question

Acute angle closure glaucoma symptoms

answer

Symptoms: Sudden onset of pain, nausea/vomiting, HA, halos, decreased vision

question

Acute angle closure glaucoma signs

answer

Signs: *Increased IOP, *cloudy cornea, narrow angle, red eye that gets pain when lights turn off, fixed mid-dilated pupil, increased cup to disc ratio, visual field loss.

question

Ruptured globe signs and symptoms

answer

Symptoms: History of trauma, loss of vision Signs: Leaking fluid, distortion of organ, *bollus sub hemorrhage, *decrease IOP

question

CRAO is referred to as a:

answer

stroke of the eye

question

CRAO risk factors:

answer

crack/meth/talc drug use, coagulation problems, usually in older pts.

question

CRAO symptoms:

answer

Sudden, painless vision loss or visual field loss

question

Signs of arterial occlusion:

answer

APD, cherry red spot

question

Viral conjunctivitis usually caused by:

answer

adenovirus, enterovirus

question

Viral conjunctivitis: Symptoms

answer

More pain than itchyness

question

Viral conjunctivitis: Signs

answer

Red, diffuse eyes, swollen conjunctiva (chemosis) mucous/serous discharge (not purulent) cervial adenopathy. *Hx of URI

question

Allergic conjunctivitis symptoms:

answer

More itchyness than pain. Signs same as viral: diffuse redness, conjunctival swelling

question

Diabetic retinopathy: Symptoms

answer

*Yellow exudates from macula, Glaucoma, "Spoke and wheel cataract"- loose blue/yellow because cataract is brown

question

Diabetic retinopathy: Signs

answer

pre-retinal hemorrhages, neovascularization secondary ischemic retina,

question

Retinal Detachment: Risk factors

answer

high myopia, trauma, boxing hx, family hx, eye surgery, old age

question

Retinal Detachment: Symptoms

answer

Painless, decrease in vision, flashing lights for more than 30 minutes (golden), burst of floaters, veil falling over part of vision

question

Retinal Detachment: Signs

answer

Displaced retina with folds, free floating blood in vitreous

question

Pituitary tumor: Symptoms

answer

Loss of peripheral vision (bitemporal hemianopia)

question

Pituitary tumor: Signs

answer

Optic nerve chiasm compression

question

Temporal arteritis: basic definition

answer

inflammation of medium sized arteries; disease of the elderly

question

Temporal arteritis: Symptoms:

answer

Jaw pain or claudication with chewing, headache, scalp tenderness, vision loss, vision field loss, weight loss, fever, night sweats, malaise, polymyalgia rheumatica

question

III nerve palsy can be caused by:

answer

aneurysm, tumor, brain herniation, ischemia

question

Signs/Symptoms of III nerve palsy

answer

Eye goes down and out, drooping eyelid, dilated pupil, *diplopia

question

Two types of III nerve palsy

answer

1. Pupil involving (masses: aneurysm, tumor, brain herniation) 2. Pupil sparing (ischemia, stroke- diabetes, HTN)

question

Myasthenia gravis signs/symptoms

answer

Drooping eyelids and double vision that worsens later in the day and worsens with fatigue

question

Zoster signs/symptoms

answer

Hutchinson's sign- lesion that appears on the tip of the nose that precedes ophthalmic zoster. Dendritic fluorescein staining. *Respects the midline

question

Orbital compartment syndrome: symptoms

answer

Pain that increases with movement, decreased vision, decreased color vision

question

Orbital compartment syndrome: signs

answer

Increased IOP, proptosis (bulging globe), decreased extra ocular movements, APD

question

Macular degeneration: Symptoms

answer

Gradual decline in visual acuity, especially central vision. Distortion of central vision: wavy lines. Scotomata in central vision: missing areas.

question

Macular degeneration: Signs

answer

Drusen (yellow) spots, atrophy, normal cup:disc, bleeding subretinal hemorrhage, neovascular net

question

Risk factors for subconjunctival hemorrhage

answer

Straining, heave lifting, trauma, HTN

question

Tx of subconjunctival hemorrhage

answer

Full eye exam, reassurance that it will resolve on own. If repeated, check BP

question

Tx chemical burn

answer

Copious flushing with saline, diffuse fluorescin stain

question

If possible foreign body, what test should you run?

answer

CT/Xray, fluorescin dye and flip lid. NO MRI

question

Tx for possible ruptured globe:

answer

CT, cover/shield, IV antibiotics, refer to ophthalmology for surgery

question

Tx for viral conjunctivitis:

answer

NO topical steroids. Patient can use artificial tears, cold compresses, handwashing. Self limiting.

question

Differential diagnosis of leukocoria in children

answer

Retinoblastoma, cataract, retinopathy of prematurity.

question

Diabetic patients must have their eyes:

answer

dilated and full exam once a year, look for exudates, check sugar.

question

Tx for diabetic patients with non proliferative

answer

observation yearly if no retinopathy, sooner if retinopathy is present.

