Term
| What are the objectives for developing and maintaining bionocular vision? |
|
Definition
| Foveal centration and lens accommodation. To be able to fix the fovea centralis in each eye on the same target. |
|
|
Term
| The Fovea centralis si about how big? |
|
Definition
|
|
Term
| What are the first things required to develop dinocular vision? |
|
Definition
| Learning to use EOMs and ciliary muscles. |
|
|
Term
| Yoked eye movement and yoked vergence movements present by what age? |
|
Definition
| yoked/ conjugate eye movments by about 4 months. Yoked vergence by about 6 months. |
|
|
Term
| What is the bilateral lens accomodation needed for? |
|
Definition
|
|
Term
| What is the primary processing center for visual info in the brain? |
|
Definition
| Lateral geniculate nuclei in the thalamus. |
|
|
Term
| How is binocular vision established with cortical mapping? |
|
Definition
| These pathways are activity-driven sorting process. |
|
|
Term
| Complete / total deprivation of vision from one eye early in life will cause what to happen? |
|
Definition
| It prevents side-to-side balance from developing and the non-deprived eye will assume control of nearly all cortical cells. |
|
|
Term
| What is emmetropia and amblyopia? |
|
Definition
| Emmetropia- perfect vision. Amblyopia- Lazy eye. |
|
|
Term
| What is important in developing depth perception? |
|
Definition
| Normal retinal correspondence (NRC). |
|
|
Term
| Convergence insufficiency can cause what? |
|
Definition
|
|
Term
| What is convergence insufficiency? |
|
Definition
| Inability to maintain binocular alignment on near objects. |
|
|
Term
| When will Convergence insufficency be uncommon? |
|
Definition
| In children under 10. More common in adolescents and young adults. |
|
|
Term
| Convergence insufficiency is associated with what? |
|
Definition
| Prolonged periods of reading and computer use. |
|
|
Term
| What happens with convergence insufficiency? |
|
Definition
| One eye usually deviates outward during convergence on a near object. |
|
|
Term
| Besides eyestrain headaches what can convergence insufficiency cause? |
|
Definition
| Blurred vision for near objects, diplopia (double vision). |
|
|
Term
| What is a treatment for convergence insufficiency? |
|
Definition
|
|
Term
| What is a potential problem with convergence insufficiency? |
|
Definition
| The patient may be asymptomatic and may learn to suppress vision from the eye that deviates during near vision. |
|
|
Term
| What % of children experience some type of vision problems? |
|
Definition
|
|
Term
| What % of children with vision problems show eye misalignment? |
|
Definition
|
|
Term
| Of the children with eye misalignment problems what % will develop amblyopia? |
|
Definition
|
|
Term
| What is the big question to ask when children have convergence insufficiency? |
|
Definition
| Is the misalignment constant, intermittent, or alternating. |
|
|
Term
| What is Amblyopia and what is anisometropia? |
|
Definition
| Amblyopia- Lay eye. Anisometropia- Not in the same measure of light the 2 eyes have an unequal refractive power/ unequality. |
|
|
Term
| What type of vision are infants born with? |
|
Definition
|
|
Term
| Amblyopia most often manifests when? |
|
Definition
| Between 6 months - 2 years. |
|
|
Term
| Amblyopia will most often be uni or bi lateral? |
|
Definition
|
|
Term
| What is the leading cause of monocular vision loss in those 20-70? |
|
Definition
|
|
Term
| What is the likely outcome of constant, intermittent or alternating deviations? |
|
Definition
| Constant- amblyopia/ vision loss. Intermittent or alternating- less likely to result in amblyopia. |
|
|
Term
| Most of the factors that lead to amblyopia involve what? |
|
Definition
| Suppression of vision usually in one eye. |
|
|
Term
|
Definition
| Latin for squinting, but is a generic term used for eyes that are not properly alligned with each other, and will not describe the circumstance under which the deviation occurs. |
|
|
Term
|
Definition
