PD II: EXAM #1 (EYES - LEC I) - from quizlet

What divides the vitreous and the aqueous humor?

Hyaloid membrane

Ovoid structure-the globe composed of the ________

sclera

Anterior to the sclera is the _______

cornea

Sclera is lined anteriorly by a thin membrane called the _____________

conjunctiva

The inside layer of the sclera is called the ______

uvea

The conjunctiva _________ cover the cornea

A. does

B. does not

does not

What fills the major portion of the inner globe?

Vitreous humor

_______________ contains: lens, iris, ciliary body

A. Posterior chamber

B. Anterior chamber

Anterior chamber

Ophthalmic artery-blood flows from _______________

A. deep to peripheral

B. peripheral to deep

deep to peripheral

Choroid plexus-blood flows from ____________________

A. deep to peripheral

B. peripheral to deep

peripheral to deep

Where is site where all vessels terminate?

Macula

Macula and fovea are supplied by _______________

Choroid plexus

Which CN is in the optic disk- nerve for vision?

CN II

Which CN provides sensory to the cornea and conjunctiva?

CN V

Which CN is responsible for the following:

▪ Levator palpebra mm for eye opening (Superior Tarsal mm)
▪ Movement of the eye
▪ Sympathetic=pupil dilation and Parasympathetic=pupil constriction

CN III

______________ =pupil dilation

A. Sympathetic

B. Parasympathetic

Sympathetic

_______________ = pupil constriction

A. Sympathetic

B. Parasympathetic

Parasympathetic

Upper/lower lid lined by what?

Palpebral conjunctiva

Where is the Lacrimal gland located?

Upper part of the eye

The medial canthus has this # of puncta of Nasolacrimal duct?

2

What overlies the sclera?

Visceral conjunctiva

Where are the eyelashes located?

lid margin

OD = ________________

Oculus Dextra, right eye

OS = __________________

Oculus Sinistral, left eye

OU = _________________________

Oculus Uterque, each eye or both eyes

_____________: no vision correction needed

Emmetropic

_________: nearsighted

Myopic

___________: farsighted

Hyperopic

____________: age related farsightedness

Presbyotic

________________: “lazy eye” poor vision of an eye that is otherwise physically normal

Amblyopia

_________: Blind spot

Scotoma

___________: Eyelid folds inward

Entropion

_____________: Eyelid folds outward

Ectropion

__________: Pus in the anterior chamber

Hypopyon

___________: Overflow of tears

Epiphora

______________: Iris adheres to cornea or lens

Synechiae

____________: hole in one of the eye structures

Coloboma

___________: congestion of blood in any part

Hyperemia

________: connective tissue framework

Stroma

________________: different colored eyes

Heterochromia

____________: No lens in the eye

Aphakia

________________: Acquired color blindness which occurs due to CN dz or degenerative dz of the macula

Dyschromatopsia

What special tool measures intraocular pressure?

Schiotz Tonometer/Tono-pen

What do you use to anesthetize the eye?

Tetracaine

What is a normal intraocular pressure reading?

10-21 mmHg

In chronic open angle glaucoma, IOP can be what?

20-30 mmHg

In acute angle closure glaucoma, IOP can be what?

Greater than 40

______________ (also called proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit.

Exophthalmos

Exophthalmos can be either bilateral (as is often seen in ____________) or unilateral (as is often seen in an orbital tumor)

Graves's Disease

Exophthalmos can be either bilateral (as is often seen in Grave's Disease) or unilateral (as is often seen in an _____________)

Orbital tumor

Complete or partial dislocation from the orbit is also possible or swelling of surrounding tissue resulting from what?

Trauma

In the case of Graves' disease, the displacement of the eye is due to abnormal connective tissue deposition in the orbit and extraocular muscle which can be visualized by what diagnostic tools?

CT or MRI

_____________________: indicates a congenital etiology. Some degree of facial asymmetry is common, but congenital relative to this disease (or ocular retrusion) may occur with in utero maldevelopment (eg, plagiocephaly, microphthalmos).

Primary Enopthalmus

__________________ is due to an acquired change in the volumetric relationship between the rigid bone cavity, the orbit, and its contents (predominantly the orbital fat and the eye). Expansion of the orbital cavity without change in the volume of the orbital contents (ie, a blow-out fracture) leads to this disease.

Secondary enophthalmos

Alternatively, scarring contracture of the orbital fat and extraocular muscles may decrease soft tissue volume, making the orbital cavity less full and causing ______________.

enophthalmos

______________: One or more yellow plaques or patches on the eyelids or periorbital skin.

Xanthelasma

________________: is caused by damage to a certain pathway in the sympathetic nervous system. The sympathetic nervous system regulates heart rate, pupil size, perspiration, blood pressure and other functions that enable you to respond quickly to changes in your environment.

Horner's syndrome

___________: Eyelid drooped over the cornea

- CN III palsy

- Horner’s syndrome

Ptosis

The nerve pathway affected in Horner syndrome is divided into ____ groups of nerve cells (neurons).

