Term
| What connects the eye to the brain? |
|
Definition
|
|
Term
| What are the components of the external eye? |
|
Definition
Eyelid
Conjunctiva
Lacrimal gland
Eye muscles
bony skull orbit ( this contains fat, blood vessels, nerves and CT that support the eye) |
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Term
| The eyelid is composed of what? |
|
Definition
Skin
Striated muscles
Tarsal plate
conjunctiva |
|
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Term
| What does the tarsus provide? |
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Definition
| A skeleton to the lid and conatins meibomian glands that provide oils to the tear film |
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Term
| What are the function of eyelids? |
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Definition
| distributes tears over the surface of the eye, limits the amount of light entering it, and protects the eye form foreign bodies |
|
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Term
|
Definition
| A thin mucous membrane covering and protecting the anterior surface of the eye with the exception of the cornea and the surface of the eyelid in contact with the globe |
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|
Term
| Where is the lacrimal gland located? |
|
Definition
| In the temporal region of the superior eyelid |
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Term
| Tears from the lacrimal gland goes where? |
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Definition
| Flow over the cornea and drain via the canaliculi to the lacrimal sac and duct and then into the nasal meatus |
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Term
Internal structure of the eye are composed of what 3 seperate coasts? |
|
Definition
Outer wall : sclera posteriorly and cornea anteriorly
Middle layer aka Uvea: choroid posteriorly and the ciliary body and iris anteriorly
Inner layer : Retina |
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Term
| ______ is a dense, avascular strucutre that appears anteriorly as the white of the eye. |
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Definition
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|
Term
| What is responsible for physically supporting the internal structures of the eye? |
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Definition
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|
Term
| _______ constitues the anterior sixth of the globe and is continuous with the sclera. |
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Definition
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Term
| What is optically clear, has rich sensory innervation, and is avascular? |
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Definition
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|
Term
| ______ is a major part of the refractive power of the eye? |
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Definition
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|
Term
| What 3 things commporomises the uveal tract? |
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Definition
| Iris, ciliary body, and choroids |
|
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Term
| The __________ is a circular, contractile muscular disk contianging pigment cells that produce the color of the eye |
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Definition
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|
Term
| What is the central aperture of the iris called? |
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Definition
|
|
Term
| what does the ciliary body produce? what does it contain? |
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Definition
| the aqueous humor and contains the muscles controlling acocomodation |
|
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Term
| what is pigmented and has a rich vascular layer that supplies oxygen to the outer layer of the retina? |
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Definition
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|
Term
| The ____ is a biconvex, transparent structure located immediately behind the iris. |
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Definition
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|
Term
| How is the lens supported? |
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Definition
| supported circumferentially by fibers arising form the cilary body. |
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Term
| What is responsible for transforming light impulses into electrical impulses? |
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Definition
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|
Term
| Where do the electrical impulses travel? |
|
Definition
| Via the optic nerve, optic tract, and optic radiation to the visual cortex and then to the consciousness in the cerebral cortex |
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Term
| What travels through the optic foramen? |
