Term
| what are the 8 parts of the external eye |
|
Definition
upper lid
sclera
lower lid
pupil
iris
lacrimal papilla
plica semilunaris |
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|
Term
| what are the 9 parts of the anterior eye |
|
Definition
ora serrata
ciliary body
posterior chamber
anterior chamber
cornea
pupil
iris
zonules
sclera |
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|
Term
| what is the middle part of the eye called |
|
Definition
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|
Term
| what are the 6 parts of the back of the eye |
|
Definition
retina
foeva centralis
centra retinal artery
optic nerve
central retinal vein
optic disc |
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|
Term
| what are the 6 extraocular muscles and their innervation |
|
Definition
CN III: superior, inferior, and medial rectus, inferior bolique
CN IV (trochlear): superior oblique
CN VI (abducens): lateral rectus |
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Term
| what should be done at a newborn to 3 mo old eye check (2) |
|
Definition
| red reflex, ocular alignment |
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|
Term
| what should be done at a 6mo - 1yo eye exam |
|
Definition
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|
Term
| what should be done at a 3 yo eye exam |
|
Definition
| snellen, allen picture, HOTV, or lea symbol chart |
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|
Term
| explain the progression of vision over the ages |
|
Definition
3yo 20/50
4yo 20/40
5yo 20/30
6yo 20/20 |
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|
Term
| what are the changes to the eye in pregnacy (3) |
|
Definition
| shape, refractive error changes, increased chance of diabetic retinopathy |
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|
Term
| what 3 eye problems are normal with age |
|
Definition
prebyopia: need for reading glasses
pearl: starts around 40. loss of accomodation, need bifocals
cataracts 50-55 yo |
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|
Term
| what are the two important history questions about a vision problem |
|
Definition
| important to ilicit timing ot onset and if it is associated with pain |
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|
Term
| what are the first 3 rules of eye examination |
|
Definition
systematic:
vision first
with corrective lenses on
one eye at a time then both |
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|
Term
| how is visual acuity tested |
|
Definition
| snellen chart for distance and rosenbaum or jager chart for near |
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|
Term
| how do you test visual acuity without a chart |
|
Definition
| fingers held up at different distances |
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|
Term
| what is the ultimate vital sign for the eye |
|
Definition
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|
Term
| what are the three vital signs of the eye |
|
Definition
| visual acuity, pupils, pressure |
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|
Term
| what do you do in the external eye exam |
|
Definition
examine head, face, eyelids, assymetry, ptosis, swelling or nodules
examine for bell's palsy (asymmetry in CV VII) |
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|
Term
| how do you check the pupils |
|
Definition
dim roomwith penlight or transilluminator
assess for assymetry or anisocoria, swinging flash light test, consensual responses |
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|
Term
|
Definition
| check pupils in light and dark to see which pupil is involved |
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|
Term
| what do you do if someone dont has their glasses and you need to test their vision |
|
Definition
| put a hold in a piece of paper and have them look through and you can see if the vision problem is refractive or not |
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|
Term
| how do you detect marcus gunn pupil, what is the real name for this, how can you tell |
|
Definition
afferent pupillary defect
swinging flash light test: one pupil dilates relative to the other |
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|
Term
| what are the limbs of the pupillary reflex arch |
|
Definition
afferent CN II (optic nerve)
efferent CN III (oculomotor nerve) |
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|
Term
| what are the two ways to test eye motility |
|
Definition
|
|
Term
|
Definition
| testing movement of each eye seperate |
|
|
Term
| what is versions, what information does this give us |
|
Definition
testing the eyes together
ilicits conjugate vs disconjugate gaze |
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|
Term
| which muscle moves the eye laterally what CN is it |
|
Definition
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|
Term
| what muscle moves the eye medially, what CN is it |
|
Definition
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|
Term
| what muscle moves the eye superior lateral, what CN is it |
|
Definition
|
|
Term
| what muscle moves the eye superior medial, what CN is it |
|
Definition
|
|
Term
| what muscle moves the eye inferior lateral, what CN is it |
|
Definition
|
|
Term
| what muscle moves, the eye inferior medial, what CN is it |
|
Definition
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|
Term
| what is consenusal reflex of the pupil |
|
Definition
| shine light on right eye and left constricts slighly too, this is normal |
|
|
Term
| how do you test conforntational fields |
|
Definition
| cover one eye on you and the patient, flash fingers in four fields |
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|
Term
| what are the degrees of visual fields in 4 directions |
|
Definition
50 deg superior
60 deg nasally
70 deg inferior
90 deg temporal |
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|
Term
| what can you use to test intraocular pressure (5) |
|
Definition
schiotz tonometer, tonopen, perkins tonometer, goldmann applanation
last resort: use tactile sensation |
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|
Term
| who should for sure get the ocular pressure tested (2) |
|
Definition
mentally or physically handicapped
young kids |
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|
Term
