Easy Points: Medicine - HEENT - Eyes

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Easy Points: Medicine - HEENT - Eyes
2013-12-10 03:08:51
HEENT Eyes olfu2016
Medicine: HEENT - Eyes
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  1. Red eyes due to Conjunctival injection: diffuse dilatation of conjunctival vessels with redness that tends to be maximal peripherally
  2. Red eyes with Mild discomfort rather than pain; temporary mild blurring due to discharge; Watery, mucoid, or mucopurulent ocular discharge
  3. red eyes due to Bacterial, viral, and other infections; highly contagious; allergy; irritation
  4. Red eyes due to Leakage of blood outside of the vessels, producing a homogeneous, sharply demarcated, red area that resolves over 2 weeks
    Subconjunctival hemorrhage
  5. Red eyes with no pain, no vision defects, no ocular discharge
    Subconjunctival hemorrhage
  6. Red eyes that May result from trauma, bleeding disorders, orsudden increase in venous pressure, as from cough
    Subconjunctival hemorrhage
  7. Red eye conditions due to Ciliary injection: dilation of deeper vessels that are visible as radiating vessels or a reddish violet flush aroundthe limbus. Ciliary injection is an important sign of these three conditions but may not be apparent. The eye may be diffusely red instead. Other clues of these more serious disorders are pain, decreased vision, unequal pupils, and a clouded cornea
    • Corneal injury or infection
    • Acute iritis
    • Acute angle closure glaucoma
  8. Red eye condition that has a moderate to severe pain that is superficial, decreased vision, and with watery or purulent ocular discharge
    Corneal injury or infection
  9. Red eye condition with moderate, deep, aching pain, decreased vision, photophobia
    Acute iritis
  10. Red eye condition with severe, aching, deep pain
    Acute angle closure glaucoma
  11. Red eye condition due to Abrasions, and other injuries;viral and bacterial infections
    Corneal injury or infection
  12. Red eye condition with small, irregular pupils,  corneas Clear or slightly clouded;injection confined to corneal limbus;  Associated with systemic infection, Herpes zoster,tuberculosis; refer promptly
    Acute iritis
  13. Red eye condition with dilated, fixed pupils, steamy, cloudy cornea, and Acute increase in intraocular pressure constitutes an emergency
    Acute angle closure glaucoma
  14. Visual field defect due to Occlusion of a branch of the centralretinal artery may cause a horizontal (altitudinal) defect. Ischemia of the optic nerve can produce a similar defect.
    Horizontal defect
  15. Visual field defect due to A lesion of the opticnerve and, of course, of the eye itself, produces unilateral blindness.
    Blind eye
  16. Visual field defect due to A lesion at the optic chiasm, may involve only fibers crossing over to the opposite side. Since these fibers originate in the nasal half of each retina, visual loss involves the temporal half of each field.
    Bitemporal hemianpsia
  17. A lesion of the optic tract, interrupts fibers originating on the same side of both eyes. Visual loss in the eyes is, therefore, similar (homonymous) and involves half of each field (hemianopsia).
    Homonymous hemianopsia
  18. Visual field defect due to A partial lesion of the optic radiation in the temporal lobe, may involve only a portion of the nerve fibers
    Homonymous quadrantic defect
  19. A complete interruption of fibers in the optic radiation, produces a visual defect similar to that produced by a lesion of the optic tract.
    Homonymous hemianopsia
  20. drooping of the upper lid. Causes include myasthenia gravis,damage to the oculomotor nerve, and damage to the sympathetic nerve supply(Horner’s syndrome).
  21. more common in the elderly, is an inward turning of the lid margin. The lower lashes, which are often invisible when turned inward,irritate the conjunctiva and lower cornea.
  22. the margin of the lower lid is turned outward, exposing thepalpebral conjunctiva. When the punctum of the lower lid turns outward, the eye no longer drains well, and tearing occurs. more common in the elderly.
  23. Wide-eyed stare suggests this condition
    Lid retraction
  24. describes protrusion of the eyeball, a common feature of Graves’ ophthalmopathy, triggered by autoreactive T lymphocytes. In this disorder, there are a spectrum of eye changes, ranging from lid retraction to extraocular muscle dysfunction, ocular pain, and lacrimation. Changes do notalways progress. In unilateral type, consider Graves’ disease (usually bilateral), trauma, orbital tumor, and granulomatous disorders
  25. A harmless yellowish triangular nodule in the bulbar conjunctiva on either side of the iris. Appears frequently with aging, first on the nasal and then on the temporal side.
  26. A localized ocular inflammation of the episcleral vessels. Vessels appear movable over the scleral surface. May be nodular or show only redness and dilated vessels. Seen in rheumatoid arthritis,Sjögren’s syndrome, and herpes zoster.
