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169 Cards in this Set
- Front
- Back
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how many rectus muscles?
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4
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how many oblique muscles?
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2
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which extraocular muscles are straight?
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rectus
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which extraocular muscles are slanted?
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oblique
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where do optic nerve fibers from the temporal fields of vision cross over?
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the optic chiasm
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lens of the eye functions as a
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refracting medium
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when inspecting the eyeballs of a black individual, what might you expect to see?
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small brown macules on the sclera
slight protrusion of the eyeballs |
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what is associated with Horner's syndrome?
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a unilateral small regular pupil that reacts to light and accommodation
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decreased vision in the elderly may be due to what?
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macular degeneration
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Mrs. Black is a 52-year-old patient who comes to the clinic for a new patient visit. You make a diagnosis of anisocoria because you observed what?
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pupils of unequal size
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Blinking and pupillary constriction in the newborn indicate that
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the lower portion of the visual apparatus is intact
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Mrs. Smith brings her 3-month-old infant to the clinic with concerns about his eyes. In an infant with pseudostrabismus, which test for misalignment would you expect to be normal?
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corneal light reflex
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The tarsal plates of the upper lid contain glands that secrete an oily lubricating substance onto the lids. These glands are called
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meibomian glands
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Accommodation of the pupil, which also influences the size of the pupil, refers to what?
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adaptation of the eye for near vision
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The continuous flow of aqueous humor in the anterior chamber of the eye serves to
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deliver nutrients to surrounding tissues and remove metabolic wastes
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Mr. and Mrs. Green are taking home their newborn infant today; they ask you if their baby can see clearly yet. As the health care provider, you explain that most neonates are born with:
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farsightedness
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Mrs. Jones comes to your office with a complaint of visual disturbances. On examination, you note an abnormal growth of conjunctiva from the limbus over the cornea. What best describes this condition?
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pterygium
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An individual who has very dark irises is also more likely to have
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a darker retina
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The confrontation test is used to determine
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gross measurement of peripheral vision
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When performing the Hirschberg test (corneal light reflex), the results would tell you what?
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the eyes are in parallel alignment
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Older adults have a deposition of degenerative lipid material around the limbus of the eye, which is called
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arcus senilis
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When testing for the pupillary light reflex, an expected result is a(n) ________ and a(n) _________ response
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direct; consenual
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Mr. Mueller, a 56-year-old carpenter, comes to the office with a complaint of eye irritation. On examination, you note that his pupils differ in size (one of the two is larger). This condition is called:
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anisocoria
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Mr. Brians is a 48-year-old patient who comes to your office for a follow-up examination. What is your first observation when you examine the patient's eye with an ophthalmoscope?
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red light reflex
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When testing a newborn for visual reflexes via light perception, what would be expected?
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blinking
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The presence of epicanthal folds in children who are not Asian is often associated with a condition identified as
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pseudostrabismus
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The sclera of the newborn may have a slight blue tinge to it that is most likely due to
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thinness of the sclera at birth
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Xanthelasma is most commonly associated with what?
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older females
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A lesion at the optic chiasm will result in a visual defect associated with the loss of
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both temporal visual fields
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The six pairs of extraocular muscles are coordinated with each other to maintain parallel or ___________ movement
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conjugate
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The elliptical opening between the eyelids is identified as the ________ fissure
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palpebral
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The three layers, or coats, of the eyeball are the
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sclera, choroid, retina
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The lens of the eye functions as a:
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refracting medium
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The size of the pupil is controlled by a balance between
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the parasympathetic and sympathetic nervous system
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The area of sharpest and keenest vision of the retina is identified as the
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fovea centralis
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The function of the retina is to transform:
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light impulses into nerve impulses
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Mrs. Woods is a 69-year-old patient who comes to the office with her daughter. Her daughter is concerned about Mrs. Woods' decreasing vision. You explain to the daughter that decreased vision in the elderly may be due to
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macular degeneration
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The confrontation test is used to assess an individual's:
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peripheral vision
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Mr. George is a 48-year-old patient who is concerned about visual disturbances. You perform the cover test as part of his eye examination. The cover test is used to assess what?