| Latin for bearing, but is refering to a latent(it is there, but cant really be tell that it is there) deviation that occurs only when one eye is covered. |
|
|
Term
|
Definition
| Children under 5 years of age. |
|
|
Term
|
Definition
| Latin for turning, but refers to a manifest(well seen) deviation that occurs when both eyes are open and uncovered. |
|
|
Term
| What type of tropias will and will not result in amblyopia? |
|
Definition
| Constant- are more likely. Intermittent and alternating are less likely. |
|
|
Term
| How is the screening for phoria done? |
|
Definition
|
|
Term
| What will surgery for eye deviation be like? |
|
Definition
| Sometimes takes about 3 surgeries to fix. |
|
|
Term
| What can prolonged or unsupervised patching cause? |
|
Definition
|
|
Term
| What are the most common types of deviations? |
|
Definition
|
|
Term
| Medial deviations are aka? |
|
Definition
|
|
Term
| Esodeviations account for what % of ocular deviations? |
|
Definition
|
|
Term
| After medial (esotropias) what are the second most common eye deviations and they are aka? |
|
Definition
| Lateral deviations aka exotropias. |
|
|
Term
| Exodeviations are often ____. |
|
Definition
|
|
Term
| Constant exodeviation could be caused by what? |
|
Definition
|
|
Term
| Vertical eye deviations are often accompanied by what? |
|
Definition
| Characterisitic head tilt. |
|
|
Term
| Vertical eye deviations are associated with what (besides characterisitic head tilt)? |
|
Definition
|
|
Term
| What % of males and females will have vision problems after whiplash accidents? |
|
Definition
| males- 11.5%. Females- 13%. |
|
|
Term
| What % of males and females will have dizziness/ unsteadiness after whiplash accidents? |
|
Definition
| males- 41.4%. Females- 48.3%. |
|
|
Term
| What is the test done for visual acuity? |
|
Definition
|
|
Term
| What is the snellen chart test of visual acuity like? |
|
Definition
|
|
Term
| What is the easiest and hardest letters to read on the snellen chart? |
|
Definition
| Easiset is L and hardest is B. |
|
|
Term
| How is visual acuity determined from a snellen chart test? |
|
Definition
| The smallest line on which the patient can distinguish more than one-half the letters is the visual acuity. |
|
|
Term
|
Definition
| A distant vision of 20/200 or less in the better eye when the best possible correction has been applied and or a visual field that subtends an angle of less than 20 degrees. |
|
|
Term
| Why is the near visual acuity not routinely assessed in a screening exam? |
|
Definition
| This exam is notoriously imprecise. |
|
|
Term
|
Definition
| Old vision. Age-related loss of elasticity in the lense that leads to a far-sightedness for near vision. |
|
|
Term
| Presbyopia is an inability to _____? |
|
Definition
| Accommodate and leads to far-sightedness for near vision. |
|
|
Term
| What % of refraction occurs in the cornea and what % happens in the lens? |
|
Definition
| 80% in the cornea. 20% in the lens. |
|
|
Term
| How common is true emmetropia? |
|
Definition
|
|
Term
| What is myopia and yperopia? |
|
Definition
| Myopia- near-sightedness. Hyperopia- far-sightedness. |
|
|
Term
| What is the difference of refractive myopia and axial myopia? |
|
Definition
| Refractive- lense is too great. Axial- eyeball is too long. |
|
|
Term
| What is the difference of refractive and axial hyperopia? |
|
Definition
| Refractive- lense is insufficient. Axial- eyeball is too short. |
|
|
Term
| What type of error is more common refractive or axial? |
|
Definition
|
|
Term
| Axial errors are more likely to have what? |
|
Definition
|
|
Term
|
Definition
| Unequal refraction in different meridians of the eyeball that cause difficulties in seeing fine detail. |
|
|
Term
| Astigmatisms affect what % of people? |
|
Definition
|
|
Term
| What is more common a regular or irregular astigmatism? |
|
Definition
| Regular is much more common. |
|
|
Term
| What should be done when testing peripheral vision with the confrontation method? |
|
Definition
| Make eye contact with patient. |
