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eye cond. part 2
med sci exam 1 material
| Question | Answer |
|---|---|
| pupil assessment includes | size/shape/symmetry, position, reactivity |
| mydriasis | pupils dilated greater than 6 mm |
| causes of mydriasis | CO poisoning, drugs (amphetamines, anticholinergics, hallucinogens), acute opioid withdrawal |
| miosis | construction of pupils less than 2 mm |
| causes of miosis | miotic eye drops, opioid use, pontine tumor/hemorrhage |
| anisocoria | ONE pupil is abnormal (unilateral shape, unilateral size abnormalities) |
| corneal abrasion | defect isolated to the corneal surface epithelium caused by mechanical trauma of the surface of the eye |
| corneal ulcer | keratitis |
| 2 types of corneal abrasions | traumatic and spontaneous |
| clinical presentation of corneal abrasion | pain, photophobia, FB sensation, decreased visual acuity, erythema, fluorescein testing |
| treatment of corneal abrasion | topical antibiotics, pain control |
| bacterial keratitis typical organisms | pseudomonas, staphylococcus aureus, serratia |
| bacterial keratitis presentation | pain, erythema, photophobia, positive fluorescein testing |
| bacterial keratitis is an ____ referral | EMERGENT |
| treatment of bacterial keratitis | topical antibiotics, referral to ophthalmology |
| strabismus | cross eyed : misalignment of the eye so that they no longer work together in a binocular fashion |
| eso = | nasal (inward) deviation |
| exo = | temoral (outward) deviation |
| hyper = | upward deviation |
| hypo = | downward deviation |
| nonparalytic | eye deviation is NOT due to any specific muscle weakness |
| non paralytic is most common in | children |
| paralytic | identifiable muscular weakness |
| paralytic is most common in | adults |
| ambylopia | lazy eye |
| 2nd leading cause of blindness worldwide | glaucoma |
| glaucoma | heterogenous group of ophthalmic conditions that cause progressive damage to the OPTIC NERVE, leading to visual field loss and irreversible blindness |
| primary open angle glaucoma | chronic, bilateral, asymmetrical disease |
| primary open angle glaucoma characteristics | optic disc or retinal nerve fiber structural abnormalities, visual field defect, open, normal looking anterior chambers |
| primary open angle glaucoma presentation | gradual development of visual defect, increased IO pressure |
| acute angle-closure glaucoma is considered | MEDICAL EMERGENCY |
| acute angle-closure glaucoma | must be treated within 24 hrs to prevent blindness- obstruction of normal aqueous humor outflow |
| acute angle-closure glaucoma presentation | sudden, unilateral vision loss, visual hallucinations prior to acute vision loss, nausea, vomiting, shallow anterior chamber, cupping of optic disc |
| age related cataracts | opacity of lens |
| classification of age related cataracts | congenital, age-related, non age related |
| presentation of age related cataracts | glare sensitivity, photo-Dias, decrease acuity, abnormal red reflex seen on physical exam |
| treatment of acute angle-closure glaucoma | topical glaucoma medications, laser therapy or surgery to correct anterior chamber |
| treatment of age-related cataracts | not needed until patient has symptoms , then refer for surgery consult |
| uveitis | inflammation of the uveal tract |
| risk factors of uveitis | patients at increase risk of infection, autoimmune conditions |
| uveitis presentation | eye pain, decreased visual acuity, miosis, erythema, build up of WBC in anterior chamber |
| infectious causes of uveitis | herpes, CMV, toxoplasmosis, cat-scratch disease, Lyme disease |
| systemic immune-mediated causes of uveitis | spondyloarthritis, sarcoidosis, psoriatic arthritis, IBD, RA, drugs |
| uveitis diagnosis | clinical and basic labs |
| uveitis treatment | emergent referral |
| optic neuritis | inflammatory , demyelinating condition that causes acute, typically unilateral vision loss (MS in 20% of patients) |
| optic neuritis presentation | vision loss (color vision), eye pain, papillitis (edema of optic disc) |
| optic neuritis diagnosis | MRI of brain, clinical suspicion |
| age-related macular degeneration | one of leading causes of blindness in US; degenerative disease of central portion of retina (MACULA), results in loss of central vision |
| age-related macular degeneration is classified based on | pathophysiologic process causing degeneration (dry / wet) |
| risk factors of age-related macular degeneration | increasing age, family history, caucasian, smoking, high BMI, heavy alcohol use |
| dry age-related macular degeneration presentation | gradual vision loss, drusen bodies on fundoscopic exam |
| wet age-related macular degeneration presentation | ACUTE vision loss, amsler grid test, hemorrhages found on fundoscopic exam |
| treatment of dry age-related macular degeneration | stop smoking, antioxidant vitamins, monitor for progression into wet |
| treatment of wet age-related macular degeneration | IV vascular endothelial growth factor*, antioxidant vitamins; some surgical & radiation options exist as well |
| retinal detachment | separation of the retina from the underlying retinal pigment epithelium and choroid causing ischemia and photoreceptor degeneration |
| retinal detachment can be | passive (non traumatic) or traumatic |
| risk factors of retinal detachment | increasing age, significant myopia, ocular surgery, eye trauma |
| presentation of retinal detachment | PAINLESS loss of vision often preceded by floaters, abnormal fundoscopic exam |
| treatment of retinal detachment | office procedures, laser, surgeries |
| common mechanisms of injury for eye trauma | blunt trauma, penetrating trauma, radiation / chemical exposure |
| epidemiology of eye trauma | male predominance (80%) |
| epidemiology of eye trauma in very young children | penetrating with sharp objects most common |
| epidemiology of eye trauma in pre-teens, teens, YA | blunt from sports/MVA, fights, and penetrating from work |
| epidemiology of eye trauma in geriatrics | blunt more common than penetrating, usually due to a fall and history of prior eye surgery |
| greater than ______ work related eye injuries report annually | 65,000 |
| occupations most commonly associated with eye injuries | laborers, production, equipment operators, repair |
| sports that most commonly cause eye injuries | baseball/softball, basketball, water sports, racquet sports |
| hyphema | presence of blood in the anterior chamber , mechanism of injury varies by age |
| clinical presentation of hyphema | decreased vision, eye pain, history of trauma, grossly abnormal eye exam |
| diagnosis of hyphema | URGENT referral, imaging needed to fully eval trauma |
| microhyphema | circulating red blood cells by slit lamp exam only |
| grade 1 hyphema | anterior chamber filling less than 33% |
| grade 2 hyphema | anterior chamber filling 33-50% |
| grade 3 hyphema | anterior chamber filling >50% |
| grade 4 hyphema | anterior chamber filling 100% |
| open globe rupture occurs | following blunt trauma |
| open globe laceration | penetrating injury of the eye by a sharp object |
| open globe laceration classified as | penetrating, perforating , or intraocular foreign body |
| chemical globe injuries is caused by | acids or alkalis |
| orbital fractures mechanism of injury | MVA, assault, sports related trauma |
| orbital fracture epidemiology | most common in males Fromm late childhood to young adulthood |
| most common type of orbital fracture | orbital zygomatic fracture |
| orbital fracture presentation | pain, edema, ecchymosis, deformity |
| orbital fracture diagnosis | CT scan |
| orbital fracture treatment | emergency stabilization, ophthalmology / surgery consult |
Created by:
thomask9
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