H&P: Eye

Myopia

Nearsightedness characterized by difficulty seeing distant objects because light rays focus in front of the retina.

Hyperopia

Farsightedness characterized by difficulty seeing objects close up because light rays focus behind the retina.

Presbyopia

Age-related loss of near vision caused by decreased elasticity of the lens, leading to impaired accommodation that worsens in dim light.

Astigmatism

Visual distortion or blurriness caused by an uneven curvature of the cornea or lens, resulting in multiple focus points.

Scotoma

A blind spot in the visual field that can be central, paracentral, scintillating, constant, flickering, or pulsating.

Diplopia

Double vision, which can be horizontal, vertical/oblique, monocular, or binocular, persisting or resolving when one eye is closed.

Anisocoria

Asymmetry or unequal size between the two pupils, evaluated by assessing light and near responses in both bright and dim lighting.

Miosis

Pupil constriction to a size smaller than 3 mm.

Mydriasis

Pupil dilation to a size larger than 5 mm.

Direct Pupillary Light Reflex

Pupillary constriction occurring in the specific eye illuminated by light.

Indirect (Consensual) Pupillary Light Reflex

Pupillary constriction occurring in the non-illuminated opposite eye when light is shone into one eye.

Near (Accommodation) Reflex

Simultaneous pupillary constriction, eye convergence, and ciliary body contraction when focusing on a close object.

Afferent Pupillary Defect (Marcus Gunn Pupil / RAPD)

Functional impairment of cranial nerve II (optic nerve) resulting in reduced sensory input to the midbrain and net pupillary dilation in the affected eye during the swinging flashlight test.

Horner Syndrome

Unilateral sympathetic pathway lesion characterized by the classic triad of ptosis, miosis, and anhidrosis.

Tonic Pupil (Adie Pupil)

Parasympathetic ciliary ganglion or nerve damage resulting in an enlarged pupil with slow or absent light reaction, slow near reaction, and slow redilation.

Argyll Robertson Pupil

Small, irregular pupils that do not react to light but maintain an intact, brisk near reflex, classically associated with neurosyphilis or multiple sclerosis.

Oculomotor Nerve (CN III) Palsy

Affected eye at rest in a "down and out" position (inferior and lateral deviation) along with ptosis, pupil dilation, loss of accommodation, and diplopia.

Trochlear Nerve (CN IV) Palsy

Superior oblique muscle weakness causing upward deviation of the eye, compensatory head tilt away from the affected side, and diplopia when reading.

Abducens Nerve (CN VI) Palsy

Lateral rectus muscle weakness preventing lateral eye movement and causing inward deviation (esotropia) when looking straight ahead.

Nystagmus

Repetitive, rhythmic oscillations of one or both eyes observed during extraocular movement evaluation.

Strabismus

Ocular misalignment evaluated clinically via corneal light reflection or the cover/uncover test.

Esotropia

Inward or medial deviation of the eye relative to normal conjugate gaze.

Photophobia

Abnormal visual intolerance or sensitivity to light.

Closed Angle Glaucoma

Ocular emergency caused by blocked aqueous humor drainage due to a closed angle between the cornea and iris, presenting with severe eye pain, halos, redness, nausea, a cloudy cornea, and a fixed, dilated pupil.

Open Angle Glaucoma

Insidious obstruction of aqueous humor drainage at the canal of Schlemm and trabecular network, causing elevated intraocular pressure, optic nerve cupping, and gradual peripheral vision loss.

Glaucomatous Cupping

Pathologic enlargement and depression of the central optic cup relative to the disc (cup-to-disc ratio > 0.5) seen on fundoscopy due to chronic pressure-induced nerve damage.

Papilledema

Swelling of the optic disc secondary to elevated intracranial pressure, marked by blurred disc margins, disc hyperemia, loss of the optic cup, and potential hemorrhages.

Cotton-Wool Spots

Fluffy white patches on the retina with soft, irregular borders caused by microinfarction of retinal nerve fibers.

Hard Exudates

Bright yellow flecks on the retina with well-defined borders caused by lipid deposits leaking from damaged capillaries.

Arteriovenous (AV) Nicking

Indentation or compression of a retinal vein where it is crossed by an overlying sclerotic hypertensive artery.