|
|
Term
| What is the difference between negative and positive defects? |
|
Definition
| Negative- objective blind spots so patient sees nothing. Positive- perceived blind spots so patient sees flashes of light. |
|
|
Term
| What is a hemianopia and a quadrantinopia? |
|
Definition
| Hemianopia- blindness in one half of the visual field of noe or both eyes. Quadrantinopia- Blindness in one quarter on the visual field of one or both eyes. |
|
|
Term
| A lesion to the midline optic chiasm will cause what type of problem with vision? |
|
Definition
| Bitemporal hemianopia this leads to a loss of peripheral vision since it is bilateral. |
|
|
Term
| A bitemporal hemianopia is commonly caused by what? |
|
Definition
|
|
Term
| A lesion to the right optic radiation will cause what type of problem with vision? |
|
Definition
| Left homonymous hemianopia. Which will be a loss of vision in the left visual field in both eyes. |
|
|
Term
| A lesion in the optic radiation is commonly caused by what? |
|
Definition
| Vertebrobasilar artery insufficiency. |
|
|
Term
| When might a patient not be awar that they have a homonymous hemianopia caused by a lesion to the optic radiation? |
|
Definition
| If macular vision is preserved. |
|
|
Term
| What is a scotoma, scotomata? |
|
Definition
| scotoma- blind island. Scotomata- blind islands. |
|
|
Term
| Scatomas can by what type of visual problems? |
|
Definition
|
|
Term
| What is the cause of floaters in the vision? |
|
Definition
| Vitreous substance between the lense and retina can become detached and this is called posterior virteous detachment PVD. |
|
|
Term
| When should floaters be taken very serious? |
|
Definition
| Sudden shower of floaters, new light flashes, a veil or curtain obstructing your vision should be refered to the ER. |
|
|
Term
| Sudden showers of floaters is a warning of what? |
|
Definition
| Retinal detachment and this is one of the 3 most time sensitive opthalmic emergincies. |
|
|
Term
| What are the first components of the eye exam? |
|
Definition
| PERRLA. P-pupils, E-equal size, R-round, R-reactive to, L-light, A-accomidates to near vision. |
|
|
Term
| What is the second component of the eye exam? |
|
Definition
| Corneal reflection test. Assesses the alignemtn of the eyes in the neutral position. |
|
|
Term
| What is the third component of the eye exam? |
|
Definition
| Cardinal field of gaze. This is done in neutral position and in conjugate pursuit movements of paired EOMS. |
|
|
Term
|
Definition
| Exraocular muscle movements. |
|
|
Term
|
Definition
| Drooping of the upper eyelid. |
|
|
Term
| With ptosis what is the question that should be asked? |
|
Definition
| Is it of new onset or an existing problem. |
|
|
Term
| What are the 2 general types of ptosis? |
|
Definition
|
|
Term
| What are the 2 causes of congenital ptosis and which one is most common? |
|
Definition
| 1. Localiezed myogenic dysgenesis and this is the most common. 2. Congenital horners syndrome or congential CN III palsy. |
|
|
Term
| Wich cause of congenital ptosis will there be abnormalities in pupil size? |
|
Definition
| Just congenital horners syndrome or congenitla CN III palsy. |
|
|
Term
| What are the 3 causes of acquired ptosis? |
|
Definition
| 1. Acquired aponeurotic ptosis- from aging, surgery or inflammation. 2. acquired horners syndrome or acquired CN III palsy. 3. Acquired myogenic ptosis. |
|
|
Term
| Of the causes of acquired ptosis which one(s) will cause abnormal pupils? |
|
Definition
| Just horners and CN III palsy. |
|
|
Term
| What should be done with lumps on the eye lid? |
|
Definition
| squeexing them is ill-advised. |
|
|
Term
| What is acquired myogenic ptosis? |
|
Definition
| acquired weakness of the superior rectus and or medial rectus muscles with concurrent weakness of the levator palpebrae supeioris is common. |
|
|
Term
| What are 2 ways to say abnormalites in the shape of the pupil? |
|
Definition
| Pupillary dyscoria, coloboma. |
|
|
Term
|
Definition
| Adhesion of the iris to the cornea or the lense. |
