when should vision screening begin in children?
3 - 3 1/2yo
in children, evaluation of fixation and alignment can identify which 2 conditions?
amblyopia or strabismus
Early examination visual milestones:
2 - 4 weeks:
neonate should stare at mother, toy or object
Early examination visual milestones:
3 - 4 months:
infant reaches for a toy
Early examination visual milestones:
4 months:
infant should fixate and follow toy/object to midline (tracking)
Early examination visual milestones:
6 - 10 months:
infant should fixate, track, and reach for a toy in all directions (EOM's)
Which components of the eye exam are done when the child is old enough to cooperate?
2
fundoscopy
fields
What are the most common cause of decreased vision?
Refractory errors
what are refractory errors?
a result of the inability of the eye to focus light on the retina and may be due to irregularities in the cornea, lens or the shape of globe
examples of refractory errors:
4
astigmatism
myopia
hyperopia
presbyopia
what is an abnormal curve in the cornea or lens?
astigmatism
what is a loss of accommodative capacity in the eye?
presbyopia
what is far sightedness that begins later in life?
hyperopia
WHat is nearsightedness which begins in early teens/20s?
myopia
Refractory errors of the eyelid causing impaired vision?
3
ptosis
edema
blepharospasm
Refractory errors of the cornea causing impaired vision?
4
abrasion
infection
edema
degeneration
Refractory errors of the anterior chamber causing impaired vision?
2
iritis
hyphema
Refractory errors of the lens causing impaired vision?
2
cataract
vascular congestion
*
poorly controlled DM
*
Refractory errors of the vitreous causing impaired vision?
2
hemorrhage
floaters
Refractory errors of the retina causing impaired vision?
7
Age-related macular degeneration
central serous retinopathy
inflammation
trauma
detachment
diabetes
hypertension
Refractory errors of the vasculature causing impaired vision?
3
retinal artery occlusion
giant cell (temporal) arteritis
retinal vein occlusion
Refractory errors of the optic nerve causing impaired vision?
5
atrophy (glaucoma)
inflammation
compression
ischemia
other (inherited diseases, drugs, toxins, vitamin deficiency)
Refractory errors of psych related issues causing impaired vision?
2
hysteria
malingering
what is the leading cause of impaired vision in the elderly?
when does it usually occur?
cataracts
6th decade
what is the most common eye problem in primary care?
red eye
redness of the eye and the periocular tissue reflects ___________ or __________.
inflammation or hemorrhage.
Causes of red eye:
9
Bacterial
viral
allergic responses
immune disorders
elevated intraocular pressure
environmental and pharmacologic irritants
foreign bodies
trauma
hemorrhage
Causes of hemorrhage in red eye:
5
idiopathic
laceration
contusion
coagulopathy
strenuous activity
How does the cornea appear in congenital closed angle glaucoma?
diffuse haze
what is anisocoria?
unequal pupil size
how does the pupil appear in iritis?
how does it appear in acute closed angle glaucoma?
constriction
dilated
what should you palpate the punctum for?
2
tenderness and discharge
what kind of lymphadenopathy is frequent with viral conjunctivitis?
Pre-auricular lymphadenopathy
Causes of non-vision threatening red eye:
6
Conjunctivitis
Dry eye
Stye
Chalazion
Bleporitis
Subconjunctival hemorrhage
Causes of vision threatening red eye (NEED IMMEDIATE OPHTHAMLO REFERRAL!)
3
Corneal infections
Iritis
Closed angle glaucoma
what are the 4 types of conjunctivitis?
allergic
bacterial
viral
chemical
what kind of bacteria can cause conjunctivitis?
Gonococcal/chlamydia
what are 2 kinds of injection? (w/ definition)
Conjunctival injection: characterized by clearly delineated individually visible vessels in the conjunctiva that branch from the sclera to the cornea (affects posterior conjunctival blood vessels)
Ciliary injection appears as a red ring or halo surroundin
what is pericorneal injection?
what kind of disorders is it seen in?
conjunctival d/os near the cornea
(rosacea, foreign body, herpetic keratitis)
what is ciliary injection?
what kind of disorders is it seen in?
d/os of deeper tissues and intraocular structures
(eposcleritis, scleritis, disciform keratitis, iritis, cyclitis)
how does allergic conjunctivitis present?
**distinguishing factor from other types?
tearing
pruritis
redness
edema of conjunctiva and lid
scant, white, watery stringy d/c
Tx of allergic conjunctiviits?