3

_______________: This neuron pathway leads from the hypothalamus at the base of the brain, passes through the brainstem and extends into the upper portion of the spinal cord. Problems include:

•Stroke

•Tumor

•Diseases that cause the loss of the protective sheath on neurons (myelin)

•Neck trauma

•Cyst or cavity in the spinal column (syringomyelia)

First-order neurons

______________: This neuron path extends from the spinal column, across the upper part of the chest and into the side of the neck. Causes related to nerve damage in this region may include:

•Lung cancer

•Tumor of the myelin sheath (schwannoma)

•Damage to the main blood vessel leading from the heart (aorta)

•Surgery in the chest cavity

•Traumatic injury

Second-order neurons

___________________: This neuron path extends along the side of the neck and leads to the facial skin and muscles of the iris and eyelids. Nerve damage in this region may be associated with the following:

•Damage to the carotid artery along the side of the neck

•Damage to the jugular vein along the side of the neck

•Tumor or infection near the base of the skull

•Migraines

•Cluster headaches, a disorder that results in cylical patterns of severe headaches

Third-order neurons

______________________ : A blocked tear duct is common in newborns. The condition usually gets better without any treatment during the first year of life. In adults a blocked tear duct may be due to an injury, an infection or a tumor.

Dacryostenosis

Exophthalmos: “Stare” on frontal gaze

- Will see lid lag as the patient looks up and down

- Lid should overlap the iris slightly throughout mvmt

- Note the lid is over the sclera from proptosis

- Seen in _______________

- Additional symptoms are nervousness, heat intolerance, and palpitations

Hyperthyroidism

______________:

Internal

▪Acute infection of a meibomian gland deep to the eyelid surface

External (stye)

▪Pustule in an eyelash gland (Moll or Zeis)

Hordeolum

Hordeolum:

____________:

▪ Acute infection of a meibomian gland deep to the eyelid surface

A. Internal

B. External

Internal

Hordeolum:

____________ (stye)

▪ Pustule in an eyelash gland (Moll or Zeis)

A. Internal

B. External

External

Swollen red eye w/ dec. ROM and/or proptosis think about ________________

orbital cellulitis

Medial canthus swelling – think _____________

dacryocystitis

______________ acute infxn of meibomian gland

Internal hordeolum

________________ –pustule in an eyelash gland

External hordeolum

_____________ is a chronic enlargement of the meibomian gland

Chalazion

________________ is a peripheral marker for

markedly elevated lipids

Xanthelasma

In a visual acuity test, the top number is the __________________

A. distance for the line read

B. distance where test is performed

distance where test is performed

In a visual acuity test, the bottom number is the __________________

A. distance for the line read

B. distance where test is performed

distance for the line read

If the patient can't read the chart at 20 feet, what do you do first?

Use a pinhole occluder and record the results

If your pt can't detect motion, what should you try next?

Use a penlight to see if they can perceive light

If your pt can perceive light with direction write "__________________."

LP with direction

If your pt can perceive light without direction write "_______."

LP

If your pt fails all visual acuity attempts and cannot perceive light write "______."

NLP

What visual acuity is Legally blind?

20/200 or worse

Your pt fails the visual acuity test at 20 ft. You move them to 15ft, they fail again. You move them to 10ft, they fail again. What do you do next?

Count fingers from 3, 2, or 1 foot

If your pt can't count your fingers, what do you try next?

Hand movement from 3,2, or 1 foot

If your pt can't see hand movement from 3, 2, or 1 foot, what do you try next?

Light source to test light perception

Refractory conditions improve with what?

Lenses

To differentiate refractory from nonrefractory, have patient read the Snellen chart through what?

a pinhole

Your patient reads the Snellen chart through a pinhole and their visual acuity improves, what kind of condition do they have?

Refractory condition

Your patient reads the Snellen chart through a pinhole and their visual acuity does NOT improve, what kind of condition do they have?

Nonrefractory condition

What chart tests for color vision?

Ishihara chart

_____________ is only part of retina with cones

Fovea centralis

________________ used to assess for macular degeneration and gross scotoma (ie) blind spots.

Amsler visual grid

_______________: a circle of 10 degrees diameter located 10-15 degrees temporal to the midpoint of the visual field

Normal blind spot

_______________ is the leading cause of blindness in the U.S. Causes the patient to lose central vision. Mainly seen in elderly.

Macular degeneration

Macular degeneration is the leading cause of blindness in the U.S. Causes the patient to lose central vision. Mainly seen in what population?

Elderly

You give your pt the Amsler Visual Grid test. What is your DDx if these are your findings?

-Grid is seen as not wavy

-Central point seen thruout the visual fields

-Absolute scotoma present 10 degrees on the temporal midline

A. Chronic glaucoma

B. Normal

Normal

You give your pt the Amsler Visual Grid test. What is your DDx if these are your findings?

-Multiple scotomas, especially on periphery

-Scotoma on an arc extending from blind spot to the superior nasal area

A. Chronic glaucoma

B. Normal

Chronic glaucoma

You give your pt the Amsler Visual Grid test. What is your DDx if these are your findings?

- Marked decrease in the ability to see the central dot

- Central grid is wavy

A. Chronic glaucoma

B. Macular degeneration

Macular degeneration

You give your pt the Amsler Visual Grid test. What is your DDx if these are your findings?

- Loss of entire half of temporal field bilaterally

A. Chronic glaucoma

B. Optic chiasm tumor

C. Macular degeneration

Optic chiasm tumor

What 4 systemic diseases are known to manifest in the eye?

DM, HTN, Thyroid Dz, HIV

You're testing your pt's visual fields and locate a horizontal (altitudinal) deficit. Where do you suspect a lesion to be located if your pt is unable to see below a horizontal point on the same eye?

A. Branch of central retinal artery or ischemia of optic nerve

B. Right Optic Tract

Branch of central retinal artery or ischemia of optic nerve