Term
1. eye is too short for focusing apparatus. what kind of lens would you correct with?
2. eye is too long for focusing apparatus. what kind of lens?
3. cornea is football shaped. what kind of lens? |
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Definition
1. farsighted (hyperopia) - convex lens
2. nearsighted (myopia) - concave lens
3. astigmatism - lens that is same shape but 90 deg off
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Term
unilatral or bilateral reduction in visual acuity (with best correction) that cannot be attributed to the effect of any structural abnormality of the eye or posterior visual pathway. typically seen before age 7 but must be diagnosed before age 4 for optimal tx. most common cause of reduced vision in kids.
3 kinds of this?
this is a disease of the brain (not the eye) in which part? |
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Definition
amblyopia
strabismus, refractive, deprivation
lateral geniculate nucleus |
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Term
___ is misalignment of the eyes
___ is cross eyes
___ is when one or both eyes is oriented outward |
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Definition
strabismus
esotropia
exotropia |
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Term
| a NON-INTERMITTENT deviation of the eye that may result form competition between neurons carrying different images to prevent diplopia |
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Definition
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Term
| child wiht abnormal red reflex in one eye, the result of asymmetric refractive errors so that one eye does not present clear images to the retina |
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Definition
| refractive amblyopia (anisometropic) |
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Term
Caused by opacity in the visual pathway between the lids and retina that deprives the retina of an image.
most difficult type to treat
critical period btwn 1 week and 2 mos of age
most common cause is unilateral cataract |
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Definition
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Term
| hemangioma in the eyelid could cause what kind of amblyopia? |
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Definition
| refractive due to mass pushing on eye |
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Term
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Definition
depends on type
remove opacity (deprivation)
correct refractive errors (refractive)
correct ocular dominance via occlusive pathces for 75-90% of waking hours (strabismic) |
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Term
chronic discharge and tearing seen in babies
__% will resolve by 6 mos
__% of remaining will resolve by 12 mos
tx? |
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Definition
nasolacrimal duct obstruction
tx: massage and lid hygiene, may need surgery if unresolved by 13-16 mos |
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Term
| discharge in the first week of life that may be gonocococal or chlamydial conjunctivitis and can cause serious corneal & thus visual damage. uncommon these days because babies are given abx eyedrops at birth |
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Definition
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Term
| dysfunction of the levator muscle that puts pts at risk for refractive amblyopia. kid will often walk around with their head tilted back |
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Definition
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Term
peripheral vision that is not vascularized at birth that results in abnormal progression of vascularization and scarring or detached retina
tx? |
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Definition
retinopathy of prematurity (avascular retina)
tx: laser peripheral retina or inject avastin |
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Term
| very rare disease that is characterized by large, opaque corneas or "Ox eyes" (buphthalmos) |
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Definition
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Term
WBC filling the vitreous cavity, causing a white reflex instead of red reflex. seen in kids.
3 kinds are retinoblastoma (malignant tumor of retina in kids), cataract, and toxocariasis |
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Definition
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Term
| lid laceration affecting canaliculi.. what tx? |
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Definition
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Term
| tx for chemical splash in eye |
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Definition
immediate irrigation
topical anesthesia
check VA and tear film pH
check for foreign bodies, esp if powder is involved
irrigate with 3L NS and check pH again at 5 min
repeat until pH is between 7-8
this is a HUGE emergency. can destroy cornea quickly and cause necrosis of conjunctiva |
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Term
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Definition
something that goes through the cornea, not just scratch
may see accumulation of WBC (pus) in eye
treat as open globe
usually requires surgery |
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Term
what dx? foreign body sensation, pain, tearing, photophobia, and hx of "glancing blow" trauma
what tx? |
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Definition
corneal abrasion
use florescein dye and black light to illuminate
DO NOT USE PATCH
topical abx
one dose of topical anesthetic
NSAID |
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Term
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Definition
| remove with 30g needle and slit lamp and anesthetic |
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Term
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Definition
iris torn from its root - causes "second pupil"
usually caused by blunt trauma
no tx other than watching pressure |
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Term
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Definition
caused by blunt trauma, when blood circulates and layers in anterior chamber
may affect pts vision due to occlusion but will resolve once hyphema resolves
complications: increased IOP, corneal blood stain, risk of rebleed. sickle cell more prone to increased IOP. bleeding disorders may be a problem