1
2
discontinue contact
antihistamines
-initial treatment of mild to moderate allergic rhinitis is intranasal corticosteroid alone, with the use of second-line therapies for mod - severe disease
� Compared with first-generation antihistamines, second-generati
what are the name of the 2 non-systemic antihistamines helpful in the tx of allergic conjunctivitis (used if patient doesn't have severe systemic s/sx)?
patanol
pataday
Dosing of zyrtec in adults and kids for allergic conjunctivitis?
syrup 2.5 mg children 2 to 5 yrs
10 mg tablets qd adults
What are the most common gram + causes of bacterial conjunctivitis?
3
staph aureus
strept pneumonia
strept group a & b
What are the most common gram - causes of bacterial conjunctivitis?
3
H. flu
E coli
Pseudomonas aerogenosa
How is bacterial conjunctivitis diagnosed?
gram stain
What are s/sx of bacterial conjunctivitis?
3
edema of the bulbar conjunctiva (chemosis)
purulent discharge (moderate to profuse)
injection
T or F
Most bacterial conjunctivitis is self-limiting within 10 days
true!
which medication for bacterial conjunctivitis cannot be used in patients with sulfa allergy?
sodium sulymid
what are the possible txs for gram +/- bacterial conjunctivitis?
6 (include dosing and duration)
EES ophth oint q12h or q8h for 7 to 10 days
gentamycin ophth 0.3% Q6h for 2 weeks
tobramycin / gentamycin 1-2 gtts q4h for 5 days
sodium sulymid 10% 1-2 gtts q4h for 5 days (???-market)
polymyxin B/ trimethprin (polytrim) 15% : 1 gtt TID/ qid for 7 to 10
Contraindications with tetracyclines: (list examples of drugs)
3
do not give in kids <8yo
do not give during pregnancy
do not use with dairy products
what is the leading cause of ophthmia neonatorium?
chlamydia infection
when is the onset of chlamydia eye infection?
5 - 12 days after birth, up to 4 weeks after birth
S/sx chlamydia eye infection: (non-systemic)
2
what would be seen if infection was systemic?
4
mild unilateral / bilateral mucopurulent discharge, spreads to the other eye
conjunctivitis with moderate lid edema, injection
rhinitis
otitis
urethritis
vaginitis
T of F
Chlamydia eye infections need to be reported to the CDC
true!
tx of chlamydia eye infection:
kids vs adults (w/ dosing for both)
kids: EES oral (30mg to 50mg /kg)
adults: EES 250mg to 500mg q8-12h
when is the onset of gonococcal infection?
5 - 12 days after birth
S/sx of gonococcal eye infection:
4
swollen eyelids
purulent discharge
edematous
beefy red conjunctiva
what 2 things does gonococcal eye infection result in?
corneal clouding and blindness
gonococcal eye infection is caused by?
a gram negative intracellular diplococcus
what kind of media is gonococcal conjunctivitis seen on in order to make a diagnosis?
2
Thayer Martin or Chocolate agar media
T or F
Gonococcal conjunctivitis does not need to be reported to the CDC
FALSE!!!! report dat shit
what is the primary cause of viral conjunctivits?
adenovirus
Does viral conjunctivitis have more or less discharge than bacterial?
less
S/sx of viral conjunctivitis:
4
watery discharge
pre-auricular lymphadenopathy
blurred vision
photophobia
which symptom of viral conjunctivitid can be used as a diagnostic tool?
+ pre-auricular lymphadenopathy
Viral conjunctivitis may occur in association with which other symptom?
fever blisters
what should NOT be used in the treatment of viral conjunctivitis?
steroids
tx for viral conjunctivitis?
NONE! will resolve on its own
what diagnostics do you run for viral conjunctivitis?
none!
what can cause chemical conjunctivitis to occur after birth?
instillation of silver nitrate
Chemical conjunctivitis:
onset:
cultures + or -?
resolves in how long?
within 24hrs
negative
3 - 5 days
Tx for pregnant and lactating females with chemical conjunctivitis?
EES 250mg Q6h 21 days
Tx for kids with chemical conjunctivitis?
kids EES 50 mg/kg qid 2wks
S/sx of iritis:
6
redness
pain
photophobia
circumcorneal injection
fine red lines, often unilateral
NO discharge!!
delineation btw iris and rednessu
what does the discharge look like in iritis?
