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44 Cards in this Set

  • Front
  • Back
conditions produce forword projection of eye ball. (pathology -> psudoexothalmos, true exothalmos, ocular proptosis,
True :
Thryoid Dz, Hyperthyroidism, thyrotoxicosis, Graves Dz  Dalrymples’s sign)
Hypothyroidism, hashimoto’s Thyroiditis, Myxedema)
Orbital cellulites
infections from periorbital structures
Orbital tumors- seen in kids
Pseudo: 
high degree of myopia, EOM paresis, bupthalmos (enlarged eye)
What are the occular findings of long standing chronic hypothyrodism
Coldwell view x-ray. Enlargement of openin in apex. What is this mean?
Suprorbital fissure:  congestion of ophthalmic vein d/t cardiojugular fistula
Optic foramen:
optic Nerve tumor
Know about Blow out Fx
Compromise to aditus (physical trauma) d/t loss of orbit floor resulting in herniation into maxillary sinus (IR mm pulls eye in) use Water’s View x-ray (hanging drop density, double osseus wall)
Causes of Enophthalmos (5)
Duane’s syndrome, marked dehydration, fat atrophy (MC!), horner’s syndrome, blow-out Fx
Problem of Epicanthus Tarsalis
- Medial portion of eyelid droops
- "Cross eyed" impression
- "Pseudo-esotropia"
Review all stages of Entropion (start to finish)
Entropian -> Trichasis -> Corneal erosion -> Corneal ulceration -> loss of vision
Internal hordoleum – what happens?
Infection of meibomian gland (not obvious on inspection, swelling occurs on post. eyelid, found upon palpation (bump), confirmaiton = eversion of eyelids)-> become fibrotic forms chalazion -> tx is surgery
Causes of Van Graff sign
Retracted eyelids:
grave’s Dz, thyroid Dx, exopthalmic goiter
Dermatocholasis (what is it?)
-loose skin (drooping eyelid)
- false ptosis, seenin elderly person, where their skin folds droop over the eye lid covering part of the eye
- the actual lid is in the proper position and hel up, so there isno real ptosis.
12. Etiology of corneal scarring
Collagen bundles in the substantia propia are arranged in precious geometric manner, but trichasis wears down layers and new epithelium tissue fills in the area erratically and there is an area where light does not pass though properly
13. Stenopeic slit – what produces one?
Hypothyroid DZ -> late in the course of DZ, swollen eyelid
14. Cause of diffuse blephoritis
cosmatics, eyeliner allergy
characteristics/etiology/findings Penguicula, Ptergium. Know differentiation
Penguicula :
Yellow waxy crap in medial canthus (not abnormal), bilateral and AVASCULAR
Outgrowth of medial canthus by trauma or sun exposure (abnormal), VASULAR, Tx is surgery (u.v. light, salt, dust from ranching etc)
17. Most likely cause – purulent conjunctivitis
18. causes of subconjuctival hemorrhage
Any event that causes and INCREASE in ICP (intra occular pressure)
such as Rubbing eyes or lifting weights
19. schimer test (I & II) – what is it for and what it evaluate
Schirmer I :
bilateral filter paper at inferior lacrimal canuliculus (5 min 10-12mm)
(with anesthesia : accessory gland
(w/o) : lacrimal gland
Schirmer II  same set-up but tickle nasal mucosa and check wetness (>15 mm is normal, decrease suggest absence of tear fluid)
24. what is cover test used for?
To check for
latent tropia, Ambylopia Ex Anopsia (Lazy eye syndrome)
22. m.c. type of strabismus
Horizontal Esotropia-> eye is nasally AD-ducted
subtle cause:
m.c. -> horizontal esophria
23. testing integrity and function of extra occular mm. what is common thing you should see normally.
- Two visual axix must be parellal
- should be same scleral volume
- but temporal is not equal to nasal
- normal hirshberg test
- orthophoric (no deviation of eye)
25. know hirschbirg test – How performed
Beam a light to the center of the nasion  the reflection should be in the center of the pupil bilaterally, if not then that is the bad eye
26. causes of band Keratopathies
Calcium deposition within the Substantia Propria of the cornea (swiss cheese appearance) with perilimbal sparing. Caused by  iridocycliditis, glaucoma, JRA
27. What produces Hudson-Stale lines
Orangey lines of iron in old people with no real significance
28. what are earlist findings in keratitis?