question

Tx for diabetic patients with proliferative

answer

Check for glaucoma

question

Blepharitis is:

answer

inflammation of the eyelids (associated with chronic conjunctivitis)

question

Tx of blepharitis:

answer

Warm compresses 1-4x/day followed by eye lid scrubs with baby shampoo. Lid massge, antibiotics if needed, topical or oral

question

Corneal abrasion Tx

answer

Antibiotic ointment, pain management

question

Tx for herpes:

answer

Refer to ophthalmology, cold compresses, anti-virals, NO STEROIDS rx in primary care

question

Orbital cellulitis tx:

answer

Tx to prevent orbital compartment syndrome: IV Antibiotics, CT scan, drain abscess, ENT referral for mucormycosis if DM Risk factor: Preexisting sinusitis

question

Hyphema definition

answer

Blood in the anterior chamber of the eye. In front of the iris, but behind the cornea.

question

Hyphema tx:

answer

bed rest w/ head elevation, avoid ASA and activity for 1-2 weeks, steroids to reduce scarring, atropine will dilate pupil and decrease pain, IOP x2-3 days requires draining

question

Hypopyon definition

answer

Pus in the anterior chamber of the eye. In front of the iris by behind the cornea.

question

The anterior chamber is from the ___ to the ____

answer

cornea to iris

question

The posterior chamber is the ___ to the ___

answer

iris to the lens

question

Where do you check for cataracts?

answer

Posterior chamber

question

Choroid:

answer

Vascular coat of eye between sclera and retina, extending from the ora serrate to optic nerve. Consists of blood vessels united by CT, contains pigmented cells.

question

Ciliary body:

answer

1. Sits directly behind iris. 2. Secretes aqueous humor 3. Contains ciliary muscle that changes the shape and thus the refractive power of the lens by tightening and relaxing the tension on the lens.

question

Conjunctiva:

answer

Mucous membrane that covers sclera and reflexes back to cover underside of eyelids. *makes it so you can't lose your contact behind your eye. *doesn't cover cornea

question

Fundus oculi:

answer

Posterior inner part of eye as seen with an ophthalmoscope. Contains the retina, optic disc, macula and fovea.

question

Lens:

answer

allows light into the retina. Ciliary body control the shape/power of the lens

question

Accommodation:

answer

The ability to change focus from far to near.

question

Limbus cornea:

answer

The edge of the cornea where it unites with the sclera.

question

Posterior segment:

answer

Vitreous, retina, disc. Best seen with dilation, look for disc edema, pallor, blood, cotton-wool spots, Roth spots

question

Retina:

answer

innermost layer of the eye, immediate instrument of vision, receives images transmitted through the lens

question

Tarsal/Meibomian glands

answer

Branched sebaceous alveolar glands embedded in the tarsus and opening on the margin of the eyelid.

question

Uveitis:

answer

Non specific term for any intraocular inflammatory disorder.

question

Risks of contact lenses:

answer

Giant papillary conjunctivitis, which is painless, so flip the eyelids to check. Scratched cornea, allergic conjunctivitis, infection- pseudomonas

question

APD

answer

When light is shown in one eye then immediatly moved to the other eye, the consensual response is seen in the second eye, then the direct response catches up. At this point the difference can be detected. In APD consensual response > direct response

question

Pinhole testing

answer

* What the patient's vision would be like with glasses. used to overcome refractive error, if the pt doesnt have their glasses with them or their rx is out of date. Test the pt with a tiny hole punched in a sheet of paper.

question

Pupil evaluation

answer

1. anisocoria: inequality of the size of the pupils. 2. Horner's syndrome: disruption of sympathetic innervation, worsens in the dark, small/affected pupil doesn't dilate 3. Triad (sympathetic control): miosis, ptosis, anhydrosis 4. Adie's pupil: disruption of parasympathetic innervation, worse in the light, large/affected pupil does not contrict.

question

DDx Diplopia (6)

answer

1. CN II/IV palsy 2. CN IV palsy: vertical double vision 3. Subluxed lens 4. Orbital fx- muscle entrapment 5. Grave's disease (proptosis) 6. Myasthenia gravis

question

Leading causes of visual loss (6)

answer

#1. AMD- central vision loss 2. Glaucoma 3. Cataract 4. Diabetes: glaucoma, diabetic retinopathies 5. Corneal blindness 6. Retinopathy of prematurity

question

DDx III nerve palsy (3)

answer

1. Myasthenia gravis (dropping of eyelids, double vision, worse later in the day and with fatigue) 2. Horner's syndrome (anhydrosis, small pupils (miosis), dropping of eyelids (ptosis) 3. Grave's disease (proptosis, misalignment of eyes, double vision)

question

DDx White spots on cornea (4)

answer

1. Fungal/bacterial infection (consider GC/Chlamydia) 2. Corneal ulcer- contact lens use 3. Chemical/Herpetic Keratitis 4. Vitamin A deficiency

question

What are you worried about with a young patient with CRAO?

answer

Atrial septal defect

question

Retinoblastoma sx:

answer

poor vision w/o explanation, family Hx, leukocoria, strabismus- eye turning out

question

IOP sign

answer

eyeballs are hard

question

What are you worried about in young patients with CRAO?

answer

atrial septal defect

question

What should you do in older patients with CRAO?

answer

ESR/CRP in case they have enteritis

question

What should you do with a patient with viral conjunctivitis with corneal involvement?

answer

refer to ophthalmology

question

Ptosis is:

answer

drooping of the eyelids

question

What conditions manifest with APD?

answer

CRAO, orbital compartment syndrome

Ophthalmology Study Guide – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards