia

Front 42

_________ is characteristically associated with allergic eye disease.

Back 42

itching

Front 43

These two symptoms are due to dryness of the eyes are common complaints of older people, but may occur at any age.

Deficiency of tear film components may be due to dry environment, local ocular disease, systemic disorders such as Sjogren’s disease, or drugs such as atropine-like agents.

Back 43

scratching and burning

Front 44

__________ is usually due to inadequate tear drainage through obstruction of the lacrimal drainage system or malposition of the lower lid.

Reflex tearing occurs with any disturbance of the corneal epithelium.

Back 44

watering

Front 45

__________ discharge usually indicates bacterial infection of the conjunctiva, cornea, or lacrimal sac.

Back 45

purulent

Front 46

___________ discharge usually indicates viral conjunctivitis or keratitis.

Back 46

watery

Front 47

______________ usually is a result of allergic conjunctivitis.

Back 47

tearing, ropy discharge, and itching

Front 48

__________ is discomfort associated with prolonged reading or close work.

Refractive error, __________ (the physiologic loss of accommodation in the eyes due to advancing age), inadequate illumination, and latent ocular deviation are causes, as are corneal inflammation, iritis, and acute glaucoma.

Back 48

eyestrain, presbyopia

Front 49

__________ may be a result of refractive error, cataract, macular degeneration, diabetic retinopathy, vitreous hemorrhage, retinal detachment involving the macula, central retinal artery or vein occlusion, corneal opacities, and optic nerve disorders.

Back 49

Blurred vision

Front 50

An individual is visually impaired if the best corrected distant visual acuity in the better eye is _________, or if the visual fields are significantly restricted.

Back 50

20/80 or less

Front 51

Legal blindness is defined as visual acuity for distant vision of ___________in the better eye with best correction.

Back 51

20/200 or less

Front 52

The leading causes of blindness in the United States are :

Back 52

glaucoma, diabetic retinopathy, and macular degeneration.

Front 53

_________(double vision) typically results from extraocular muscle imbalance.

Back 53

diplopia

Front 54

_________ (spots before the eyes) are often caused by benign vitreous opacities.

However, they may also be caused by posterior retinal detachment, vitreous hemorrhage, or posterior uveitis.

Back 54

floaters

Front 55

Sudden onset of floaters, particularly when associated with flashing lights (________), necessitates dilated fundal examination to exclude a retinal tear or detachment

Back 55

photopsia

Front 56

A corrected acuity of less than ________ is abnormal.

Back 56

20/30

Front 57

In room lighting, the normal diameter of the pupils is __________.
A large and poorly reactive pupil may be due to third nerve palsy, iris damage caused by acute glaucoma, or pharmacologic mydriasis.

Physiologic anisocoria is defined as pupillary inequality of less than ____ mm.

It is present in about 20% of normal people, and it’s considered benign if pupillary reactions are normal.

Back 57

3 to 5 mm, 0.5 mm

Front 58

Pupil size should be compared in both light and dark.

In physiologic anisocoria, the pupil size disparity is the same in light as it is in dark.

Anisocoria that is greater in ____ light suggests that the smaller pupil is abnormal (cannot dilate), and it is caused by an interruption of the sympathetic nerve supply …

… while anisocoria that is greater in bright light suggests that the larger pupil is abnormal (cannot constrict), and it is caused by impaired parasympathetic nerve supply to the iris.

Back 58

dim, sympathetic, bright, parasympathetic

Front 59

__________ pupils are small, irregular pupils that accommodate but do not react to light, seen in central nervous system syphilis

Back 59

Argyll Robertson

Front 60

____________ (tonic pupil) is an idiopathic unilateral process where a pupil is large with severely reduced and slow reaction to light. It is often seen with asymmetrically decreased deep tendon reflexes.

Back 60

Adie's pupil

Front 61

The anterior chamber should be examined for __________ (blood in the anterior chamber).

Back 61

hyphema

Front 62

A sudden loss of vision requires _________ ophthalmologic consultation.

Important causes of a sudden loss of vision in an uninflamed eye are vitreous hemorrhage, retinal detachment, exudative age-related macular degeneration, retinal artery or vein occlusions, anterior ischemic optic neuropathy, giant cell arteritis (temporal arteritis), and optic neuritis.

Other ophthalmologic emergencies include orbital cellulitis, gonococcal keratoconjunctivitis, and ocular trauma.