Copper and Silver Wiring

Sclerosis and thickening of retinal arteriole walls that increase light reflection, turning vessels bright red-brown or white

Flame Hemorrhages

Superficial, linear red streaks on the retina originating within the nerve fiber layer.

Dot and Blot Hemorrhages

Small, rounded red spots representing deep retinal capillary microhemorrhages.

Drusen

Yellow-white round lipid and protein deposits beneath the retina associated with age-related macular degeneration.

Chemosis

Swelling or edema of the conjunctiva.

Entropion

Inward turning of the eyelid margin causing eyelashes to rub against and irritate the conjunctiva.

Ectropion

Outward turning of the eyelid margin leading to impaired tear drainage and excessive tearing.

Ptosis

Drooping of the upper eyelid.

Blepharitis

Inflammation along the eyelid edges causing redness, swelling, and crusting ("eye dandruff").

Chalazion

A firm, painless, non-tender nodule on the eyelid caused by obstruction of a Meibomian gland.

Hordeolum (Stye)

An acute, painful, tender red bump on the eyelid margin typically caused by a Staphylococcus aureus infection of eyelid glands.

Dacryocystitis

Infection and inflammation of the lacrimal sac secondary to nasolacrimal duct obstruction, presenting with pain, redness, and swelling at the medial canthus.

Pinguecula

A yellow, elevated growth or nodule of tissue on the conjunctiva that does not extend onto the cornea.

Pterygium

A triangular, fleshy growth of conjunctival tissue that can extend onto the cornea and potentially impair vision.

Conjunctivitis

Inflammation or infection of the conjunctiva (viral, allergic, or bacterial) causing redness, irritation, and discharge.

Subconjunctival Hemorrhage

Focal bleeding beneath the bulbar conjunctiva creating a bright red patch on the sclera.

Acute Iritis/Uveitis

Inflammation of the iris or uveal tract presenting with deep ocular pain, photophobia, red eye, and pupillary constriction.

Corneal Abrasion / Ulcer

Epithelial defect or infection on the cornea causing severe pain, redness, foreign body sensation, and photophobia, evaluated using fluorescein dye with a blue light aperture.

Hyphema

Blood accumulation within the anterior chamber of the eye.

Hypopyon

Purulent inflammatory exudate (pus) forming a visible fluid level in the anterior chamber.

Keratitis

Inflammation of the cornea.

Episcleritis

Benign inflammation affecting the episcleral tissues of the eye.

Optic Disc

The round yellow-orange structure on the nasal side of the retina where retinal vessels emerge and optic nerve fibers exit.

Optic Cup

The central physiological depression within the optic disc, normally having a horizontal diameter less than half the total disc diameter.

Macula (Macula Lutea)

The specialized, pigmented area of the retina temporal to the optic disc responsible for central vision.

Fovea (Fovea Centralis)

The central pit within the macula that contains the highest concentration of cones for maximum visual acuity.

Limbus

The anatomical border where the cornea merges with the sclera and conjunctiva.

Uvea

The vascular middle tunic of the eye comprising the iris, ciliary body, and choroid.

Anterior Chamber

The fluid-filled cavity situated between the cornea anteriorly and the iris/pupil posteriorly.

Posterior Chamber

The narrow space located behind the iris and in front of the lens where aqueous humor is secreted by ciliary processes.

Trabecular Meshwork

Mesh-like tissue at the anterior chamber angle responsible for filtering aqueous humor before it drains into Schlemm's canal.

Canal of Schlemm (Scleral Venous Sinus)

Circular vascular structure at the anterior chamber angle that receives aqueous humor from the trabecular meshwork and drains it into systemic circulation.

Diopter

Unit of lens power used on the ophthalmoscope dial to focus the image, where green positive numbers correct for hyperopia and red negative numbers correct for myopia.

Swinging Flashlight Test

Clinical test alternating light between eyes to compare pupillary response and detect an afferent pupillary defect.

Snellen Eye Chart

Standardized chart positioned 20 feet away to test distance visual acuity.

Rosenbaum Pocket Vision Card

Handheld chart positioned 14 inches from the eyes to evaluate near visual acuity.

Red Reflex

The normal red-orange light reflection observed through the pupil during ophthalmoscopy.

Visual Fields by Confrontation

Screening exam assessing peripheral visual boundaries by comparing the patient's visual field against the examiner's