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alignment of the eyes
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Mrs. Jones is a 54-year-old patient who comes to the office for an appointment. You perform the cover test as part of her eye examination. What is an expected response to the cover test?
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The covered eye maintains its position when uncovered.
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what do you write for normal anterior eyeball structures?
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PERRLA
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what does PERRLA stand for?
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Pupils
Equal Round React to Light Accommodation |
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normal Macula size
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1 DD
located 2 DD temporal to the disc |
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light perception
birth to 2 weeks |
refusal to reopen eyes
increasing alertness fixate on object |
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light perception
2 to 4 weeks |
fixate on object
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light perception
1 month |
fixate and follow a light or bright toy
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light perception
3 to 4 months |
fixate, follow, reach for toy
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light perception
6 to 10 months |
fixate and follow toy in all directions
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what ages is the Allen test used?
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2.5 years to 2 years 11 months
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what ages is the E chart used?
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3 to 6 years
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what age is the Snellen chart started?
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7/8 years
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by what age does a child reach 20/20 acuity?
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6/7
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what is considered blindness at 3 years?
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20/50 or less in either eye
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what is considered blindness at 4+ years?
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20/40 or less in either eye
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corneal light reflex
some asymmetry under what age is normal? |
6 months
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at what age does "dolls eye" reflex disappear?
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2 months
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what is setting sun?
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eyes appear to deviate down and you see a white rim of sclera over the iris
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what does setting sun occur with?
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hydrocephalus
malnutrition, dehydration, severe illness |
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lacrimal glands are ?function/not functional? at birth?
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not functional
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opthalmia neonatorum
aka |
conjunctivitis of the newborn
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what is the normal color of the iris in newborns?
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blue or slate-gray in light skinned
brown in dark-skinned |
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what are white specks around the edge of the iris called?
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Brushfield's spots
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what do Brushfield's spots occur with?
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may be normal
Down Syndrome |
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at what age is permanent eye color differentiated?
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6-9 months
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when is searching nystagmus normal?
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just after birth
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what does interruption in the red reflex indicate?
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opacity in the cornea/leans
congenital cataracts or retinal disorders |
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how does the fundus appear in newborns?
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pale
vessels are not fully developed |
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is there foveal light reflection in newborns?
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no
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when does the macula area mature?
(foveal light) |
1 year old
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it is normal for what visual acuity to be decreased/diminished in aging adults?
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central acuity
peripheral vision |
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tear production is ?increased/decreased? in the aging adult?
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decreased
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difference between pingueculae and pterygium
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pterygium grows over the cornea
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pingueculae is normal/abnormal in the aging adult?
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normal
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pterygium is normal/abnormal in the aging adult?
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abnormal
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xanthelasma is normal/abnormal in the aging adult?
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normal
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pupils are ?small/large? in old age?
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small
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benign, degenerative deposits in the fundus
small, round, yellow dots |
drusen
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drusen are ?normal/abnormal?in aging adults?
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normal
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hard exudates are ?normal/abnormal? in aging adults?
