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71 Cards in this Set
- Front
- Back
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What is the primary muscle that moves an eye in a given direction called?
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agonist
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What is the muscle in the same eye that moves the eye in the same direction as the agonist called?
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synergist
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What is the muscle in same eye that moves eye in opposite direction of agonist?
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antagonist
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EOM Medial rectus
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adduction CN3
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EOM: lateral rectus
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abduction CN6
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EOM: Inferior rectus
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depression; extorsion, adduction-CN 3
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EOM: superior rectus
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elevation; intorsion; adduction-CN3
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EOM: Superior oblique
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intorsion; depression; abduction-CN 4
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Inferior oblique
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extorsion; elevation; abduction-CN 3
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At birth there is little pigmentation in iris, which is why babies have blue eyes when born... when is pigmentation complete?
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6months
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What is the artery to vein ratio in retina?
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2:3 is normal ; arteries are 2/3 to 4/5 the size of veins
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Major Eye Sx? (top 2)
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Loss of vision
Eye pain |
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What may be the causes of sudden loss of vision?
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retinal vascular occlusion, retinal detachment
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Loss of vision coupled with eye pain can be signs of what?
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sudden -acute narrow angle glaucoma; grad-chronic simple glaucoma
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With eye pain what may be a cause of light sensitivity?
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iritis
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unknown etiology-middle aged females. Keratoconjunctivitis, xerostomia, connective tissue disease (RA, SLE, scleroderma, polymyositis).
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Sjogrens-Syndrome
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Physical of Red Eye
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• Visual acuity
• Pupil shape • Reactivity • Comparison between pupils • EOM function • Confrontation fields • Palpation for pre-auricular nodes |
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DDx of Red Eye
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• Eyelid disorders-blepharitis, hordeolum, chalazion
• Conjunctivitis-allergic, viral, bacterial, chemical • Orbital cellulitis-inflammatory response. Pain, redness, swelling, pressure, tearing, blurred vision. • Keratoconjunctivitis sicca-dry eyes • Dacryocystitis-infected or blocked nasolacrimal duct. Pain, tenderness, swelling and redness in tear sac. • Episcleritis-inflammation of blood vessels and connective tissue. Rapid onset. Localized, unilateral redness, discomfort, no discharge • Uveitis/Iridocyclitis-inflammation of iris, choroids, ciliary body. Onset is sudden with ocular pain, redness, blurred vision, watery discharge • Scleritis-painful and may be severe. Ocular tenderness, tearing and photophobia. Bluish red appearance. Associate with connective tissue disease like rheumatoid arthritis. • Keratitis-inflammation of cornea; asymptomatic then pain, photophobia, redness, tearing • Acute Angle Closure Glaucoma-red, blurred vision, pain, headache, nausea, vomiting, increased intraocular pressure • Trauma-corneal abrasion, hyphema • Subconjunctival hemorrhage |
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Area of depressed vision is called
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scotoma
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*Normal central vision extends approx. _____ in all directions of central fixation.
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30 degrees
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The blind spot is the physiologic ____?? Where is it?
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Scotoma; approx. 15-20 degrees temporal to central fixation and corresponds to optic nerve head (optic disc)
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Malingering pts who fake blindness claim to have this:
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Optokinetic Nystagmus (OKN):
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What is the Hirschberg Test?
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Corneal light reflex. used to test balance of EOM. Light directly in front of pt. and reflex should be in center of each cornea.
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What is Strabismus
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non alignment of eyes, diplopia, lazy eye. esotropia (cross eyes)
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How do we test Marcus Gunn Pupil-Optic nerve disease (retrobulbar neuropathy)?
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Detect by swinging flashlight test-patient fixates on distant target while examiner rapidly swings light from one eye to the other-observing for constriction of pupils.
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Argyll Robertson Pupil
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smal irregular and bilateral. Do not react to light but do react to near vision -- think CNS syphillis
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Tonic "Adie's" Pupil
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Large
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one pupil smal, regular, and normal rxn to light and near vision. ptosis of eyelid, loss of sweating on forehead of invovled side occurs in which dz?
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homer's syndrome
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What does PERRLA stand for?
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pupils equal, roud, reactive to light and accommodation.