|
|
Term
| Synechia are uncommon complications of what? |
|
Definition
|
|
Term
| Acute iritis is often confused with what? |
|
Definition
| Conjunctivitis aka pink eye. |
|
|
Term
|
Definition
| an inequality in pupil size. |
|
|
Term
| How common is anisocoria? |
|
Definition
| seen in up to 20% of the population. |
|
|
Term
| What is the pupilary refelx like with anisocoria? |
|
Definition
|
|
Term
| What drugs are used to dialate the pupils? |
|
Definition
|
|
Term
| What is adie's tonic pupil/ adies pupillotonia? |
|
Definition
| Sluggish and delayed reactions of the pupil. |
|
|
Term
| What is associated with argyll robertson pupil? |
|
Definition
| Tabes dorsalis, and syphilis. |
|
|
Term
| If there is a picture on the midterm of eyes with different pupil sizes which one will be the affected or problem pupil the large or small one? |
|
Definition
| The one that is bloodshot. |
|
|
Term
|
Definition
| A painful, aching, bloodshot eye and small pupil. |
|
|
Term
|
Definition
| a very painful, bloodshot eye and a large pupil. |
|
|
Term
| Which condition is a true medical emergency acute iritis or acute glaucoma? |
|
Definition
|
|
Term
| What is the key difference between conjunctivitis vs. acute iritis/ glaucoma? |
|
Definition
| pink eye is not an intra-ocular inflammation and does not change pupil size or shape. |
|
|
Term
| Do you need good vision to have a direct and a consensual pupil response to light? |
|
Definition
| No you can even be blind and have both direct and consensual pupil responses to light. |
|
|
Term
|
Definition
| Normal variant in the pupillary reaction to light. |
|
|
Term
| What is miosis of the eye? |
|
Definition
| Excessive constrictino of the pupil. This is abnormal when the pupil will not dilate in the dark. |
|
|
Term
|
Definition
| Excessive dilation of the pupil. This is abnormal when the pupil will not constrict in bright light. |
|
|
Term
| What is the second step in an eye exam after PERRLA? |
|
Definition
| Assessing ocular alignment in the primary (neutral position). |
|
|
Term
| How is the assessment of ocular alignment in a neutral position done? |
|
Definition
| Have patient stare at an object and look for the corenal reflection. |
|
|
Term
| Will the corneal reflex test determine if there is a phoria? |
|
Definition
| No. A phoria is an eye deviation that occurs only when one eye is closed or covered. |
|
|
Term
| What % of population will have some degree of eye deviation? |
|
Definition
|
|
Term
| What is the third step in the eye exam (after PERRLA and ocular alignment)? |
|
Definition
|
|
Term
| What is concomitant strabismus? AKA? |
|
Definition
| Abnormal cardinal gaze, A noticeable deviation of the eye. AKA non-parylitic strabismus. |
|
|
Term
| Will concomitant strabismus involve muscle weakness? |
|
Definition
|
|
Term
| What 3 things will a concomitnat strabismus imply? |
|
Definition
| abnormal origin or insertion of a muscle. Abnormallity in muscle length. Abnormallity associated amblyopia. |
|
|
Term
| What is non-concomitant strabismus? |
|
Definition
| Abnormla cardinal gaze with paralysis and or restrictions to movement of the extra-ocular muscles. |
|
|
Term
| When will the worst deviation and double vision occur with extraocular muscle palsy? |
|
Definition
| When the patient looks in the direction of the weak muscle. |
|
|
Term
| What will it suggest when the patient looks in the direction of a weak muscle with extraocular muscle palsy? |
|
Definition
| Lesion of the cranial nerve nucleus, the cranial nerve, the neuromuscular junction, or the muscle itself. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is ectropion and endtropion? |
|
Definition
| Ectropion- eversion of the eyelid margin. Endtropion- inversion of the eyelid margin. |
|
|
Term
| How will ectropion happen? |
|
Definition
| Acquired- age related or paralytic like bells palsy |
|
|
Term
| What are the complications of ectropion? |
|
Definition
| inadequate tear drainage which leads to excessive tearing. |
