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120 Cards in this Set
- Front
- Back
What visual defect may result from occlusion of a branch of the central retinal artery, or ichemia of the optic nerve?
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Horizontal defect
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A partial lesion of the optic radiation in the temporal lobe may result in what visual defect?
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Homonymous quadrantic defect
i.e. Homonymous left superior quadrantic defect (due to a partial lesion of the right optic radiation) |
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Is ptosis of the eyelid as seen in Horner's syndrome, due to damage to the sympathetic or parasympathetic nerve supply?
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Sympathetic
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An inward turning of the lid margin. The lashes often irritate the conjunctiva and cornea.
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Entropion
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An outward turning of the lower lid, exposing the palpebral conjunctiva. The eye will no longer drain satisfactorily.
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Ectropion
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A harmless yellowish triangular nodule in the bulbar conjunctiva on either side of the iris.
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Pinguecula
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A localized ocular redness from inflammation of the episcleral vessels.
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Episcleritis
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Can episcleritis present in nodular form?
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Yes, or it may show only redness and dilated vessels.
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A painful, tender red infection in a gland at the margin of the eyelid.
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Sty
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A subacute nontender and usually painless nodule involving a meibomian gland.
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Chalazion
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What is the dif between a sty and a chalazion?
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Stys are on the margin of the lid.
Chalazions are inside the lid. |
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Chalazions involve what kind of gland?
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Meibomian gland
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A slightly raised, yellowish, well-circumscribed plaque that appears along the nasal portions of the eyelid.
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Xanthelasma
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Inflammation of the lacrimal sac resulting in swelling between the lower lid and nose.
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Dacrocystitis
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In a chronic phase of Dacrocystitis, may result in obstruction of what duct?
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Nasolacrimal duct
(tearing and regurgitation through the puncta may result) |
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T or F
Acute iritis may be associated with some systemic disorders. |
True
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A thin grayish white arc or circle not quite at the edge of the cornea.
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Corneal arcus
(common with aging, but can be in young, especially blacks) |
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When a young person presents with Corneal arcus, it may suggest what condition?
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Hyperlipoproteinemia
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A triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side.
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Pterygium
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Opacities of the lenses visible through the pupil.
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Cataracts
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How can you distinguish between a cataracts and a corneal scar which may look similar?
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A cataract is visible on a deeper plane and only through the pupil.
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A cataract appearing gray when seen by a flashlight which is surrounded by a black rim when the pupil is dilated.
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Nuclear cataract
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A cataract that produces spokelike shadows that point inward - gray against black as seen with a flashlight, or black against red with a opthalmoscope.
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Peripheral cataract
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Unequal pupils.
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Anisocoria
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Aka for Tonic pupil.
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Adie's pupil
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A pupil with severely decreased or absent constriction with no ptosis present.
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Tonic pupil (Adie's pupil)
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Paralysis of which nerve will result in the dilated pupil being fixed to light and near effort, with ptosis of the eyelid and lateral deviation of the eye.
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CN III
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T or F
The affected pupil as seen in Horner's syndrome, is dilated and fixed. |
False - Though the affected pupil is small, it will react briskly to light.
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Small, irregular pupils that accomodate but do not react to light.
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Argyll Robertson pupils
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Which disease is associated with Argyll Robertson pupils?
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CNS Syphilis
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Will unilateral blindness result in anisorcoria (unequal pupils).
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Not as long as the sympathetic and parasympathetic innervation to both irises are normal.
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A congenital dysconjugate gaze, one eye turned in.
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Esotropia
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A congenital dysconjugate gaze, one eye turned out.
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Exotropia
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When the patient looks right the eyes are conjugate, looking straight esotropia appears, and looking left esotropia is maximum.This can be due to paralysis of this cranial nerve.
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Left CN VI
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When trying to look down and to the right, the left eye can only look right but not down. This can be due to paralysis of this cranial nerve.
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Left CN IV
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If a patient's left eye is pulled outward by CN VI and upward, downward and inward movements are impaired or lost and ptosis and pupillary dilation may present, this could be due to paralysis of this cranial nerve.
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Left CN III
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A small whitish depression in the optic disc sometimes present.
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Physiological cup
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If a physiological cup is present, where would it be found?
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In the optic disc either centrally or toward the temporal side.
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Irregular white patches with feathered margins that obscure the disc edge and retinal vessels.
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Medullated nerve fibers
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In a normal optic disc, how wide is the physiological cup?
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< 1/2 of the optic disc
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In this optic disc abnormality, the physiological cup is enlarged (> 1/2 of the optic disc) and pale. There is also a backward depresssion of the disc.
