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85 Cards in this Set

  • Front
  • Back
Myopia (nearsighted) is a condition where the light rays are focused where on the retina?
In front of the retina enabling clear vision for a short distance.
Hyperopia (farsighted) is a condition where the light rays are focused where on the retina?
Behind the retina due to the flatting of the globe of the eye or of an error in refraction.
What is a defect of vision associated with advancing age and loss of accomodation?
What is the usual age of onset for presbyopia?
Between 40-45.
What affects the Zeis glands or glands of Moll ate the edge of the lid?
External Hordeolum (Sty).
This is a localized, purulent inflammatory staph infecton of one or more sebaceous gands of the eye lids
If an abrasion is suspected but cannot by seen what can be used and what would be seen?
Fluorescein stain, area of abrasion will stain a deeper green than surrounding cornea.
This may develop at any age usually following minor trauma, straining, sneezing, or coughing?
Subconjunctival Hemmorrage.
Subconjuctival Hemmorrage rarely occur spontaneously or may indicate what?
Systemic coagulopathy or sysemic hypertension.
What should be tested both before and after treatment of an ocular foreign body?
Visual Acuity
What is used to remove an ocular foreign body?
Sterile, wet CTA
Which types of foreign body will occasionally leave a rust ring?
Fine silk is used to repair what type of lid lacerations?
Minor lid laceration.
Major lacertions involving the lacrimal apparatus should be repaired by who?
Ophthalmic surgeon.
Destruction of the corneal epithelium by ultraviolet light is known as what?
Actinic Keratitis, ultraviolet keratitis (Flash Burn).
Ultraviolet burns of the cornea are usually caused by what?
Use of sunlamp with eye protection, exposure to a welding arc, or exposure to the sun when skiing.
What is the treatment for flash burn?
Bilateral patching for 24 hours, instillation of 1-2 gtts short acting cycloplegics, use of ophthalmic antibiotic, provide systemic analgesics for pain. Recovery in 12-36 hours.
Blood in the anterior chamber is called what?
What is the immediate treatment for hyphema?
Bedrest with head elevated at 60 degrees. Sedate patient with both eyes covered.
What is given if IOP is increased with hyphema?
Acetazolamide 250mg P.O. q6 hours or other carbonic anhydrase inhibitors (methazolamide)
What medication is used for total hyphema?
IV mannitol 20% 250-500 ml over 2-3 hours.
What products are contraindicated in hyphema?
Products containing aspirin.
What is essential in the disposition of hyphema?
Acute care by an ophthalmologist, including exam of the optic nerve head.
What is the difference between penetrating and perforating eye injury?
Penetrating - disruption of outer coat of eye (sclera) without interupting anatomic continuity thus preventing prolapse.
Perforating - complete anatomic disruption.
What is the treatment for an ocular penetration wound?
Relieve pain, preserve or restore vision, achieve good cosmetic result.
Why should a patient with a rupture of the ocular globe be NPO?
Pending surgery.
What is medication used to relieve pain of an rupture of the ocular globe?
Morphine 2-4mg IV or SC PRN.
What is use to avoid inadvertant pressure that could extrude contents in a rupture of the ocular globe?
Binocular eye patch and a metal shield.
What medications can be given to prevent further injury with a rupture of the ocular globe?
In a blowout fracture this gives way because it is the weakest component of the orbit.
The orbital floor.
What confirms ocular muscle entrapment as a result of a blowout fracture?
Diplopia and restricted upward gaze.
What may be present due to laceration of the roof of the maxillary sinus with a blowout fracture?
Unrepaired blowout Fx may result in what?
Permanent diplopia, disfiguring enopthalmos, and herniation of orbital contents into the antrum.
What are two most common predisposing factors of retinal detachment?
Cataract extraction and myopia.
What might a pt complain of in retinal detachment?
Painless decrease in vision, Hx of flashes of lights or sparks.
What are the two types of lens dislocation?
Partial (subluxation) or complete.
Dislocation of the lens may result from what 2 things?
Hereditary or result from trauma.
A partial dislocation that stays behind the iris plane resulting from zonular damage or zonular irregularity is also called what?
What are 2 common complications of dislocation of the lens?
Iritis and glaucoma.
What is a complication of surgical removal of the lens?
Vitreous loss and retinal detachment.
What is the conjunctiva?
It is the clear, leathery outer covering of the eye.
What are the characteristics of conjunctivitis?
Foreign body sensation
Preauricular LAD
What is the most conspicuous sign of conjunctivitis?
Copious and purulent exudate is what type of conjuctivitis?
Exudate is stringy in what type of conjuctivitis?
What strongly suggest acute hay fever conjunctivitis?
Chemosis (conjunctival edema).
What is seen in most viral conjunctivitis and all chlamydial conjunctivitis and may be recognized as an avascular white or grey round structure?
What is an important sign that occurs in: HSV conjunctivitis, Epidemic keratoconjunctivitis, Inclusion conjunctivitis, Trachoma.
Preauricular LAD.
In gonococcal conjunctivitis what is given in regards to corneal involvement?
If not involved: Single dose Ceftriaxone 1g IM.
If involved: 5 day course IV ceftriaxone 1-2g.
Trachoma is caused by what?
Chlamydia trachomatis serotypes A-C.
What is a major cause of blindness worldwide?
Trachoma, which is spread by direct familial contact.
What is caused by chlamydia serotyopes D-K, acquired through contact with infected genital secretions, and frequently in sexually active adults.
Inclusion conjunctivitis (Blenorrhea).
What describes inflammation of the cornea?
When does a pt with an ocular forgien body need to follow up?
24 hours
What is Blepharitis?
A chronic bilat inflammation of the lid margins with redness, thickening, and often the formation of scales and crust or shallow marginal ulcers.
Anterior blepharitis involves what structures?
eyelid skin, eyelashes, and associated glands
Ulcerative Ant. Blepharitis is usually due to?
Staph. infection
Seborrheic blepharitis is almost always associated with what?
Seborrhea of the scalp, brows, and ears.
Describe how scales present in a staphylococcal blepharitis infections?
Describe how scales present in a seborrheic blepharitis infection?
Two complications of blepharitis are?
Hordeolum and/or Chalazion
Uncomplicated corneal ulcers resolve with in what time frame?
2-3 weeks
What begins as a dull, grayish circumscribed superficial infiltration and subsequently necroses and suppurates?
Corneal Ulcer
What are the TX for the following in a corneal ulcer?