Back 62

emergency

Front 63

Additionally, the following conditions require immediate referral to an ophthalmologist:

1. an eye that is getting progressively _____ and more inflamed after ocular surgery (this indicates infection)
2. a _______ spot on the cornea (this indicates a corneal ulcer)
3. a “____ hard” globe (this indicates acute angle- closure glaucoma)

Back 63

redder, white, rock

Front 64

__________ are the most common cause of blurred vision.

In __________ (the normal state), objects at infinity are seen clearly with the unaccommodated eye; objects nearer than infinity are seen with the aid of accommodation, which increases the refractive power of the lens

Back 64

refractive errors, emmetropia

Front 65

____________ (farsightedness), is a defect in vision in which parallel rays come to a focus ______ the retina as a result of flattening of the globe of the eye or of an error in refraction.

Back 65

hyperopia, behind

Front 66

Hyperopia (farsightedness) is corrected with a _________ lens.

Back 66

plus / convex

Front 67

The _______ globe associated with hyperopia is best examined using the positive black or green numbers on the ophthalmoscope (turning clockwise from zero).

Back 67

short

Front 68

In _________ (nearsightedness), the unaccommodated eye brings into focus images of objects closer than infinity, while objects beyond this distance cannot be seen without the aid of corrective lenses.

Back 68

myopia

Front 69

Myopia is corrected with _________ lenses.

Back 69

minus / concave

Front 70

The _________ globe associated with myopia is best examined using the negative red numbers on the ophthalmoscope (turning counter-clockwise from zero

Back 70

long

Front 71

In __________, the refractive errors in the horizontal and vertical axes differ

Back 71

astigmatism

Front 72

_________ is the natural loss of accommodative capacity with age.

It is corrected with plus lenses for near work.

Back 72

Presbyopia

Front 73

A __________ is an acute development of a small abscess within a gland of the upper or lower eyelid of one eye (most commonly the upper eyelid).

Back 73

hordeolum

Front 74

The causative pathogen is typically Staphylococcus aureus.

It is not contagious.

It is characterized by the acute onset of pain and edema of the involved eyelid.

Increasing tearing and redness of the involved eye may occur.

There is a palpable, indurated area in the involved eyelid, which has a central area of purulence with surrounding edema.

Back 74

hordeolum

Front 75

An internal hordeolum is a __________ gland abscess that is situated deep from the palpebral margin, and points onto the conjunctival surface of the lid.

Back 75

meibomian

Front 76

An external hordeolum, also known as a sty, is smaller and is caused by inflammation and infection of the glands of __________, with abscess formation in those glands.

It is situated immediately adjacent to the edge of the palpebral margin (in the lid margin).

Back 76

Moll or Zeis

Front 77

The chief symptom is pain of an intensity directly related to the amount of swelling.

Back 77

hordeolum

Front 78

Warm compresses are helpful and should be applied intermittently for 48 hours.

Incision and drainage may be indicated if resolution does not begin within 48 hours.

An antibiotic ointment such as bacitracin or erythromycin, applied to the eyelid every 3 hours, may be beneficial during the acute stage.

Internal _________ may lead to generalized cellulitis of the lid.

Back 78

hordeolum

Front 79

_________ is a common granulomatous inflammation of a meibomian gland that may follow an internal hordeolum.

It is a painless, hard lesion on the upper or lower lid, deep from the palpebral margin, characterized by insidious onset with minimal irritation.

Back 79

chalazion

Front 80

It can become pruritic and can cause erythema of the involved eye and lid.

The conjunctiva in the region of the ________ is red and elevated.

Back 80

chalazion

Front 81

If the _________ is large enough to impress the cornea, vision will be distorted.

Treatment involves referral to an ophthalmologist for elective excision.

Back 81

chalazion

Front 82

__________ is a common chronic bilateral inflammatory condition of the lid margins.

Symptoms are irritation, burning, and itching.

Vision is not impaired.

Eyelashes adhere together.

The conjunctiva is clear or slightly erythematous.

Back 82

blepharitis

Front 83

Anterior ___________ involves the eyelid skin, eyelashes, and associated glands.

It may be ulcerative, because of infection by staphylococci, or seborrheic, and associated with seborrhea of the scalp, brows, and ears.

Back 83

blepharitis

Front 84

The eyes are "red-rimmed" and scales and granulations can be seen clinging to the lashes.

Back 84

blepharitis

Front 85

In anterior ________, cleanliness of the scalp, eyebrows, and lid margins is effective local therapy.