|
|
Term
|
Definition
|
|
Term
| What are the 2 types of blepharitis? |
|
Definition
| Anterior- an inflammation around the eyelashes and follicles. Posterior- involves the meibomian gland. |
|
|
Term
| Posterior blepharitis is aka? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is an external hordeolum? |
|
Definition
| A stye, a painful inflammation of an eyelash follice. |
|
|
Term
| What are external hordeolums like? |
|
Definition
| Painful self-limiting, usually don’t result in problems, recurrences are common. |
|
|
Term
| What is an internal hordeolum? |
|
Definition
| A painful meibomian gland. |
|
|
Term
| What are the internal hordeolums like? |
|
Definition
| self limiting, can result in compliations and recurrences are common. |
|
|
Term
|
Definition
| Painless retention cysts associated with the meibomian gland. |
|
|
Term
| What should be considered with a recurrent chalazia? |
|
Definition
| sebaceous carcinoma, squamous cell carcinoma, microcystic adnexal carcinoma or TB. |
|
|
Term
|
Definition
| Subcutaneous lipid deposition and it is the most common cutaneous xanthoma. |
|
|
Term
| What is the possible correlation with xanthelasma's? |
|
Definition
| elevated plasma lipid levels in 50% of people. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Painful inflammation and swelling of the lacrimal gland. |
|
|
Term
| What is keratoconjunctivitis sicca and what is it aka? |
|
Definition
| aka KS and it is dry eyes due to insufficient tear production. |
|
|
Term
| What is sjogren syndrome? |
|
Definition
|
|
Term
|
Definition
| Infection of the lacrimal sac. |
|
|
Term
| Where is the palpebral conjunctiva? |
|
Definition
| It lines the inner surface of the eyelids. |
|
|
Term
| Where is the conjunctiva at? |
|
Definition
| The transparent modified mucous membrane of the eye. |
|
|
Term
|
Definition
| A transparent multi-layered avascular structure of the eye. |
|
|
Term
| What will provide 85% of the refractive power of the eye? |
|
Definition
|
|
Term
| What is the pain like for the conjunctiva and the cornea? |
|
Definition
| Conjunctiva- much less pain-sensitive than the cornea- which is VERY pain sensitive. |
|
|
Term
| What is found in the iridocorneal angle? |
|
Definition
|
|
Term
| What is the normal intra-ocular pressure? |
|
Definition
|
|
Term
| What is pinguecula and pterygium? |
|
Definition
| Pinguecula- elevated, benign, yellow fibrovascular connective tissue mass. Pterygium- a benign, fleshy wing like fibrovascular connective tissue growth. |
|
|
Term
|
Definition
|
|
Term
| What is worse conjunctiva injection or ciliary injection? |
|
Definition
| Conjunctiva not so bad, but ciliary is bad. |
|
|
Term
| What are the general signs and symptoms of conjunctivitis? |
|
Definition
| red eye, discomfort, discharge, not overtly painful, not photophobic, vision unchanged, pupillary reactions are normal. |
|
|
Term
| What is the most important clinical feature of acute allergic conjunctivitis? |
|
Definition
|
|
Term
| What else is possible with acute allergic conjunctivitis? |
|
Definition
| Lymphoid follicular response. |
|
|
Term
| What is a lymphoid follicular response? |
|
Definition
| Bumbs of lymphoid tissue aggregate in the palpebral conjunctiva giving it a cobblestone appearance. |
|
|
Term
|
Definition
| Adenoviral conjunctivitis. |
|
|
Term
| Adenoviral conjunctivitis is the most common cause of what? |
|
Definition
|
|
Term
|
Definition
| sudden onset and can last 2-4 weeks with redness, mild itching, tearing, chemosis, and pseudomembranous. |
|
|
Term
| What is the clinical concern with adenoviral conjunctiva? |
|
Definition
| differentiating it from conjunctivitis due to herpes simplex infection. |
|
|
Term
| What are the common pathogens that cause acute bacterial conjunctivitis? |
|
Definition
| Staphylococcus pneumoniae and haemophilus influenza. |
|
|
Term
| What is the stronges perdictor that one might have an acute bacterial conjunctivitis? |
|
Definition
| Awakening with one or both eyes glued shut. Also a mucopurulent discharge that crusts on eyelashes. |