NONE!!!! there is none
Diagnosis/tx of iritis?
Immediate referral TO OPHTHOMOLOGIST
uveitis is Inflammation of the _____ ______ including which 2 parts?
uveal tract
iris
ciliary body
Uveitis is associated with?
vision-threatening complications
S/sx uveitis:
2
red halo above iris
injection is mashed together and very red
pupil may not be symmetric or round (iris adheres to the lens)
WHich type of injection is commonly seen in acute anterior uveitis?
ciliary
vision-threatening complications associated with uveitis may be?
insidious in onset and may initially be asymptomatic
Uveitis is often a symptom of ________ disease
systemic
Uveitis needs which kind of referrals?
2
OPHTHOMOLOGIST
rheumaotologist
Children with which condition often have active inflammation without any symptoms and should therefore have ophthalmic screening?
juvenile idiopathic arthritis
Uveitis and iritis likely will not have _____, just ________.
drainage
redness
Any person presenting with which 2 symptoms should trigger suspicion of a sinister disorder, such as uveitis or acute glaucoma?
persistent red eye
blurred vision
WHat is acute Dacryocystitis?
Inflammation/infection of the lacrimal sac
S/sx of acute Dacryocystitis?
5
pain
tearing
redness
discharge
+/- fever
what are the most common offending organisms causing acute Dacryocystitis?
3
Pneumococcus
Staph A
Strept pneumonia
How to diagnose acute Dacryocystitis?
gram stain/ culture & sensitivity
2 treatment options (not meds) for acute Dacryocystitis?
refer
possibly systemic antibiotics based on offending organism and sensitivity
S/sx of chronic Dacryocystitis?
2
chronic tearing
crusting / yellow discharge
___% of chronic Dacryocystitis resolves on its own after how long?
80%
6 mos
If chronic dacryocystitis lasts longer than 14 months, what should you do?
referral for dilation
duct compression and massage
what should you do if you suspect chronic dacryocystitis - how to diagnose?
gram stain/ culture & sensitivity
Tx for chronic dacryocystitis is suspected bacterial origin?
2 (not w/ specific meds)
refer
systemic antibiotics based on offending organism and sensitivity
what is the term for overflow of tears?
Epiphora
epiphora may be a sign of which more sinister conditions?
3
Neoplastic
infectious
inflammatory cause
causes of Epiphora:
6
over production of tears
increased secretion of tears
irritation of ocular surface
impaired lacrimal drainage
Insufficient or impeded drainage
abnormalities
examples of irritations of ocular surface that can cause epiphora:
5
corneal abrasion
reflex tearing in the setting of severe dry eyes inflammation within the eye
aberrant regeneration after Bell's Palsy
ocular allergy
WHat abnormalities can cause epiphora?
4
lid malposition
punctual stenosis
canalicular stenosis
nasalacrimal duct obstruction
causes of excessive tear production causing watery eye:
4
Keratitis
blepharitis
conjunctivitis
allergy
what can cause watery eye due to impaired tear drainage?
7
Punctual stenosis
dacryostenosis
nasolacrimal duct obstruction with or without dacryocystitis ectropion
lid laxity
lacrimal sac or nasal mass
allergic rhinitis
DIfferential diagnosis for watery eye r/t impaired tear drainage may be associated with systemic pathology such as:
3
lymphoma
Wegener granulomatosis
sarcoidosis
which type of diagnostic testing should you do for watery eye?
2
Slit-lamp examination
fluorescein dye testing
what can fluorescein dye testing help visualize?
corneal abrasion
treatment plan for watery eye:
2
when should you refer?
remove irritants
lubrication
if unresponsive
____% of people over ___ have dry eye
15%
65
What is the treatment for dry eye?
is there a cure?
lubricating gtts (make sure they have no salts or preservatives!)
nope
what is a yellow triangular nodule in the bulbar conjunctiva on either side of the iris / yellow-white deposit on the conjunctiva adjacent to the limbus ?
pinguecula
where is pinguecula found?
on the conjunctiva adjacent to the limbus (the junction between the cornea and sclera)
Pinguecula are often a/w what?
aging
do pinguecula cause s/sx usually?
no
where are pinguecula usually most prevalent?
tropical climates, correlated with UV exposure
what is a pterygium?
wedge shaped area of fibrosis of triangular thickening of the conjunctival tissue that appears to grow into the cornea
pterigyum comes from the Greek word pterygion meaning what?