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palpation of eye is not very sensitive measure of what? it can also cause what?
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measure of IOP and it can be dangerous, retinal detachment post surgery
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what does regurgitation of mucopurulent fluid from puncta suggest?
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obstructed nasolacrimal duct
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what should you do if eye area is inflamed or tender?
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avoid it!
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what apperature allows observation of eccentric fixation without masking macula?
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fixation
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which aperature is helpful in determining various levels of lesions, especially tumors and edematous discs?
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slit or streak
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what filter is good for visulatization of blood vessels and hemorrhages? can distinguish veins from arteries (veins blue, arteries black!)
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red-free filter
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normal cup to disc ratio varies from...
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01. to 0.5
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when looking at optic discs, make sure to check...
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both eyes for symmetry
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Copper wiring means?
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hypertension
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arteriovenous nicking is?
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vein appears to stop abruptly on either side of arteriole
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arteries are what size compared to veins?
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2/3 to 4/5 size of veins. and have a prominent light reflex. veins may show pulsations
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what does the medial rectus muscle do?
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adduction CN 3
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what does the lateral rectus muscle do?
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abduction CN 6
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what does the inferior rectus muscle do
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depression and extorsion CN 3
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what does superior rectus do?
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elevation and intorsion CN 3
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what does superior oblique do?
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depression, abduction, intorsion, CN 4
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what does inferior oblique do?
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elevation, abduction, extorsion CN 3
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until what age do babies have little pigmentation in their eyes?
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6 months
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artery to vein ratio is?
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2:3
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what are 6 major eye symptoms?
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1. loss of vision 2. eye pain 3. diplopia - double vision 4. tearing or drying 5. discharge 5. redness
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what is sjogrens syndrome?
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unknown etiology, middle aged females, keratoconjunctivitis, xerostomia, CT disease (RA, SLE, scleroderma, polymosities)
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physical of the eye includes?
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1. visual acuity 2. pupil shape 3. reactivity 4. comparison between pupils 5. EOM fnx 6. confrontation fields 7. palpation for pre-auricular nodes
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What are eyelid disorders? 3
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1. blepharitis 2. hordeolum 3. chalazion
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What are reasons for conjuctivitis?
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1. allergic 2. viral 3. bacterial 4. chemical
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what is orbital cellulitis?
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inflammatory response. pain, red, swelling, pressure, tearing, blurred vision
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Keratoconjunctivitis sicca means?
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dry eyes
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dacryocysitisis means?
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infected or blocked nasolacrimal duct. pain, tenderness, swelling an redness in tear sac
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what is episcleritis?
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inflammation of blood vessels and CT. rapid onset. localized unilateral redness discomfort no discharge
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what is uveitis/iridocyclitis?
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inflammation of iris, choroids, ciliary body, onset is sudden with ocular pain, redness blurred vision, watery discharge
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what is scleritis?
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painful and may be severe. ocular tenderness, tearing and photophobia. bluish red appearance. associt. with RA
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what is keratitis?
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inflammation of cornea, asymptomatic then pain, photophobia, redness, tearing,
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what is acute angle closure glaucoma?
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red, blurred vision, pain, HA, nausea, vomitting increased intraocular pressure
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what is an example of eye trauma?
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corneal abrasion, hypthema
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what is a subconjunctival hemorrhage?
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painless red eye without discharge, clear borders and masks conjunctival vessels. appears as fresh red blood against white scleral background. can be spontaneous or valsalva maneuver
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upon confrontation testing you notice an are of depressed vision. what is this called?
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scotoma
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normal central vision extend how far in all directions?
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30 degrees
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where is the blind spot?
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physiologic scotoma approx. 15-20 degrees temporal to central fixation and corresponds to optic nerve head
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what is OKN, optokinetic nystagmus?
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malingering pts. who fake blindness
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which test is used to test thebalance of EOM muscles? light falls in the center of each cornea?
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hirschberg test
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what is strabismus?
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heterotropia or tropia. non alignment of the eyes such athat the object being observed is not projected simultaneously on the fovea of each eye.
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what is exotropia
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deviation of eye temporally (outward)
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what is the term used to describe cross eyes. deviation of eye nasally?
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esotropia
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