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Glaucomatous cupping
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Sometimes the arteries become full and tortuous and develop and increased light reflex. This is known as ______.
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Copper wiring
(the light reflex has a bright coppery luster) |
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When a portion of a narrowed artery develops such an opaque wall that no blood is visible in it, it is known as ______.
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Silver wiring
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The process in which a vein is twisted on the distal side of the artery and forms a dark, wide knuckle.
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Banking
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Small, linear, flame-shaped, red streaks in the fundi sometimes containing a white center.
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Superficial retinal hemorrhage
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Develops when blood escapes into the potential space between the retina and vitreous, creating a horizontal line of demarcation between plasma above and cells below.
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Preretinal hemorrhage
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Small, rounded, slightly irregular red spots that are sometimes called dot or blot hemorrhages.
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Deep retinal hemorrhages
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A common cause of deep retinal hemorrhages.
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Diabetes
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Tiny, round, red spots seen commonly but not exclusively in and around the macular area, too small to be seen with an opthalmoscope.
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Microaneurysms
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A common cause of microaneurysms.
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Diabetic retinopathies
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A common cause of neovascularization.
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Diabetic retinopathy (proliferative stage)
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What may happen to a neovascularization that would be a cause of concern.
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It may grow into the vitreous, where retinal detachment or hemorrhage may cause blindness.
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What characteristics differentiate hypertensive retinopathies from normal fundi?
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Hypertensive may have marked arteriolar-venous crossing changes (especially inferiorly), copper wiring, or cotton-wool spots.
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In addition to the expected findings in hypertensive retinopathies, what charcteristics may be seen in accelerated (malignant) hypertension.
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Punctate exudates, macular star, flame-shaped hemorrhages, and often papilledema.
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What is the difference between a non-proliferative and a proliferative diabetic retinopathy?
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Non-prol: microaneurysms, hemorrhages, cotton wool patches, hard exudates
Prol: will include new pre-retinal vessels (neovascularization) arising from the disc. If advanced, fibrous proliferations and distortion of the macula. |
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Is there a treatment for proliferative diabetic retinopathies.
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Yes, photocoagulation reduces risk of vision loss by > 50%.
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Soft exudates that are white or grayish ovoid lesions with irregular soft borders, resulting from infarcted nerve fibers.
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Cotton wool patches
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What specifically causes cotton wool patches?
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Infarcted nerve fibers
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Creamy or yellowish, often bright, small, with well defined borders, causes include diabetes and hypertension.
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Hard exudates
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Yellowish round spots, tiny to small, haphazardly distributed but often accumulate at the posterior pole, normal with aging.
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Drusen
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Normal peripheral field angles.
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Sup: 50 deg
Nasal: 60 deg Inf: 70 deg Lat: 90 deg |
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Near-sightedness (impaired far vision).
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Myopia
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Far-sighted in older people (impaired near vision).
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Presbyopia
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A fine, rhythmic oscillation of the eyes.
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Nystagmus
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An enlarged physiological cup would suggest what?
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Chronic open-angle glaucoma
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Are SVPs (spontaneous venous pulsations) considered a normal finding?
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Yes, in approximately 75% of patients.
(Loss might indicate meningitis, head trauma, etc.) |
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After inspecting the fundus, what changes must be made to see the anterior structures (i.e. vitreous or lens)?
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Change the diopter setting to approximately +10 or +12.
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What are Roth's spots?
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Areas of emboli and retinal infarcts.
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Where is the macula located in relationship to the optic disc?
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Approximately 1.5 - 2.0 DD temporal.
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Which is more common, Wet or Dry macular degeneration?
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Dry
(Wet involves hemorrhages) |
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When inspecting the fundus, you find a broken-ring shaped whitish exudate around the macula. Name the lesion and list 2 possible causes.
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Circinate retinopathy
1. Diabetes 2. Central retinal vein occlusion |
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When inspecting the fundus, you notice a whitish exudate that radiates around the macula. Name the lesion and list 4 possible causes.
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Macular star
1. Hypertension 2. Papilledema 3. Papillitis 4. Central retinal vein occlusion |
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List the directions in which the eye will not move according to to paralysisi of each induvidual extraocular muscle.
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Med rectus - Nasal
Inf oblique - Up and nasal Sup oblique - Down and nasal Lat rectus - Temporal Sup rectus - Up and temporal Inf rectus - Down and temporal |
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What are the normal peripheral field angles?
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Sup - 50 deg
Nasal - 60 deg Inf - 70 deg Lat - 90 deg |
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Rhythmical oscillation of the eyeballs, either pendular or jerky.