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abnormal
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exophthalos
causes |
thyrotoxicosis
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exophthalmos
symptoms |
protruding eyes
lid lag |
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ptosis
symptoms |
drooping upper lid
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ptosis
causes |
neuromuscular weakness
CN III damage sympathetic nerve damage |
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upward palpebral slant
causes |
Down Syndrome
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ectropion
symptoms |
lower lid is loose and rolling out
does not approximate to eyeball excess tearing dry & itchy risk for inflammation |
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ectropion
causes |
trauma
aging |
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entropion
symptoms |
lower lid rolls in
"foreign body" sensation rubbing of lashes may irritate cornea |
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entropion
causes |
spasms of lids
scar tissue contraction |
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blepharitis
symptoms |
inflammation of the eyelids
red, scaly, greasy flakes thickened, crusted lid margins burning, itching, tearing, pain, foreign body sensation |
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blepharitis
causes |
staphylococcal infection
sebhorrheic dermatitis of the lid edge |
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chalazion
symptoms |
beady nodule on the lid
nontender, firm, discrete swelling, freely movable |
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chalazion
when inflammed, points where? |
inside
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chalazion
causes |
infection
retention cyst of meibomian gland |
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hordeolum
aka |
stye
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hordeolum
symptoms |
painful, red, swollen
pustule at lid margin rubbing eyes can cause cross contamination |
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hordeolum
causes |
staphylococcal infection
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dacryocystitis
symptoms |
inflammation of the lacrimal sac
pain, warmth, redness, swelling below the inner canthus toward nose pressure on sac yields purulent discharge from puncta |
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dacryocystitis
causes |
infection and blockage of sac and duct
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basal cell carcinoma
symptoms |
papule with an ulcerated center
rolled out, pearly edges most often of the lower lid and medial canthus |
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dacryoadentitis
symptoms |
inflammation of the lacrimal gland
pain, swelling, redness occur in the outer third of upper lid |
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dacryoadentitis
causes |
mumps
measles infectious mononucleosis trauma |
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anisocoria
symptoms |
unequal pupil size
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anisocoria is caused by what?
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normal in 5% of population
central nervous system disease |
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monocular blindness
symptoms |
no response in either eye when light is directed into blind eye
both pupils constrict when light is directed into normal eye |
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monocular blindness causes
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both pupils constrict if CN III is intact
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miosis
symptoms |
constricted and fixed pupils
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miosis
causes |
drops for glaucoma
narcotics iritis brain damage of pons |
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mydriasis
symptoms |
dilated and fixed pupils
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mydriasis
causes |
stimulation of sympathetic nervous system
dilating drops trauma acute glaucoma deep anesthesia |
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argyll robertson pupil
symptoms |
no reaction to light
pupil does not constrict with accommodation small and irregular bilaterally |
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argyll robertson
causes |
central nervous system syphilis
brain tumor meningitis chronic alcoholism |
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tonic pupil/Adie's pupil
symptoms |
sluggish reaction to light and accommodation
tonic pupil is usually unilateral, a large pupil that does react, but sluggishly |
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tonic pupil/Adie's pupil
causes |
no pathologic significance
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cranial nerve III damage
symptoms |
unilateral dilated pupil with no reaction to light or accommodation
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occulomotor nerve damage
occurs with damage to what nerve? |
cranial nerve III
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Horner's syndrome
symptoms |
unilateral, small, regular pupil
does not react to light and accommodation |
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Horner's syndrome
causes |
lesion of the sympathetic nerve
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conjunctivitis
symptoms |
"pink eye"
red beefy looking vessels at periphery, usually clearer around iris purulent discharge preauricular lymph node is swollen and painful |
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conjunctivitis
causes |
bacterial or viral infection
allergy chemical irritation |
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subconjunctiva hemorrhage
symptoms |
red patch on the sclera
sharp edges like a spot of paint looks alarming, but usually not serious |
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subconjunctiva hemorrhage
causes |
trauma
increased intraoccular pressure from coughing, sneezing, etc |
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iritis
symptoms |
circumcorneal redness
deep halo around the iris and cornea pupil shape may be irregular from the swelling of iris photophobia, constricted pupil, blurred vision, throbbing pain |
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acute glaucoma
symptoms |
circumcorneal redness around the iris with dilated pupil
cornea looks "steamy" anterior chamber is swollen sudden clouding of vision, sudden eye pain, halos around eyes EMERGENCY TREATMENT TO AVOID VISION LOSS |
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acute glaucoma
causes |
sudden increase in intraocular pressure from blocked outflow from anterior chamber
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pterygium
symptoms |
triangular opaque wing of bulbar conjunctiva overgrows toward center of the cornea
