Opthomology

usually bilateral, blacks, heredity, visual field and ocular pressure changes, disk cupping, targeted screening at first degree relative, black, diabetes, old, long term steroid TX

Primary open-angle glaucoma

old age, farsighted, rapid onset of pain and profound vision loss with halos around lights, red eye, cloudy cornea, dilated pupil, hardy aye on palpation, occurs with pre-existing narrow anterior chamber angle, RF are shallow anterior chamber (associated

Acute angle closure glaucoma

Bilateral itching thick ropey discharge, usually in boys in spring and summer in younger PTs, large conjunctival papillae/ bumps under the eyelid, treat as allergic, late childhood/ early adulthood,

Vernal keratoconjunctivitis- Atopic Conjunctivitis

cells and flare in the anterior chamber, ciliary flush, keratic precipitates, Bilateral alternating anterior ________is very characteristic of HLA-B27 ______, can be cause by medication- Rifabutin,
Cause in infants- TORCH, retinoblastoma
Children- JIA, To

Acute Iritis- Iritis / Uveitis

MC commonly caused by an infection, (can be non-infectious cause) infection of the corneal stroma that presents with pain, redness and photophobia, slit lamp exam shows staining corneal defect with hazy infiltrate, TX is hourly application of topical ABX

Corneal Ulcer

severe pain and photophobia, hx of trauma, TX is bacitraicin-polymixin ointment and cyclopentalate and NSAIDs

Corneal Abrasion

Scleritis VS Episcleritis (what are the key differences)

Scleritis does NOT blanch when phenylephrine is applied VS Episcleritis will blanch, Scleritis has severe boring eye PN and is usually in old people VS Episcleritis has less PN and is usually in young adults: MC Cause is idiopathic, TX is NSAIDS and artif

rapid loss of vision in one eye, curtain spreading across one eye, no pain or redness, detachment seen by ophthalmoscopy, usually due to development of one or more peripheral retinal tears/ holes secondary to spontaneous degeneration in the vitreous, usua

Retinal detachment

white precipitate that is not steamed, usually immunologic, pain, redness, photophobia, and visual loss, inflammatory cells and flare in the aqueous, kertic precipitates (larger in granulomatous uveitis, smaller in agranulomatous), responds to topical cor

Severe anterior uveitis- The same as Iritis

UV burns of the cornea caused by use of sunlamp without protection, exposure to welding, or exposure to the sun when skiing. No immediate symptoms, 6-12 hours later the PT CO agonizing PN and severe photophobia, slit lamp and staining shows diffuse puncta

Ultraviolet keratitis

disruption of conjunctival blood vessels from trauma, sneezing, gagging, Valsalva that will spontaneously resolve within 2 weeks, when dense bloody chemosis is present globe rupture must be ruled out. No TX necessary

Subconjunctival hemorrhage

Blood or clot in the anterior chamber, may be black or red, screen for Sickle cell, if they have sickle cell hospitalize, atropine or scopolamine BID-TID, no NSAIDs/ aspirin, monitor for IOP increases, r/o globe rupture, limit physical activity. If PT has

Hyphema

consider use of blood thinners or blood dyscarias/ coagulopathies, evaluate by gonioscopy PT and INR, CBC, bleeding time, protein C and S, cyclopege with atropine

Spontaneous hyphema

sudden vision loss, abrupt onset of floaters that progressively increase in severity, VA ranges, eye is not inflamed, a clue is inability to see fundus clearly despite clear lens or localized blood in front of the retina, MC cause is diabetic retinopathy

Vitreous hemorrhage

pain with attempted eye movement with eyelid edema, proptosis, erythema, warmth and tenderness. CT scan shows adjacent sinusitis. Caused by adjacent infection, or direct trauma or infection from blood. Ask for hx of recent illness, tooth pain, neck stiffn

Orbital cellulitis

eyelid edema, erythema, maybe mild fever, no proptosis or restriction of extra-ocular motion, no pain with eye movement, may not be able to open the eye because of the swelling, MC caused by trauma or adjacent infection staph and strep, H influenza in non

periorbital cellulitis

MC of vitreous hemorrhage, any retinal edema within 500um of the center of the fovea, hard exudates within 500um of the center of the fovea if associated with adjacent areas of retinal thickening, retinal edema >1 disc are in size and within 1 disk diamet

Diabetic retinopathy

unequal light reflex

Strabismus

bilateral itchy eyes, watery discharge, HX of allergies, bilateral, , chemosis and red edematous eyelids, conjunctival papillae, no pre-auricular node, eliminate the inciting agent, cool compressed, artificial tears, oral antihistamine, shiners, patanol

Allergic conjunctivitis

MC cause/ RF is age relate changes, glare from oncoming headlights while driving at night, reduced color perception, opacification of the crystalline lens, blurred view of the retina, other causes, diabetes, atopic dermatitis, trauma, steroids, mitotic, a

Cataracts

inflammation of the lacrimal gland, unilateral pain, redness and swelling over the outer third of the upper eyelid with tearing or discharge, children and young adults, outer one third with erythema, swelling, and tenderness, ipsilateral preauricular lymp

Dacryoadenitis

infection of the lacrimal sac from obstruction of the nasolacrimal DUCT system, MCC is staph A, pain swelling and redness of the tear sac area, TX is systemic ABX and eventually a ryocystorhinostomy (removal of the blockage). Chronic is caused by candida

Dacryocystitis

What is the primary purpose of pilocarpine administration?