Scales must be removed from the lids daily with a damp cotton-tipped applicator and baby shampoo.

An anti-staphylococcal antibiotic eye ointment such as bacitracin or erythromycin is applied daily to the lid margins with a cotton-tipped applicator.

Back 85

blepharitis

Front 86

Posterior ___________ involves the eyelids secondary to dysfunction of the meibomian glands.

There may be bacterial infection, particularly with staphylococci, or primary glandular dysfunction, in which there is a strong association with acne rosacea.

Back 86

blepharitis

Front 87

In __________, the lid margins are hyperemic with telangectasias; the meibomian glands and their orifices are inflamed, with dilation of the glands, plugging of the orifices, and abnormal secretions.

The lid margin is frequently rolled inward to produce a mild entropion, and the tears may be abnormally frothy and greasy

Back 87

posterior blepharitis

Front 88

In mild __________, regular meibomian gland expression may be sufficient to control symptoms.

Inflammation of the conjunctiva and cornea indicates a need for more active treatment …

… long-term low-dose systemic antibiotic therapy, usually with tetracycline (250 mg twice daily), doxycycline (100 mg daily), or erythromycin (250 mg three times daily), and short-term topical steroids.

Back 88

posterior blepharitis

Front 89

__________ is defined as an inward turning (inversion) of the eyelid and lashes (usually the lower).

Back 89

Entropion

Front 90

It occurs occasionally in older people as a result of degeneration of the lid fascia, or may follow extensive scarring of the conjunctiva and tarsus, or spasm of the orbicularis oculi muscles.

Surgery is indicated if the lashes rub on the cornea, cause excessive tearing, or cosmetic distress.

Back 90

entropion

Front 91

is defined as an outward turning (eversion) of the lower lid.

Back 91

ectropion

Front 92

It is common with advanced age, trauma, infection, or palsy of the facial nerve.

Surgery is indicated if there is excessive tearing, exposure keratitis, or a cosmetic problem.

Back 92

ectropion

Front 93

__________ is infection and inflammation of the lacrimal sac due to obstruction of the nasolacrimal system.

It may be acute or chronic, and occurs most often in infants and in persons over the age of 40.

It is usually unilateral.

Back 93

dacryocystitis

Front 94

In acute ____________, the usual infectious organisms are Staphylococcus aureus, and Beta-hemolytic streptococci.

In chronic _____________ , Staphylococcus epidermidis, anaerobic streptococci, and, or Candida albicans are the usual infectious organisms.

Back 94

dacryocystitis, dacryocystitis

Front 95

In chronic __________, tearing and discharge are the principle signs, and mucus or pus may also be expressed.

It may be kept latent with antibiotics, but relief of the obstruction is the only cure.

Back 95

dacryocystitis

Front 96

Congenital ___________ duct obstruction is common in the newborn after the first month of life, and occurs when the duct does not open.

It often resolves spontaneously by the age of 9 months.

Treatment includes warm compresses and massage.

If no resolution, it can be treated by surgical probing of the nasolacrimal system.

Back 96

nasolacrimal

Front 97

__________ is an uncommon condition involving acute inflammation of the lacrimal gland.

Symptoms are localized to the outer one-third of the upper eyelid, and include swelling, conjunctival chemosis, pain, erythema, tenderness, and tearing

Back 97

dacryoadenitis

Front 98

Acute infections may demonstrate ipsilateral preauricular lymphadenopathy and fever.

Associated organisms include Staphylococcus aureus, Neisseria gonorrhoeae, Epstein-Barr virus, influenza virus and herpes zoster virus.

Back 98

dacryoadenitis

Front 99

Acute ___________ is most often seen in children as a complication of mumps, measles, or influenza.

In adults, it is associated with gonorrhea, lacrimal gland trauma, or as a retrograde infection from bacterial conjunctivitis.

Chronic ___________ may be seen with lymphoma, leukemia, tuberculosis, and sarcoidosis.

Back 99

dacryoadenitis, dacryoadenitis

Front 100

In the setting of acute bacterial infection, oral antibiotics such as amoxicillin-clavulanate (Augmentin) are given in mild to moderate cases.

In moderate to severe infections, IV antibiotics such as ticarcillin-clavulanate (Timentin) may be necessary.

Proptosis and limitation of ocular motion require an urgent CT scan and ophthalmology evaluation for orbital cellulitis.

Back 100

dacryoadenitis