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96 Cards in this Set
- Front
- Back
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external eye structures
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lacrimal gland
lacrimal sac inner canthus outer canthus conjuctiva limbus pupil iris nasolacrimal duct caruncle lower lacrima puctum |
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three layers / tunica of the eye
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1. external - sclera and cornea
2. middle layer - choroid, ciliary body, iris 3. inner layer - retina |
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ciliary body
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three bundles of muscle fibers provide visual accommodation
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optic disc
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where optic nerve enters eyeball
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Aqueos humor
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anterior chamber (between cornea, iris, and lens)
nourishes the lens |
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canal of schlemm
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drains the anterior chamber of the eye
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Vitreous humor
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gelatinous substance that fills the posterior chamber of the eye
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Retina
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inner most tunica
made of photosensitive cells - rods and cones |
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rods
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receptors for low levels of light
responsible for night vision |
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cones
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better visual acuity
color vision |
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Eye anatomy
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optic disc - blind spot
retina - choriod - sclera = three tunics (inside out) macula vitreous body ciliary muscle iris pupil corenea lens anterior chamber with aqueus humor conjuctiva |
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limbus
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outer edge of iris
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lateral and medial canthus
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two corners of the eye
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palpebral fissure
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opening between the eyelids
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palpebral conjuctiva
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covers the inner aspect of the eye lids
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bulbar conjunctiva
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covers the sclera over the globe
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macula = fovea
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site of central vision and color perception.
lateral to the optic disc |
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accomodation
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curvature of lens changes to adjust to distance of objects
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convergence
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slight coming together of the eyes when the focus is shifted from far to near
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epiphora
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excessive tearing of the eye
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keratitis
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inflamation of the cornea
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arcus senilis
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thin gray-white arc or circle around the iris cornea border caused by lipd deposits
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esotropia
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eye returns to midline from medial side
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exotropia
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eye returns to midline from the lateral side
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strabismuss
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cross-eyes
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ambylopia
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aka lazy eye
caused by a disruption of normal development of vision |
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tonometry
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measures intraocular pressure
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normal intraocular pressure
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10-24 mmHg
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xanthelasma
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flat, slightly raised irregularly shaped, yellow tinted lesion on the periorbital tissue that represents depositions of lipids
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chemosis
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swelling of the bulbar conjunctiva
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OD
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oculus dexter = right eye
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OS
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oculus sinister = left eye
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OU
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oculus uterque = both eyes
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symptoms of ocular disease
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redness
ocular pain foreing body sensation photophobia itiching scratching and burning watering purulent discharge watery discharge tearing, ropy discharge and itchy eyestrain blurred vision visually impaired legally blind diplopia floaters |
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trichiasis
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eyelashes rubbing cornea
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photophobia
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pain or sensitivity to light
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purulent
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puss
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presbyopia
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loss of accomodation in the eyes due to advancing age
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diplopia
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double vision
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floaters
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spots before the eyes caused by vitreous opacities
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visually impaired
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best corrected distant visual acuity in the better eye is 20/80 or less
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legally blind
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best corrected distan vision of 20/200 or less in the better eye
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pupil irregularity may indicate
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ruptured globe
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normal pupil diameter is
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3-5 mm
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mydriasis
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dialtion of the pupil
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anisocoria
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one pupil larger than the other
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Argyl Robertson pupils
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small, irregular pupils that accomodate but do not react to light.
seen in CNS syphilis |
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Adie's pupil
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idiopathic unilateral process where a pupil is large with severly reduced and slow rxn to light
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LR6(SO4)3
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lateral rectus muscle = CN VI
Superior oblique muscle = CN IV all others CN III |
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opthalmologic conditions that require immediate referral
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progressive reddness after ocular surgery
white spot on the cornea rock hard globe |
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most common cause of blurred vision
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refractive errors
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emmetropia
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normal state of the eye/vision
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hyperopia
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farsightedness
parallel rays come to focus behind the retina |
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short globe
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associated with hyperopia
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myopia
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nearsightedness
parallel lines focus anterior to retina |
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long globe
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associated with myopia
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astigmatism
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refractive errors in the horizontal and vert. axis
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presbyopia
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natural loss of accomodative capacity with age
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meibomian glands
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sebaceous glands in the rim of the upper and lower eyelids
