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96 Cards in this Set
- Front
- Back
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Yellowish pigmented area around the fovea
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Macula Lutea
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What is the Jaeger Eye Test used for?
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Presbyopia (near vision)
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What test do you use to differentiate refraction errors from organic disease?
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Pinhole Test
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How do you record visual acuity for :
1)Right Eye 2)Left Eye 3)Both Eyes |
1)O.D. (Oculus Dexter)
2)O.S. (Oculus Sinister) 3)O.U. (Oculus Uterque) cc: with glasses, sc: without glasses |
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Dilation of the pupils mediated from subthalamic ganglion, getting impulses from spinal-thalamic tract triggers what reflex?
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Pain Pupillary Reflex
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Small pupil dilation with irritation of cornea, eyelids, conjunctiva, or tissues surrounding the eye, which is rapidly followed by pupil constriction
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Trigeminal Pupillary Reflex
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Bilateral pupil dilation upon irritation of vestibular apparatus (rotation)
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Cochlea Pupillary Reflex
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Dilation of pupils due to irritation of the posterior pharyngeal wall
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Pharyngeal Pupillary Reflex
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Constriction of pupils when an effort is made to close the eyelids while they are forcibly held apart describes ________syndrome (pupillary reflex)
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Plitz Syndrome
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Constriction of the pupils when conceiving sunlight or bright flame describes ______syndrome
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Gaab's Syndrome
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A patient presents with a painful red eye with circumcorneal injection and watery discharge. The patient was previously diagnosed with exposure keratitis. What condition do you suspect?
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corneal ulcers
-discharge may be purulent also |
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A patient presents with abrupt onset of fever, proptosis, restriction of EOMs, and swelling of the eye lids. What do you suspect?
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orbital cellulitis
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What are the key symptoms of cataracts?
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1)painless blurring of vision
2)Diplopia in one eye 3)fading or yellowing of colors 4)glare, light sensitivity |
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During the ophthalmoscopic exam you notice an impaired red reflex and lens opacity. What is the probable diagnosis?
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cataracts
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Gradual progressive optic nerve neuropathy with cupping of the optic
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chronic glaucoma
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Elevated intraocular pressure due to reduced drainage of the aqueous through the trabecular meshwork is associated with which type of glaucoma?
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chronic open-angle glaucoma
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obstructed flow of aqueous into the anterior channel angle is associated with which type of glaucoma?
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chronic angle-closure glaucoma
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optic nerve damage with with no increased intraocular pressure is associated with which type of glaucoma?
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normal tension glaucoma
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What factors put a patient at higher risk for open-angle glaucoma?
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1st degree relative w/disease
diabetes African-American |
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What are the best diagnostic tests for open-angle glaucoma?
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1)tonometry
2)ophthalmoscopic visualization of the optic nerve 3)central visual field tests |
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How do you test IOP?
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tonometry
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For a diagnosis of glaucoma the cup to disc ratio will be ____ or the asymmetry of the disc will be ____
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cup to disc ratio >0.5
asymmetry >0.2 |
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What is normal IOP?
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10-21 mm/hg
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What are the preventative screening guidelines for glaucoma?
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over age 40: tonometric & ophthalmoscopic exams every 2 years
DM or FH of glaucoma: test annually |
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What are the pharmaceutical treatments for glaucoma?
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b-blockers
alpha-2 agonist oral carbonic anhydrase |
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Other than pharmaceuticals, what treatment options are available for glaucoma?
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Surgery:
laser trabeculoplasty trabeculectomy |
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What is the leading cause of gradual, painless, permanent bilateral central visual loss in the elderly?
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macular degeneration
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condition where light sensing cells in the macula malfunction over time & then cease to work
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macular degeneration
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What is the hallmark of macular degeneration?
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development of hard or soft retinal drusen
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Discreet yellow deposits usually in the macular region are _______ drusen. Larger, paler and less distinct deposits are ____drusen
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hard
soft |
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Gradual, progressive, moderate visual loss, atrophy & degeneration of the outer retina, chorio-capillaries, and Bruchs membrane are associated with ___________
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Atrophic (dry) Macular Degeneration
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How is exudative (wet) macular degeneration different from atrophic macular degeneration?
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-Visual loss is rapid and greater severity
-2 eyes effected over years -90% of all legal blindness |
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What are the treatment options for macular degeneration.
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1)laser photocoagulation of the subretinal neovascular memb.
2)photodynamic laser therapy (PDT) 3)antiangiogenic agents |
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What is the leading cause of new blindness among US adults age 20-65?
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diabetic retinopathy
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Neovascularization from optic disc or major vessels, and vitreous hemorrhage is associated with ______retinopathy
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proliferative retinopathy
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Dilation of veins, microaneurysms, retinal hemorrhage & edema, and hard exudates are associated with _______ retinopathy
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non-proliferative retinopathy
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group of rod and cone dystrophies
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retinitis pigmentosa
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A thirty year old patient presents with progressive night blindness, visual field constriction, and photopsia. What is the most probable diagnosis?
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retinitis pigmentosa
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What are the fundoscopic findings associated with retinitis pigmentosa?
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irregular black deposits in the periphery of the retina
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A vertical curtain across the visual field with complete monocular blindness lasting a few minutes is characteristic of ____________
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amaurosis fugax
(fleeting blindness) |
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What causes Amaurosis Fugax?
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retinal emboli from ipsilateral carotid disease (plaque)
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What is the treatment for Amaurosis Fugax?
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high grade stenosis: endarterectomy
med. grade stenosis: antiplatelet therapy or aspirin |
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What are the important diseases/disorders to rule out before diagnosing a patient with conjunctivitis?
