1
Q
where does the aqueous humor originate
A
ciliary body of posterior chamber
2
Q
what is aqueous humor
A
clear, watery fluid
3
Q
where does the aqueous humor drain
A
into the nervous system through canal of schlemm
4
Q
*what is important to note about aqueous humor
A
production has to match outflow
5
Q
what happens if pressure from aqueous humor builds
A
destruction of the optic nerve
6
Q
patho of aqueous humor
A
originate in ciliary body of posterior chamber - flows thru the pupil into the anterior chamber
7
Q
what is the role of the aqueous humor
A
nourishes/bathes whole part of the eye
8
Q
visual pathway crosses at
A
optic chiasm
9
Q
with a left sided stroke which eye would be effected
A
opposite side is effected - right eye
10
Q
light passes through the eye through these structures
A
cornea, lens, aqueous humor, vitreous humor
11
Q
structures must be clear for light to pass through, t or f
A
true
12
Q
what conditions effect clarity of vision
A
cataracts, cornea abrasion
13
Q
2 types of conjunctiva
A
bulbar - palpebral
14
Q
what is conjunctiva
A
transparent mucous membrane covering inner surface of eyelid (palpebral) - extends over sclera (bulbar) - forming a pocket under eyelid -
15
Q
conjunctiva that covers inner surface of eyelid
A
papebral
16
Q
conjunctiva that extends over the sclera
A
bulbar
17
Q
glands in conjunctiva secrete what
A
mucous and tears
18
Q
what is sclera
A
the white of the eyes - shell which protects
19
Q
how to communicate w/pt who is visually impaired
A
normal tone of voice - doesn’t mean they are deaf
use clock when offering food
20
Q
what is the sighted guide technique for visual impairment
A
slightly to front - holding elbow - describe environment
21
Q
what do you NOT want to do to environment w/visual impairment
A
change things around
22
Q
dx studies of visual impairment
A
refractometry
ultrasonography
fluorescein angiography
amsler grid
23
Q
what happens during refractometry
A
looking through lens (which looks clearer?)
24
Q
what happens in fluorescein angiography
A
inject dye to look at vessels
25
when would you see fluorescein angiography used
retinopathy
26
when would you see amsler grid used
macular degeneration
27
what is myopia
near-sighted
28
what is hyperopia
far-sighted
29
what is astigmatism
cornea is uneven - light rays are bent right
30
what is presbyopia
normal aging of the eye - seen in elderly - lose ability to accommodate (focus)
31
what are refractive errors
myopia, hyperopia, astigmatism, presbyopia
32
uncorrectable visual impairments
total/functional blindness (legally blind), partially sighted
33
what is functional blindness
some light perception w/no usable vision
34
total/functional blindness are both legally blind, t or f
true
35
what is total blindness
no light perception, no usable vision
36
is partially sighted considered legally blind
no
37
to be classified legally blind you must meet this criteria
visual acuity of 20/200 or worse in better eye
| visual field no > than 20 degrees in better eye
38
what does 20/200 vision mean
what a person can see at 20ft you can see at 200 ft
39
eye trauma types
non penetrating
contusion
abrasion
40
how would we treat a corneal abrasion
patch - cold compress - Tylenol
41
how would we trt penetrating eye injury
shield - refer to ophthalmology specialist - DON'T PULL IT OUT
42
how would we trt a splash injury to the eye
flush it - irrigate for 15-20 min (lukewarm or norm. saline)
43
what is hyphema
blunt trauma to the eye - blood covers eye
44
hyphema usually goes away on its own, t or f
true
45
retinal detachment is often described as a
curtain covering the eye
46
another term for external sty
hordeolum
47
how does a hordeolum present
red, swollen, tender
48
how do we treat hordeolum (sty)
warm compresses - Tylenol
49
if a sty gets worse what should we do
refer to ophthalmologist for trt. (antibiotic)
50
another term for an internal sty
chalazion
51
how do we treat chalazion (internal sty)
warm compresses - OR for surgical removal
52
infections of the eye
blepharitis - conjunctivitis - keratitis
53
what is blepharitis
inflammation of the lid margin
54
trt for blepharitis
lubricating eye drops
55
what is conjunctivitis
inflammation of the conjunctiva
56
trt for conjunctivitis
allergic (allergy med) - antibiotic eye drops
57
what are the 3 different types of conjunctivitis
allergic, viral, bacterial
58
important teaching for conjunctivitis
wash your hands - don't touch your eye - avoid make-up - don't wear contact lenses - don't share wash rags
59
what is keratitis
inflammation/infection of the cornea
60
common dry eye disorder commonly found in elderly and those with lupus or scleroderma
keratoconjunctivits sicca "sand in eye"
61
trt for keratoconjunctivitis sicca
artificial tears/ointment
62
what is strabismus
pt can't focus both eyes - wandering eye
63
what part of the eye is affected in strabismus
the muscle is weakened
64
