Term
| what is the afferent end of the pupil reflex |
|
Definition
| optic nerve to pretectal nuclei then edwst nuclei |
|
|
Term
| what is the efferent end of the pupil reflex |
|
Definition
| edwst nuclei to ciliary ganglion to pupil |
|
|
Term
| what is the MOST important thing to remember about acute vision loss |
|
Definition
|
|
Term
| what are the 6 most important things to ask in a history for acute vision loss |
|
Definition
transient or persistent
monocular or binocular
partial or total visual field loss
temp
past eye history
medications |
|
|
Term
| when someone comes in with acute vision loss what are the 9 tests you will do on them |
|
Definition
visual acuity
visual fields
confrontational fields
amsler grid test
pupil reflex test
swinging flashlight test
penlight exam
tonometry
opthalamascope |
|
|
Term
| what is always the first test to do in acute vision loss |
|
Definition
|
|
Term
| when doing a viscual acuity test for acute vision loss, what do they do with their glasses |
|
Definition
if they have them wear them
if they dont have them with them use pinhole |
|
|
Term
| what does the amsler grid test test for, what is positive |
|
Definition
| macular degeneration, makes grid look bent or gray |
|
|
Term
| pupil reflex exam: how is it done, what should it be like, what is a positive test called |
|
Definition
patient looks at distant target
pupils should be round and rqual
anscordia: unequal |
|
|
Term
| swinging flashlight test: what does it test for, wha are two names for a positive test |
|
Definition
test pupil afferent reflex
macrus gunn: afferent defect
hippus: initial construction then dilation |
|
|
Term
| what does the penlight exam test for |
|
Definition
| corneal and anterior chamber issues |
|
|
Term
| what does tanomometry test for, what is a positive test |
|
Definition
|
|
Term
| what sides of the brain do the fibers of the eye go do |
|
Definition
| nasal portion crosses over in optic chiasma, temporal portions do not cross over |
|
|
Term
| where do fibers from the macula go |
|
Definition
temporal left and nasal right fibers fo to the tip of the occipital love on the left side
flip that for the others |
|
|
Term
| what are 5 categories of acute vision loss |
|
Definition
media opacities
retinal disease
optic nerve diseases
visual pathway disorders
acute discovery of chronic vision loss |
|
|
Term
| what disease is an example of a medial opacity |
|
Definition
|
|
Term
| what are the normal clear, reflective parts of the eye (should not have media opacity) (4) |
|
Definition
cornea
anterior chamber
lens
vitrous |
|
|
Term
| what are 2 signs of corneal edema |
|
Definition
may caue changes in pupil (not the reflex)
ground glass appearance |
|
|
Term
| what are 4 causes of corneal edema |
|
Definition
| acute angal closure glaucome, infection, inflammation, chronic damage (dystrophy) |
|
|
Term
| what are 4 retinal diseases |
|
Definition
retinal detachment
retinal inflammatory process
retinal vascular occlusion
macular disease |
|
|
Term
| 3 symptoms in retinal detachment |
|
Definition
photopsias: flashing lights
floaters
curtian coming over one eye |
|
|
Term
| what are 4 exam signs of retinal detachment that have a not so bad prognosis |
|
Definition
visual loss
afferent pupil defect
retinal elevations, folds, detachments, tear
choroid background indistinct |
|
|
Term
| what are 3 exam signs of retinal detachment that have a bad prognosis |
|
Definition
posterior virteous detachment
high myopia
post intraocular surgery symptoms |
|
|
Term
|
Definition
|
|
Term
| what is the prognosis of macular degeneration |
|
Definition
|
|
Term
| what are the 4 types of vascular occlusion in the eye |
|
Definition
central retinal artery occlusion
branch retinal artery occlusion
central retinal vein occlusion
branch retinal vein occlusion |
|
|
Term
| what is the MOST important thing to remember about central retinal artery occlusion |
|
Definition
|
|
Term
| what is the main symptom of central retinal artery occlusion |
|
Definition
| sudden, painless, loss of vision |
|
|
Term
| what can be seen on an occular exam for retina vascular occlusion (6) |
|
Definition
vascular stasis
superificial whitening except macula
emboli in arterioles on disc
cilioretinal artery visulization
amaurosis fugax
afferent pupil defect |
|
|
Term
|
Definition
| unilateral loss of vision |
|
|
Term
|
Definition
| narrowed arterioles and boxcar venules |
|
|
Term
| what is the treatment for central retinal artery occlusion |
|
Definition
must dislodge embolus within a few hours to restore vision
screen for hypertension, diabetes, cadiac and carotid athlerosclerosis |
|
|
Term
| what is the main sign of branch retinal artery occlusion |
|
Definition
| vision loss in corresponding distribution to occlusion |
|
|
Term
| what is the treatment for branch retinal artery occlusion |
|
Definition
none, 80% improvement of 20/40 or better, may loose visual field defect
screen for hypertension, diabetes, cadiac and carotid athlerosclerosis |
|
|
Term