Control of increased intraocular pressure

A 73-year-old African American man presents for routine follow-up at a primary eye care clinic. He notes that he has been diagnosed with glaucoma and his ophthalmologist has started him on a topical carbonic anhydrase inhibitor (dorzolamide) in order to l

Ciliary body epithelium

40 y/o presents to ER with severe pain in his left eye, decreased vision, nausea, and abdominal pain. On examination, the patient's left pupil is moderately dilated and nonreactive. The cornea is "steamy" in appearance and generally the eye is red. What d

Acute angle-closure glaucoma

A 64-year-old African-American man presents after he went blind in his right eye "out of the blue" 20 minutes ago. There is no pain associated with his symptoms and he is not nauseated. Past medical history is positive for DMII for the past ten years. The

Occlusion of the central retinal artery

Which test can detect esotropia

corneal light reflex test

bilateral conjunctivitis with moderate white discharge. He is acting normally, has no fever, and is feeding well. He was born full term via vaginal delivery without any complications.

Chlamydia trachomatis

A client comes into the clinic with a complaint of a hard, non-tender swelling on the upper lid of her left eye. The conjunctiva in the region of the lesion is red and elevated. What is the most likely diagnosis?

chalzion

A 28-year-old man came to the ER complaining of diplopia and the inability to move the right eye outwards. He was hit by a ball on the right side of his face while playing volleyball 2 hours ago. His symptoms are non-progressive. On examination, his visua

abducens

A 52-year-old man presents with a burning sensation of both eyes. He denies recent trauma and ill contacts. On examination, his eyelid margins are red and inflamed. His eyelashes are greasy and adherent with a surrounding dandruff-like scale. Conjunctiva

blephritis

A 2 week old female infant is seen for her newborn well baby exam after a normal birth and delivery. She has been nursing well, has regained her birthweight and her development appears normal for her age so far. Physical examination is normal with the exc

retinoblastoma

Which drug used in glaucoma therapy has a prolonged duration of action and can be administered relatively infrequently?

Echothiophate

A 64-year-old Asian man presents with a 1-hour history of severe right eye pain that started while he was watching a movie at the theater. He notes right eye "blurred vision and seeing halos around lights". He denies loss of vision, trauma, discharge, and

Acute angle-closure glaucoma

A 25-year-old malepresents with 'acute red eyes' with copious watery discharge. He also notes some aversion to bright light. While rubbing his left eye, he describes a sensation of a 'gritty' foreign body. He denies any visual disturbance or pain.
On phys

Allergic conjunctivitis

A 32-year-old man presents to an urgent care center with complaints of swelling of his right eyelid along the lash line. He works in construction and needs to be able to use his eyes, so he came in for treatment promptly. He is quickly diagnosed with a ho

Erythromycin ophthalmic ointment

A white male comes into the ER with the complaint of pain in his right eye. He was whittling and felt like something went into his eye. This happened four hours ago. He has washed his eye with water, but it still feels funny. What is your working diagnosi

FB

An 84-year-old man presents to the emergency room with 2.5-hour history of painless, progressive vision loss in his right eye, which began while he was reading. He denies any other symptoms. Past medical history is positive for hypertension and a cardiac

Central retinal artery occlusion

A 25-year-old man came to the outpatient clinic complaining of redness, itching, and swelling in the right upper eyelid that started 1 day ago. The redness increased, and there has been no eye discharge or watering. On examination, a pustular swelling at

external hordeolum/ stye

A 14-year-old adolescent is seen in the office for a sports physical for the freshman basketball team. Past history is significant only for a high degree of myopia bilaterally, first diagnosed at age 4 years, and a dislocated shoulder at age 10 years that

Ophthalmology evaluation (Ectopia lentis, retinal detachment, and other ocular anomalies are frequent in Marfan syndrome.)

A 36-year-old woman presents with a small and irregular right pupil. On exam, you note that the pupil does not respond to direct or consensual light stimuli; however, it becomes smaller during an accommodation testing. What is the most likely diagnosis??

Tertiary syphilis (pupil describe here is the Argyll Robertson pupil. The pupil reacts poorly to light, but it reacts well to accommodation.)

baseball player presents to the clinic after being struck in the eye with a baseball. On examination, you note bright red blood in the anterior chamber. What is your initial diagnosis?

