eye Flashcards

Question

conjunctivitis

Answer 1

most common in children bacteria viral allergic chemical conjunctiva injected no eye pain visual acuity not affected flu adenovirus gonorrhea and chlamydia (neonates) HSV (vesicles around eye; dendritic legion) highly contagious unilateral or bilateral redness itchy discharge/matted eyelid mild photophobia edema erythromycin ointment (babies) trimethoprim-polymyxin B solution

Answer 2

due to contact w/ genital secretions ability to penetrate cornea eye pain blurry vision swollen lymph nodes systemic therapy (ceftriaxone 250 mg IM and 1 doxycycline 100 mg PO BID x 10) NO STEROIDS

Answer 3

adenovirus highly contagious watery/tearing mucous discharge redness second eye becomes involved within 24-48 hrs enlarged and tender preauricular node self-limiting cool compress lubricants

Answer 4

allergens not contagious more common with hay fever , eczema, asthma patients seasonal redness itchy tearing in both eyes morning crust chemosis (conjunctival edema) cool compress decongestants antihistamines

Answer 5

chemicals dust smoke improper contact lens cleaning not contagious irrigation avoid trigger

Answer 6

anterior (iris) posterior (choroid) diffuse (entire uvea) painful herpes redness photophobia ciliary flush (ring of red around cornea) WBC floaters (leukocytic exudate) hypopyon (inflammation cells in the anterior portion of the eye)->red and white episclera slit lamp refer to ophthalmologist treatment should be done within 24 hrs treat underlying cause antivirals topical and oral steroids cyclosporine

Answer 7

very common no pain to severe eye pain inability to open eye slit lamp patient w/ dysfunction of CN 5 (trauma, tumor, herpes) FB sensation antibiotic drops ointment oral NSAIDs (drops) cycloplegic (drops) patch the eye oral analgesic contact wearer (peudomonas)

Answer 8

break in corneal epithelium bacteria virus fungus 1-2 days after abrasion pain redness photophobia tearing decreased vision circumcorneal injection white spot on eye prompt referral edema enlargement of the ciliary and conjunctival BV near the margin of the cornea and reduction of in size peripherally hypopyon

Answer 9

blunt eye injury

Answer 10

penetration injury to the eye via a sharp object projectile (entry w/o exit) perforating (entry w/ exit)

Answer 11

large non-reacting pupil/irregular pupil hyphema or hypopyon in anterior chamber seidal test (chamber leakage of AH) visual acuity and eye exam; can you see this? (exam before anesthetic) vision loss needs immediate attention refer to ophthalmology for removal and globe repair

Answer 12

decreased visual assessment pupil irregular w/ sluggish rxn hazy cornea daily monitoring IOP limit PA elevate head or bed eye shield cyclopentolate (pain) topical steroid (decrease bleeding) eye exam 1 month after injury

Answer 13

rust ring fundoscopic exam rust ring removal w/ cornea burr treat like corneal abrasion-> leads to abrasion antibiotic drops cycloplegic optic NSAID oral analgesic patch the eye

Answer 14

decreased visual acuity diplopia w/ upgaze eyelid edema epistaxis bruising sunken eye (hypoglobus and enophthalmos) blowout fracture NO NOSE BLOWING oral antibiotics ice pain meds surgery (diplopia, nausea, vomiting, syncope, heart block, complex trauma involving rim and zygomatic arch w/ displacement)

Answer 15

indicates subcutaneous emphysema from an associated sinus fracture

Answer 16

impaled or perforated globe should be left undisturbed until surgery

Answer 17

enopthalmos->recession of the globe within the orbit do not check pressure do no check extraorbital motility shield eye immediately no drops do not patch bed rest IV antibitoics tetanus shot surgery eye exam of other eye CT scan to rule out FB

Answer 18

check for hyphema-> blood accumulation-> rest w/ elevated head, eye shield, no aspirin or NSAIDs, ice complete eye exam CT if severe and consult with ophthalmology X-ray EOMI->rule out entrapment palpate around around orbit bilateral deep periorbital ecchymosis->raccoon eyes->skull fracture