wing
pterigyum are twice as likely to occur in _____ than ____
men than women
pterigyum are initially asymptmoatic.. then what happens?
c/o a foreign body sensation
Conjunctival redness and irritation with dryness, burning and discharge of the eyelid margins lid crusting- dandruff-like debris on lid margins and eyelashes-lash matting and lash loss
T or F
Over a long period of time, you can have visual acuity loss or photophobia from a pterigyum:
FALSOOOOO
another word for stye is?
acute hordeolum
what is a stye/acute hordeolum?
size?
inflammation of the exocrine glands of the eyelid due to an obstruction of the perifollicular glands
small papule to abscess
A stye/acute hordeolum is a ______ infection with pus accumulating in which part of the gland?
They are usually ________ in nature and caused by which pathogen?
local
lumen
bacterial; staph aureus
What can stye/acute hordeolum be triggered by?
3
stress
poor nutrition
sleep deprivation
what defines an external hordeolum?
how does it present?
Acute inflammation of the sebaceous glands of zeis at the base of the eyelashes
small red bump on the outside of the lid
what is an internal hordeolum/stye?
Acute inflammation of the meibomian sebaceous glands on the inside of the eyelids
how does a stye/hordeolum present?
Discrete pustules on the anterior surface of the eyelid margin with lash involvement
S/sx of stye/hordeolum:
10
Red, swollen, tender to touch
Localized erythema, edema, and pain
Crusting of the eyelid margins
Burning in the eye
Droopiness of the eyelid
Scratchy sensation on the eyeball-Irritation of the eye -sensation of a foreign body in the eye - Discomfort durin
Stye/hordeolum tx:
2 main choices
warm compresses (tid for 20 mins)
topical antibiotic ointment (EES/Polysporin @ 1/2 inch - apply 4-5 times per day
What may you have to do for stye/hordeolum if not improved within 4 weeks?
REFER!
-inject with triamcinolone or surgery for incision and drainage
what is a chalazion?
Chronic inflammation of the meibomian glands - sterile inflammation of the meibonian gland, resulting in obstruction, preventing the excretion of its sebaceous products
which population are chalazions more commonly seen in?
immunocompromised (diabetics, cancer patients, RA, etc)
Compare and contract stye and chalazion:
both inflame the meibomian glands
stye are smaller, very painful, produce no lasting damage, acute in onset, and short in duration, usually infectious
chalazion are larger, start not painful but can become more painful with time as it grows, chronic, and
Tx for chalazion:
3 options
warm compress (tid for 20 mins)
systemic antibiotics (only for preseptal cellulitis)
I&D/removal
systemic antibiotics are only to be used in tx of chalazion if?
which antibiotics can be used? (med and dose)
3 (which needs to be taken with food?)
there is cellulitis present
Cefaclor 375 mg q12h for 7 to 10 days (take with food!)
Dicloxacillin 250mg q6h
EES 250mg to 500mg Q8h
you should you refer a chalazion if there is no improvement within?
24 hours
what is this condition?
Chronic lid inflammation that involves structures of the lid margins with redness, scaling, crusting
blepharitis
what are the 2 types of blepharitis?
caused by staph
seborrheic
What are s/sx of blepharitis caused by staph?
3
dry scales
lash loss
with conjunctival and corneal limbic infiltrates (at times: not always present)
Tx for blepharitis caused by staph?
ref derm
What are s/sx of seborrheic blepharitis?
2
seborrhea of the scalp, eyebrows, and ears
greasy dandruff like scales without ulceration
Tx for seborrheic blepharitis?
2
(specific meds for second tx option)
Shampoo associated areas with dandruff shampoo after applying baby oil to those area and allowing it to penetrate the crusted areas
Apply topical antibiotics for 7 to 10 days
� consider bacitracin (q6 -8 h) or sulfacetamide/ 0.2% prednisone (tid and hs) -
Blepharitis can be mistaken for?
which populations is it more common in?
lice and tics
older people esp if they dont wash their hair often, and newborns with cradle cap
what is this condition?
a raised, yellow, well circumscribed skin plaque near the nasal portion of the eye
what is it thought to be associated with?
xanthelasma
hyperlipidemia disorders
how does orbital cellulitis present?
3
pain on eye movement
limited EOMs
conjunctival edema
what organisms can cause orbital cellulitis?