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Definition
| Optic nerve, opthalmis artery and vein, and the autonomic nervous system. |
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|
Term
| Where do the fibers located in the nasal retina decusssate? |
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Definition
|
|
Term
| When do the eyes form embyologicaly? |
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Definition
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|
Term
| Term infants are ____, with a visual acuity of less than 20/400. |
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Definition
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|
Term
| At what age can infants differentiate colors? |
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Definition
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|
Term
| Adult visual acuity is achieved at what age? |
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Definition
|
|
Term
| What is most likely to occur in the 3rd trimester? |
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Definition
| Mild corneal edema and thickening associated with blurred vision |
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|
Term
| _____ is the perception of 2 impages and may be monocular or binocular |
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Definition
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|
Term
| Monocular diploia is a _____ problem, binocular diplopia is an ______ problem |
|
Definition
Monocular diplopia is an optical problem
Binocular diplopia is an alignment problem |
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|
Term
| Name the risk factors for cataract formation? |
|
Definition
Steroid medication use
exposure to ultraviolet light
cigarette smoking
diabeted mellitus
aging |
|
|
Term
| Vision should always be tested ____ glasses first |
|
Definition
|
|
Term
| Visual acuity is recorded as a Fraction in which the numerator indicates the _______ |
|
Definition
| the distance of the patient from the chart. |
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|
Term
| Vision not correctable to better than _____ is considered legal blindness |
|
Definition
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|
Term
| How far should the rosenbaum pocket vision screener be held at? |
|
Definition
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|
Term
| Peripheral vision can be acurately measured by using the _______ test. |
|
Definition
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|
Term
| When performing the confrontation test, how far should you sit from the patient? |
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Definition
|
|
Term
| What are the lesions most likeyly to produce confrontation abnormalities? |
|
Definition
| Stroke, retinal detachment, optic neuropathy, pituitary tumor compresssion at the optic chiasm, and central reinal vascular occlusion |
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|
Term
| If a patient has hypothyroidism, what should your look for in the eye brows? |
|
Definition
|
|
Term
| In a person with hypothyroidism, the eyebrows will not extend beyond ___________ |
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Definition
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|
Term
| Elevated plaque of cholesterol deposited in macrophages most commonly in the nasal portion of the upper or lower lid is called______ |
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Definition
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|
Term
| What should the superior eyelid cover? |
|
Definition
| Portion of the iris but not the pupil itself |
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|
Term
|
Definition
| one superior eyelid covers more of the iris than the other or extend over the pupil |
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|
Term
| What does ptosis indicate? |
|
Definition
| a congenital or acquired weakness of the levator muscle or a paresis of a branch of the third cranial nerve |
|
|
Term
Where is the average upper lid position in regard to the limbus? |
|
Definition
|
|
Term
| Average lower lid position is at the ____ limbus |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| a condition in which the lid is turned inward toward the globe |
|
|
Term
|
Definition
| when the lower lid is turned away from the eye |
|
|
Term
| what is hordeolum? what is it caused by? |
|
Definition
| A sty, an acute suppurative inflammation of the follicle of an eyelash casued by staph |
|
|
Term
| What are clinical signs of blepharitis? |
|
Definition
| crusting along the eyelashes |
|
|
Term
| Lagophthalmos is a condition in which ______ |
|
Definition
| closed lids do not completely cover the globe |
|
|
Term
| What are the come causes of lagophtalmos? |
|
Definition
1. thyroid disease
2. 7th nerve palsy ( bells)
3. blepharoplasty surgery
4. overaggressive ptosis |
|
|
Term
| An eye that feels very firm and resists palpation may indicate what? |
|
Definition
| Glacoma, hyperthyroidism, presence of retrobulbar tumor |
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|
Term
| When should you inspect the upper tarsal conjunctiva? |
|
Definition
| Only when there is a suggestion that a foreign body may be present |
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|
Term
| An erythematous or cobblestone appearnce, especially on the tarsal conjunctiva, may indicate _______ |
|
Definition
| an allergic or infectious conjunctivitis |
|
|
Term
|
Definition
| an abnormal growth of conjunctiva that extend over the cornea from the limbus |
|
|
Term
| Where do pterygium more commonly occure? |
|
Definition
| nasal side in people heavily exposed to uv light |
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|
Term
| Corneal sensitivity is controled by which cranial nerve? |
|
Definition
|
|
Term
| Blinking is controled by which nerve? |
|
Definition
|
|
Term
| Corneal arcus is composed of _____ |
|
Definition
| lipids deposited in the periphery of the cornea |
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|
Term
| If arcus is present before the age 40, what should be suspected? |
|
Definition
|
|
Term
| What does the swinging flashlight test detect? |
|
Definition
| afferent pupilary defect, an important sign of optic nerve disease |
|
|
Term
| During the accomodation test, the pupils should ____ when looking at the object place 10 cm from the bridge of the nose |
|
Definition
|
|
Term
| pupillary constriction of less than 2 mm is called |
|
Definition
|
|
Term
| Pupillary dilation of more than 6 mm is called |
|
Definition
|
|
Term
| inequality of pupillary size is known as |
|
Definition
|
|
Term
| Describe senile hyaline plaques |
|
Definition
| dark, slate gray pigment just anterior to the insertion of the medial rectus muscle |
|
|
Term
| with what conditions are lacrimal glands known to enlarge? |
|
Definition
| tumors, lymhoid infiltration, sarcoid disease, and sjorgren syndrome |
|
|
Term
| Full movement of the eyes is controlled by the integrated function of which cranial nerves? |
|
Definition
|
|
Term
|
Definition
| The involuntary rhytmic movement of the eys that can occur in a horizontal, vertical, rotary, or mixed pattern. |
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|
Term
| What is jerking nystagmus characterized by? Defined by? |
|
Definition
| Faster movement in one direction, defined by its rapid movement phase |
|
|
Term
| Lid lag, the exposure of the sclera above the iris when the patient is asked to follow your finger as you direct the eye in a smooth movement from ceiling to floor may indicate what? |
|
Definition
|
|
Term
| When performing the corneal light reflex, where should you point the light and how far? |
|
Definition
|
|
Term
| When should you perform the cover/uncover test? |
|
Definition
| when an imbalance is found with the corneal light reflex test |
|
|
Term
| How do you perfrom the cover/uncover test? |
|
Definition
1. Ask patiet to stare straight ahead at a near fixed point
2. Cover one eye and observe the uncovered eye for movement as it focuses on the designeated point.
3. Remove the cover and watch fro movement of the newly uncovered eye as it fixes on the object
4. Repeat process, covering the other eye |
|
|
Term
| How far should you start the opthalmoscope examination? |
|
Definition
| From about 30cm (12inches) |
|
|
Term
| What causes the red reflex? |
|
Definition
| Light illuminating the retina |
|
|
Term
| On the fundus, a findings of a crescents or dots at the disc margin along the temporal edge a call for alarm? |
|
Definition
|
|
Term
| If your patient is myoptic, which lens should you use? |
|
Definition
|
|
Term
| If the patient is hyperoptic or lacks a lens(aphakic), you should use _____ lens. |
|
Definition
|
|
Term
| When a patient has a shallow anterior chamber, it is a risk of what? |
|
Definition
|
|
Term
| Mydriatics shold be avoided in patients with |
|
Definition
|
|
Term
| How to the vesself of the retina branch? |
|
Definition
First, superior and inferior
Second, nasal and temporal |
|
|
Term
| Optic disk margin should be ____ and _____ defined and about ____mm |
|
Definition
sharp and well defined
1.5 mm |
|
|
Term
| How far is the macular normally located in relative to the optic disc? |
|
Definition
|
|
Term
| A white area with soft, ill defined peripheral margins usually continous with te optic disc is indicative of what? |
|
Definition
|
|
Term
| In myelinated retinal nerve, what helps distinguish this benign condition from chorioretinitis? |
|
Definition
| Absence of pigment, feathery margins, and full visual fields |
|
|
Term
| In what condition are the central vessels pushed forward, and the veins are markedly dilated? Venous pulsations are not visible and cannot be induced by pressure applied to the globe and venous hemorrhages may occur. |
|
Definition
|
|
Term
The physiologic disc margins are raised with a lowered central area in which blood vessels may disappear over the edge of the disc. Look for asymmetry of the cupping between the eyes.