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Nystagmus
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"Squint", a misalignment of the eyes, unparalleled, or crossed eye(s).
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Strabismus
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What is tropia?
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Abnormal deviation of the eye.
(i.e. Strabismus) |
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Would a lesion of the afferent part of the pupillary light reflex produce a + or - direct and indirect result.
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- direct, - indirect
(lesion of the efferent would result in - direct, + indirect) |
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What is the size of the pupils to be considered "anisocoria"?
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2 - 3 mm and round
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Pupil measurements of > 6mm is considered what?
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Mydriasis
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Pupil measurements of < 2 mm is considered what?
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Miosis
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An overflow of tears.
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Epiphora
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What is a possible cause of diplopia?
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Extraoccular muscle paralysis
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What are 2 possible causes of seeing halos around lights?
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1. Acute narrowed angle glaucoma
2. Opacities in lens or cornea |
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Seeing "flashes" could be due to what?
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Migraine, Retinal detachment, or Posterior vitreous detachment
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Having a glare or photophobia may be due to what?
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Irititis or Meningitis
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Distortion of vision may be due to what?
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Retinal detachment or Macular edema
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Difficulty seeing in dim light may be due to what?
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Myopia, Vit A def., or Retinal degeneration
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Changes in colored vision may be due to what?
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Cataracts or Drugs
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A loss of a visual field or presence of shadows or curtains may be due to what?
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Retinal detachment or Retinal hemorrhage
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Dryness of the eyes may indicate what syndrome?
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Sjogren's syndrome
(or simply due to age) |
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Feeling sandiness or grittiness may be due to what?
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Conjunctivitis
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"Bulging" of the eye.
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Proptosis
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"Twitching of the eye may be due to fibrillation of what muscle?
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Obicularis oculi
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T or F
Spots are commonly seen in migraines. |
False
(Flashes may be seen) |
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What disease is commonly associated with disc atrophy?
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MS
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Are most glaucoma cases Primary open angle or Narrow angle?
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85% Primary open angle
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Which form of glaucoma may present headaches, halos, pain, or vomitting.
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Narrow-angle
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In which form of glaucoma may the peripheral fields be affected early?
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Primary open-angle
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Which form of glaucoma might present a fixed partially dilated pupil and a "steamy" cornea?
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Narrow-angle
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Horner syndrome is due to a lesion of which of the following nerve fibers, sympathetic or parasympathetic?
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Sympathetic
(results in anhydrosis, myosis, and ptosis) |
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T or F
A lesion of the sympathetic fibers of CN III will lead to midriasis. |
False
A lesion of the (parasympathetics) of CN III |
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Name 3 possible causes of Chorioretinitis.
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Toxoplasmosis
Sarcoidosis Cytomegalovirus |
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What percentage of fibers are for vision and what percentage for light?
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80% vision
20% light |
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Incomplete closing of the eye.
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Lagophthalmos
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A form of chronic progressive external ophthalmoplegia with associated cardiac conduction defects, short stature, and hearing loss.
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Kearns-Sayre syndrome
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A greenish yellowish ring encircling the cornea.
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Kayser-Fleisher rings
(copper deposits associated with Wilson's disease) |
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Aka "Hooker pupil".
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Argyll Robertson pupil
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A notch in the iris.
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Iris coloboma
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What instrument would you use to determine the depth of the anterior chamber of the eye?
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Schiotz tonometer
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What is Marcus Gunn pupil and when will you see it?
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An afferent limb defect in the eye being illuminated; the pupil will dilate instead of constricting.
Seen in blind eyes |
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Farsightedness.
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Hyperopia
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Nearsightedness.
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Myopia
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While adjusting the diopters of the opthalmoscope, how do you accomodate for myopia?
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Use Minus numbers (red) because the light is focused anterior to the retina.
Opposite is true for Hyperopia, so use Positive numbers. |
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What are the 4 classifications of Keith, Wagner, Barker regarding effects of hypertension on the retina?
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(note: progressive to each step)
1. Arteriolar narrowing (incrsd BP over time) 2. AV nicking 3. Exudates / hemorrhages 4. Papilledema |
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The leading cause of blindness in people over 60.
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Macular degeneration
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Cholesterol emboli.
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Hollenhorst plaques
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Where are microaneurysms, neovascularizations, and retinitis proliferans associated with diabetes primarily located in the eye?
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Posterior pole
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The leading cause of blindness in Americans ages 20 -75.
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Diabetic retinopathy
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The leading cause of slow progressive blindness.
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Primary open-angle (simple, chronic) glaucoma
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