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Intro to Optho
Clinical Medicine II
| Question | Answer |
|---|---|
| What is the appreviation for R eye and L eye and both | R: oculus dexter OD L: oculus sinister both: oculus unitas |
| What is visual acuity | distance at which u can c an object/distance at which a “normal” person can see an object |
| Is 20/10 or 20/100 better vision | 20/100 nl person can see at 20 feet I can see at 100 |
| When do you take a visual acuity, why? | 1st!! before everything you do!!!! It establishes a baseline |
| Normal vision without corrective lenses | emmetropia |
| Near sightedness | myopia, focuses before the retina |
| Far sightedness | hyperopia, focuses behind the retina (born this way) |
| Light focuses at two points rather than one | astigmatism, shape of eye is different |
| What are the glands locted posterior to the eyelashes | Meibomian oil glands, prevents eyes from drying out |
| Inflammation of the lid margin | blepharitis MC is Staph |
| Tx for blepharitis | lid scrubs, possibly topical abx? |
| Bacterial infx inside the meibomian glands | hordeolum (stye) |
| Tx for stye | warm compress, NOT abx, heal in 1-2wks pt ed: will get worse before getting better |
| Difference b/w chalazion and hordeolum | styes are painful to the touch, chalazion is not |
| Sxs free minimally tender nodule of the lid | chalazion |
| Tx for chalzion | warm compress and time |
| Lower eyelid and eyelashes turn out abnormally w/ poor apposition of the globe and lid | ectropion |
| Lower eyelid and eyelashes abnormally turn inward: pain/irritation | entropion Common w/ Asians |
| Dropping of the lid | ptosis |
| Waxy, raised cholesterol deposits around medial canthal region | Xanthelasma |
| Inflammation of the drainage system of the eye | dacrocystitis |
| Inflammation of the tear duct/gland itself | dacroadenitis |
| L6(SO4)3 | lacteral rectus innervated by VI Superior rectus: 4 rest are 3 |
| Difference between phorias and tropias | phorias: cover eyes→turn in or out Tropia happens all the time, Esotropia/exotropia |
| Disruption of normal vision development | Ambylopia: lazy eye |
| Anterior refractive surface | cornea |
| Is the cornea vascular? | no, but HIGHLY innervated: painful!!!! |
| 5 layers of the cornea | epithelium, bowman’s membrane, stroma, descemet’s membrane, endothelium |
| Why does the cornea often get abrasians but no perforations | Bowman’s membrane, extremely thick |
| Dry eyes | keratitis |
| Squamous epithelial membrane covering the globe (bulbar) and eyelids (palpebrae) | conjunctiva, has glands and lymphatics |
| MC cause of conjunctivitis | VIRAL!!!!!!! |
| What should we always consider if conjunctivitis is occurring | iritis |
| How do we tell the difference b/w bacterial and viral conjunctivitis | bacterial: mucopurulent discharge all day long (not just the morning) |
| When do we prescribe antivirals | ONLY if cornea is involved, VERY rare to prescribe |
| When do we prescribe soft steroids | ONLY when there is something BIG in their life next day, must taper: rebound infx |
| White part of the eye | sclera |
| Gradual onset, DEEP sclera injection, deep pain what may radiate to jaw or temple painful to palpation | Scleritis |
| Causes of scleritis | connective tissue dz, RA, disorders of menstruation |
| Acute onset of redness, pain dull ache localized to eye, VA nl, recurrent episodes | Episcleritis |
| Causes of episcleritis | 75% idiopathic, Gout, Rosacea, young adults |
| Space between cornea and lens (holds what ) | anterior chamber, aqeous humor |
| Dark, unreflective layer b/w sclera and retina | choroid: so light doesn’t reflect back out |
| What attachs the lens to the eye | Zonules |
| Cataract | loss of transparency of lense, biochemical changes occur within cells of lens |
| Jelly-like substance giving body to the globe | vitrous humor |
| What is vitreous humor made of | hyaluronic acid and hyaloid fibers |
| Yellow or yellow-white calcium-laden lipids suspended in the vitrous | asteroid hyalosis |
| Rare cholesterol formations, in dz’d eyes, settles to the bottom | synchisis scintillans |
| Suddenly see white spots and when I move my eyes I see flashes | THINK RETINAL detachment, commonly post vitreous detachment |
| What does the Cup: disc ration measure | pressure in the eye, d/t 1: physiological 2: eye pressure |
| What measurement of the cup do we worry about | >.5 but must take into account physiological causes |
| Main characteristic of papilledema | BILATERAL swelling of the optic nerve head: ↑ICP need CT r/o bleed |
| Unilateral inflammation of the optic nerve head | papillitis: dramatic ↓ VA, d/t HSV, MS, giant cell arteritis |
| What does papilledema look like | can’t see the borders of the optic disc, not smooth |
| Difference b/w papilledema and papillitis | look very similar edema: bilateral, it is: unilateral |
| What is the only place to see blood vessels inside the body | ophthalmic artery in posterior eye |
| Name 4 pathologies of BV’s in the eye | exudates, hemorrhage, AV nicking, Copper wiring→silver wiring |
| What it’s the light and color receptor | retina |
| Micro-infarctions of nerve fiber layers | cotton wool spots, non-proliiferative diabetic retinopathy |
| Separation of the retinal tissue from underlying retinal pigment epithelium | retinal detachment |
| Flashing lights, superior vision is blocked | inferior retinal detachment |
| R sided vision lost | L sided retinal detachment |
| 3 classic signs of retinal detachment | flashing lights, ↑ floaters, curtains of loss of vision |
| Straight ahead, color vision | fovea, where most of our vision is directed ↑ cone concentrated |
| MC cause of legal blindness in western world | macular degeneration |
| Hyaline material present in optic disc or substrate of the retina | dursen |
| How can we put in eye drops | put 1 drop on lower lid |
Created by:
becker15
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