secrete sebum to prevent evaporation of eyes tear film aand allow an airtight seal |
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glands of zeis
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modified sebaceous glans
glands at base of eyelashes |
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Glands of Moll
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apocrine sweat glands
in dermis of eyelids |
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Hordeolum
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acute development of a small abscess within a gland of the upper or lower eyelid of one eye
PAIN |
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internal hordeolum
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meibomian gland abscess deep from palpebral margin
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external hordeolum
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aka sty
infection of glands of zeis or moll adjacent to edge of the palpebral margin |
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Chalazion
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follows an internal hordeolum
inflammation of a meibomian gland PAINLESS |
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Blepharitis
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bilateral inflammatory condition of the lid margins
irritation burning itching eyelashes adhere together anterior and posterior blepheritis may cause telangectasias |
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entropian
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inward turning of the eyelid and lashes
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ectropion
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outward turning of lower lid
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dacryocystitis
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infection and inflamation of the lacrimal sac
(medial and inferior to eye - location of lacrimal sac) |
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dacryoadenitis
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acute inflamation of lacrimal gland
(localized to the outer one-third of the upper eyelid) |
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4 types of conjunctivitis
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1. bacterial conjunctivitis
2. viral conjunctivitis 3. keratoconjuctivitis sicca 4. allergic eye disease |
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Every pt. with conjunctivitis should be tested using
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flourescein Dye for coneal abrasions, ulcers, or herpetic infection
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three most common agents of bacterial infection
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1. staph
2. strep. 3. moraxella |
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bacterial conjunctivitis signs
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>copious purulent sticky discharge
>mild decrease in visual acuity >mild discomfort >palpebral conjunctiva is red compared to bulbar conjunctiva |
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2 emergency bacterial conjunctiva
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1. gonococcal conjunctivitis
2. chlamydial keratoconjuctivitis |
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gonococcal conjunctivitis
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>causeitive agent gonorrhoeae
>contact with infected gental secretions >copious purulent discharge >corneal involvement can lead to perforation |
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Chlamydial keratoconjunctivitis
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>causitive agent - chlamydia
>major cause of blindness worldwide >treat before geting lab results back >transmission by direct contact or non-chlorinated swimming pools >severe conjunctivitis and keratitis |
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viral conjunctivitis
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>most common cause - adenovirus type 3
>assosicated with pharnygitis, fever, malaise, and preauricular adenopathy >signs: palpebral conjunctiva is red, copious WATERY discharge >from contaminated swimming pools, direct contact >treat to prevent secondary bacterial infection |
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Keratoconjunctivits Sicca
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>AKA "dry eyes"
>most common in elderly women >symptoms: dryness, redness, scratchy feeling of eyes >severe cases: conjunctival injection, loss of normal conjunctiva and corneal luster, ulceration, mucous strands Treat with artificial tears, preservatives can be toxic or alergic rxn |
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causes of Keratoconjunctivits Sicca
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hormone replacement therapy
mucin deficiency evaporationof tears due to environmental factors (hot, dry, windy) abnormalities in lipid component of tears |
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Allergic eye disease
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number of different forms: atopic asthma, atopic dermatitis, allergic rhinitis
symptoms: itching, tearing, redness, stringy discharge, photophobia, visual loss, CONJUNCTIVAL HYPEREMIA, EDEMA (CHEMOSIS), LARGE "COBBLESTONE PAPILLAE ON EVERTED UPPER LID CONJUNCTIVA, lymphoid follicles at the limbus |
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atopic keratoconjunctivitis
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Allergic eye disease
chronic disorder of adults blepharitis corneal involvement - refractory ulceration entropian with trichiasis |
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steroid side effects on eyes
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cataracts
glaucoma exacerbatio of herpes simplex keratitis |
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Pinguecula
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degenerative lesion of bulbar conujunctiva
presents with yelow-white subepithelial nodule adjacent to limbus (usually on nasal side) may become: inflamed, enlarged, and become pterygium |
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pterygium
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benign proliferation of fibro-vascular tissue withing teh bulbar conjunctiva that extends onto the peripheral cornea
>triangular configuration with apex toward pupil. >growth into limbal cornea |
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pinguecula & Pterygium
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bilateral
risk factors: UV light, wind, dust irritation and foreing body sensation |
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disorders of the cornea (all emergency referal)
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corneal ulcer
bacterial keratitis herpes simplex keratitis fungal keratitis acanthamoeba keratitis corneal ulcer |
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corneal ulcer
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lack of treatment lead to intraocular infection or corneal scarring
symptoms: pain, photophobia, tearing, decreased vision, purulent or watery discharge, foreing body sensation signs: corneal stromal injection, miotic pupil, chemosis, lid edema, lid erythema |
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bacterial keratitis
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very aggressive
precipitation: contact lens, corneal trauma pathogens: pseudomonas, strep, moraxella, staph. signs: thick yellow-green or blue-green mucopurulent discharge, tenacious exudate, ground-glass edema surronding the ulcer Hypopyon - layer of WBC in inferior portion of anterior chamber of eye |
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Hypopyon
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layer of WBC in the inferior portion of the anterior chamber of the eye
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herpes simplex keratitis
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important cause of ocular morbidity in adults
most common cause of corneal ulcers in adults symptoms: pain, irritation, foreing body sensation, redness, photophobia, tearing , decreased visual acuity DENDRITIC ULCERS in secondary disease with terminal bulbs at the end of each branch Recurences due to: fever, exposure to UV, trauma, stress, immunodeficiencdy unilateral blepharitis with corneal lesions, conjunctivitis examination using woods lamp |
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HSV dendrites
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occur in the center of the cornea
branches have terminal bulbs at the end of each branch |
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Herpes Zoster Opthalmicus
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secondary to activation of latent varicella zoster virus
symptoms: malaise, fever, headache, periorbital burning and itching symptoms procede eruption = called PRODROME signs: lesions on tip of nose (hutchinson's sign), lid margin, conjuctivitis, keratitis, episclaritis, anterior uveitis DENDRITIC LESIONS WITH NOT TERMINAL BUDS |
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Fungal keratitis
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after corneal injury involving plant amterial or in agricultural setting, contact lens weares
multiple stromal abscesses an little epithelial loss |
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acanthamoeba keratitis
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suspect in contact wearers with contaminated lens solutions, swim wearing contact lenses
pain out of proportion of their clinical findings organism is able to encyst within the corneal stroma making it difficult to treat |
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What one, often overlooked, very important historiacl question must be asked of the patient with an eye complaint?
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Do you wear contact lenses?
Have you been swimming in a non-chlorinated swimming pool |