  27. A painful, tender, red infection in a gland at the margin of the eyelid.
  28. A subacute nontender, usually painless nodule involving a blocked meibomian gland. May become acutely inflamed but, unlike a sty,usually points inside the lid rather than on the lid margin.
  29. Slightly raised, yellowish, well-circumscribed plaques that appear along the nasal portions of one or both eyelids. May accompany lipid disorders.
  30. A swelling between the lower eyelid and nose. An acute inflammation is painful, red, and tender. Chronic inflammation is associated with obstruction of the nasolacrimal duct. Tearing is prominent, and pressure on the sac produces regurgitation of material through the puncta of the eyelids.
  31. A thin grayish white arc or circle not quite at the edge of the cornea. Accompanies normal aging but also seen in younger people, especially African Americans. In young people,suggests possible hyperlipoproteinemia. Usually benign.
    Corneal arcus
  32. A golden to red brown ring,sometimes shading to green or blue, from copper deposition in the periphery of the cornea found in Wilson’s disease. Due to a rare autosomal recessive mutation of the ATO7B gene on chromosome 13 causing abnormal copper transport, reduced biliary copper excretion, and abnormal accumulation of copper in the liver and tissues throughout the body. Patients present with liver disease, renal failure, and neurologic symptoms of tremor, dystonia, and psychiatric disorders ranging from behavior changes to depression and schizophrenia.
    Kayser-Flescher Ring
  33. A superficial grayish white opacity in the cornea,secondary to an old injury or to inflammation. Size and shape are variable. Do not confuse with the opaque lens of a cataract,visible on a deeper plane and only through the pupil.
    Corneal scar
  34. A triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side. Reddening may occur. May interfere with vision as it encroaches on the pupil.
  35. Opacities of the lenses visible through the pupil. Risk factors are older age, smoking, diabetes, corticosteroid use
  36. looks gray when seen by a flashlight. If the pupil is widely dilated, the gray opacity is surrounded by a black rim.
    Nuclear cataracts
  37. Produces spokelike shadows that point—gray against black, as seen with a flashlight, or black against red with an ophthalmoscope. A dilated pupil, as shown here, facilitates this observation.
    Peripheral cataract
  38. Causes include blunt trauma to the eye, open-angle glaucoma and impaired parasympathetic nerve supply to the iris, as in tonic pupil and oculomotor nerve paralysis.
  39. Pupil is large, regular, and usually unilateral.Reaction to light is severely reduced and slowed, or even absent. Near reaction, although very slow, is present. Slow accommodation causes blurred vision. Deep tendon reflexes are often decreased.
    Tonic pupil (Adie's pupil)
  40. The dilated pupil is fixed to light and near effort. Ptosis of the upper eyelid and lateral deviation of the eye are almost always present.
    Oculomotor nerve (CN III) paralysis
  41. The affected pupil, though small, reacts briskly to light and near effort. Ptosis of the eyelid is present, perhaps with loss of sweating on the forehead.
    Horner's syndrome
  42. Small, irregular pupils that accommodate but do not react to light indicate Argyll Robertson pupils. Seen in central nervous system syphilis.
    Small, irregular pupils
  43. small whitish depression in the optic disc, the entry point for the retinal vessels. Although sometimes absent,the cup is usually visible either centrally or toward the temporal side of the disc. Grayish spots are often seen at its base.
    Physiologic cupping
  44. often seen around the optic disc. These are developmental variations that appear as either white sclera, black retinal pigment, or both, especially along the temporal border of the disc.
    Rings and crescents
  45. much less common but dramatic finding. Appearing as irregular white patches with feathered margins, they obscure the disc edge and retinal vessels. They have no pathologic significance.
    Medullated nerve fibers
  46. Tiny disc vessels give normal color to the disc.Color yellowish orange to creamy pink Disc vessels tiny Disc margins sharp (except perhaps nasally)The physiologic cup is located centrally or somewhat temporally. It may be conspicuous or absent. Its diameter from side to side is usually less than half that of the disc.
    Normal optic disc
  47. Optic disc defect due to Tiny disc vessels give normal color to the disc.Color yellowish orange to creamy pink Disc vessels tiny Disc margins sharp (except perhaps nasally)The physiologic cup is located centrally or somewha ttemporally. It may be conspicuous or absent. Itsdiameter from side to side is usually less than half thatof the disc.
  48. Optic disc defect with the following:
    Color pink, hyperemic Often with loss of venous pulsations Disc vessels more visible, more numerous, curve overthe borders of the disc
  49. Optic disc defect due to the following:
    Disc swollen with margins blurred The physiologic cup is not visible.Seen in intracranial mass, lesion, or hemorrhage,meningitis
  50. Optic defect due to Increased pressure within the eyeleads to increased cupping (backward depression of the disc) and atrophy.The base of the enlarged cup is pale.