| what are 2 signs of central retinal vein occlusion |
|
Definition
blood and thunder opthalamascope exam
variable vision loss that is acute or subacute |
|
|
Term
| who gets central retinal vein occlusion most often |
|
Definition
| elderly with hypertension, athlerosclerosis, diabetes, hyperviscious conditions |
|
|
Term
| what are the three type sof central retinal vein occlusion |
|
Definition
papillophlebitis
venous stasis retinopathy
hemorrhagic |
|
|
Term
| who gets papillophlebitis, what is the prognosis |
|
Definition
young and healthy pt
good prognosis |
|
|
Term
| who gets venous stasis retinopathy, what is the prognosis, what conditions is it associated with |
|
Definition
old pt
ok prognosis
athlerosclerosis |
|
|
Term
| who gets hemorrhagic central retinal vein occlusion, what is the prognosis, what conditions is it associated with |
|
Definition
old pt
poor prognosis
maculopathy and neovascular glaucoma |
|
|
Term
| what is the tx for hemorrhagic central retinal vein occlusion |
|
Definition
|
|
Term
| what are 4 signs of optic nerve diseases |
|
Definition
afferent pupil defect if unilateral
rapid vision loss
visual field defects
duschromatopsia |
|
|
Term
|
Definition
|
|
Term
| what are the 6 optic nerve diseases |
|
Definition
optic neuritis
retrobulbar optic neuritis
papilledema
ischemia optic neuropathy
giant cell arteritis
trauma to nerve |
|
|
Term
| what are the three types of optic neuritis |
|
Definition
idiopathic
primary
secondary |
|
|
Term
| what is the cause of primary optic neuritis, what is the prognosis |
|
Definition
myelin sheath is targeted by inflammatory cells, sparing axon
good prognosis if once incident |
|
|
Term
| what are two examples of primary optic neuritis |
|
Definition
MS demyelination
papillitis (infection, inflammation) |
|
|
Term
| what is the cause of secondary optic neuritis |
|
Definition
| loss of myelin due to compression, sichemia, or metabolism |
|
|
Term
| what are two symptoms of retrobulbar optic neuritis |
|
Definition
acute or sub acute vision loss
pain with eye movement |
|
|
Term
| what are 4 optic exam findings in retrobulbar optic neuritis |
|
Definition
normal optic disc
afferent pupil defect
poor vision
visual field defect |
|
|
Term
| when you suspect retrobulbar optic neuritis, what tests should you send the pt out to get (3) |
|
Definition
|
|
Term
| what are 5 signs of papilledema |
|
Definition
hyperemic swellingin both optic nerves due to increased ICP
normal vision unless chronic
pupillary defect not evident - it is in both eyes
transient obscuring vision
visual field defects |
|
|
Term
| what causes ischemic optic neuropathy |
|
Definition
| vascular, not inflammatory problem |
|
|
Term
| what are the 5 signs of ischemia optic neuropathy |
|
Definition
pale swollen disc with splinter hemorrhages
loss of visual acuity
afferent pupillary defect
dyschromatopsia
visual field defect -altitudinal |
|
|
Term
| what is the most important thing to remember about giant cell arteritis |
|
Definition
| can cause bilateral blindness and be prevented with early diagnosis and treatment |
|
|
Term
| what is another name for giant cell arteritis |
|
Definition
|
|
Term
| what are the 4 symptoms of temporal arteritis |
|
Definition
loss of vision
malaise
scalp tenderness
jaw claducation |
|
|
Term
| what are 2 exam findings in temporal arteritis |
|
Definition
westergern sed rate
temporal artery biopsy positive |
|
|
Term
| what is the treatment for temporal arteritis |
|
Definition
| high dose systemic steroids |
|
|
Term
| what are the 3 visual pathway disorders |
|
Definition
hemianopia
cortical blindness
functional disorders |
|
|
Term
| what are the two types of hemianopia |
|
Definition
|
|
Term
| define homonymous hemianopia |
|
Definition
| loss of visual field on same side of both eyes |
|
|
Term
| what causes homonymous hemianopia (3) |
|
Definition
vascular occlusion of posterior cerebral A
infarction of occipital love
occlusion of MCA |
|
|
Term
| what do you do when someone has homonymous hemianopia |
|
Definition
|
|
Term
| define bitemporal hemianopia |
|
Definition
| loss of visual field on opposite side of both eyes |
|
|
Term
| what causes bitemporal hemianopia |
|
Definition
|
|
Term
| what do you do if someone has bitemporal hemianopia |
|
Definition
|
|
Term
| what causes cortical blindness |
|
Definition
| bilatreal occipital lobe damage |
|
|
Term
| what are three signs of cortical blindness |
|
Definition
complete vision loss
normal pupil reflex
normal fundus exam |
|
|
Term
| what is the prognosis of cortical blindness, why |
|
Definition
| poor, associated with neurological damage |
|
|
Term
| what are two signs of functional visual pathway disorders |
|
Definition
| hysterical or malingering visual loss without a cause |
|
|
Term
| define acute discovery of chronic visual loss |
|
Definition
someone covers a normal eye and discovers they cannot see with the other one
diagnosis of exclusion after negative exam, lack of damage, or optical history |
|
|