Hyphema

3-day-old girl presents with rapidly progressing bilateral conjunctivitis with white discharge. She was born full term via precipitous vaginal delivery, and her mother had no prenatal care. On exam she is alert and active. The eye discharge is purulent, a

Admit to the hospital for IV antibiotics and evaluation. (Ophthalmia neonatorum is a form of conjunctivitis occurring in infants younger than 4 weeks. The usual incubation period is 2 - 5 days for N. gonorrhoeae and 5 - 14 days for C. trachomatis. Conjunc

acute infection of the oil gland at the lid margin, TX is warm compresses and erythromycin for 7-10 days, Painful staph abscess of the eyelid

Hordeolum- (external hordeolum)/ stye

acute or chronic granulomatous infection of the meibomian gland, TX with warm compress and Erythromycin ointment and 14-21 days Doxy for refractory cases/ refer to optometry

chalazion

(eyelids unable to close) DDX: severe proptosis, or 7th CN palsy/ Bell 's palsy (7th is the hook that shuts the eyes)

Lagopthalmos

drooping of the upper eyelid, visual loss often worse with reading or at night, MC it is benign, other DDX are horners syndrome, CN3 palsy, myasthenia gravis (improvement after application of ice is highly suggestive of myasthenia gravis, chest CT if susp

Ptosis

bilateral inflammatory condition of the lid margins may be seborrheic and involve the scalp, eyebrows, and ears. Anterior is the eyelid skin and eyelashes, posterior is the meibomian glands. Itching burning, mild pain, FB sensation, crusting around the ey

Blepharitis

eyes, old, obese, women, around 40 Y/O, s/s of ICP, HA, transient episodes of visual loss precipitated by changes in posture, double vision, pulsatile tinnitus, N/V, findings are papilledema due to ICP, negative MRI of the brain, increased opening pressur

Pseudotumor Cerebri

binocular horizontal diplopia worse with distance vision, deficient lateral movement

Sixth nerve palsy

MC cause of isolate 7th nerve palsy, may have viral prodrome followed by ear pain, decreased tearing or taste, facial numbness, progresses over 10 days, rarely bilateral, family disposition

Bell's palsy

will cross dermatomes, dendrites, do not use steroids, will increase viral replication

HSV dermatitis

Positive FTA-ABS in the serum or positive CSF VDRL, TX is PenG 2-4 million units IV every 4 hours for 10-14 days followed by bezathine penicillin 2.4 million units (1.2 in each buttock) IM weekly for 3 weeks, repeat LP every 6 months for 2 years and repea

Neurosyphilis

Common congenital ophthalmic infection

CMV, 90% are asymptomatic at birth

sudden onset of decreased vision and increasing eye pain after a surgical procedure, hypopyon, fibrin, and sever anterior chamber reaction, decreased red reflex, MC is staph

Post-op enopthalmitis

R/O FB, if caused by bacillus PT will have high fever, leukocytosis, proptosis, and a corneal abcess in the form of a ring with rapid visual deterioration, TX w/ fortified topical ABX tobramycin/ cefazolin/ vacomycin

Traumatic endopthalmitis

MC cause is toxoplasmosis, gradual loss of vision in a quiet eye, cells in the vitreous, needs systemic corticosteroids, VS anterior uveitis responds to topical steroids

Posterior uveitis

autoimmune disease activated by an infection, commonly a GI infection or a GI infection, causes inflammatory arthritis of large joints, anterior uveitis or chronic conjunctivitic And cervictitis/ urethritis (can't see/ can't pee/ can't climb trees)

Reiter's syndrome-/ reactive arthritis

sudden monocular loss of vision, no pain or redness, widespread or sectorial retinal hemorrhages, commonly noticed upon waking, also seen is retinal vein dilation/ tortuosity/ retinal cotton wool spots/ optic disc swelling, check blood pressure in all PTs

Central retinal vein occlusion

sudden monocular vision loss, no pain or redness, widespread or sectorial retinal swelling, if PT is over 50 consider GCA, VA is reduced to finger counting or worse, visual field is restricted to island of vision in the temporal field, ophthalmoscopy reve

Central arterial occlusion

most commonly caused by toxoplasmosis, most cases are congenital, most common symptom is decreased visual acuity in one eye. The diagnosis is made by examination of the eye, using ophthalmoscopy. Sometimes serologic testing is used to rule out the disease

Retinochoroiditis

blurred vision and floaters, redness and photophobia, pain is absent, new unilateral white yellow retinal lesion associated with old chrioretinal scar, vitreous reaction directly over the lesion, does the PT eat raw meat or have exposure to cats, draw ant

Toxoplasmosis

Emergent Ct, start amphotericin B in D5W, biopsy the necrotic tissue and consult for early surgical debridement of necrotic tissue, fungal invasion into the blood vessels which results in the formation of blood clots and surrounding tissue death by loss o