What is the expected finding of this description? |
|
Definition
|
|
Term
Identify:
Spots are ill defined, yellow areas caused by infaction of the nerve layer of the retina |
|
Definition
|
|
Term
| Papilledema is caused by ?? |
|
Definition
| increased intracranial pressure transmitted along the optic nerve. initially vision is not altered |
|
|
Term
| What is the significance of glaucomatous optic nerve head cupping? |
|
Definition
| increased intraocular pressure leads to loss of nerve fibers with the death of ganglion cells. Impairment of the blood supply will ulimately lead to optic nerve atrophy, causing the optic disc to appear much whiter than usual. |
|
|
Term
| Vasuclar disease secondary to hypertension or diabetes mellitus are teh common causes of_____ |
|
Definition
|
|
Term
| Loss of defination of the optic disc margin occurs in what order? |
|
Definition
| First superiorly and inferiorly then nasally and temporally |
|
|
Term
|
Definition
| small discrete spots that are slightly more yellow than the retina. Consequence of aging |
|
|
Term
| Drusen bodies are a precurosr of what? |
|
Definition
| senile macular degerneation |
|
|
Term
| Amsler grid is used to evaluate what? |
|
Definition
|
|
Term
| A hemorrhage at the disc margin often indicates |
|
Definition
| poorly controlled glaucoma or undiagnosed glaucoma. |
|
|
Term
| Where does flame shaped hemorrhages occur? |
|
Definition
| In the nerve fiber layers, and the blood spreads parallel to the nerve fibers |
|
|
Term
| Round hemorrhages tend to ccur where? |
|
Definition
| Deeper layers and may appear as a dark color instead of the bright red that is characteristic of flame hemorrhages. |
|
|
Term
| Dot hemorrhages represent _____ and are common in _______ |
|
Definition
microaneurysms
diabetic retinopathy |
|
|
Term
| What should be given to old people to prevent macular degeneration? |
|
Definition
|
|
Term
| Retinal changes associated with hypertension are generally classified accordding to what? |
|
Definition
| Keith-wagner-barker system |
|
|
Term
| What is the ratio of arterial-venous size? |
|
Definition
|
|
Term
| Group I of the KWB classification is characterized as |
|
Definition
| increased light reflex from the arteriorles |
|
|
Term
| Group II of KWB is marked by |
|
Definition
| appearance of arterial venous crossing changes |
|
|
Term
| Group III is characterized |
|
Definition
| by a shiny retina and by the appearance of cotton wool spots, which represents ischemic infarcts of the retina |
|
|
Term
| What do you look for when looking for epicanthal folds? |
|
Definition
| vertical fold of skin nasally that covers the lacrimal caruncle |
|
|
Term
| When the outer canthi are above the line drawn between the 2 canthis, it is called |
|
Definition
|
|
Term
| What is the sunsetting sign? |
|
Definition
When a infant is rapidly lowered from an upright position to a supine position, sclera above the iris is present
May be an expected variant in new borns however it also may be observed in infants with hydrocephalus and brainstem lesion |
|
|
Term
|
Definition
|
|
Term
| Pseudostrabismus is common in |
|
Definition
| Asians and native americans |
|
|
Term
| Corneal light reflex can distinguish between what two conditions? |
|
Definition
| Pseudostrabismus and Strabismus |
|
|
Term
|
Definition
| Keyhole pupil, associated with other congenital anomalies |
|
|
Term
| Brushfield spot strongly suggests what? |
|
Definition
| down syndrome or mental retardation |
|
|
Term
| How many degrees should an infant track a light trough? |
|
Definition
|
|
Term
| Name a popular mydriatic used in infants |
|
Definition
| Cyclopentolate hydrochloride .5% |
|
|
Term
| What is the expected visual acuitys for 3, 4, 5, 6 year olds? |
|
Definition
3: 20/50
4: 20/40
5: 20/30
6: 20/20 |
|
|
Term
| 2 line difference indicates |
|
Definition
|
|
Term
| Retinal examination in the pregnant women can help differentiate between what? |
|
Definition
| Chronic hypertension and PIH |
|
|
Term
|
Definition
| Increase in the volume of the orbital content, causing a protrusion of the globes forward. |
|
|
Term
| What are a few things that can cause exophthalmos? |
|
Definition
Graves
Retro-orbital tumor |
|
|
Term
| What is episcleritis? And what is it indicative of? |
|
Definition
Inflammation of the superificial layers of the sclera anterior to the insertion of the rectus muscle
Crohns disease, rheumatoid arthritis, Auto Immune |
|
|
Term