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acute glaucoma
acute uveitis corneal disorders |
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What are the treatment options for bacterial conjunctivitis?
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topical sulfonamide 2-3 days
povidone-iodine (Betadine) *topical flouroquinilones are not recommended for benign, self-limiting infections |
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What is the treatment for gonococcal conjunctivitis?
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*Emergency Referral
IM Rocephin |
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A 20 year old sexually active patient presents with conjunctivitis & a palpable non-tender, pre-auricular lymph node. What is the probable diagnosis?
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Chlamydial Keratoconjunctivitis
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What is the treatment for Chlamydial Keratoconjunctivitis?
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-Doxycycline 100mg BID 3 weeks
or Erythromycin or Tetracycline QID 3 weeks Always check for genital STDs |
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What is the most common cause of viral conjunctivitis?
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Adenovirus type 3
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What are the clinical findings associated with viral conjunctivitis other than the eye symptoms?
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pharyngitis
fever malaise preauricular adenopathy |
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What is the treatment plan for viral conjunctivitis?
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1)topical sulfonamides to prevent bacterial infection
2)cold compresses |
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What type of surgical procedures may be helpful for patients with Keratoconjunctivitis Sicca?
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Lacrimal punctal occlusion surgery
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Bulbar conjunctival redness & swelling and cobblestone papillae in the upper conjunctiva are associated with _____________
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allergic conjunctivitis
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What is the treatment for allergic conjunctivitis?
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-topical histamine H1-antagonist
-Alamast -Systemic antihistamines -topical corticosteroids (only ophthalmologist) -avoid allergens |
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Dendritic corneal ulcer is characteristic of ____________
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Herpes Simplex Keratitis
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What is the treatment for Herpes Simplex Keratitis?
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Referral
topical antivirals oral acyclovir **corticosteroids may enhance viral replication so only RX from ophthalmology |
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What is the treatment for episcleritis?
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None - it's self-limiting
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With the ______form of scleritis the globe appears to have a violet hue.
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Anterior
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With the ______form of scleritis the patient will have deep ocular pain on palpation, proptosis, visual loss and reduced motility.
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Posterior
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What is the treatment for scleritis?
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Referral
NSAIDS -steriods if underlying disease is active |
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Which eye disorder is associated with sarcoidosis?
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anterior uveitis
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Small hemorrhage from a ruptured vessel between the sclera & conjunctiva
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Subconjuctival Hemorrhage
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Small conjunctival nodule at the temporal or nasal limbus
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Pinguecula
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What causes pinguecula?
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constant exposure to sun, wind, and sand
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Small conjunctival nodule that has crossed the limbus onto the cornea
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pterygium
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What are the signs/symptoms of blepheritis?
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irritation & burning lids
scales or granulations on lashes entropion maybe hordeola |
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What is the treatment for anterior blephritis?
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1)cleanliness of scalp, eyebrows, & margins
2)remove scales w/baby shampoo 3)antistaphylococcal ointment |
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What is the treatment for posterior blephritis?
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1)regular mebobian gland expression
2)low systemic antibiotics if cornea is inflamed 3)may need short term topical steroids - consult ophthalmologist 1st |
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Staphylococcal abscess of the upper or lower lid
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hordeolum (sty)
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Mebomian gland abscess that points into the conjunctival surface of the skin
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internal hordeolum (sty)
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Granulomas inflammation of a mebomian gland that may follow a hordeolum
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chalazion
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Inward turning of the lid (usually lower) that usually occurs in older patients due to degeneration of the lid fascia
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Entropion
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Outward turning of the eyelid
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Ectropion
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What complication may arise in patients using mydriatics?
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acute glaucoma if patient has a narrow anterior chamber
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How do you test newborn visual acuity?
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blepharospastic response to bright light in sleeping infant
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How do you test visual acuity for a 6 week old?
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eye to eye contact with slow following movements
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How do you test visual acuity for a 3 month old?
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demonstrate fixing & following ocular movements at a distance of 2-3 feet
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How do you test visual acuity for a 6 month old?
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interest in movements across the room
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How do you test visual acuity for a 2 1/2-3 year old child?
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(verbal child)
Allen & Lea symbols and familiar picture identification |
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How do you test visual acuity for a 4 year old?
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tumbling E
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What is the typical acuity for a 2 1/2-3 year old?
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20/60
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What is the typical acuity for a 3 year old?
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20/40 - 20/35
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What is the typical acuity for a 4 year old?
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20/30 - 20/25
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What is the typical acuity for a 5-6 year old?
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20/20
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What is the most important thing to look for during visual acuity of children? Why?
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1)difference between 2 eyes
2)difference may indicate amblyopia, refractive error, or disease |
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unilateral or bilateral reduction in central visual acuity due to sensory deprivation of a retinal image
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amblyopia (lazy eye)
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When does amblyopia occur?
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1st decade of life
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What do you look for in preverbal children when screening for amblyopia?
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strabismus
media opacities unequal red reflexes family history |
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Congenital cataracts & opacities must be diagnosed _________ because of the extreme sensitivity of the visual nervous system
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1st few weeks of life
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What is the most accurate way to evaluate straight eyes?
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look for position of penlight on the cornea during the red reflex
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20% of patients with retinoblastoma present with ______
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strabismus
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Esotropia (strabismus) first presenting after age 5 should arouse suspicion of ___________
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CNS disease
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visual axes converge with ______
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esotropia (strabismus)
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visual axes deviated in a divergent position
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exotropia
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Early onset exotropia occurs in patients with ________. All patients with constant exotropia require __________
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neurological disorder
CNS imaging |
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What is a positive Brukner test?
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difference in the quality of the red reflex in the 2 two eyes
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What is the usual age at onset for myopia?
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8
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