Mucorymycosis

(rare) a sarcoma (cancer of connective tissues), in which the cancer cells are thought to arise from skeletal muscle progenitors. It can also be found attached to muscle tissue, wrapped around intestines, or in any anatomic location. It mostly occurs in a

Rhabdomyosarcoma

type of blood vessel malformation or hemangioma, where a collection of dilated blood vessels form a tumor. Because of this malformation, blood flow through the cavities, or caverns, is slow. Additionally, the cells that form the vessels do not form the ne

Cavernosus hemangioma

Ptosis, Miosis, and anhidrosis. Anisicoria in a dim room, if it dilates it dilates less than the other pupil, mild ptosis and lower lid elevation, lower IOP, DX is confirmed with cocaine test, normal pupil will dilate and normal pupil will not, to disting

Horner's syndrome

MC cause is pseudomonas aeruginosa, overnight wear, and topical fluoroquinalones hourly day and night for at least first 48 hours,

Contact lens corneal ulceration

retina or optic nerve pathology, observed during the swinging-flashlight test[1] whereupon the patient's pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye. The affected eye still

Marcus Gunn pupil

Transient monocular vision loss caused by retinal embolus from ipsilateral carotid disease or heart, described as curtain passing vertically across the eye with complete vision loss lasting a few minutes, immediate TX with oral aspirin until the cause can

Amarausis fugax

cholesterol embolus that is seen in a blood vessel of the retina, seen when a physician performs ophthalmoscopy, during which a plaque will appear bright, refractile, and yellow. It is caused by an embolus lodged within the retinal vessel that originated

hollenhorst plaques

itchy, FB sensation, pinpoint hemorrhages, intraepithelial microcytosis, may develop a pseudomembrane, HX of recent URI, MC cause is adenovirus: wash hands, topical antihistamines, Eye clinics and swimming pools are a source of infection

Keratoconjunctivitis/ viral

23-year-old woman presents with a 2-week history of left eye irritation. She insists that there is a foreign object lodged under her eyelid. There are no other symptoms. Physical examination is remarkable for unilateral conjunctivitis, which appears acute

Chlamydia trachomatis

22-year-old woman presents with a 1-day history of foreign body sensation in her right eye. She woke up with pain in the right eye, and she immediately had trouble opening her eye. She wears soft contact lenses and does not remember how long the last pair

Ciprofloxacin 0.3% solution (TX for pseudamonas)

35-year-old man presents with a piece of wood sticking out of his right eye. He denies any past medical or surgical history or any alcohol ingestion; however, he smells of alcohol. He states that his tetanus immunization is up-to-date. What is most approp

Start the patient on intravenous antibiotics (Ophthalmic ointments should be avoided, as they may penetrate the globe. Also, one should never give oral antibiotics, as the patient may need surgery to remove the foreign body.)

18-year-old man presents with blurred vision and some eye pain that began 2 days ago and has become progressively worse. Upon examination, the eye is slightly edematous with a white to yellow exudate present under the eyelid and at the corner. The rest of

Staphylococcus aureus

38-year-old man presents with a firm, painless bump on his left eyelid. On examination, you note a 5 mm mass within the tarsus of the left eye. The skin is freely movable over the mass. The remainder of the eye exam is unremarkable. What is most likely di

Chalazion

A 44-year-old man presents for follow-up of poorly controlled type I diabetes mellitus, which was diagnosed 32 years ago. What change on his funduscopic examination would indicate a need for urgent referral to an ophthalmologist??t??

Neovascularization

Flame-shaped hemorrhages are indicative of

HTN

are indicative of nonproliferative diabetic retinopathy, which is usually seen 10 to 20 years after the onset of diabetes. Nonproliferative retinopathy does not always progress to proliferative retinopathy, but if it becomes extensive, it can result in re

Blot hemorrhages, cotton wool spots, and microaneurysms

previously healthy 5-year-old boy presents with complaints of bilateral eye pain and redness. The child's mother reports that several children in his daycare facility have had similar symptoms. Results of physical exam indicate bilateral nonsuppurative co

adenovirus

A 14-year-old girl has had a small, slightly tender swelling in her left upper eyelid for 2 - 3 days that has gradually enlarged, becoming round and painless. There has not been any drainage, visual changes, or itching noted. She has been well otherwise.