long term complications: angle-recession glaumcoma, traumatic cataract, associated retinal damage
tx: bed rest, shield, follow IOP, topical steroid to dilate eye. surgery if complications |
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Term
| pt cannot look up after blowout fx. why? |
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Definition
| inferior rectus muscle is trapped in floor of orbit |
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Term
| pt presents with lid crepitus, diplopia, inability to look up, and hypesthesia of cheek and gum after being hit in the face with a baseball. dx? tx? |
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Definition
blowout fx - inferior rectus and trigeminal are trapped
tx: systemic abx, surgical repair possibly |
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Term
| what should you do if you suspect an open globe? |
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Definition
discontinue exam
apply shield
DO NOT APPLY PRESSURE PATCH
tetanus prophylaxis
NPO
consult |
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Term
| What should you do if you suspect intraocular foreign body? |
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Definition
slit lamp or ophthalmoscope exam
plain films if suspect metallic
CT for non-metallic |
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Term
| sx of shaken baby syndrome |
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Definition
lethargy
absence of external injuries
ecchymoses of upper arms
subconjunctival hemorrhage
lid ecchymoses
intraocular hemorrhage- hyphema, vitreous, preretinal, or intraretinal hemorrhage |
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Term
| how long will retinal hemorrhage from birth trauma last? |
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Definition
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Term
| ddx for retinal hemorrhages in baby |
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Definition
birth trauma
shaken baby
leukemia
anemia
thrombocytopenia
malignant htn
sepsis
accidental trauma (mild hemorrhage)
cpr |
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Term
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Definition
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Term
| intraocular fluid is produced by the ___ and flows out through the ___ |
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Definition
ciliary body
trabecular meshwork |
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Term
visual field loss of ___ starts in the periphery
visual field loss of ___ starts in the center |
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Definition
glaucoma
macular degeneration |
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Term
| which is more common, open or closed angle glaucoma? |
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Definition
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Term
| what is an early indicator of glaucoma damage? |
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Definition
| disc cupping, esp if in the vertical direction (cup:disc ratio >0.5) |
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Term
| tx for open angle glaucoma has what purpose? |
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Definition
| decrease fluid production or increase efficiency of outflow |
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Term
pt presents with sudden rise in IOP, associated with headache that are relieved by light +
severe ocular pain/redness
blurred vision
haloes around lights
n/v
fixed pupil in mid-position
tx? |
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Definition
acute angle-closure glaucoma
tx: surgery to create another pathway from fluid to get into anterior chamber and reduce IOP (iridectomy) |
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Term
ocular trauma resulting is scarring of trabeuclar meshwork
retinal vein occlusion
intraoccular inflammation (iritis/uveitis)
intraocular tumor
DM
carotid vascular disease
all are causes of ? |
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Definition
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Term
| never give what to pts with acute narrow angle glaucoma? |
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Definition
| dilating drops or OTC cold meds (bc they can dilate pupils) |
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Term
| is IOP directly related to systemic BP? |
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Definition
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Term
| clouding of lens, usually due to hardening of nucleus |
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Definition
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Term
nuclear cataracts are ____
cortical cataracts are ____ |
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Definition
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Term
dx?
older pt who has become gradually, increasingly nearsighted (can read ok up close but not at a distance) |
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Definition
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Term
| ultrasonic procedure that breaks up a cataract |
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Definition
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Term
| what is the first thing you hsould check on ALL pts with eye problems? |
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Definition
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Term
what eye muscles do what movement?
lateral?
torsional + elevation/depression? |
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Definition
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Term
| in esotropia, which muscle is too strong? |
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Definition
medial rectus
(esotropia = cross eyes) |
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Term
pt presents wtih acute onset headache, ptosis, and improper fxn of superior and medial rectus and inferior oblique.
dx? |
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Definition
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Term
| components of the anterior segment of the eye |
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Definition
| conjunctiva, sclera, cornea, pupil, lens |
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Term
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Definition
acute conjunctivitis
acute iritis
acute angle glaucoma
corneal trauma/infection |
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Term
what dx?