Answer 19

conjunctival swelling (chemosis) minimal injection minimal to no pain do not use fluorescein uptake facial distortion itchy no redness, photophobia, fever anterior chamber normal cool compress atarax (antihistamine) all clear drops (eye decongestant)

Answer 20

infection of soft tissue of the face and eyelids (anterior portion) staph strep more common in children trauma swelling tenderness erythema fever conjunctiva injected no pain on eye movement no proptosis CT is severe, broad spectrum antibiotics, admit (<1 yrs) visual acuity, eye motility, pupillary rxn normal augmentin if >1 yr w/ no signs of systemic toxicity immunize for flu and pneumonia eye exam-> fluorescent staining and IOP

Answer 21

recent SI or preseptal cellulitis swelling double and blurry vision soreness proptosis poor motility fever looks ill chemosis injection discharge redness elevated IOP optic nerve edema IV antibiotics admission

Answer 22

most common cause of corneal blindness leads to corneal ulceration can reoccur dendritic ulcer FB sensation photophobia hyperemia lacrimation refer to ophthalmology topical or oral antivirals avoid steroids-> can enhance viral replication slit lamp

Answer 23

involvement of ophthalmic division of trigeminal nerve upper lid and does not cross the midline pain edema oral acyclovir refer to ophthalmologist hutchinson's sign->vesicles on tip of nose

Answer 24

lens opacity aging congenital trauma diabetes blurry vision surgery

Answer 25

inflammation of the anterior and posterior of the eye following surgery (cataract) pain worsening vision hypopyon injection corneal edema vitreous opacities vitreous tap and injection of abx vitrectomy

Answer 26

optic nerve damage due to increased pressure can cause blindness no pain open angle or angle closure

Answer 27

aka wide angle most common in elderly no pain gradual vision loss at night topical prostaglandins topical betablockers IOP may or may not be elevated progressive loss of peripheral vision, then central affects blacks more

Answer 28

narrowing or closure of the anterior chamber angle-> improper drainage of AH IOP elevates and damages optic nerve (w/o proper drainage) pain redness blurred vision ipsilateral headache nausea vomiting steamy/hazy cornea conjunctival injection ciliary flush halos around lights pupil mid-position or slightly larger and fixed refer to ophthalmology timolol, apraclonidine, pilocarpine (1 min apart; IOP is >40 mmHg) LPI (definitive treatment) precipitated by a sudden dilation of the pupil from dark room

Answer 29

transient monocular blindness TIA of retina (embolus from carotid disease or cardia thromboemboli) rapid fading of vision (curtain coming down over eye)

Answer 30

blood vessels break in conjuctiva bright red spontaneous cough sneeze strain vomiting valsalva maneuvar minor blunt trauma blood is limited to the bulbar conjunctiva (stops at limbus) no pain no visual changes redness worsens before improvement consider other hematologic diseases no treatment (blood reabsorption 2-3 wks) involvement of extreme lateral globe= blunt trauma resulting in zygomatic arch fracture non-traumatic= needs eval for underlying metabolic or structural disorder

Answer 31

separation of retina from underlying retinal pigment epithelium and choroid leads to vision loss aging injury painless floaters and flashes of light eye exam->low IOP and RBC in vitreous surgery (sooner if macula involved)

Answer 32

ocular emergency sudden acute painless visual loss due to carotid artery disease, a-fib, giant cell arthritis cherry red spot on fundoscopic exam treatment needed within 90 mins (prevents retinal damage) ocular massage hyperbaric o2 low IOP vasodilators intraarterial thrombolytic therapy

Answer 33

painful 2nd common cause of vascular-related visual loss fluid leaks into retina and vision gets blurry glaucoma diabetes hypertension age vasculitis sarcoidosis AIDs SLE endothelial GF (decreases edema) steroids thrombolytic agents (restores BF)