Gram Pos. Cocci

Gram Neg. Bacilli
Ceflasporin (cefazolin 100mg/ml

Aminoglycosides (gentamicin 10mg/ml)
In HSV Keratitis what is he most characteristic lesions?
Dendritic lesion
Trifluridine (viroptic) or idoxuridine (herplex, stoxil) used every 2 hours during the day is tx for what?
HSV Keratitis
This is a meibomian gland abscess, marked by swelling on the conjunctival surface of the lid, it may point to the skin or the conjunctival surface>
Internal Hordeolum
This is a localized small infection of the glands, normally found on the lid margin always points to the skin?
External hordeolum (sty)
Dacryocystitis is usually bilat or unilateral?
Usually unilateral
What is the tx of Dacryocystitis
Frequent application of hot compress, Cephalexin 500mg po q6 for mild cases or Cefazolin 1gm IV for severe cases
A common granulomatous inflammation of a meibomian gland that may follow an internal hordeolum.
The onset of this disease is insidious with the pt. complaining of blurred vision, severe photophobia, and headache or ocular pain
What is the etiology of Acute Angle Closure Glaucoma?
A sudden increase in the IOP from the blockage of the outflow channels in the anterior chamber of the eye
What are the characteristics for glaucoma?
Blurred vision, localized extreme pain, rainbow colored halos, N/V, increase IOP, shallow anterior chamber, edematous (steamy) cornea, decrease VA, dilated or fixed pupil, ciliary injection.
What medications are given prior to surgery to reduce IOP?
Glycerin 1g/kg body weight
Pilocarpine 1-2% eye drops. 2 gtts q15 min for 2-3 hrs.
Mannitol 20% 250-500ml IV over 2-3 hrs
Acetazolamide 500mg IV followed by 250mg PO QID.
In 2-5 days untreated acute glaucoma will result in what?
Permanent vision loss.
This is an insidious disease that causes slow progressive loss of peripheral vision by damaging the optic nerve.
Open angle glaucoma.
What meds are avoided in open agle glaucoma due to the potential for causing acute narrow angle glaucoma?
Cycloplegics and Mydriatics
What meds are used for the treatment of open angle glaucoma?
Pilocarpine 1-4%
What percentage of the population presents with essential anisocoria?
This is caused by lesions affecting the sympathetic or parasympathetic pathways or local iris disease.
Patholgical anisocoria
Lesions of what visual system do not cause anisocoria?
Afferent visual system
What is the disposition for a pt with TM perf involving severe vertigo or complete hearing loss?
Hospitalization and obtain emergency otolarygeal consultation.
Is hospitalization required for a patient who has recieved chricothyrotomy?
If tinitis is sever and/or persistant that interferes with sleep or ability to concentrate what is done?
Refered to higher level of care.