Internal Eye Flashcards

1
Q

At what distance do we hold the ophthalmoscope when assessing the red retinal reflex?

A

6 inches away from patient’s eye

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2
Q

What does it mean when the red retinal reflex is created without any dark shadows?

A

No opacities of the cornea (scars), lens (cataracts), nor blood or pus in the aqueous or vitreous fluids

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3
Q

What are cataracts?

A

Abnormal progressive loss of lens transparency

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4
Q

What causes cataracts?

A

Degenerative changes usually occurring after age 50

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5
Q

What is the eventual appearance of cataracts?

A

Gray-white opacity

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6
Q

What is the vision like in a patient with cataracts?

A

Progressively blurry vision as if looking into frosted glass

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7
Q

What is unique about the tendency to develop cataracts?

A

Inherited

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8
Q

What should be the shape and color of the optic nerve head, and the ratio between the opt disc and the physiologic cup?

A
Shape = disc-shaped/round
Color = yellow-orange
Ratio = cup usually less than 1/2 the entire disc area
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9
Q

Where is a choroidal crescent located?

A

On the optic nerve head

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10
Q

Choroidal crescents are especially common among what population?

A

Near-sighted individuals (myopic patients)

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11
Q

What is unique about the vascularization of the physiologic cup?

A

Lack a capillary bed (appears as a small light yellow area for this reason)

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12
Q

What is the physiologic cup?

A

Small indentation of the optic nerve head from which blood vessels emerge from

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13
Q

What are the four layers of the eye before the retina that are assed via the red retinal reflex?

A

1 cornea
2 aqueous humor
3 lens
4 vitreous humor

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14
Q

Which are usually fatter: arteries or veins?

A

Veins

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15
Q

Which border of the optic disc is often not as sharp as the rest?

A

Nasal border

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16
Q

What should be the overall general appearance of a normal and healthy retina?

A

Uniform red color and texture

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17
Q

Describe the appearance of both the macula and fovea.

A

Macula - darker pigmented area in retina

Fovea - pinhole dot of light in the macula

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18
Q

What is the most sensitive part of the retina?

A

Macula/fovea

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19
Q

Why is the macula/fovea region difficult to inspect?

A

1 most sensitive part of retina
2 pupil will further constrict
3 patient won’t hold still

20
Q

Where is the macula located in relation to the optic disc?

A

2 disc diameters lateral

21
Q

If papilledema is observed, what must be ruled out as a cause?

A

Intracranial pressure

22
Q

Is an atypical, deep, and escalating headache present in all cases of papilledema?

A

No, about 25%

23
Q

How is visual acuity affected by papilledema?

A

Only affected in advanced stages

24
Q

What is the most consistent funduscopic finding associated with space occupying intracranial lesions?

A

Papilledema

25
Q

What is the funduscopic appearance of papilledema?

A

Distorted optic disc with blurry borders

26
Q

What are the signs and symptoms of chronic glaucoma?

A

1 headaches originates near eyes
2 tunnel vision
3 increased physiologic cup size

27
Q

What is the cause of the increased physiologic cup size seen with chronic glaucoma?

A

Atrophy (whitening) of nerve fibers leading to blindness

28
Q

What are the general symptoms of diabetes mellitus?

A

Frequent urination and thirst

29
Q

What is the most frequent form of diabetic neuropathy?

A

Bilateral sensory loss in the feet

30
Q

What is the most common symptoms of neuropathy in 50-60% of males with diabetes mellitus?

A

Impotence with gradual firmness of erections over 6-12 months

31
Q

What diagnostic test is used in suspected cases of diabetes as the “gold standard”?

A

Glucose tolerance test

32
Q

When are funduscopic signs of diabetic retinopathy usually first detected?

A

5 or more years after diagnosis

33
Q

Funduscopic signs of diabetic retinopathy may only be present in 50% of patients to some degree how many years post diagnosis?

A

10

34
Q

What are the funduscoptic signs of diabetic retinopathy in order of earliest to latest stages?

A

1 microaneurysms
2 hard exudates
3 soft exudates
4 neovascularization

35
Q

Are there any obvious signs of hypertension?

A

No

36
Q

What kinds of funduscopic signs may be seen with hypertensive retinopathy?

A

1 arteriole constriction/A-V tapering
2 flame-shaped hemorrhages
3 silver-wiring

37
Q

Is retinal detachment always due to trauma?

A

No (can be age-related)

38
Q

Shrinkage of which fluid of the eye occurs in retinal detachment?

A

Vitreous

39
Q

What population is especially at risk for retinal detachment?

A

Near-sighted people over 50 years old

40
Q

What are symptoms of retinal detachment?

A

1 new vitreous floaters
2 flashing lights
3 loss of peripheral vision in the area of detachment

41
Q

What kind of eye condition is associated with an adult with a narrow corneal angle?

A

Acute glaucoma

42
Q

What is the genetic eye condition where night blindness occurs followed by progressive tunnel vision starting during youth and appears as a “bone spicule” retinopathy?

A

Retinitis pigmentosa

43
Q

Which eye condition is often due to atherosclerosis and usually precedes a vascular event like a stroke?

A

Amaurosis fugax

44
Q

What are the physical findings of amaurosis fugax?

A

Small embolus or thrombus in retinal artery, possible carotid bruit

45
Q

What are the symptoms of central cataract?

A

Central blurred vision progressing into a central scotoma

46
Q

What are the symptoms of macular degeneration?

A

Slowly progressive central vision loss with distorted images

47
Q

What are the physical exam findings involved with macular degeneration?

A

Altered color and configuration of the macula/fovea