    Glaucomatous cupping
  51. Optic defect with the following:
     The physiologic cup is enlarged, occupying more than half of the disc’s diameter, at times extending tothe edge of the disc. Retinal vessels sink in and underit, and may be displaced nasally.
    Glaucomatous cupping
  52. Optic disc defect due to Death of optic nerve fibers leads to loss of the tiny disc vessels.
    Optic atrophy
  53. Optic defect with the following:
    Color white Tiny disc vessels absent Seen in optic neuritis, multiple sclerosis, temporal arteritis
    Optic atrophy
  54. Small, linear, flame-shaped, red streaks in the fundi, shaped by the superficial bundles of nervefibers that radiate from the optic disc in the pattern illustrated (O = optic disc; F = fovea). Sometimes the hemorrhages occur in clustersand look like a larger hemorrhage but can be identified by the linear streaking at the edges. These hemorrhages are seen in severehypertension, papilledema, and occlusion of the retinal vein, among other conditions. An occasional superficial hemorrhage has a whitecenter consisting of fibrin. White-centered retinal hemorrhages have many causes
    Superficial retinal hemorrhages
  55. Develops when bloodescapes into the potential space between the retina andvitreous. This hemorrhage is typically larger than retinalhemorrhages. Because it is anterior to the retina, itobscures any underlying retinal vessels. In an erect patient,red cells settle, creating a horizontal line of demarcationbetween plasma above and cells below. Causes include asudden increase in intracranial pressure.
    Preretinal hemorrhage
  56. Small, rounded, slightly irregular redspots that are sometimes called dot or blot hemorrhages. They occur ina deeper layer of the retina than flame-shaped hemorrhages. Diabetes isa common cause.
    Deep retinal hemorrhages
  57. Tiny, round, red spots commonlyseen in and around the macular area. They are minutedilatations of very small retinal vessels; the vascularconnections are too small to be seen with anophthalmoscope. A hallmark of diabetic retinopathy.
  58. Refers to the formation of new blood vessels.They are more numerous, more tortuous, and narrower than otherblood vessels in the area and form disorderly looking red arcades. A common feature of the proliferative stage of diabetic retinopathy. Thevessels may grow into the vitreous, where retinal detachment orhemorrhage may cause loss of vision.
  59. Marked arteriolar-venous crossing changes are seen, especially along the inferior vessels. Copper wiring of the arterioles is present.A cotton-wool spot is seen just superior to the disc. Incidental discdrusen are also present but are unrelated to hypertension.
    Hypertensive retinopathy
  60. Punctate exudates are readily visible: some are scattered; othersradiate from the fovea to form a macular star. Note the twosmall, soft exudates about 1 disc diameter from the disc. Findthe flame-shaped hemorrhages sweeping toward 7 o’clock and8 o’clock; a few more may be seen toward 10 o’clock. Thesetwo fundi show changes typical of accelerated (malignant)hypertension and are often accompanied by papilledema
    Hypertensive retinopathy with macular star
  61. Note tiny red dots or microaneurysms. Note also the ring of hard exudates(white spots) located superotemporally. Retinal thickening or edema in the areaof the hard exudates can impair visual acuity if it extends into the center of themacula. Detection requires specialized stereoscopic examination.
    Nonproliferative Retinopathy, Moderately Severe
  62. In the superior temporal quadrant, note the large retinal hemorrhage betweentwo cotton-wool patches, beading of the retinal vein just above them, and tinytortuous retinal vessels above the superior temporal artery.
    Nonproliferative Retinopathy, Severe
  63. Note new preretinal vessels arising on the disc and extending across the discmargins. Visual acuity is still normal, but the risk for visual loss is high.Photocoagulation reduces this risk by >50%.
    Proliferative Retinopathy, With Neovascularization
  64. Neovascularizationhas increased, now with fibrous proliferations, distortion of the macula, and reduced visual acuity.
    Proliferative Retinopathy, Advanced
  65. white or grayish, ovoid lesions withirregular “soft” borders. They are moderate in size but usuallysmaller than the disc. They result from infarcted nerve fibers.Seen in hypertension and many other conditions.
    Soft Exudates: Cotton-Wool Patches
  66. creamy or yellowish, often bright, lesions withwell-defined “hard” borders. They are small and round but maycoalesce into larger irregular spots. They often occur in clusters orin circular, linear, or star-shaped patterns. Causes include diabetesand hypertension.
    Hard exudates
  67. yellowish round spots that vary from tiny to small.The edges may be soft, as here, or hard. They are haphazardly distributed but may concentrate at the posterior pole between the optic disc and the macula. appear in normal aging but may also accompany various conditions,including age-related macular degeneration.
  68. inflammation has destroyed the superficial tissues to reveal a well-defined, irregular patch of white sclera marked with darkpigment. Size varies from small to very large. Toxoplasmosis isillustrated. Multiple, small, somewhat similar-looking areas may bedue to laser treatments.
    Healed Chorioretinitis