Term
|
Definition
| transparent structure forming the anterior part of the fibrous tunic of the eye |
|
|
Term
| cornea is always covered with : |
|
Definition
|
|
Term
| cornea contains highest concentration of ______ _______ of any body structure. |
|
Definition
|
|
Term
| does the cornea heal quickly? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
1. let light enter the eye
2. helps shield the rest of the eye
3. major refractive surface of eye
4. majority of eye's total focusing power |
|
|
Term
| how many layers make up the cornea? |
|
Definition
|
|
Term
| which instrument is used to determine how many layers a foreign body has penetrated within the cornea? |
|
Definition
|
|
Term
| where does the cornea's moister come from? |
|
Definition
|
|
Term
| when would vessels be present within the cornea? |
|
Definition
| vessels may come into the cornea in the presence of continued irritation |
|
|
Term
| 5 significant presentations associated with foreign bodies |
|
Definition
1. pain
2. tearing
3. photophobia
4. finding of particulate matter
5. may have rust ring |
|
|
Term
| 4 complications of foreign bodies |
|
Definition
1. rust ring
2. infection
3. corneal ulceration or scaring
4. globe perforation; leakage of fluid |
|
|
Term
| 6 treatments for foreign bodies |
|
Definition
1. check visual acuity
2. saline irrigation
3. removal with damp steril cotton swab
4. removal with 25 gauge needle(slit lamp)
5. topical antibiotic coverage
6. reevaluate in 24 hrs
(ck infection/healing)
5. |
|
|
Term
| 3 etiologies of corneal abrasion |
|
Definition
1. trauma
2. contacts
3. spontaneous |
|
|
Term
| superficial corneal abraision |
|
Definition
| involves the epithelium of the cornea only. most heal quickly and completely without scaring (24-48hrs) |
|
|
Term
| deep corneal abraision penetrates ________ but not _________ and increases the risk of __________ |
|
Definition
| Bowman's membrane but not Descement's membrane & increases the risk of scaring. |
|
|
Term
| 7 presentations for corneal abraision |
|
Definition
1. pain
2. redness
3. swelling
4. photophobia
5. blurred vision
6. foreign body sensation
7. abraision stains with fluorescein dye. |
|
|
Term
| 3 conditions that require differential diagnosis from corneal abraision |
|
Definition
1. corneal ulcer
2. retained corneal foreign body
3. herpes simplex keratitis |
|
|
Term
| 5 factors of diagnosis for corneal abraision |
|
Definition
1. history
2. eye exam
3. visual acuity
4. pen light and fundoscopic exam
5. fluoroscein exam |
|
|
Term
| what should be documented at time of injury? |
|
Definition
| time, place, surroundings, size location, shape and depth |
|
|
Term
| 3 complications of cornea abraision |
|
Definition
1. recurrent corneal erosion (10%)
2. infection
3. corneal ulcer |
|
|
Term
| define: recurrent corneal erosion |
|
Definition
| erosion with sudden eye pain weeks after healing = refer |
|
|
Term
| for corneal abraision when would topical antibiotics be waranted? |
|
Definition
| when the abraision is caused by contact lenses (pseudomonas) |
|
|
Term
| Why might you use oral instead of topical NSAIDs? |
|
Definition
| topical can delay healing time. |
|
|
Term
| 4 treatment optioins for corneal abraision |
|
Definition
1. topical antibiotic
2. oral or topical NSAIDs
3. follow up visit in 24hrs
4. a third visit at 3-4 days for contact wearers |
|
|
Term
| 5 indications for fluorescein |
|
Definition
1. corneal inflammation
2. corneal trauma
3. corneal abraision
4. corneal foreign body
5. keratitis |
|
|
Term
| which bacteria can easily grown in flourescein solution? |
|
Definition
|
|
Term
| what exactly does the fluoroscein stain? |
|
Definition
|
|
Term
| what are the 2 lamps effective for viewing fluorescein staining? |
|
Definition
| woods lamp or cobalt blue lamp |
|
|
Term
| you should always __________ the eye after staining to avoid eye reaction to the dye |
|
Definition
|
|
Term
| what type of lesions are caused by UV radiation? What are the sources of UV? |