| Band keratopathy is produced by what deposits in the superficial cornea? |
|
Definition
|
|
Term
| Band keratopathy is most commonly found in patients with |
|
Definition
Chronic corneal disease
hyperparathyroidism
Renal failure
syphilis |
|
|
Term
| What are some cuases of corneal ulcers |
|
Definition
desiccation
Viral/bacteria
incomplete lid closure
poor lacrimal function |
|
|
Term
| Strabismus is a condition when _____ |
|
Definition
| both eyes do not focus on an object simultaneously |
|
|
Term
| Non paralytic strabismus can be the presenting sign of |
|
Definition
| intraocular pathology producing poor vision such as an infantile cataract or a retinoblastoma |
|
|
Term
|
Definition
| pupillary contriction: usually less than 2 mm in diameter |
|
|
Term
|
Definition
| pupillary dilation; usually more than 6 mm in diameter |
|
|
Term
"Bilateral, miotic, irregularly shaped pupils that fail to constrict with light but retain constriction with convergence; pupils may or may not be equal in size; commonly cuased by neurosyphils or lesion in idbrain where afferent pupillary fibers synapse"
This describes what? |
|
Definition
|
|
Term
| Will damage to CN III cause mydriasis or miosis? |
|
Definition
|
|
Term
| Unequal size of pupils is called? |
|
Definition
|
|
Term
" acute uveitis is commonly unilateral; constriction of pupil accompanied by pain and circumcorneal flush"
is a contributing factor for |
|
Definition
| iris constrictive response |
|
|
Term
| When CN 3 is damaged what happens? |
|
Definition
pupil dilated and fixed
eye deviated laterally and downward
ptosis |
|
|
Term
| Name some contributing factors for adie pupil (tonic pupil) |
|
Definition
Affected pupil dilated and reacts slowly or fails to react to light
responds to convergence; cuased by impariment of postganglioinc parasympathetic innervation to sphincter pupillae muslce or ciliary malfunction
often accompanied by diminished tendon relfexes |
|
|
Term
| how does horner syndrome occur? |
|
Definition
| by interruption of the sympathetic nerve supply to the eye usually at the cervical sympathetic trunk |
|
|
Term
| What are the signs of horners? |
|
Definition
| ipsilateral miosis and mild ptosis |
|
|
Term
| what is the result of denaturation of lens protein caused by aging? |
|
Definition
|
|
Term
| Rubella during the first trimester of pregnancy can cause what? |
|
Definition
|
|
Term
| What can chronic steroid use result in? |
|
Definition
|
|
Term
| What are the primary symptom of optic atrophy? |
|
Definition
| loss of central or peripheral vision or both |
|
|
Term
| How do hard exudates form? |
|
Definition
| lipid transudation through incompetent capilaries |
|
|
Term
| What causes soft exudates, give example |
|
Definition
infarction of nerve layer and appear as dull gray spots with poorly defined margins
Cotton wool spots |
|
|
Term
| What level of serum triglyceride causes lipema retinalis? |
|
Definition
|
|
Term
| development of night blindness and loss of peripheral vision is characteristics of what condition? |
|
Definition
|
|
Term
| What are the hallmarks of retinitis pigmentosa? |
|
Definition
| Optic atrophy "waxy pallor" narrowing of teh arterioles, and peripheral "bone spicule" pigmentation are hallmarks of the disease |
|
|
Term
| Blindess in HIV patients are commonly cuased by |
|
Definition
|
|
Term
| "pizza pie" appearane in the retina is characteristic of what? |
|
Definition
| cytomegalovirus infection |
|
|
Term
What happens in glaucoma to cause blindness?
What is its characteristic appearance? |
|
Definition
| nerve cells dies, producing a characteristic apearance of the optic nerve ( increased cupping) |
|
|
Term
| chorioretinal inflammation results in what? |
|
Definition
| a sharply defined lesion that is generally whitish yellow and becomes stippled with dark pigment in later stages ending with a chororetinal scar |
|
|
Term
| Pigmented lesion of the chroid is called |
|
Definition
|
|
Term
| interruption of the optic chiasm results in |
|
Definition
|
|
Term
| homonymous hemianopia is caused by |
|
Definition
| lesion arising in the opitc nerve radiation on either side of the brain |
|
|
Term
| what is an embryonal malignant tumor arising form the retina, often during the first 2 years of life? |
|
Definition
|
|
Term
| a white reflex aka cat's eye reflex is indicative of |
|
Definition
|
|
Term
| when a baby is shaken like a martini, what happens? |
|
Definition
| retinal hemorrhage, a shaken baby syndrome |
|
|
