Term
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Definition
- right hand, right eye, for right eye - RRR
- Start with wheel at 0
- Start about 12" from patient w/ both eyes open and move in to 1-2" |
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Term
| Fundoscopic exam, look for what? |
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Definition
1. Red reflex
2. optic disc
3. fovea |
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Term
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Definition
- doughnut-like w/ orange pink rim and central white depression
- cup should not be more than 1/2 size of the disc diameter |
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Term
| What if the cup-disc ratio is larger than 1/2? |
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Definition
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Term
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Definition
- Arteries = brighter red and smaller
- Veins = LARGER
- A:V ratio = 2:3 or 4:5
- look for AV nicking |
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Term
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Definition
- raised area where Artery and vein meet in the eye
- sign of HYPERTENSION |
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Term
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Definition
- 2 to 2.5 disc diameters temporal to the optic disc and avascular
- have pt look directly into the light so u can see macula
- look for fovea centralis |
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Term
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Definition
| - 2.5 mm-diameter reflective area that looks slightly darker and lies in the center of the macula |
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Term
| If you can't find the macula, what do you have the patient do? |
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Definition
| - look directly into the light |
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Term
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Definition
| 20/20 = the person can see at 20 what the normal person can see at 20 feet |
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Term
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Definition
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Term
|
Definition
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Term
| When to refer a patient to optometrist? |
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Definition
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Term
|
Definition
- Common after age 40
- results in greater difficulty maintaining a clear focus at a near distance due to a lessening of flexibility of the crystalline lens and weakening of the ciliary muscles which control lens focusing |
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Term
|
Definition
- cloudy cornea w/ a gray/white arc or circle around the limbus due to deposition of lipid material
- NO EFFECT ON VISION
- LIPID THING |
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Term
|
Definition
- raised, wedge-shaped growth of thin, noncancerous tissue over the conjunctiva
- dry air, windy areas |
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Term
| Hordeolum (Stye) w/ management (6) |
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Definition
- HURTS
- staph aureus infection
- abrupt onset can be on upper or lower lid (tender mass)
- warm compress
- topical bacitracin or erythromycin ophthalmic ointment
- REFER to ophthalmologist if not resolved in 2 days |
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Term
|
Definition
- PAINLESS, BEADY nodule usually on upper lid
- infection or retention cyst of a meibomian gland
- sensitivity to light, increased tearing, eyelid tenderness
- if large, MAY CAUSE ASTIGMATISM
- warm compress
- REFER FOR SURE FOR SURGICAL REMOVAL |
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Term
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Definition
- Staph infection or seborrheic dermatitis of lid edge
- red, scaly, GREASY flakes
- burning, itching, tearing
- thickened, crusted lid margins
- hot compresses and scrub lashes and lid margins w/ eyes closed with rinsing after
- topical antibiotics |
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Term
| Conjunctivitis - KNOW THIS |
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Definition
- inflammation/infection of the conjunctiva
- cuz of allergies, chemical irritation, bacterial, viral or gonococcal/chamydial infections |
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Term
| Conjunctivitis - s/sx (8) |
|
Definition
- itching
- burning
- redness
- increased tearing
- blurred vision (possible)
- swelling of eyelids
- sensation of foreign body in eye
- eyelids may show curst of stick, mucopurulent discharge |
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Term
| Conjunctivitis - PURULENT |
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Definition
- Bacterial
- self-limiiting - 72 hours max
- abx drops: levofloxacin, ofloxacin, cipro, tobramycin, gentamycin ophthalmic |
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Term
| Conjunctivitis - COPIOUS, PURULENT |
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Definition
- Gonococcal: Ceftriaxone 250 mg IM
- Chlamydial: Erythromycin ophthalmic ointment
- oral: tetracycline, erythromycin, clarithromycin, azithromycin, doxycycline |
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Term
| Conjunctivitis - STRINGY; INCREASED TEARING |
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Definition
- Allergic
- oral antihistamines |
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Term
|
Definition
- Viral
- symptomatic care |
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Term
|
Definition
- increased intraocular pressure
- closed-angle = acute (EMERGENCY)
