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25 Cards in this Set
- Front
- Back
- 3rd side (hint)
complication of neurofibromatosis, type 1?
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optic glioma (15%)
clinical presentation? |
usually children younger than 6, hx of slowly progressive unilateral visual loss and dyschromatopsia, exophthalmos, optic disk may be normal, swollen, or atrophic
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episcleritis
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infection of episcleral tissue between conjunctiva and sclera
clinical presentation? |
mild to moderate discomfort, photophobia, watery discharge
exam: diffuse or localized bulbar conjunctival injection |
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orbital cellulitis
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infection posterior to the orbital septum
unilateral, more common in children, abrupt onset of fever, proptosis, restriction of extraocular movements and swollen, red eyelids |
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dacryocystitis
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infection of lacrimal sac
presents with inflammatory changes in the medial canthal region of the eye Staph a. and Strep B are the usual infecting organisms |
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macular degeneration
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age-related - usually in pts above 50
present with progressive and bilateral loss of central vision peripheral and navigational vision always maintained, but may become impaired by development of cataracts pathophys? |
degeneration and atrophy of outer retina, retinal pigment epithelium, Bruch's membrane and choriocapillaries
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Acute ocular conditions p/w complete vision loss
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central retinal artery occlusion (usually noted upon waking in morning- see disc swelling, venous dilation and tortosity, retinal hemorrhages and CWS) -> "blood and thunder" appearance
tx? retinal detachment (retina hanging in the vitreous) |
high flow oxygen and ocular massage (which dislodges the embolus to a point further down the arterial circulation and improves retinal perfusion
(medical mgmt and and anterior chamber paracentesis to lower the IOP may be used as well, but ocular massage has most rapid action) treat atherosclerotic risk factors |
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sudden loss of vision in one eye that resolved in 15 min. "curtain falling down on one eye"
fundoscopy: zones of whitened, edematous retina following distribution of the retinal arterioles dx? |
retinal emboli -> amaurosis fugax, characterized by visual loss commonly monocular and transient
retinal emboli from ipsilateral carotid artery -> noninvasive evaluation of the carotids is useful in providing info regarding the degree of carotid artery stenosis (curtain description may also be indicative of retinal detachment) |
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diabetic retinopathy: discuss different types
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simple: microaneurysms, hemorrhages, exudates, and retinal edema
pre-proliferative: cotton wool spots proliferative: newly formed vessels |
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presbyopia
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common age-related disorder that results from loss of elasticity of the lens
prohibits accommodation of the lens, which is required in order to focus on near objects clinical presentation: pts have to hold reading material at a further distance. onset in 40s, sx peaking in 60s tx with reading glasses |
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astigmatism
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nonspherical cornea, typically p/w blurry vision both at a distance and up close
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glaucoma
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p/w peripheral visual field defects followed by central vision loss
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florescein exam
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to detect foreign bodies or corneal pathology
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external hordeolum
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aka stye
common staphylococcal abscess of eyelid that usually responds to WARM COMPRESSES if lesion does not resolve in 48 hrs, incision and drainage |
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non-ketotic hyperosmolar state -> ocular manifestations?
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Type 2 diabetics are prone to the development of a hyperosmolar hyperglycemic state without ketoacidosis.
Decreased consciousness is the most common sx other reversible neurologic abnormalities, such as blurred vision, can also be caused by hyperglycemic hyperosmolarity |
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Herpes simplex keratitis
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corneal vesicles and dendritic ulcers
also pain, photophobia, blurred vision, tearing, and redness antiviral therapy |
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bacterial keratitis - when to suspect
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contact lens wearers following corneal trauma or entry of foreign body - cornea appears hazy with a central ulcer and adjacent stromal abscess. hypopyon may be present
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vitreous hemorrhage vs detachment
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hemorrhage: typically with sudden LOV and onset of floaters (most commonly with diabetes), often fundus is hard to visualize
detachment: LOV, photopsia with showers of floaters. but fundus is CLEAR and demonstrates ELEVATED RETINA with folds and/or a tear |
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tx for acute glaucoma
what to avoid? |
emergently with mannitol, acetazolamide, pilocarpine or timolol
avoid mydriatic agents like atropine (which can actually precipitate glaucoma alone) |
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optic neuritis
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rapid impaired vision in one eye (or rarely both) and pain on eye movement
marked changes in color perception APD and field loss occur, usually with central scotoma |
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one of earliest signs of macular degeneration
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activities requiring fine visual acuity are usually the first affected, and pts with this condition may report that straight lines appear wavy . also driving and reading more difficult
primary risk factor: increasing age, although smoking can increase risk as well either monocular or binocular fundus exam: Drusen deposits in macula |
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endophthalmitis
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most commonly after surgery
infection within eye, particularly the vitreous present with pain and decreased visual acuity swollen eyelids and conjunctiva, hypopyon, corneal edema and infection vitreous can be sent for gram stain and culture and based on severity, intravitreal antibiotic injection or vitrectomy can be done |
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conjunctivitis presentation
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excessive tearing, burning sensation, mild pain, conjunctival, and eyelid edema
vision not affected |
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corneal ulceration presentation
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foreign body sensation, blurred vision, photophobia, pain
hx of contact lens use, recent trauma or ocular dz eye is erythematous, and ciliary injection is present. purulent exudates in conjunctival sac and on the ulcer surface |
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sx of acute angle closure glaucoma
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acute onset of severe eye pain and blurred vision a/w N/V
exam reveals red eye with steamy cornea (hazy) and moderately dilated pupil that is nonreactive to light |
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CMV retinitis - fundoscopic analysis
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occurs when CD4 count less than 50/ul. may be asymptomatic
characteristic fundoscopic findings of yellow-white patches of retinal opacification and hemorrhages are diagnostic |
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