Chalazion

3-year-old boy presents after waking up with his eyelids glued together. His mother states that he has been rubbing his eyes constantly. The medical history is unremarkable, and the patient had not been sick before. Upon examination, redness of the lid ma

Blepharitis

A 24-year-old man presents with a painless, localized swelling of his left lower eyelid; it has developed over a period of weeks. He is seeking medical attention because it is now producing a foreign body sensation in his left eye; it is also hindering hi

Chalazion

are evaluating a 24-year-old woman for bilateral eye pain. She describes red, itching, irritated eyelids for several weeks. She states she has had "several bouts" of similar symptoms over the last few years. Exam is consistent with blepharitis. She does n

Discuss good eye hygiene and eyelid scrubbing

A 64-year-old woman presents with acute onset of right eye pain and blurred vision, as well as nausea and vomiting. After physical examination and determination of elevated intraocular pressure, the emergency room physician starts treatment for acute angl

<35 mmHg

Case Cross Highlights
A 1.5-year-old boy presents with a squint in the left eye. His mother informed you that the child's eyes were quite normal until about 2 months ago, when she noticed asymmetric movements of her son's eyes. She also felt that the chil

Retinoblastoma

68-year-old woman presents with episodic, monocular blindness lasting typically less than 5 minutes described as a curtain moving vertically over her visual field. She denies pain or other related vision symptoms. Fundoscopic exam reveals no significant a

Retinal artery emboli

25-year-old man came to the outpatient clinic complaining of redness, itching, and swelling in the right upper eyelid that started 1 day ago. The redness increased, and there has been no eye discharge or watering. On examination, a pustular swelling at th

Warm compresses and local antibiotic cream

Question Cross Highlights
A client comes into the clinic with a complaint of flaking and scaling around her lashes, along with itching and burning sensation, occurring over the past year. She has also noted her lid margins are red, and some of her lashes

Blepharitis

62-year-old woman presents to the Emergency Department with acute unilateral loss of vision for 1 hour. Fundoscopic examination demonstrates vein dilation, intraretinal hemorrhages, and cotton-wool spots with optic disc swelling. Which of the following is

Retinal vein occlusion

Dilated central and conjunctival vessels, dilated pupil, and decreased vision

red eye caused by glaucoma

26-year-old man presents with an eye issue. He does not wear corrective lenses. The only change of lifestyle that he states is that, a few months ago, he quit his office job and began to "help out a buddy" in the construction business. On physical examina

Pterygium

A 68-year-old woman presents with episodic, monocular blindness lasting typically less than 5 minutes described as a curtain moving vertically over her visual field. She denies pain or other related vision symptoms. Fundoscopic exam reveals no significant

Retinal artery emboli

A mother brought her otherwise healthy 12-month-old son to your attention because she noticed that he has crossed eyes that are different colors. His mother has been smoking for about 10 years, including during the pregnancy. She remembers that her brothe

Heredity

16-year-old boy was at his team basketball practice when a team member forcefully jabbed his fingers into the 16-year-old's left eye while trying to block his shot. He felt sharp, blinding pain and has had much tearing. He was taken out of practice, ice a

Evaluate visual acuity with corrected vision in place

27-year-old woman presents with a 3-day history of left eye pain. The patient notes sensitivity to light, and she comments that her eye throbs in pain at night. On physical examination, you note a redness and loss of visual acuity. What would be an approp

Dexamethasone and homatropine ophthalmic drops (The clinical picture is suggestive of uveitis. Patients with uveitis usually note redness, pain, photophobia, and visual loss. Treatment is with topical steroids and a dilating agent to relieve the discomfor

25-year-old man presents to your office after a skiing vacation. He is complaining about sensitivity to light and eye pain bilaterally that rates 8 out of 10. In order to better evaluate this patient you instill fluorescein and perform a slit lamp exam. Y

Cyclopentolate drops

6-year-old girl presents with a 2-day history of a small, tender, superficial abscess on her left upper eyelid at the lid margin. She denies discharge, fever, or trauma. There is mild pain on palpation, and she has a normal ophthalmic exam. What treatment

Warm compresses

25-year-old man has been enjoying 3 days of skiing in Taos, New Mexico. After a few hours of sleep the 3rd night, he awakens with severe bilateral eye pain associated with lacrimation and photophobia. What will be most helpful in confirming your suspected

Fluorescein staining

63-year-old woman presents to her ophthalmologist with a complaint of decreased vision in the right eye. On examination, her right lens is noted to have a mild opacification, and she is diagnosed as having a cataract. Which of the following complaints mig

Visual halos around objects

66-year-old man presents with sudden onset of brief episodes of blindness in his right eye, with complete recovery before the next episode. The event is described as a shade coming down across his field of vision, and it is not painful.
what is the most l

Carotid stenosis

70-year-old man presents with paralytic strabismus with maximal esotropia as he gazes to the left.
Question Cross
Which of the following nerves is most likely affected in this case?

Left sixth cranial nerve

An 8-year-old child is brought to your office because of swelling of the left upper eyelid; the swelling is associated with redness and tolerable pain. No fever is noted. Physical examination shows a localized swelling and redness on the upper middle lid

Hordeolum

33-year-old man presents with acute left eye pain. He was working in his garage on a woodworking project, and as he hammered in a nail, he felt that something hit him in the left eye. On examination, you note that the left pupil has a teardrop appearance.