red eye
normal vision
no pain
no photophobia
normal pupils
clear cornea
watery discharge
white follicles on inside of eyelid
enlarged preauricular node |
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Definition
| viral conjunctivitis (probably adenovirus) |
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Term
what dx?
red eye
normal vision
no pain
no photophobia
normal pupils
clear cornea
purulent discharge
"angry looking eye" |
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Definition
bacterial conjunctivitis - probably gonococcal
if enlarged preauricular nodes, def gonococcal |
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Term
what dx?
red eye
normal or blurred vision
moderate to severe pain
marked photophobia
small, poorly reactive pupil
clear cornea |
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Definition
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Term
what dx?
red eye
markedly blurred vision
severe pain
moderate photophobia
mid-position fixed pupil
"steamy" cornea |
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Definition
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Term
nisseria gonorrhea
H. influenza
staph aureus (chronic)
pneumococcus
h. aegyptius
all causes of? |
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Definition
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Term
| ___ is staph infection at base of lashes. can cause chronic conjunctivitis |
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Definition
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Term
| ___ - plugging of myobean gland |
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Definition
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Term
| course of viral onjunctivitis |
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Definition
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Term
| tx for viral conjunctivitis |
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Definition
erythromycin (azasite) or moxyfloxicin/cipro to prevent secondary bacterial infection
NOT neosporin |
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Term
| components of uveal tract |
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Definition
| iris, choroid, ciliary body |
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Term
| posterior v. anterior uveitis |
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Definition
posterior - choroid inflammation
anterior - iritis |
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Term
granulomatous iritis is caused by?
tx? |
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Definition
sarcoid
dilation + topical steroids |
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Term
| if you're not an ophthalmologist, don't use steroids in the eye because ___ can devleop |
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Definition
| herpex simplex dendritic inflammation, which can lead to corneal blindness |
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Term
| layer of tissue between sclera and conjunctiva |
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Definition
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Term
| conjunctiva grwoing onto cornea |
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Definition
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Term
| point of light floating above the fovea - concetnration of the reflecting light |
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Definition
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Term
dot/blot hemorrhages
hard exudates (protein and lipid molecules)
cotton wool spots
intraretinal microvascular abnormalities (IRMA)
what dz? |
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Definition
| background diabetic retinopathy (BDR) |
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Term
most common cause of vision loss in type II DM
what is tx for this? |
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Definition
diabetic macular edema
tx: focal laser (FLP), VEGF (vascular endothelial growth factor) |
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Term
most commonly seen in type I DM, neovascular generation of the disc that carries a high risk of blindness. could also result in vitrous hemorrhage.
often seen in type I diabetics who were poorly controlled as teenagers
tx? |
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Definition
proliferative diabetic retinopathy (PDR)
laser surgery (panretinal photocoagulation - PRP, or pars plana vitrectomy PPV)
VGEF inhibition/steroids |
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Term
| maintenance tx for diabetics |
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Definition
type I - yearly dilated eye exams starting at puberty or within 5 years of diagnosis
Type II - yearly dilated exams after diagnosis
pregnant - in their first trimester and then each trimester as indicated |
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Term
| points to emphasize with pts with diabetic eye disease |
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Definition
most damage is asymptomatic
control is of utmost importance
some can cure themselves with diet and exercise |
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Term
what dz?
worses diabetic retinopathy
vein & artery occlusions/narrowing
macroaneurysms
optic nerve problems
macular degeneration
exudates
A/V nicking
optic nerve swelling |
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Definition
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Term
main cause of blindness in HIV/AIDS pts?