Answer 34

leads to blindness (loss of central vision, rarely peripheral) age ethnicity smoking alcohol diet famHx chronic med conditions meds

Answer 35

more common vision loss is slow drusen deposits= localized deposits of EC material concentrated in macula (small, bright-yellow on ophthalmoscope) larger soft drusen=associated w/ vision loss risk increases w/ size and number of soft drusen geographic atrophy

Answer 36

growth of abnormal vessels into subretinal space BV leak=subretinal fluid, blood under retina rapid distortion and central vision loss (days-wks) distortion of straight lines (metamorphopsia)

Answer 37

dysfunc. in third CN (oculomotor) lesions along its path btw the oculomotor nucleus in the midbrain and the extraocular muscles in the orbit double vision ptosis dilated pupil (difference greater in light) eye down and out (impaired motility) CT angio or MRA to r/o aneurysm neurosurgery consult

Answer 38

recurrent inflammation of superior cornea and limbus, and superior tarsal and bulbar conjunctiva red eye burning tearing FB sensation photophobia lubrication

Answer 39

fibrous layer vascular layer inner layer

Answer 40

internal cavity filled w/ fluid

Answer 41

separates internal cavity into anterior and posterior segments

Answer 42

outer most layer= dense avascular CT sclera and cornea

Answer 43

continuous w/ dura matter of brain opaque posterior region protects and shapes eyeball optic nerve exits

Answer 44

transparent anterior one-sixth of fibrous layer forms clear window that lets light enter and bends light as it enters eyes epithelia protects from abrasions corneal endothelium= contains sodium pump that help maintain clarity of cornea numerous pain receptors blinking and tearing

Answer 45

middle pigmented layer choroid, ciliary body, iris

Answer 46

posterior portion supplies blood to all layers of eyeball brown pigment absorbs light to prevent it from scattering (prevents visual confusion)

Answer 47

anterior choroid becomes ciliary body thickened ring of tissue around lens SM bundles and ciliary muscles control shape of lens capillaries of ciliary processes secrete fluid for anterior segment of eyeball ciliary zonule (suspensory ligament) extends for ciliary processes to lens-> holds lens in position

Answer 48

colored part of eye that lies between cornea and lens, continuous w/ ciliary body

Answer 49

central opening that regulates amount of light entering eye close vision and bright light cause sphincter pupillae (circular muscle) to contract and pupils to constrict->PS control distant vision and dim lights cause dilator pupillae (radial muscle) to contract and pupils dilate-> S control

Answer 50

inner layer originates as an outpocketing of brain millions of of photoreceptor cells that transduce light energy neurons glial cells outer pigmented layer inner neural layer

Answer 51

single cell thick lining next to choroid extends anteriorly, covering ciliary body and iris absorbs light and prevents its scattering phagocytizes photoreceptor cell fragment stores vit. A

Answer 52

transparent layer that runs anteriorly to margin of ciliary body anterior end has serrated edges called ora serrata spread from photoreceptors->bipolar cells->ganglion cells-> optic nerve optic disc= where optic nerve leaves eye lacks photoreceptors= blind spot rods cones

Answer 53

dim light, peripheral vision receptor more numerous and more sensitive to light than the cornea no color or sharp images numbers greatest at periphery as many as 100 rods may converge into on ganglion converging

Answer 54

vision receptors for bright light red, blue, green macula lutea= area at posterior pole lateral to blind spot fovea centralis= tiny pit in center of macula lutea that contains all cones-> best visual acuity (eye movement allows to focus in on object so fovea can pick it up nonconverging have own ganglion cell

Answer 55

supplies outer third (photoreceptors) blood supply to retina

Answer 56

supplies inner 2/3 of retina enter/exit eye in center of optic nerve

Answer 57

posterior segment anterior segment

Answer 58

iris divides into 2 chambers (anterior and posterior chamber) anterior chamber-> between cornea and lens posterior chamber-> between iris and lens AH-> supplies nutrients, O2, mainly to lens and cornea but also to retina, removes wastes; drains via sclera venous sinus (canal and schlemm) at sclera-cornea junction