An X-ray of the orbits ( clinical picture is suggestive of an intraocular foreign body or penetrating injury to the eye. This is commonly seen in individuals with a history of pounding on metal or using grinding equipment. The patient may give a history o

32-year-old woman presents with a 3-day history of irritation, burning, itching, and redness of both eyelids. She denies fever, visual changes, and photophobia. On physical examination, you note the presence of scales clinging to the eyelids bilaterally.

Daily cleaning with a damp cotton applicator and baby shampoo

A 30-year-old woman presents to the emergency room at 7 am with severe pain and swelling of her right eye. She was awakened early the previous evening due to the discomfort and swelling of the surrounding conjunctiva. She found it difficult to sleep due t

Pseudomonas aeruginosa (Pseudomonas aeruginosa is a Gram-negative rod; it is a non-lactose fermenting, oxidase-positive motile bacteria. Growth on MacConkey agar is usually characterized by the production of a "grape-like" smell. A blue-green color, due t

33-year-old man presents with a 1-day history of a painful left upper eyelid. He denies any change in vision, discharge, trauma, or foreign body. The pain started after the patient was cleaning out the garage. On physical exam, the visual acuity is OD/OS/

Hordeolum

A 72-year-old African-American man is brought to the emergency room with a sudden onset of excruciating pain and vision loss in the right eye. He is experiencing nausea, and he had been vomiting in the ambulance. The upper eyelid is swollen; there is circ

Administration of oral glycerin

35-year-old woman presents with a painful swelling of her left eyelid. On physical exam, there is tenderness to palpation and erythematous swelling present on the lid margin involving the eyelashes.

Hordeolum

74-year-old man presents with a 1 �-hour history of severe pain and blurred vision in his left eye. Upon examination, his left eye is erythematous with a steamy cornea and a nonreactive, dilated pupil. An ophthalmologic consult is ordered, and tonometry i

Bilateral laser peripheral iridotomy

72-year-old woman presents complaining of a severe unilateral headache, jaw pain, and scalp tenderness. The patient states the headache is of a piercing quality and her jaw hurts only when she chews and feels better after she stops chewing a few minutes l

risk of blindness with GCA

A 35-year-old female presents to her primary care provider's office with the chief complaint of purulent drainage and erythema of her right eye for the past 24 hours. After a brief physical examination, her provider would like to take cultures of the drai

Erythromycin ( if trying to cover all bacterial etiologies of conjunctivitis, then erythromycin can be given in the oral form in order to include good coverage for both gonococcal conjunctivitis and chlamydial conjunctivitis. If the erythromycin ophthalmi

A 78-year-old Caucasian male presents with unilateral painless loss of vision in the right eye of 3 hours duration. Examination reveals an elderly gentleman who is anxious but in no acute distress. Visual acuity is light perception only in the right eye a

Central retinal artery occlusion

A 32-year-old woman with a past medical history of multiple environmental allergies presents with bilateral ocular pruritis, eye redness, and excessive tearing over the last several days. She notes associated nasal congestion. She states that these sympto

Pillow and mattress covers, air purifiers, and dust filters should be purchased.

43-year-old woman presents to a walk-in clinic with a complaint of a painful, red lump on her left eyelid. Examination shows an oozing erythematous pustule surrounded by hyperemia edema. What is the most likely diagnosis?

Hordeolum

48-year-old Caucasian man presents with acute onset of blurring of vision and severe pain in the left eye that began 1/2 hour ago. He notes seeing halos with his left eye; he is also experiencing nausea and vomiting; those symptoms started at the same tim

Tonometry

white female comes into the evening clinic with complaint of red eyes with a sticky discharge. Her eye feels irritated, the pain is mild. She tells you she shared towels with her boyfriend who had a red eye. She asks you if you think her boyfriend gave he

Conjunctivitis

predisposes PT to retinal detachment Condition of the eye where the light that comes in does not directly focus on the retina but in front of it, causing the image that one sees when looking at a distant object to be out of focus, but in focus when lookin

Myopia

progressively diminished ability to focus on near objects. The first signs of it is - eyestrain, difficulty seeing in dim light, problems focusing on small objects and/or fine print - are usually first noticed between the ages of 40 and 50. Research evide

Presbyopia

eyeball is too short or the lens cannot become round enough), causing difficulty focusing on near objects. Farsightedness is the result of the visual image being focused behind the retina rather than directly on it. It is mainly cause by two reasons-
� Lo

Hyperopia

bulging of the eye anteriorly out of the orbit. Can be either bilateral (as is often seen in Graves' disease) or unilateral (as is often seen in an orbital tumor). In the case of Graves' disease, the displacement of the eye is due to abnormal connective t

Exophthalmos- Proptosis

where rays that propagate in two perpendicular planes have different focus. Ophthalmic is a refraction error of the eye in which there is a difference in degree of refraction in different meridians. It is typically characterized by an aspherical, non-figu

Astigmatism

a form of strabismus where the eyes are deviated outward. People with ________ often experience crossed diplopia. Intermittent ________ is a fairly common condition.

