WVSOM -- Tips for Success EYE
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| What is xanthelasma? | depositions of lipids in upper and lower eyelids. ABNORMAL lipid metabolism
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| What is ptosis? | dropping of the upper eyelid (CNIII)
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| What is Blepharitis? | inflammation of the eyelid with associated crusting and itching. Caused by infection or autoimmune conditions. Expect so tbe more generalized than a stye or chalazion
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| What is hordeolum? | stye. Infection of the sebaceious glands at the base of eyelashes. Usually staph. Painful
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| What is chalazion? | a blockage of the meibomian glands on the endge of th eyelid. NOT painful
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| What is the conjunctiva? | clear membrane as opposed to the white sclera covering the eye surface. Keeps the eye most and serves as a barrier to microbial invasion
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| What is conjunctivitis? | inflammation of the conjunctivae caused by infection or allergic reactions. Usually associated with an erythematous, cobblestoned appearance, especially on the posterior surface of the eyelid
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| What is the arcus senilis of the Cornea | ring around the edge of the cornea caused by lipid deposition. Normal finding in patients > 60 y/o.
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| What is the corneal light reflex? | shine penlight directly at patient's eyes. Look for the reflection off the cornea. It should shine equally on the nasal portion of each cornea. Aysmmetry indicates strabismus or amblyopia
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| What is strabismus? | patient cannot focus both eyes on an object simultaneiously. May have defvfaion of one eye out of position. Called lazy eye
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| What is exopthalmos? | bulging eyes. Increased volume of orbital content.
if bilateral, commonly associated with hyperthyroidism. Grave's disease is a common cause of autoimmune induced hyperthyroidism especially in women
If UNILATERAL suspect retro-orbital tumor or mass
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| Waht is anisocoria? | unequeal pupils
Normal in 20% of people but may be associated with destruction of teh sympathetic or parasympathetic pathways during trauma
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| What is miosis | pinpoint pupils
Opiod abuse
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| What is mydriasis | abnormally dilated pupils.
midbrain lesions, hypoxia, CN III damage. Acute angle glaucoma, drug abuse
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| What should you suspect if the pupils fail to constrict? | PSNS problems
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| What should you suspect if pupils fail to dilate | think SNS problems
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| What is horner's syndrome? | hi-sided loss of cervical sympathetic innervation to face and eye. Results in ipsilateral ptosis, miosis, vasodiation and anhydrosis.
May be congenital, trauma or cancer
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| What is CN III Palsy | damage to CN III which results in ptosis, mydriasis and abducation and depression of the pupil
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| What is cataracts? | clouding or increased opacity of teh lens leading to blurring of loss of vision.
Risk factors: increased age, corticosteroid use, UV light exposure, smoking, diabetes
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| What is retinoblastoma | malignant tumor of the retina often found in children < 2 yo. usually present with loss of the reflex in the affected eye adn replacement with a white reflex instead
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| What is glaucoma? | disease consisting of damage to the optic nerve usually caused by increased intr-ocular pressure frmo blocked exit of the aqueous humor fromt eh anterior chamber of the eye
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| What is open angle glaucoma? | chronic glaucoma
Trabecular meshwork becomes blocked over time.
Often asymptomatic except for gradual loss of vision over a period of years.
tiny blind spot appear at teh edges of teh visual field. colored halos around lights
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| Waht is closed angle glaucoma? | opening between the cornea and iris narrows resulting in a rapid buildup of pressure.
Intense ocular pain, blurred vision, visual halows, red eyes, dilated pupils or rapid loss of vision
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| What are the physical findings of glaumoa? | cupping of the optic disc, hemorrhages around the edge of the optic disk
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| What are the normal structures seen in fundoscopic examination? | fundus
optic disc
macula lutea
fovea
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| Where is fundus found? | posterior retina
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| Describe the optic disk | where vessels and nerves enter the eye. Shoudl be yellow to creamy pink with well definded margins
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| Describe teh macula lutea | yellowish area without blood vessels where visual acuity is heightened. Contains teh fovea
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| Describe the fovea | area of highest visual acuity on the retina. Within the macula lutea
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| What is papilledema? | increased intracranial pressure. Optic disc looses definition and pushed out central vessels.
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| What is glaucomatous cupping of the optic disc? | caused by increased intra-ocular pressure and the death of ganglion cells secondary to glaucoma.
cupping around the edges of the optic disc. Blood vessels may disappear around the edge of the disc
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| What are drusen bodies? | usually caused by aging, associated with senile macular degeneration.
Small discrete yellow spots on the retina that enlarge over time
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| What is diabetic retinopathy? | dot hemorrhages, hard exudates, soft exudates ("cotton wool spots")
Local hypoxia leads ot neovascularaion but the new vessels are weak adn leak easily leading to hemorrhage and vision loss
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| What is hypertensive retinopathy? | increased light reflex from teh arterioles. Thre is narrowing adn AV nicking. Shiny retina, cotton wool spots. Flame hemorrhages, pailledema (late findig)
Normal arterial-venous size ration is 3:5 and it will be decreased in hypertensive retinopathy
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| What is difference between diabetic retinopathy and hypertensive retinopathy? | in HTN retinopathy look for AV nicking. It appears wehre an arteriole adn vein cross over each other.
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| AV nicking is associated with? | hypertensive retinopathy
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| What are cotton woll spots | infact areas assocaited with diabetic retinopathy or HTN retinopathy
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| Neovascularization | diabetic retinopathy
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| Drusen bodies | macular degeneration and aging
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| Hemorrhage at teh edge of optic disc | glaucoma
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| flame hemorrhages | diabetic retinopathy or HTN retinopathy
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| Retinal hemorrhages in infant | SHAKEN BABY SYNDROME!!!!
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