Answer 59

VH-> transmits light, supports posterior surface of lens, holds neural layer of retina firmly against pigmented layer, contributes to IOP, forms in embryo and lasts a lifetime

Answer 60

biconcave, transparent, flexible, avascular changes shapes to precisely focus light on retina lens epithelium= anterior region of cuboidal cells that differentiate into lens fiber cells lens fibers= form bulk of lens and filled w/ transparent protein crystallin (added continuously; lens becomes more dense, convex, and less elastic w/ age)

Answer 61

cornea-> AH-> lens-> VH-> neural layer of retina-> photoreceptors light is refracted in cornea and lens (majority in cornea)-> constant and cannot change focus lens can adjust curvature to allow for fine focusing-> distant and close vision

Answer 62

eyes are best adapted for distant vision far point vision= distance beyond which no change in lens shape is needed for focusing 20 ft emmetrophic (normal) eye-> cornea and lens focus light precisely on retina at this distance ciliary muscles relaxed in distant vision, causes pull on ciliary zonule-> lens are stretched flat

Answer 63

light for close eyes objects diverges as approaches eye accommodation= changing lens shape to increase refraction near point vision= closest point on which eyes can focus presbyopia= loss of accommodation in ages over 50

Answer 64

accommodation of pupillary reflex PS

Answer 65

medial rotation of eyeball cause convergence of eyes towards object being viewed-> controlled via somatic motor neuron innervation on medial rectus muscle

Answer 66

nearsightedness lens wont lengthen (focal point in front of retina) corrected w/ concave lens

Answer 67

farsightedness lens wont bulge (focal point behind retina) corrected w/ convex lens

Answer 68

unequal curvature in different parts of cornea and lens corrected w/ cylindrically grounded lens and laser procedures

Answer 69

modified neurons rods and cones synaptic terminal inner fibers cell body outer fiber inner segment outer segment

Answer 70

joins cell body to outer segment connected to cell body via outer fibers and w/ connecting cilia to outer segment

Answer 71

light receiving region visual pigments (photopigments) that change shape as they absorb light

Answer 72

key light absorbing molecule that combines w/ one of four proteins (opsins) to form visual pigments (synthesized via vit. A) rhodopsin (four opsins found in rods) 3 opsins found in cones

Answer 73

only organ in the body with light input where there is light= no melatonin= awake where there is no light= produce melatonin= sleep

Answer 74

process by which pigment captures photon of light energy, which is converted into a graded receptor potential (IPSP or EPSP)

Answer 75

1. Retinal absorbs light, changes shape and activates rhodopsin 2. Activated rhodopsin the activates G protein transducin 3. Transducin activates PDE (phosphodiesterase) 4. Activated PDE which breaks down cyclic GMP (cGMP) to GMP * Causing cGMP levels to fall 5. As cGMP levels fall (in light), cation channels close, and cell hyperpolarizes * Hyperpolarization is signal for vision!

Answer 76

local change in membrane potential due to a stimulus, where the change depends on amplitude of the stimulus (not all or none = AP) photoreceptors and bipolar cells

Answer 77

cGMP-gated Ca2+ channels are open-> depolarization->release glutamate – inhibit bipolar cells = create IPSPs in bipolar cells

Answer 78

generate APs transmitted in optic nerve to brain

Answer 79

optic nerve->optic chiasm->optic tract->lateral geniculate nuclei->thalamic neurons form optic radiation->primary visual cortex in occipital lobe

Answer 80

control extrinsic eye muscles

Answer 81

pupillary reflexes

Answer 82

timer for daily biorhythms

Answer 83

circadian pigment small subset of ganglion cells in retina project to pretectal nuclei and supraciamatic nucleus

Answer 84

do not cross over at optic chiasm

Answer 85

cross over at optic chaism

eye Flashcards

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