Edema of inflammatory cells cause the cornea to loose is shiny appearance  dull cornea and ciliary flush (redness at edge of iris)
29. what are ultimate result of keratitis?
Will produce a Keratoconjunctivitis, leading to an Entropion, leading to a Trichiasis
30. what are cuases of sclearal ectasia?
(blue sclera) from the thinning of the sclera from an increase ICP allowing the choroids to be visible. Can herinate through causing a staphyloma
1. silver intoxication
2. increase in IOP
3. Ochronosis
4. osteogenesis imperfecta
5. murphan's syndrome
6. pseudo hypoparathyroidism
31. occular findings of inborn metabolism problem with tyrosine breakdown?
Blue scerla too! D/T Onchronosis (can't breakdown Homogenistic acid)
33. what produces a fixed Meiosis
Patient is under treatment for Glaucoma (b/c keeping pupil constricted is good for the condition),Anterior Segment Irritation, Horner's Syndrome, Drugs i.e. Morphine
34. what are possible causes of Anosocoria?
(unequal pupils) serious neurological conditions, some people have physiological type
1. Diabetic neuropathy
2. orbital tumor
3. Herpes Zoster ophalmicus
35. Argyl – Robertson puple – what it means, where lesion, findings
(Basically like the prostitute) the eye still reacts to accommodation, but does not have the light reflex present (d/t tertiary syphilis = aortitis)
36. know signs and symptoms of Glare, fog, colored lights, visula acuity etc <– cataracts symptoms - know how and why.
Glare Water filled structure refracts more light when light hits it
Visual Discolorations  Blue or yellow casts to objects in room
Halos seen around lights, "Fog" or "Haze" seen, and a Reduction in visual acuity
37. Exam –think cataracts devleoping pt. – symptoms that will help you.
- Old age pt. -> lens oaqcity
- decrease visual accuity
- increase myopic (comportable reading closer)
38. something essential in beginning of ophthalmic exam of eye – to get close to eye – beginning – that will facilitate getting into eye
- exam R eye -> hold scope in R hand and use DC's R eye
- 15" away
- 15 degree lat tangential to visual axis.
39. how to use ophthalmoscope to determine Optic Nerve Atrophy.
When detecting Flame around cup. (Splinter) type of hemorrhage.
40. Diabetic eye – areas of infarction and ischemia
Soft exudate
41. possible causes of A.V nicking
- Hypertensive retinopaty
- Atherosclerosis of the arterial lumen
- AV long axis angle widens past 90 degree
42. What is metamorphopsia – what does it mean?
- in macular degeneration
- presence of wavy lines on amsler grid
43. list of Retinal Disease of Eye – what cause retinal detachment in what disease
Diabetes mellatus
44. how do lipid depositions present in an eye?
- exudate stage
- Forms around the margins of optic disc
- Hard exudate = area of lipid deposition
45. What are causes of papilledema
1. Increase in ICP
2. end of hypertention retinopathy
3. Central Ret. Vein Occlus
4. Cranial arteritis
5. Optic neuritis with M.S.
46. Findings in macular degeneration
- Central visual field is Blurred or Foggy
- Drusen ->Herniation of Brup’s Membrane (yellow dots)
- Raised area of macula
- Neo-vascularization
47. if no physiological cup – most obvious Reason
- Papiledema (swelling of optic disc)
48. Findings in glaucoma
- physiological cup become eccentric to the temporal side
- Nasaldisplacement of vessels
- one margin
- increased pressure
- increased in cup depth, diameter
- can see portions of lamina criborosa
- disc color pallored
49. Palpation of Eyeball – how and why?
- Check pressure of the eye ball
- for glaucoma (check increase in IOP)
- palpate sup. sclera
- feels like pushing on hot water bottle with two finger
- pressing on one should raise the other finger.
- procedure
1. ask pt to look down
2. upper eyelid always follows the limbal line
3. with eye having a partially closed upper eyelid, palpate the sclera, not the cornea.