trt of strabismus in children
corrective lenses - patch for good eye - surgery
65
in adults strabismus is usually caused by
palsy of cranial nerves 3, 4, or 6
66
primary complaint in adult strabismus
double vision - diplopia
67
new trt for strabismus
botox injected into muscle of the eye
68
pt complains of windshield glare, abnormal color perception and decreased vision what do you suspect
cataracts - lens becomes opaque
69
another name for age related cataracts
senile cataract
70
congenital factor that causes cataracts in kids
maternal rubella
71
long term use of steroids can cause
cataracts
72
diabetics are very prone to cataracts, t or f
true
73
trt of cataracts
conservative (non- surgical)
| surgical
74
non-surgical methods to trt cataracts
magnifying glass/chg prescriptions
75
surgical treatment for cataracts
phacoemulsification - break up cataract - suck it out - replace lens
76
does pt have pain post phacoemulsification
no - red flags with pain/drainage
77
what to teach pt post phacoemulsification
don't rub eye - use shield when sleeping - don't lift anything heavy
78
what is retinopathy
micro-vascular damage to the retina
79
early retinopathy presents like this
tiny pinpoint hemorrhages or small infarcts "cotton wool spots"
80
non proliferative retinopathy presents like this
capillary micro aneurisms - exudate - hemorrhage
81
retinopathy becomes proliferative retinopathy when pt is
not controlling blood pressure/diabetes
82
what happens when pt develops proliferative retinopathy - what do they form
new vessels (fragile/leak)
83
****biggest risk factor for retinopathy
hyperglycemia - tight glucose control
84
***most common diagnosis in eye exam
type II diabetes
85
trt of retinopathy
argon laser
| meds that restrict new vessels from forming
86
pt complains of light flashes, floaters, ring in field of vision, curtain came over field of vision what do you suspect
retinal detachment
87
what happens in retinal detachment
separation of neuro-sensory retina from pigment epithelium
88
most common cause of retinal detachment
aging - vitreous shrinks (gel-like substance)
89
are floaters always an indication of retinal detachment
no
90
caring for pt w/suspected or confirmed retinal detachment
lay down - don't lift - limit activity
91
pt complains of central vision loss, blurred/darkened vision, scotoma, metamorphopsia what do you suspect
macular degeneration
92
what is a scotoma
blind spot in visual field
93
what is metamorphopsia
distorted vision
94
major risk factor for macular degeneration
family history - nutritional factors
95
2 types of macular degeneration
dry (non-exudate) and wet (exudate)
96
what causes macular degeneration
unknown
97
what happens in dry (non-exudate) macular degeneration
atrophy and degeneration of macula (clear vision of eye)
98
what happens in wet (exudate) macular degeneration
formation of new vessels, leak causing loss of sight
99
how/when does wet macular degeneration occur
rapid onset, ***always comes after dry
100
trt for macular degeneration
laser
photo-dynamic therapy
*vitamins
*stop smoking
101
once vision is affected can it improve w/macular degeneration
not usually
102
pt complains of peripheral vision loss, IOP (increased ocular pressure), optic nerve atrophy what do you suspect
glaucoma
103
2nd leading of cause of permanent blindness in the US
glaucoma
104
***is blindness from glaucoma preventable
yes - get pressure measured and treated
105
patho of glaucoma
balance of aqueous humor is off causing IOP
106
primary glaucoma usually occurs without
an identifiable cause - usually 65> - can be congenital
107
most common type of glaucoma
Primary Open Angle Glaucoma (POAG)
108
when outflow occurs its called
angle of the eye
109
secondary glaucoma is usually caused by
eye trauma
110
the angle of the eye is where the
iris meets the cornea
111
patho of open angle glaucoma
drainage channels become clogged (at angle of eye) - aqueous humor can't drain out (reduction in outflow)
112
patho of closed angle glaucoma
bulging lens pushes forward blocking the canal of schlemm
113
manifestations of open angle glaucoma
**only symptom peripheral vision loss, develops slowly
114
acute closed angle closure is an emergency, t or f
true
115
manifestations of acute closed angle glaucoma
headache with n/v - pain around the eye - halo around lights - reddened/nonreactive pupil - will go blind w/o trt
116
normal IOP
10-21 mm Hg
117
unrelieved pressure r/t glaucoma causes blindness, t or f
true
118
IOP w/closed angle glaucoma
>49 mm Hg
119
IOP w/open angle glaucoma
22-32 mm Hg
120
care/trt for open-angled glaucoma
eye drops
121
care/trt for acute closed-angled glaucoma
osmotic agents
| *OR - iridectomy (keyhole surgery) - usually trt both eyes
122
if someone goes to surgery with artificial eye (enucleation) what must you do
take the eye out
Final - Patho - Neuro/Psych
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