- open-angle = chronic |
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Term
| What age do people need tonometry screening? |
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Definition
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Term
| Glaucoma: open-angle s/s (4) |
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Definition
1. asymptomatic
2. Elevated IOP
3. Cupping of the disc
4. Constriction of visual fields |
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Term
| Glaucoma: closed-angle s/s (4) |
|
Definition
1. Extreme pain
2. Blurred vision
3. Halos around lights
4. Pupil dilated or fixed |
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Term
| Glaucoma: open angle management (3) |
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Definition
1. Alpha 2 adrenergic agonists (Brimonidine, Alphagan, etc.)
2. Beta-adrenergic blockers (Timolol, etc.)
3. Miotic agents (Pilocarpine, etc.) |
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Term
| Glaucoma: closed angle management (3) |
|
Definition
1. Carbonic anhydrase inhibitor (Acetazolamide (Diamox))
2. Osmotic diuretics (Mannitol)
3. Surgery
4. REFER - Emergency |
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Term
| Aging is independent risk factor for? |
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Definition
|
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Term
|
Definition
| - Clouding and opacification of the normally clear lens of the eye |
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Term
| Highest cause of treatable blindness and most common procedure in 65+? |
|
Definition
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Term
|
Definition
1. Painless **
2. Clouded, blurred or dim vision**
3. Halos around lights**
4. Difficulty with vision at NIGHT **
5. Sensitivity to light and glare
6. Fading/yellow of colors
7. Diplopia (double vision) in a single eye****
8. The need for brighter light for reading and other activities
9. No red reflex
10. Opacity of the lens*** ON EXAM |
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Term
|
Definition
1. change glasses as cataract develops
2. Refer to ophthalmologist
3. SURGERY |
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Term
|
Definition
| - separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers |
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Term
| Retinal detachment: s/s and management (5) |
|
Definition
1. Flashes of light (photopsia), especially in peripheral vision***
2. Floaters in the eye***
3. Blurred vision
4. Shadow or blindness in a part of the visual field of one eye
Management = REFER FOR SURGERY |
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Term
| Otitis Externa - definition and 3 types |
|
Definition
inflammation and/or infection of the external auditory canal (and/or auricle and tympanic membrane)
cause: S. aureus
Types:
1. Acute localized (furunculosis) - older adults
2. Acute diffuse bacterial (swimmer's ear): swimmer's in hot, humid climates
3. Others: Chronic (adults and older adults), fungal, eczema? |
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Term
|
Definition
1. Pustules and furuncles in the outer third of the ear canal
2. Sever pain (otalgia) with area of cellulitis
3. Itching
4. Erythema
5. Scaling
6. Crusting
7. Fissuring
8. Possible exudates |
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Term
| Otitis externa: Management (3) |
|
Definition
1. Cleansing and debridement of the ear
2. Topical otic drops: cortisporin otic, others
3. Pain control: NSAIDs, topical corticosteroids, etc. |
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Term
| S. pneumoniae is responsible for which conditions? |
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Definition
| - OM, sinusitis, meningitis, CAP |
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Term
| AOM and serous: definition and causes |
|
Definition
- Presence of fluid in the middle ear accompanied by s/s of infection
1. Most common: URI (often viral)
2. Bacterial:
a. Strep pneumoniae (40-50% of cases)
b. Haemophilus influenzae (20-30% of cases)
c. Moraxella catarrhalis (10-15%) |
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Term
|
Definition
1. otalgia - spreading to temporal region
2. Otorrhea
3. Vertigo
4. Nystagmus
5. Tinnitus
6. Fever
7. Lethargy
8. Nausea and vomiting
9. Anorexia
10. Local inflammation: erythema w/ diminished light reflex; fluid in middle ear
11. Exudative phase: middle ear serous exudate
12. Suppurative phase (Serous): Purulent exudates; retraction and poor motility of the TM; becomes bulging and convex; membrane may rupture |
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Term
| AOM and serous: Management (2) |
|
Definition
- uncomplicated, resolves spontaneously or w/ hydration, avoid irritants, use topical or oral decongestants and cool mist humidifiers
- ABX: AMOXICILLIN if not better, AUGMENTIN |
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Term
|
Definition
| If you are not MARKEDLY better in 3 days, come back |
|
|
Term
|
Definition
- chronic OM consisting of peeling layers of keratinized epithelium
- if untreated, may erode middle and cause nerve damage and deafness |
|
|
Term
| Cholesteatoma: s/s and management (7) |
|
Definition
1. squamous epithelium lined sac, filled with desquamated keratin
2. Chronic infxn
3. Painless otorrhea, either unremitting or frequently recurrent
4. Hearing loss
5. Canal filled with mucopus and granulation tissue
6. TM PERFORATION***** (90% of the time)
Management: REFER FOR SURGERY |
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Term
| Vertigo: def and causes (8) |
|
Definition
- BPP is most common - sensation initiated by sudden head movements
common causes:
1. Brain tumor - adult/older adult
2. Medication - older adult
3. OM or labyrinthitis
4. Meniere's disease
5. Acoustic neuroma
6. Head trauma or neck injury
7. Migraines
8. Cerebellar hemorrhage |
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Term
| Vertigo: labs and diagnostics (5) and (5) |
|
Definition
Labs:
1. CT scan
2. VDRL/RPR
3. Serum medication levels
4. Hearing exam
5. Blood glucose and ECG
Management:
1. Diazepam (Valium) - usually in combo w/ meclizine
2. Meclizine hydrochloride (antivert)
3. Diphenhydramine (Benadryl)
4. Scopolamine transdermal patch
5. Antiemetics |
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Term
| Hearing loss: def and 2 types |
|
Definition
- loss of ability to detect pure tones in decibels > 20 dB
Types:
Conductive - most common foreign body (wax), infxn
Sensorineural - Meniere's, Ototoxic drugs, infection, trauma |
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Term
|
Definition
- Hit tuning fork and put it on top of head, where does it lateralize?
Normal: Sound heard bilaterally equal, does not lateralize |
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Term
|
Definition
- Hit tuning fork, put on mastoid process, then air
Normal: AC>BC by 2:1 ratio |
|
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Term
| Conductive hearing loss tests |
|
Definition
| Weber: Sound lateralizes to affected ear
Rinne: Abnormal in the affected ear AC |
|
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Term
| Sensorineural hearing loss tests |
|
Definition
Weber: lateralizes to unaffected ear
Rinne: Normal in the affected ear |
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Term
|
Definition
Sensorineural loss: REFER
conductive: clean ear, treat underlying cause |
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