may obstruct vision looks membranous, translucent, yellow to white |
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pterygium
causes |
chronic exposure to hot, dry, sandy climate
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corneal abrasion
symptoms |
irregular ridges visible when florescent stain revel yellow-green branching
top layer of corneal epithelium removed intense pain, foreign body sensation, lacrimation, redness, photophobia |
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corneal abrasion
causes |
blunt eye injury
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normal anterior chamber
symptoms |
light directed across the eye from temporal side illuminates the entire iris evenly because the normal iris is flat and contains no shadow
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shallow anterior chamber
symptoms |
iris pushed anteriorly because of increased intraocular pressure
nasal side is shadowed only temporal part of iris is illuminated |
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shallow anterior chamber
iris looks bulging because why? |
aqueous humor cannot circulate
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shallow anterior chamber
causes |
acute angle-closure glaucoma
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hyphema
symptoms |
blood in anterior chamber
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hyphema
causes |
serious result of blunt trauma
spontaneous hemorrhage scleral rupture or major intraoccular trauma |
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hypopyon
symptoms |
purulent matter in anterior chamber
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hypopyon
causes |
iritis
inflammation in the anterior chamber |
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nuclear cataract
symptoms |
opaque gray surrounded by black background
forms in the center of lens nucleus looks like a black center against the red reflex |
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nuclear cataract
causes |
begins after 40
develops slowly, gradually obstructing vision |
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cortical cataract
symptoms |
star-shaped opacity
asymmetrical, radial, white spokes with black center black spokes are evident against the red reflex |
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optic atrophy
symptoms |
disc pallor
white/gray color of the disc decreased visual acuity, decreased color vision, decreased contrast sensitivity |
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optic atrophy
causes |
partial or complete death of the optic nerve
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papilledema
symptoms |
choked disc
venous stasis in the globe blurred margins hemorrhages absent venous pulsations visual acuity not affected |
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papilledema
causes |
intracranial pressure
usually caused by a space occupying mass (tumor or hematoma) |
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excessive cup-disc ratio
symptoms |
cup enlarges to more than half of the disc diamter
vessels appear to plunge over edge of cup vessels are displaced nasally asymptomatic |
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excessive cup-disc ratio
causes |
primary, open-angle glaucoma
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arteriovenous crossing
symptoms |
nicking
dilates distal to crossing |
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arteriovenous crossing
causes |
hypertension
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narrowed arteries
symptoms |
generalized decrease in diameter
light reflex narrows |
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narrowed arteries
causes |
severe hypertension
occlusion of central retinal artery and retinitis pigmentosis |
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vessel nicking
symptoms |
localized narrowing in vein caused by arteriole crossing
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vessel nicking
causes |
hypertension
arteriosclerosis |
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microaneurysms
symptms |
round, punctuate red dots that are localized dilations of a small vessel
edges are smooth and discrete |
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microaneurysms
causes |
diabetes
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intraretinal hemorrhages
causes |
hypertension
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intraretinal hemorrhages
symptoms |
dot shaped hemorrhages
look splattered on flame shaped hemorrhages |
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exudates
symptoms |
look fluffy gray-white cumulous clouds
arteriolar microinfarction that envelop and obscure the vessels |
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exudates
causes |
diabetes
hypertension subacute endocarditis lupus papilledema of any cause |
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movement of the extraocular muscles is stimulated by what 3 cranial nerves?
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III (3)
IV (4) VI (6) |
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cornea is vascular/nonvascular?
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nonvascular
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fovea centralis
is located where? |
at the center of the macula
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glaucoma affects ?men/women? more?
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men
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what is the most common form of glaucoma?
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chronic open-angle glaucoma
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what is glaucoma?
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increased intraoccular pressure
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incidence of glaucoma increases after what age?
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75 to 85
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what is macular degeneration?
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the breakdown of cells in the macula of the retina
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what is the most common cause of blindness?
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loss of central vision
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macular degeneration affects what % of those aged 75 to 85?
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28%
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macular degeneration affects ?men/women? more?
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women
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macular degeneration does not affect what part of visual acuity?
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peripheral vision
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