Extropia

form of strabismus, or "squint," in which one or both eyes turns inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. It is sometimes erroneously called "lazy eye," which

Esotropia

will have unequal light distribution on the pupil/ diplopia, decreased vision in an eye that otherwise appears normal, or out of proportion to associated structural problems of the eye; there is much more damage to or impact on vision in that eye than is

Amblyopia

optic disk swelling due to raised ICP is usually bilateral and produces enlargement of the blind spot without loss of VA, if chronic weight loss acetazolamide, and if not effective a shunt

Papilledema

can be caused by Bell's palsy/ 7th nerve palsy, lower eyelid turns outwards. It is one of the notable aspects of newborns exhibiting congenital Harlequin-type ichthyosis, but it can occur due to any weakening of tissue of the lower eyelid. The condition c

Ectropion

constriction of the pupil

Miosis

decreased vision or blindness (anopsia) in half the visual field of one or both eyes, usually on one side of the vertical midline. The most common causes of this damage are stroke, brain tumor, and trauma.

Hemianopsia

contraction of the ciliary muscle to focus the lens, process by which the vertebrate eye changes optical power to maintain a clear image or focus on an object as its distance varies. Occurs as a consequence of a reduction in zonular tension induced by cil

Accommodation

Yellow elevated conjunctival nodule, more commonly on the nasal side, does not cross the limbis of the iris

Pinguecula

Fleshy triangular encroachment of the conjunctiva onto the nasal side of the cornea associated with prolonged wind/ sun exposure, indication for surgery is when it grows and threatens the vision, crosses the limbus of the iris

Ptergium

Dialates the eyes for several days and is often used for very large painful abrasions. will cause dialation/ mydriasis used to widen the pupils for eye examination or eye surgery. It is also used to decrease pain and swelling from an inflammation of the e

Scopolamine .25% drops

least effect on B2 receptors, it is B1 selective, selective for beta1 receptors, it typically has fewer systemic side effects than non-selective beta-blockers, for example, not causing bronchospasm (mediated by beta2 receptors) as timolol may. Also shows

Betaxolol

can precipitate an acute glaucoma in a PT with a narrow anterior chamber, no effect on IOP over 60. It is a non-selective muscarinic receptor agonist in the parasympathetic nervous system, which acts therapeutically at the muscarinic acetylcholine recepto

Pilocarpine

(class of meds) agent that induces dilation of the pupil. Drugs such as tropicamide are used in medicine to permit examination of the retina and other deep structures of the eye, and also to reduce painful ciliary muscle spasm. Phenylephrine is used if st

Mydriatics

paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation. This class of drugs are generally muscarinic receptor blockers. These include atropine, cyclopentolate, homatropine, scopolamine and tropicamide. They are indicated for use

Cyclopegics

trade name Diamox, diuretic, carbonic anhydrase inhibitor that is used for the medical treatment of glaucoma, In the eye this results in a reduction in aqueous humour SE's is Steven Johnson syndrome, nearsightedness, angle closure glaucoma due to ciliary

Acetazolamide

aminoglycoside antibiotic derived from Streptomyces tenebrarius and used to treat various types of bacterial infections, particularly Gram-negative infections. It is especially effective against species of Pseudomonas, it is ototoxic, topically though it

Tobramycin

also known as Iopidine is a sympathomimetic used in glaucoma therapy. It is a ?2-adrenergic agonist and a weak alpha-1 adrenergic receptor agonist. Topical _________________ is administered for the prevention and treatment of postsurgical intraocular pres

Apraclonidine

severe anterior uveitis- to relieve pain by immobilizing the iris, to prevent adhesion of the iris to the anterior lens capsule (posterior synechia), which can lead to iris bombe and elevated IOP, to stabilize the blood-aqueous barrier and help prevent fu

Atropine

ophthalmic solution is a topical medication used for controlling the progression of glaucoma or ocular hypertension, by reducing intraocular pressure. It is a synthetic prostaglandin analog (or more specifically, an analog of prostaglandin F2?) that works

Travoprost

It is a sympathomimetic agent with marked alpha adrenergic activity. It is a vasoconstrictor with a rapid action in reducing swelling when applied to mucous membrane. It acts on alpha-receptors in the arterioles of the conjunctiva to produce constriction,

Naphazoline

parasympathomimetic alkaloid, specifically, a reversible cholinesterase inhibitor. It occurs naturally in the Calabar bean, has a miotic function, causing pupillary constriction. It is useful in treating mydriasis. Also increases outflow of the aqueous hu

Physostigmine

used for newborns to prevent GC, used for crazy glue in the eye. Macrolide group of antibiotics. It is basic and readily forms a salt when combined with an acid. For the treatment of superficial ocular infections involving the conjunctiva and/or cornea ca

erythromycin

class of drugs that increases outflow, wider use of is limited by unwanted side effects and their abortive potential. Used in the management of open-angle glaucoma. They reduce intra-ocular pressure by enhancing uveoscleral outflow and may also have some

Prostaglandin analogs

Dacryocystitis is infection of the ____________, upper dilated end of the nasolacrimal duct, and is lodged in a deep groove formed by the lacrimal bone and frontal process of the maxilla. It connects the lacrimal canaliculi, which drain tears from the eye

Lacrimal sac

paired almond-shaped glands, one for each eye, that secrete the aqueous layer of the tear film. They are situated in the upper, outer portion of each orbit, Inflammation of the ________________is called dacryoadenitis. The _________________produces tears

Lacrimal gland

sometimes called the tear duct) carries tears from the lacrimal sac into the nasal cavity.

