Diseases/Disorders of the Eye & Systemic Disorders with Ocular Manifestations

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ketch22
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Diseases/Disorders of the Eye & Systemic Disorders with Ocular Manifestations
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2013-07-31 19:06:56
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ocular ophthalmic COA pathology eye disease
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Ophthalmic Medical Assisting 5th ed. Chapters 3 & 4
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  1. types of strabismus / causes of poor muscle tone
    • congenital (present since birth): usually secondary to abnormal brain signal
    • paralytic: damage (from stroke, trauma, etc.) to the nerves controlling the muscle 
    • restrictive: loss of muscle elasticity (due to scarring, inflammation, trauma, etc.)
  2. exo-
    (strabismus with) outward deviation, resulting in light reflex apparent on nasal side of cornea
  3. eso-
    (strabismus with) inward deviation, resulting in light reflex on temporal side of cornea
  4. -tropia
    ocular deviation is continually manifest
  5. -phoria
    misalignment is controlled by the brain and only manifest when one eye is covered
  6. strabismus vs. amblyopia
    • strabismus: eyes out of alignment due to muscle imbalance
    • amblyopia: uncorrectable decreased vision as a result of visual deprivation in early childhood (suppression secondary to strabismus)
  7. sign vs. symptom
    • symptom: effects the pt. experiences; e.g. diplopia
    • sign: abnormalities quantifiable on exam; e.g. strabismus
  8. eyeball protruding due to increased orbital pressure (2 terms)
    • proptosis
    • exophthalmos
  9. stye vs. chalazion
    • chalazion: internal hordeolum caused by blockage of the meibomian gland
    • stye: external hordeolum caused by bacterial infection of gland around eyelash follicle
  10. ptosis vs. blepharochalasis
    • ptosis = droop of upper eyelid due to muscle or nerve damage
    • blepharochalasis = folds of skin above the upper lid due to repeated eyelid edema that thins and loosens the skin
  11. legophthalmos
    globe is not completely covered when eye is closed
  12. dacryocystitis
    inflammation of lacrimal sac, usually caused by blockage of lacrimal duct
  13. conjunctivitis signs: viral vs. bacterial
    • bacterial: thick fluid (mucus & pus "mucopurulent")
    • viral: watery discharge; palpebral conjunctiva appears to have tiny bumps on it. Photophobia indicates corneal involvement.
  14. ophthalmia neonatorum
    conjunctivitis in infants (<30 days old) due to bacteria or viruses present in the birth canal
  15. pinguecula vs. conjunctival nevus
    • pingueculae: small yellow-white masses (degenerated bulbar conjunctival tissue) on the sclera
    • nevi: yellowish-pink or brown tumors on bulbar conjunctiva
    • both are usually benign; pingueculae may cause minor irritation
  16. keratitis
    inflammation of the cornea
  17. hypopyon
    accumulation of pus in the anterior chamber and redness of the bulbar conjunctiva secondary to corneal infection/ulcer
  18. arcus sinilis
    opacity of outer edge of cornea; degenerative; does not affect vision
  19. hyphema
    accumulation of blood in the anterior chamber, usually due to trauma but can also be caused by "certain diseases" (thanks a lot for the clarity, textbook)
  20. 4 types & etiology of glaucoma
    • primary/chronic open-angle (POAG): aqueous humor fails to drain through trabecular meshwork
    • primary/acute angle-closure (NAG): increase of lens size as pt ages blocks aqueous humor from flowing out through pupil, then pushes iris forward until it blocks the outflow from anterior chamber angle
    • secondary: drainage reduced due to other disease processes (inflammation, PDR, trauma, etc.)
