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mucous membrane covering the eye, semi-transparent, starts at edge of cornea. Bulbar conjunctiva covers the sclera, palpebral conjunctiva coverse inside eyelids |
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pigmented muscle that controls the amount of light going into the retina sphincter pupillae - inner, dilator pupillae - outer |
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| junction of sclera and iris |
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| clear part of eye, avascular |
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| secrete oil, keeps tears from evaporating quickly |
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| around eyelids, closes eyelid, CN VII |
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| Circulation of aqueous humor |
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| ciliary body -> posterior chamber -> through pupil -> anterior chamber -> canal of Schlemm -> circulation |
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| yellow discoloration of sclera, caused by excessive bilirubin the blood |
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| excessive tearing, caused by blockage of tear drainage or hypersecretion by lacrimal gland |
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| bening dropping of eyelid, normal in geriatrics |
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| extruding eyes, seen most often in Grave's disease, not usually reversible |
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| pupil inequality > 0.5 mm, normal in 20% of population, unilateral defect, usually benign, always present, could be a defect in retina/optic nerve, oculomor nerve |
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Horizontal defect
optic lesion caused by occlusion at optic disk
possible causes: CVA (stroke), tumors, glaucoma, intracranial bleeding |
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Blind right eye
optic nerve lesion caused by retinal detachment
no sensory information will be able to get in causing the R eye to be blind |
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Bitemporal hemianopsia
defect in both temporal fields
optic chiasm lesion
no peripheral vision
possible causes: pituitary tumor, central retinal artery disease, retinal detachment
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Homonymous hemianopsia
optic tract lesion, seen unilaterally, not bilaterally (like bitemporal hemianopsia)
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Left superior quadrant Defect
field loss in one quadrant
usually caused by: right optic radiation lesion or occipital cortex lesion
defect is contralateral to vision loss |
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| deviation of the eyes, use the cover/uncover test |
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Esotropia
imbalance caused by ocular muscle tone
medial gaze deviation
cross-eyed |
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Exotropia
imbalance caused by ocular muscle tone
lateral gaze deviation
wall-eyed |
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| decrease in vision in one eye, due to disease, increase in premature infants |
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| fine, rhythmic oscillation of eyes, few beats are normal, suggests neurological conditions when it is non stop |
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| deviation of one eye inward or outward, cause by muscle weakness of CN |
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| deviation of one eye, esotropia or exotropia, constant in all directions of gaze, eye will be stuck in that area, occurs with fatigue, caused by muscle weakness |
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| loss of vision in one or both eyes, no direct rxn, no consensual rxn |
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| affected eye has no consensual rxn, affected eye dilates instead of restricts with direct response to light, decrease in sensory input, good eye is normal, optic nerve is damaged |
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Oculomotor Nerve palsy
CN III
complete ptosis, dilated unreactive pupil, impaired EOMs (H pattern) |
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Horner's syndrome
paralysis of sympathetic nerves, unilateral ptosis, ipsilateral pupil constriction, no sweating
Miosis, ptosis, anhydrosis (constriction, lid lag, no sweating) |
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Adie's pupil
one dilated pupil
tonic pupil, no reaction to light, constricts to near reaction
benign but may need to wear sunglasses when it is bright |
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| Causes of nonreactive bilateral pupils |
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| drugs (oral or palced in the eye), altered mental status (fixed pupils, brain stem problem, syphilis complications), specific disease (Argyll Robertson pupil) |
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Argyll robertson pupil
bilateral small irregular pupils
no light reaction
react to accommodation |
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Ectropion
eversion of eyelid causing inadequate draining and dry eyes |
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Entropion
inversion of eyelid, lashes could abrade cornea |
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Periorbital edema
eyes appear swollen, could be caused by cellulitis, allergy, or renal problems |
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Basal Cell Carcinoma
local skin cancer, firm mass, may ulcerate, nonhealing |
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Hordeolum aka sty
obstuction fo glands of Zeiss/Moll
lump within eyelid follicle on eyelid margin
painful
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Chalazion
lump on outside of eyelid, painless, caused by obstruction to Meibomian glands |
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Xanthelasma
soft yellow plaques of cholesterol on eyelid
caused by increased cholesterol or congenital disease |
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Dacryocystitis
Unilateral infection of lacrimal gland/sac causing painful, tearing, nasal, swelling
Caused by obstruction of nasolacrimal duct usually around the puncta or sace |
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Ecchymosis (raccoon eyes)
Caused by basilar skill fracture or orbital floor fracture
bruising appears dropped down due to gravity |
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Conjunctivitis
inflammation of conjunctiva, could be bacterial, viral, or allergic
Conjunctival injection, clear cornea, pus discharge, crusting, itching and painless |
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| inflammation of iris, sudden onset of pain, photophobia, ciliary injection, blurriness, tenderness to touch |
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Corneal abrasion
superficial disruption of cornea, conjunctival erythema
caused by trauma |
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Corneal ulcer
painless infection of the cornea
possibly caused by infection or contact lenses |
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| closed or narrow, increase in intraocular pressure caused by blockage of the canal of Schlemm, sudden onset, causes blurriness, HA, halos, severe eye pain, rock hard eye with ciliary injection |
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| mild increase in intraocular pressure, non-emergency |
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Subconjunctival hemorrhage
Ruptured blood vessel causing blood between the sclera and teh conjunctiva
painless, caused by coughing, vomitting, weight lifting, constipation |
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Episcleritis
local patch of erythema on sclera
asymptomatic
autoimmune |
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Cataracts
opacity of the lens, grayish pupil, no red reflection
decrease in visual acuity
can be congenital or acquired |
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Blepharitis
chronic inflammation of eyelid margins, small white scales |
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Arcus senilis
Arc around cornea due to increased cholesterol
usually seen in people over 60 yo |
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Hypopeion
pus in anterior chamber |
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Hyphema
blood in anterior chamber |
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Pinguecula
small raised nodule in conjunctiva
caused by exposure to light or dust
found on nasal or temporal limbus |
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Pterygium
degeneration of conjunctiva and cornea
caused by exposure to sunlight and dust |
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Kayser-Fleischer ring
greenish yellow ring near limbus
found in Wilson's disease ONLY (disorder of copper metabolism) |
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Blue sclera
sclera appears blue and thin, usually found in infants
could be associated with osteogenesis imperfecta (hereditary disorder of bone fragility) or with Ehler Danlos syndrome (causing deafness) |
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