Eye disorders

Question 1

malposition of lid AWAY from eyeball–typically lower lid involved

Answer 1

ectropion

Question 2

etiology of ectropion (5)

Answer 2

1. involution–change in lid laxity
2. cicatricial–scar
3. paralytic–CN VII palsy
4. Mechanical–space-occupying lesion
5. Infection–HSV

Question 3

Inward turning eyelid

Answer 3

Entropion

Question 4

entropion etiology (5)

Answer 4

1. cicatricial
2. chemical burn
3. trauma
4. infection HSV
5. laxity of lid

Question 5

lid disorder that is chronic or acute; anterior or posterior, or both

Answer 5

blepharitis–usually Staph

Question 6

Pathophys of blepharitis

Answer 6

1. infections or seborrheic (Anterior blepharitis involves skin of external eyelid, eyelashes, and associated glands.
2. inflammation of meibomian glands –secondary to seborrhea or acne rosacea
3. infections (staph, demodex)
4. Seborrheic (isolated to lid margins–ant or post)
5. Acne rosacea–POSTERIOR blepharitis

Question 7

burning, itching, redness, and mildly decreased vision

Answer 7

Seborrheic blepharitis

Question 8

demodex Tx

Answer 8

metronidozole, tea-tree oil

Question 9

chronic inflammatory skin disease which affects the MIDLINE skin of face and upper chest – persistent erythema, telangiectasis, papules, pustules, and sevaceous gland hypertrophy

Answer 9

Acne Rosacea – may be from Demodex

Question 10

Tx of acne rasacea

Answer 10

1. avoid triggers
2. metronidazole gel to lids
3. doxycycline

Question 11

common acute infections abscess typically caused by staph.

Answer 11

hordeolum (stye)

Question 12

types of Stye

Answer 12

1. internal hordeolum–small staph abscess of meibomian glands
2. external hordeolum–acute staph abscess of a lash follicle–associated w/ Zeis or Moll glands

Question 13

TX for Stye and chalazion

Answer 13

1. hygiene
2. warm compress
3. I&D if surrounding cellulitis

Question 14

a form of blepharitis that is a localized nontender sterile granulomatous inflammation w/in a MEIBOMIAN gland

Answer 14

Chalazion

Question 15

conjunctivitis usually always _____ etiology

Answer 15

viral (^adenovirus or HSV)

Question 16

pink eye usually

Answer 16

acute viral conjunctivitis

Question 17

bacterial conjunctivitis usually from (4)

Answer 17

1. Staph aureus
2. staph epidermidis
3. Strep pneumoniae
4. Haemophilus influenzae

Question 18

H&P bacterial conjunctivitis (5)

Answer 18

1. redness
2. foreign body sensation
3. purulent discharge
4. itchy
5. more likely unilateral

Question 19

flat or elevated, cream-colored, white, or chalky lesion of conjunctiva adjacent to the limbus and w/in the palpebral fissure

Answer 19

Pinguecula

Question 20

triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over the limbus ONTO CORNEA

Answer 20

Pterygium

Question 21

changes in the retina due to hypertension

Answer 21

hypertensive retinopathy

Question 22

Signs os hypertensive + diabetic retinopathy (3)

Answer 22

1. “cotton wool spots”
2. coper/silver wire (3D in appearance)
3. punctate hemorrhages

Question 23

TX for hypertensive retinopathy

Answer 23

lower blood pressure + ophthalmology exam

Question 24

hypertensive retinopathy may predispose pt to

Answer 24

retinal detachment

Question 25

diabetes causes vascular pathology to the retina

Answer 25

Diabetic retinopathy (proliferative or nonproliferative)

Question 26

Tx for diabetic retinopathy (3)

Answer 26

1. control diabetes 2. laser for diabetic retinopathy 3. ophthalmology exam and f/u

Question 27

small, bright yellow DRUSEN (pigmentary changes--deposits under retina)

Answer 27

Age related macular degeneration Dry --> Wet

Question 28

___ARMD most frequently progresses to blindness

Answer 28

wet

Question 29

non-exudate ARMD

Answer 29

dry vs. exudate=wet

Question 30

macular degeneration leads to loss of _____ ______ not ______ vision

Answer 30

20/20 vision not peripheral

Question 31

Wet ARMD characterized by...

Answer 31

presence of choroidal neovascularization and associated exudation

Question 32

opacity of lens of the eye, localized or diffuse, potentially causing problems w/ vision

Answer 32

Cataract

Question 33

H&P cataract (6)

Answer 33

1. decreased vision 2. Glare esp at night 3. alterations in color vision 4. reduced acuity 5. alteration in red reflex 6. "crystalline lens"

Question 34

Irreversible optic neuropathy typically associated w/ elevated intraocular pressure. If left untreated can lead to blindness

Answer 34

Open angle glaucoma

Question 35

open angle glaucoma leads to

Answer 35

optic nerve damage--> vision loss

Question 36

DDX of open angle glaucoma

Answer 36

Angle closure glaucoma

Question 37

blockage of tear drainage may lead to

Answer 37

acute angle closure glaucoma

Question 38

PE glaucoma

Answer 38

1. visual field defects 2. changes in cup:disk ratio CD 3. raised intraocular pressure IOP

Question 39

Misalignment of eyes, such that the two visual axes are not simultaneously directed at the same object

Answer 39

strabismus

Question 40

main goal when treating glaucoma

Answer 40

lower IOP

Question 41

etiology of strabismus (2)

Answer 41

1. genetic | 2. paralysis of ocular muscles

Question 42

inward deviation of eye

Answer 42

esotropia

Question 43

outward deviation of eye--may be observable when pt tired, unwell or daydreaming

Answer 43

exotropia

Question 44

Tx for strapismus --refer ASAP, preferably before pt is 2 yo

Answer 44

1. corrective lenses 2. patching 3. eye muscle surgery

Question 45

inflammation of the lacrimal gland--acute or chronic

Answer 45

dacryoadenitis

Question 46

etiology of dacroadenitis (4) -- treat accordingly

Answer 46

1. Staph 2. Epstein-barr virus 3. HSV 4. N. gonorrhoeae

Question 47

painful, tender swelling of the inferior medial canthal area, w/ surrounding cellulitis. infections obstrucion of nasolacrimal duct. INFRAMEDIAL region.

Answer 47

dacryocystitis

Question 48

blood in the anterior chamber--traumatic typically from BLUNT TRAUMA

Answer 48

Hyphema

Question 49

PE of hyphema (5)

Answer 49

1. photophobia 2. decreased visual acuity 3. anisocoria (mydriasis or miosis) 4. ^ IOP 5. corneal blood staining

Question 50

demyelinating optic neuropathy idiopathic or w/ MS

Answer 50

optic neuritis

Question 51

W/ Hyphema don't miss (2)

Answer 51

orbital fracture or globe rupture