Nasolacrimal duct

they function to collect tears produced by the lacrimal glands. The fluid is conveyed through the lacrimal canaliculi to the lacrimal sac, and thence via the nasolacrimal duct to the inner nose.

Upper lacrimal punctum

serrated junction between the retina and the ciliary body. This junction marks the transition from the simple non-photosensitive area of the retina to the complex, multi-layered photosensitive region. In this region the pigmented epithelium of the retina

Ora serrata

area of tissue in the eye located around the base of the cornea, near the ciliary body, and is responsible for draining the aqueous humor from the eye via the anterior chamber (the chamber on the front of the eye covered by the cornea). The tissue is spon

Trabecular meshwork

a ring of fibrous strands connecting the ciliary body with the crystalline lens of the eye. The number of zonules present in a person appears to decrease with age

Zinns membrane

known as the lacrimal canals or lacrimal ducts, are the small channels in each eyelid that commence at minute orifices, termed puncta lacrimation, on the summits of the papillae lacrimales, seen on the margins of the lids at the lateral extremity of the l

Inferior canaliculus

the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The ________, with the anterior chamber and lens, refracts light, with the cornea accounting for approximately two-thirds of the eye's total optical power. contribute

Cornea

biconvex structure in the eye that, along with the cornea, helps to refract light to be focused on the retina. By changing shape, functions to change the focal distance of the eye so that it can focus on objects at various distances, thus allowing a sharp

Lens

light-sensitive layer of tissue, lining the inner surface of the eye. layered structure with several layers of neurons interconnected by synapses. The only neurons that are directly sensitive to light are the photoreceptor cells. These are mainly of two t

Retina

thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. It gives the eye its color

Iris

white of the eye. forms the posterior five-sixths of the connective tissue coat of the globe. It is continuous with the dura mater and the cornea, and maintains the shape of the globe, offering resistance to internal and external forces, and provides an a

Sclera

bring the pupil away from the midline of the body, originates at the lateral part of the annulus of Zinn, also known as the annular tendon or common tendinous ring, and inserts into the temporal side of the eyeball, It is the only muscle innervated by the

Lateral rectus

As with most of the muscles of the orbit, it is innervated by the oculomotor nerve (Cranial Nerve III). It depresses, adducts, and helps extort (rotate laterally) the eye. This muscle is the only muscle that is capable of depressing the pupil when it is i

Inferior rectus

abducts, depresses and internally rotates the eye. It is the only extraocular muscle innervated by the trochlear nerve (the fourth cranial nerve).

Superior oblique

is a thin, narrow muscle placed near the anterior margin of the floor of the orbit. Is an extraocular muscle, and is attached to the maxillary bone (origin) and the posterior, inferior, lateral surface of the eye (insertion). The ____________is innervated

Inferior oblique- or obliquus oculi inferior

transparent, gelatinous fluid similar to plasma, but containing low protein concentrations. It is secreted from the ciliary epithelium, a structure supporting the lens. It is located in the anterior and posterior chambers of the eye, the space between the

Aqueous humor

clear gel that fills the space between the lens and the retina of the eyeball. Floaters are generally harmless, but the sudden onset of recurring floaters may signify a posterior vitreous detachment (PVD) or other diseases of the eye.

Vitreous humor

supplies blood to the outer retinal layer, vascular layer of the eye, containing connective tissue, and lying between the retina and the sclera. The human _______ is thickest at the far extreme rear of the eye, while in the outlying areas it narrows. The

Choroid

good for orbital blowout fracture because it shows blood/ fluid level in the maxillary sinuses on the side of trauma, X-ray beam is angled at 45� to the orbitomeatal line. The rays pass from behind the head and are perpendicular to the radiographic plate.

Waters view

X-ray plate is angled at 20� to orbitomeatal line. The rays pass from behind the head and are perpendicular to radiographic plate. It is commonly used to get better view of frontal sinuses.

Caldwell view

MC malignant tumor of the eyelids is

BCC

MC eye disease is

conjunctivitis

old, chronic deterioration of central vision in one or both eyes, distortion of size of images, no pain or redness, macular abnormalities seen on exam (drusen), white and female family hx, smoking

Macular Degeneration