|
Definition
1. diffuse punctate lesions
2. sunlight and welding arcs |
|
|
Term
|
Definition
| local defect in the surface of the cornea |
|
|
Term
| etiology of corneal ulcer (2 broad) |
|
Definition
1. infection
2. non-infection (dryness, allegies, inflammatory disorders, exposure and neurotropic keratitis) |
|
|
Term
| 6 presentations for corneal ulcers: |
|
Definition
1. pain
2. photophobia
3. tearing
4. reduced vision
5. circumcorneal injection
6. corneal appearance varies with organism |
|
|
Term
| complications of corneal ulcers: |
|
Definition
| leads to corneal scaring which obscures vision |
|
|
Term
|
Definition
URGENT REFERAL TO OPTHALMOLOGIST
culture, topical treatment around the clock, close supervision |
|
|
Term
| which is more acute, corneal abraision or ulcer |
|
Definition
|
|
Term
| which is usually related to trauma, ulcer or abraision of the cornea? |
|
Definition
|
|
Term
| describe corneal appearance during an ulcer |
|
Definition
| there is a white necrotic area |
|
|
Term
| in which condition is iris detail obscured? |
|
Definition
|
|
Term
| how is corneal thickness affected by a corneal ulcer? |
|
Definition
| may have crater/defect thining |
|
|
Term
| corneal ulcer may extend into the |
|
Definition
|
|
Term
| etiology of bacterial keratitis (4) |
|
Definition
1. s. aureus
2. p. aeruginosa
3. pneumococcus
4. Moraxella |
|
|
Term
| define bacterial keratitis |
|
Definition
| inflammation of the cornea |
|
|
Term
|
Definition
1. direct corneal trauma
2. chronic eyelid disease
3. tear film abnormalities
4. hypoxic trauma from contact lens wear
5. microbial invasion |
|
|
Term
| 3 major complications of bacterial keratitis |
|
Definition
1. collagen and stroma undergo degredation, necrosis and thining
2. cornea may perforate
3. scaring leads to reduced vision |
|
|
Term
presentation of bacterial keratitis
(6 points) |
|
Definition
1. usually unilateral occular redness, pain, photophobia
2. reduced visual acuity
3. corneal edema surrounding the infiltrate
4. may have thick ropy mucopurulent discharge
5. edematous eyelid
6. may have hypopion in severe cases |
|
|
Term
|
Definition
| accumulation of blood/pus in anterior chamber |
|
|
Term
| treatment for bacterial keratitis |
|
Definition
| referal: culture, topical antibiotics,steroids once infection is resolved, followed daily until infection under control |
|
|
Term
| most common virus foudn in humans |
|
Definition
|
|
Term
| how is HSV-1 transmitted? |
|
Definition
| body fluids usually saliva |
|
|
Term
| Herpes Simplex Keratitis occurs most often in children btwn the ages::: |
|
Definition
6months - 5yrs
can occur at any age |
|
|
Term
| which nerve is HSV housed in Herpes simplex kertaitis? |
|
Definition
|
|
Term
| In apx 25% the virus is reactivated by which 5 factors? |
|
Definition
1. fever
2. trauma
3. stress
4. immunosuppressive agents
5. UV light |
|
|
Term
| within the eye the virus replicates and causes disease within the |
|
Definition
|
|
Term
| do we refer HSV keratitis? |
|
Definition
|
|
Term
| what is the halmark sign of herpes simplex keratitis? |
|
Definition
|
|
Term
| presentation of herpes simplex keratitis (7) |
|
Definition
1. unilateral red eye
2. pain/irritation
3. photophobia
4. decreased vision
5. tearing
6. dendritic corneal ulcer
7. ulcer stains with fluoroscein dye |
|
|
Term
| 2 complications of herpes simplex keratitis |
|
Definition
1. corneal scaring
2. increased severe corneal opacity with each recurrence |
|
|
Term
| treatment of herpes simplex keratitis |
|
Definition
| refer: topical antivirals, oral acyclovir, avoid topical steroids incase of active HSV |
|
|
Term
| pathophysiology of herpes zoster opthalmicus: |
|
Definition
| virus in trigeminal nerve involves the opthalmic division of the nerve and damages the eye and surrounding structures by secondary perineural and intraneural inflammationof sensory nerves |
|
|
Term
| herpes zoster opthalmicus presentation (6) |
|
Definition
1. prodrom phase: flu like symptoms