    • congenital: malformation of anterior chamber angle from birth
  21. symptoms of angle-closure glaucoma
    • severe pain
    • redness
    • halos around lights (rainbow-colored)
    • headache
    • nausea/vomiting (sometimes)
  22. iritis symptoms
    • pain
    • photophobia
    • blurred vision
  23. rubeosis iridis: definition & symptoms
    • neovascularization (growth of new blood vessels) on iris
    • may lead to reddish iris coloring
    • can cause secondary angle-closure glaucoma
  24. anisocoria
    unequal pupils due to muscular dysfunction (in turn usually due to nerve damage)
  25. endophthalmitis
    bacterial infection of the vitreous (and possibly surrounding tissue)
  26. 3 mechanisms of retinal detachment
    • rhegmatogenous: liquid vitreous goes through a retinal tear/hole to the subretinal space
    • exudative: fluid collects in subretinal space due to RPE abnormailty or defect of choroid or sclera
    • tractional: fibrous growth (usually due to DM retinopathy) pulls on retina
  27. types/severity of diabetic retinopathy
    • background (early): capillaries narrow, swell, and clog, and leak blood & exudate into the retina
    • proliferative (advanced): the leaks cause new blood vessels & tissue to form (which pulls on the retina and can cause tractional detachment) and may leak blood into the vitreous
  28. treatment options (5) for retinal detachment
    • cryopexy: surgially freezing
    • photocoagulation: "welding" by laser
    • pneumatoretinopexy: injected gas bubble
    • scleral buckle: block of silicone to indent the wall
    • posterior vitrectomy: surgical removal of vitreous
  29. retinitis pigmentosa
    hereditary retinal degeneration
  30. papilledema
    compression of optic nerve due to intracranial pressure, leading to engorged blood vessels and optic disc swelling
  31. anterior ischemic optic neuropathy
    untreatable occlusion of blood supply to optic nerve
  32. 10 types of disease/injury process
    • infectious
    • inflammatory
    • allergic
    • ischemic
    • metabolic
    • congenital
    • developmental
    • degenerative
    • neoplastic
    • traumatic
  33. corneal ulcer causes, symptoms/signs & treatment
    • bacterial or fungal or result of herpes simplex
    • corneal epithelium becomes eroded
    • cornea becomes opaque
    • herpes - branch-shaped figure shows on cornea under fluorescent dye
    • antibiotics (topical and/or systemic) for bacterial/fungal; antiviral (topical and/or oral) for herpes
  34. 4 causes of cataract
    • aging
    • injury 
    • disease
    • congenital
  35. 5 categories of disease types
    • inflammatory / autoimmune
    • metabolic
    • vascular / ischemic
    • infectious
    • malignant / neoplastic
  36. synechiae
    scarring of the pupil
  37. thyroid ophthalmopathy: definition & ocular manifestation
    • immune system attacks extraocular muscles' receptor cells
    • swelling can lead to proptosis, which can lead to exposure keratopathy
  38. sarcoidosis: definition & ocular manifestation
    • inflammation & granulomas throughout the body
    • most commonly causes uveitis, iritis or vitritis, but can also affect choroidal and retinal vessels, optic nerve and/or lacrimal gland
  39. myasthenia gravis: definition & ocular manifestation
    • neurotransmitter deficiency in skeletal muscles
    • commonly causes ptosis and diplopia, and can also cause limited ocular movement
  40. rheumatoid arthritis: definition & ocular manifestation
    • joint pain, inflammation, stiffness (unknown cause)
    • common ocular manifestations are uveitis, scleritis, corneal ulcers, and episcleritis
  41. lupus (systemic lupus erythematosus): definition & ocular manifestation
    • autoimmune disorder, unknown cause
    • causes retinal vasculitis & cotton-wool spots on retina; can also cause dry eye, scleritis and corneal ulcers
  42. multiple sclerosis: definition & ocular manifestation
    • nervous system disease, affects white matter
    • can casue optic neuritis
  43. ischemic optic neuropathy
    loss of vision due to reduced blood supply
  44. Kaposi sarcoma: definition & ocular manifestation
    vascular growth of malignant cells on the lid & conunctiva; usually found in HIV+ pts
  45. cytomegalovirus: definition & ocular manifestation
    a type of herpes, most commonly found in HIV+ pts, causes retinitis
  46. metastatic carcinoma: definition & ocular manifestation
    cancerous tumors metastasizing from other body parts (usually breast or lung), most commonly into choroid
  47. to reduce risk of diabetic retinopthy, A1C and BP should remain under what threshold
    • 7.0 A1C
    • 140/85 BP
  48. cerebral neoplasm: definition & ocular manifestation
    • brain tumor
    • visual field defect & pupillary abnormality
    • can also cause headaches and lead to papilledema
  49. other name for temporal arteritis
    giant cell arteritis

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