creates retinal whitening/moth eaten appearance at periphery
tx |
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Definition
CMV retinitis
tx: cyclovirs
uncommon these days because of tx. t4 > 100 will not have this. |
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Term
| white plaque under retina that is treated with steroids |
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Definition
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Term
| hard exudate without other signs of DR? |
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Definition
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Term
| twisted blood vessels and hemorrhage of retina |
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Definition
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Term
| elevated choroid under retina |
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Definition
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Term
visual pathway: left eye sends messages to ___ brain, left side of retina responsible for __ visual field
fibers cross at ___ |
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Definition
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Term
shine light in left eye and both pupils contract
shine light in right eye and both eyes dilate
what is the problem? |
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Definition
| afferent pupillary defect - severing of right optic nerve |
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Term
| causes of APD (afferent pupillary defect) |
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Definition
corneal trauma
virteous hemorrhage
macular problem
retinal detachment
optic nerve damage
retrochiasmal prolbme |
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Term
most common cause of legal blindness > 65
painless central scotoma or metamorphopsia
tx? |
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Definition
macular degeneration
VEGF inhibition (avastin or lucentis)
lucentis much more expensive than avastin |
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Term
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Definition
floaters
flashers
photopsia
visual field loss |
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Term
scleral buckle
vitrectomy
pneumatic retinopexy
all are tx for? |
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Definition
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Term
pt wtih htn and >55 y/o
hemorrhage where arteries cross veins in retina
blurred vision possible |
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Definition
| branch retinal vein occlusion |
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Term
| "blood and thunder" effect |
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Definition
| central retinal vein occlusion |
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Term
| tx for retinal vein occlusions |
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Definition
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Term
whitening of retina due to infarction
hollenhorst plaque - if yellow from carotids, if white from heart
high risk factor for stroke |
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Definition
| branch retinal artery occluison |
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Term
chery red spot - normal fovea in an area of whitening
caused by embolus or thrombus
could be due to cilioretinal artery, causes wedge vsiion |
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Definition
| central retinal artery occluiosn |
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Term
| tx for retinal artery occlusiosn |
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Definition
draw fluid off eye
poor outcome |
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Term
mostly occurs in young women
moderate to severe vision loss in one eye
high association with MS
may have pain wtih eye movement
near complete recovery
optic nerve is swollen
APD common
tx? |
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Definition
optic neuritis
do MRI to look for plaques of MS and start MS tx if necessary |
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Term
optic nerve swelling
more common in older eople
usually irreversible
arteritic:
polymyalgia rheumatica
scalp tenderness, HA< fever, chills, jaw claudication
OTHER EYE AT RISK
non-arteritic:
elderly "vasculopaths"
no GCA sx
nocturnal hypotension
small cup
other eye at risk |
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Definition
| ischemic optic neuropathy |
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Term
| tx for ischemic optic neuropathy |
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Definition
stat esr, crp
start high dose prednisone
do temporal artery biopsy |
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Term
1. epiphoria
2. limbus
3. nystagmus
4. retinitis pigmentosa
5. chemosis
6. aphakia
7. fovea
8. mydriasis
9. miotic
10. cycloplegia
12. canthus |
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Definition
1. excessive tearing
2. border of cornea and sclera
3. involuntary eye movement
4. progressive genetic disorder of neuroepithelium
5. accumulation of fluid beneath the bulbar conjunctiva - seen in conjunctivitis
6. absence or loss of the eye's nature lens
7. area of sharpest vision
8. dilation of the pupil
9. agent causing pupil to contract
10. paralysis of ciliary muscles resulting in loss of accomodation
11. angle formed by upper and lower eyelids |
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Term
1. enucleation
2. synechia
3. leukoma
4. papilledema
5. scotoma
6. tonometry
7. hordeolum |
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Definition
1. removal of the eye
2. scarring - found in wegener's
3. densee, white corneal opacity caused by scarring
4. edema/inflammation of optic nerve
5. area of depressed vision surrounded by an area of normal vision
6. measures IOP
7. stye
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Term
inflammation of the cornea
causes: bacteria (pseudomonas, pneumococcus, staph), herpes simplex or zoster, fungal, acanthamoeba
often has a corneal ulcer |
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Definition
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Term
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Definition
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Term
| infection of nasolacrimal sac |
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Definition
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Term
extremely common eye problem
lots of discharge
no effect on vision
no pain
diffusion red eye
clear cornea
normal pupil size & response
normal IOP |
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Definition
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Term
common eye problem
no discharge
slightly blurred vision
moderate pain
circumcorneal red eye
clear cornea
small pupil
poor pupillary response
normal IOP |
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Definition
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Term
uncommon eye problem
no discharge
markedly blurred vision
severe pain
diffuse red eye
steamy cornea
moderately dilated & fixed pupil with no pupillary rxn
elevated IOP |
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Definition
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Term
common cause of red eye
watery or purulent discharge
usually blurred vision
moderate to severe pain
normal pupil
normal IOP
caused by trauma or infection |
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Definition
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