| how can you palpate the eye pressure |
|
Definition
| with index finger genetly palpate the globe over the superior upper lip and compare the eyes |
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|
Term
| what are the parts of the anterior segment exam (10) |
|
Definition
eyelids, cornea, conjunctiva, anterior chamber, iris, lens using a slit lamp or penlight
evert lid if foreign body
look for opacity, discoloration, nodules |
|
|
Term
| how can you check for a foreign body |
|
Definition
| evert the eye lid: have patient look down pull down and out the upper lid by grasping lashes. use cotton tip applicator to push down on the upper tarsus everting the lid |
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|
Term
| how do you use the opthalamoscope (4) |
|
Definition
examing their eye with your same eye
start dial on zero
keeo your other eye open so you can guide yourself to the eye
adust the dial for a clear view |
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|
Term
| what do you look for in the opthalamascope exam (4) |
|
Definition
| nerve, vessels, peripherial retina, macula |
|
|
Term
| how should the optic nerve look |
|
Definition
|
|
Term
| how should the retina look |
|
Definition
| orange hue, depends on race |
|
|
Term
| what is a normal optic cup to disc ratio |
|
Definition
|
|
Term
| what is the normal size of the optic nerve |
|
Definition
|
|
Term
| what do you look for in the optic disc examination |
|
Definition
| sharp border. blurred means edema |
|
|
Term
| what are the parts of the anterior segment exam (10) |
|
Definition
eyelids, cornea, conjunctiva, anterior chamber, iris, lens using a slit lamp or penlight
evert lid if foreign body
look for opacity, discoloration, nodules |
|
|
Term
| how can you check for a foreign body |
|
Definition
| evert the eye lid: have patient look down pull down and out the upper lid by grasping lashes. use cotton tip applicator to push down on the upper tarsus everting the lid |
|
|
Term
| how do you use the opthalamoscope (4) |
|
Definition
examing their eye with your same eye
start dial on zero
keeo your other eye open so you can guide yourself to the eye
adust the dial for a clear view |
|
|
Term
| what do you look for in the opthalamascope exam (4) |
|
Definition
| nerve, vessels, peripherial retina, macula |
|
|
Term
| how should the optic nerve look |
|
Definition
|
|
Term
| how should the retina look |
|
Definition
| orange hue, depends on race |
|
|
Term
| what is a normal optic cup to disc ratio |
|
Definition
|
|
Term
| what is the normal size of the optic nerve |
|
Definition
|
|
Term
| what do you look for in the optic disc examination |
|
Definition
| sharp border. blurred means edema |
|
|
Term
| why might someone have a white streak around their optic disc |
|
Definition
| in development the myelin sheath stops just short of the cribiform plate but sometimes it does. tis is benign and anatomical |
|
|
Term
| what does it mean if the the area around the disc looks like a donught |
|
Definition
|
|
Term
| what do yellow/white spots on the retina mean |
|
Definition
| cotton wool spots: retinal nerve fiber layer ischemia |
|
|
Term
| what does yellow exudate in the eye mean |
|
Definition
|
|
Term
| what does wispy vessels branching around the optic disc mean |
|
Definition
| neovasculization of the disc, diabetic retinopathy, formation of new flragile vessels |
|
|
Term
| what does it mean if the cup is bigger than the cup to disc ratio |
|
Definition
|
|
Term
| how do you check for occular alignment in a kid |
|
Definition
| hirschberg technique: red reflex equal in both eyes using penlight (can be a little nasal) |
|
|
Term
|
Definition
| light reflex is nasal to pupil |
|
|
Term
|
Definition
| light reflex is temporal to pupil |
|
|
Term
| what should be looked at in the eye exam of infants of any age |
|
Definition
distance between eyes and nose and laterally
palpebral fissures
lateral canthi should be equal or 1mm higher than medial |
|
|
Term
| what does it mean if the lateral canthus is slanted up |
|
Definition
| mongolian slant: down syndrome |
|
|
Term
| what does it mean if the lateral canthi is slanted down |
|
Definition
| anti-mongolian slant: treacher-collins syndrome |
|
|
Term
| what can prominent epicanthal folds give a false appearance of |
|
Definition
| estropia (pseudo strbismus. go back to the hirchbergs test to test alignment |
|
|
Term
| how can you a visual assessment of a infant or preverbal child before 6mo |
|
Definition
fix and follow should be present at 6mo
cover one eye at a time, if kid resists or gets aggitated it could be because of a visual acuity decrease |
|
|
Term
| what do you need to do before you call the opthalamologist (2) |
|
Definition
3 optic vital signs
good history |
|
|
Term
| proptosos: what is it, what is the cause |
|
Definition
| white bulging eyes, lid retraction, caused by graves disease |
|
|
Term
| dendritic lesion is caused by |
|
Definition
|
|
Term
| one pupil fixed and dilated is caused by |
|
Definition
| 3rd nerve palsy that is pupillary involving because it can be a sign of a posterior communicating artery injury |
|
|
Term
| what can cause ulceration of the lower eye lid |
|
Definition
|
|
Term
| pupil dilated, cloudy blue eye, pressure high. cause |
|
Definition
| angle closure glaucoma, emergeny |
|
|
Term
| what is the cause of a cherry red spot |
|
Definition
| chentral retinal artery occlusion, temporal arteritis |
|
|
Term
| temporal arteritis: who gets it, what lab values show it |
|
Definition
pt 60yo+
elevated sedimentation rate, CRP, platelets |
|
|
Term
| what are signs of temporal arteritis (6) |
|
Definition
| temporal headache, jae claudication, scalp tenderness, myalgia, arthralgias, low grade fever, weight loss |
|
|
Term
| what gives the official diagnosis of temporal arteritis |
|
Definition
|
|
Term
| temporal arteritis treatment |
|
Definition
| IV sterids - emergent can spread to other eye |
|
|
Term
| what causes blood and thunder, massive hemorrages in all 4 quadrants |
|
Definition
|
|
Term
| what is the ocular sign of horner syndrome (4) |
|
Definition
| mitosis, ahyidrosis, enophthalmosis, ptosis |
|
|
Term
| what does it mean if someones eye is swollen, fever, periorbital edema |
|
Definition
| canvernous sinus thrombosis |
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