2. dermatome rash/pain of forehead
3. if tip of nose is involved, 75% that eye is involved
4. lid:edema, ptosis, inflammation
5. photophobia
6. decreased vision |
|
|
Term
| define Hutchinson's sign: |
|
Definition
| if tip of nose is involved in rash assoc. w. herpes zoster then 75% involve the eye as well |
|
|
Term
| hallmark of herpes zoster opthalmicus: |
|
Definition
| dermatomal rash distribution and repects the midline |
|
|
Term
| 8 complications of herpes zoster opthalmicus |
|
Definition
1. chronic occular inflammation
2. corneal perforation/scaring
3. loss of vision
4. debilitating pain
5. neurotrophoc keratopathy
6. uveitis
7. glaucoma
8. cataract formation |
|
|
Term
| herpes zoster opthalmicus treatment |
|
Definition
| urgent referal: antivirals |
|
|
Term
| important cause of keratitis in contact lens wearers |
|
Definition
|
|
Term
| acanthamoeba keratitis persentation |
|
Definition
pain
perineural & ring infiltrates in the corneal stroma |
|
|
Term
| treatment of acanthamoeba keratitis is hampered by the organsims ability to |
|
Definition
| encyst within the corneal stroma |
|
|
Term
| acanthamoeba keratitis treatment |
|
Definition
epithelial debridement may be useful in early infections
corneal grafting may be required |
|
|
Term
|
Definition
| circulating or layered RBCs in anterior chamber |
|
|
Term
|
Definition
| area btwn iris and cornea |
|
|
Term
| 4 presentations for hyphema |
|
Definition
| blurred vision, pain, photophobia, lacrimation |
|
|
Term
|
Definition
| referal: acetominophen (not NSAIDs) |
|
|
Term
|
Definition
| deposition in the coreal periphery of a grey to white or yellow band of opacity |
|
|
Term
| which is the most common corneal degredation? |
|
Definition
|
|
Term
| epidemiology of arcus senilis |
|
Definition
most common corneal degeneration
most common in men 40-80
prevalence increases with age
women 50-90yrs |
|
|
Term
| what are the arcus senilis depostions made up of? |
|
Definition
| lipoproteins mostly of low density |
|
|
Term
| what other test would you definately want to run on a 50yomale presenting with arcus senilis? |
|
Definition
|
|
Term
|
Definition
in elderly there is no correlation with mortality
in pt <50 there is a 4X increse in risk of mortality from coronary heart disease and cardiovascular disease |
|
|
Term
| define kayser-fleischer ring |
|
Definition
| brown-yellow-green pigmented ring in periphery of cornea |
|
|
Term
| kayser-fleischer ring is composed of: |
|
Definition
|
|
Term
| kayser-fleischer ring is indicative of what disease? |
|
Definition
|
|
Term
|
Definition
| liver doesn't release copper in bile, copper builds up and damages liver which then releases copper into blood stream which then damages kidneys, brain and eyes |
|
|
Term
|
Definition
| thin layer of vascularized tissue btwn the sclera and conjunctiva |
|
|
Term
|
Definition
| idiopathic; collagen vascular diseases or infections |
|
|
Term
| episcleritis signs and symptoms |
|
Definition
| usually asymptomatic, may present with mild pain and red eye |
|
|
Term
|
Definition
| place drop of phenylephrine in affected eye, 10-15 minutes later- episcleral vessels should branch scleral vessels would not |
|
|
Term
|
Definition
generally self limited
recurrent in 2/3 of cases
topical steroid Rx from opthalmologist |
|
|
Term
| name two types of scleritis: |
|
Definition
|
|
Term
| anterior scleritis may cause: |
|
Definition
|
|
Term
| posterior scleritis may cause: |
|
Definition
| exudative retinal detachment |
|
|
Term
| is scleritis usually unilateral or bilateral? |
|
Definition
|
|
Term
| scleritis can be a manifestation of which diseases, but 50% of the time is __________. |
|
Definition
system diseases:infections, thyroid, collagen disorders
50% of the time scleritis is idiopathic |
|
|
Term
| scleritis signs and symptoms: |
|
Definition
| severe pain, photophobia, redness, decreased vision, scleral edema, failure to blanch |
|
|
Term
|
Definition
| systemic NSAIDs, treat underlying cause |
|
|