4
can possibly be from?
staph A
strept
H. flu
strept pneumonia
allergic reaction
Tx for orbital cellulitis?
IMMEDIATE REFERRAL TO EMERGENCY ROOM!
**
can cause vision loss!
**
What are causes of periorbital edema (swelling of the eyelid)?
7
allergic
crying
local inflammation
myxedema
fluid retention
nephrotic syndromes
CHF
Tx of periorbital edema?
when to refer immediately? why?
treat the cause
if cause is not obvious or is thought to be infectious
*
CAN RESULT IN BLINDNESS!
*
How to diagnose periorbital edema?
3
culture nasopharynx
blood
Conjunctiva
what is periorbital edema commonly caused by?
an extension of an ethmoid sinus infection (complication of meningitis, sinus thrombosis)
Tx for periorbital edema depends on?
when to hospitalize?
culture and sensitivity and s/sx
if need for IV antibiotics
how does herniated fat present?
flat fat area causing bulging right below the lower lid
when can herpes zoster exacerbation occur?
throughout lifespan
how does herpes zoster present?
which patients is it more likely to occur in?
PAINFUL vesicular ulceration in a wedge pattern involving the eyelid/cornea
in patients under high stressed or who are immunocompromised
The initial herpes zoster infection is usually ______ _____ but the virus remains latent where ?
self limiting
trigeminal ganglion
Herpes zoster incubation time is __-__ days after exposure
2 - 12
Tx of herpes zoster?
meds?
consult who?
REQURES HOSPITALIZATION!
idoxuridine or vidarabine ointment 4 - 5 times daily for 3 weeks
neuro-ophtho
what is important to make sure if patient has herpes zoster?
optic nerve isn't damaged
which condition is referred to as "lazy eye"?
ambylopia
what are s/sx of subconjunctival hemorrhage?
2
what is it a/w?
4
bright light red eye
no pain
coughing, straining, sneezing, or trauma
tx for subconjunctival hemorrhage?
resolves on it's own in 2-3 weeks
fast facts about glaucoma:
4
can occur throughout the lifetime
multiple types
results in visual compromise and loss
African Americans > whites
what causes glaucoma?
increased intraoccular pressure
how is glaucoma diagnosed?
tomometry test
Glaucoma risk factors:
3
+ genetic predisposition associated with open angle @ 6% first degree relatives
advancing age
incurable once damage has occurred the damage to the optic nerve is permanent
Acute onset of IOP in acute glaucoma results from:
5
blocked outflow of aqueous humor
pupil dilation
meds
dim light exposure
stress
s/sx acute glaucoma:
5
severe ocular pain
blurred vision
redness
rainbow / halo around lights
nausea / vomiting
Strabisumus involves _______ of the eyes
malalignment
T or F
Strabismus has a greater incidence in adults
FALSSOOOO!!!! in children
T or F
acute glaucoma is an OPHTHMOLOGICAL EMERGENCY
truuuu
Strabismus has a esp greater prevalence in kids with which type of conditions?
neuralgic (trisomy 21, CP)
pseudostrabismus is often confused with?
congenital estropia
what is the correction for 3rd cranial nerve palsy (+/- congenital) in strabismus?
surgery
what needs to be done with ALL types of strabismus?
referral to a neuro - ophthalmologist
what is the leading cause of poor vision AND vision loss in kids?
ambylopia
ambylopia is what kind of diagnosis?
how is it diagnosed?
diagnosis of exclusion
when visual acuity is less than anticipated for that age
T or F
Ambylopia is a reportable condition to the CDC
true
what is this condition?
Is a significant decrease in visual acuity caused by an interruption of normal development during a critical period in the first few years of life. The interruption occurs when there isn't a maintained sharp focused image on the __
fovea
ambylopia
Tx for ambylopia?