|
|
Term
| What is the clinical concern with acute bacterial conjunctivitis? |
|
Definition
| The concern would be if the infection was caused by bacteria that is very aggressive to the conjunctivia like N. Gonorrhoeae or chlamydia. |
|
|
Term
| What are signs of corneal diseases? |
|
Definition
| Localized pain, photophobia, reduced visual acutiy, lacrimation, blepharospasm (spasm of the eyelids), iridescent vision, and ciliary injection. |
|
|
Term
| What is the most important (for the test) sign of corneal disease and what is it? |
|
Definition
| Iridescent vision. Breaking down of halo into light specturms. |
|
|
Term
| How will adenovirus, herpes simplex, and chlamydia affect the cornea? |
|
Definition
| Adenovirus- rarely results in complications. Herpes and chlamydia often result in complications. |
|
|
Term
| Adenviral keratoconjunctivitis manifests how? |
|
Definition
| minimal pain, some photophobia, pre-auricular lymphadenopathy, lymphoid follicular response. |
|
|
Term
| What type of herpes simplex virus affects the ocular area? |
|
Definition
| HSV-1. HSV-1 is genital infection. |
|
|
Term
| What are the important patient presentations with HSV-1? |
|
Definition
| Vesicular eruptions on eyelids or face (like chicken pox), Photophobia, blurred vision. |
|
|
Term
| What is the most common cause of blindness in the USA and the world? |
|
Definition
| USA- HSV-1 keratitis. World- Chlamydial keratitis. |
|
|
Term
| Why is chlamydial keratitis the most common cause of blindness in the world? |
|
Definition
| Poor sanittation and poor public heatlth. |
|
|
Term
| What type of medical emergency will chlamydial keratitis be? |
|
Definition
| A ophthalmologic emergency since the cornea may rapidly lead to perforation of the cornea. |
|
|
Term
|
Definition
| Inflammation of the Episcleral tissue found between the conjunctiva and the sclera. |
|
|
Term
|
Definition
| Diffuse or localized inflammation of the anterior sclera with necrosis. |
|
|
Term
| What is a common cause of scleritis? |
|
Definition
| 48% are associated with autoimmune disorders. |
|
|
Term
|
Definition
|
|
Term
| What is anterior uveitis? |
|
Definition
| Inflammation of the anterior chamber. |
|
|
Term
| What are the classic indications of anterior uveitis? |
|
Definition
| Direct eye pain, redness, small pupil that reacts poorly to light. |
|
|
Term
| What type of medical emergency is anterior uveitis? |
|
Definition
| A true medical urgency not a true medical emergency. |
|
|
Term
| What is angle-closure glaucoma like? |
|
Definition
| a less common type of glaucoma and is usually unilateral and symptoms are present form onset of angle closure. |
|
|
Term
| What are the diagnostic critera for a angle-closure glaucoma? |
|
Definition
| at leaste 2 of these; ocular pain, intermittent blurring of vision with halos, nausea/vomiting. At leaste 3 of these; nonreactive pupil in mid-dilation, ciliary injection, corneal epithelial edema, intraocular pressure that is > 21 mm Hg, a shallow anterior chamber. |
|
|
Term
| What type of a medical emergency is acute angle-closure glaucoma? |
|
Definition
| A true medical emergency that can result in permanent vision loss in a matter of hours. |
|
|
Term
| What is a subconjunctival hemorrhage? |
|
Definition
| Rupture of conjunctival and or episcleral blood vessels, with bleeding inot the potential space between the conjunctiva and sclera. |
|
|
Term
| What causes a subconjunctival hemorrhage? |
|
Definition
| Trauma, may be idiopathic, may be due to coughing, vomiting, straining, etc. |
|
|
Term
| What happens to someone with subconjunctival hemorrhage? |
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Definition
| Usually asymptomatic and resolves completely within 2 weeks. |
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|
Term
| What is traumatic hyphema? |
|
Definition
| Accumulation of blood in the anterior chamber following trauma to the eye. |
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