refer ophthalmology
American Association for Pediatric Ophthalmology and Strabismus Vision Screening Recommendations:
newborn - 6mos
tests:
5
referral criteria:
3
External inspection of the eyes and lids
ocular hx
ocular motor assessment
pupil exam (red reflex)
vision assessment
Infants who do not track well after 3 months of age, OR
have an abnormal red reflex OR
history of retinoblastoma in a parent or sibling
American Association for Pediatric Ophthalmology and Strabismus Vision Screening Recommendations:
6 months to 3.5 years of age
tests:
6
referral criteria:
3
External inspection of the eyes and lids
Objective screening device (photoscreening)
Ocular history
Ocular motility assessment
Ophthalmoscopy /Pupil examination (Red reflex)
Vision assessment/Visual acuity testing
Infants with strabismus OR
chronic tearin
American Association for Pediatric Ophthalmology and Strabismus Vision Screening Recommendations:
3.5 to 5 years of age
tests:
6
referral criteria:
1
External inspection of the eyes and lids
Ocular history
Ocular motility assessment
Ophthalmoscopy / Pupil examination (Red reflex)
Vision assessment /Visual acuity testing (preferred) or photoscreening
Children who cannot read at least 20/40 with either e
American Association for Pediatric Ophthalmology and Strabismus Vision Screening Recommendations:
5 years of age and up
tests:
6
referral criteria:
2
External inspection of the eyes and lids
Ocular history
Ocular motility assessment
Ophthalmoscopy Pupil examination (Red reflex)
Vision assessment /Visual acuity testing (preferred) or photoscreening
Children who cannot read at least 20/32 with either eye
how often should vision screening be done after 5yo?
Repeat screening every 1 to 2 years after 5 years of age.
S/sc corneal lacerations:
excessive tearing
pain
a feeling of a foreign substance within the eye
** can be hard ro detect!
how are corneal abrasions diagnosed?
Corneal Staining with Fluorescein
Corneal Staining with Fluorescein is good for which conditions?
3
foreign bodies
corneal abrasions
herpes infection
Describe how Corneal Staining with Fluorescein works:
5 steps
Dampen the fluorescein strip with sterile water.
Then touch the conjunctiva (away from the cornea).
Then have the patient blink (blinking spreads the flourescein).
Finally, examine the eye under an ultraviolet light.
The areas affected will appear green s
Rule of thumb for eye trauma:
2
Cover with moist clear cloth
Send to ER for evaluation
ptosis is a sign of?
underlying disease
what is the most common condition that affects hearing AND vision?
usher syndrome
usher syndrome predominantly affects which population?
kids
usher syndrome is an autosomal ________ inherited trait.
how many types of usher syndrome are there?
recessive
3 types (type 1, 2 and 3)
Major s/sx of usher syndrome:
2
hearing loss
retinitis pigmentosa
-can affect balance too
what does retinitis pigmentosa cause?
night-blindness and a loss of peripheral vision (side vision) through the progressive degeneration of the retina.
is there a cure for usher syndrome?
nope
what is the best tx for usher syndrome?
early identification so that educational programs
how does the eye of a patient with usher syndrome vary than a normal eye upon fundoscopy?
2
the optic nerve (arrow) looks very pale
the vessels (stars) are very thin and there is characteristic pigment, called bone spicules (double arrows)
Central retinal artery occlusion can be well-managed in office before referring out.q
FALSE!! refer IMMEDIATELY
what are the most common causes of retinal hemorrhage?
4
hypertension
diabetes mellitus (which causes small fragile blood vessels to form, which are easily damaged)
retinal vein occlusion (a blockage of a retinal vein)
shaking (shaken baby syndrome)
Tx for retinal hemorrhage?
refer dat shit
retinal detachement is commonly preceded by?
a posterior vitreous detachment
S/sx of retinal detachment:
4
flashes of light (photopsia) - very brief in the extreme peripheral (outside of center) part of vision
a sudden dramatic increase in the number of floaters
a ring of floaters or hairs just to the temporal side of the central vision
a slight feeling of hea
Tx for retinal detachment?
REFER IMMEDIATELY!!
what are cotton wool spots?
what are they representative of?
are small yellowish-white deposits in the retina
They represent swelling of the retinal nerve fibers (seen in DM & HTN)
what are the most common causes of cotton wool spots?
chronic diseases, such as diabetes and high blood pressure, infections
trauma
toxins
other unknown factors can also initiate the chain of events that creates the deposits
Dx and treatment of cotton wool spots?
- refer to ophthalmology
difference between retinal artery occlusion and cotton wool spots?
-retinal artery occlusion has large areas that are white but has some vasculature present
-cotton wool spots have no (or limited) vasculature to the area
acute vision loss suggests:
2
vascular event
retinal detachment
Sudden flurry of flashes or vitreous floaters suggests:
retinal detachment
Conditions with foreign body sensation:
3
corneal abrasion
foreign body
herpes keratitis
What conditions would you expect for progressive, painless vision loss with chronic distrubance?
3
glaucoma
cataract
macular degeneration