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physical diagnosis eye


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medial rectus: action
medial rectus: cranial nerve
medial rectus: will not turn eye where if palsy
lateral rectus: action
lateral rectus: cranial nerve
lateral rectus: will not turn eye where if palsy
inferior rectus: action
depression; extorsion; adduction
inferior rectus: cranial nerve
inferior rectus: will not turn eye where if palsy
down and temporal
superior rectus: action
elevation; intorsion; adduction
superior rectus: cranial nerve
superior rectus: will not turn eye where if palsy
up and temporal
superior oblique: action
intorsion; depression; abduction
superior oblique: cranial nerve
superior oblique: will not turn eye where if palsy
down and nasal
inferior oblique: action
extorsion; elevation; abduction
inferior oblique: cranial nerve
inferior oblique: will not turn eye where if palsy
up and nasal
history: acute conjunctivitis
sudden onset; exposure to conjunctivitis
history: acute iritis
fairly sudden onset, often recurrent
history: narrow angle glaucoma
rapid onset; sometimes history of previous atttack; highest incidence in jews; swedes; and inuit
history: corneal abrasion
trauma; pain
vision: acute conjunctivitis
vision: acute iritis
impaired if untreated
vision: narrow angle glaucoma
rapidly lost if untreated
vision: corneal abrasion
can be affected if central
vision: Spanish
la visión
vision: French
la vision
vision: Arabic
vision: Chinese
pain: acute conjunctivitis
gritty feeling
pain: acute iritis
pain: narrow angle glaucoma
pain: corneal abrasion
pain: Spanish
el dolor
pain: French
la douleur
pain: Arabic
pain: Chinese
bilaterality: acute conjunctivitis
bilaterality: acute iritis
bilaterality: narrow angle glaucoma
bilaterality: corneal abrasion
usually unilateral
vomiting: acute conjunctivitis
vomiting: acute iritis
vomiting: narrow angle glaucoma
vomiting: corneal abrasion
cornea: acute conjunctivitis
cornea: acute iritis
cornea: narrow angle glaucoma
cornea: corneal abrasion
irregular light reflex
pupil: acute conjunctivitis
normal, reactive
pupil: acute iritis
sluggishly reactive; somteimes irregular in shape
pupil: narrow angle glaucoma
partially dilated; oval; nonreactive
pupil: corneal abrasion
normal; ractive
pupil: Spanish
la pupila
pupil: French
la pupille
pupil: Arabic
pupil: Chinese
iris: acute conjunctivitis
iris: acute iritis
iris: narrow angle glaucoma
difficult to see; owing to corneal edema
iris: corneal abrasion
shadow of corneal defect may be projected on the iris with penlight
ocular discharge: acute conjunctivitis
mucopurulent or watery
ocular discharge: acute iritis
ocular discharge: narrow angle glaucoma
ocular discharge: corneal abrasion
watery or mucopurulent
systemic effect: acute conjunctivitis
systemic effect: acute iritis
systemic effect: narrow angle glaucoma
systemic effect: corneal abrasion
prognosis: acute conjunctivitis
self limited
prognosis: acute iritis
poor if untreated
prognosis: narrow angle glaucoma
poor if untreated
prognosis: corneal abrasion
good if not infected
loss of vision: possible causes
optic neuritis; detached retina; retinal hemorrhage; central retinal vascular occlusion; cns disease
spots: possible causes
no path significance; maybe retinal detachment or fertility drugs
flashes: possible causes
migraine; retinal detachment; posterior vitreous detachment
loss of visula field or presence of shadows or curtains: possible causes
retinal detachment or hemorrhage
glare, photophobia: possible causes
iritis; meningitis
distortion of vision: possible causes
retinal detachment; macular edema
difficulty seeing in dim light: possible causes
myopia; vitamin a deficiency; retinal degeneration
colored halos around lights: possible causes
acute narrow angle glaucoma; opacities in lens or cornea
colored vision vhanges: possible causes
cataracts; drugs (digitalis increases yellow vision)
double vision: possible causes
extraocular muscle paresis or paralysis
double vision: Spanish
la visión doble
double vision: French
la vision double
double vision: Arabic
رُؤْيَة مُزْدَوِجة
foreign body sensation in eye: possible causes
foreign body, corneal abrasion
burning in eye: possible causes
uncorrected refractive error; conjunctivitis; sjogren's syndrome
throbbing, aching in eye: possible causes
acute iritis; sinusitis
tenderness in eye: possible causes
eyelid inflammation; conjunctivitis; iritis
headache: possible causes
refractive errors; migraine; sinusitis
headache: Spanish
el dolor de cabeza
headache: French
le mal de tête
headache: Arabic
headache: Chinese
drawing sensation: possible causes
uncorrected refractive errors
itching: possible causes
dry eyes; eye fatigue; allergies
itching: Spanish
el picazón
itching: French
la démangeaison
itching: Arabic
itching: Chinese
tearing: possible causes
emotional states; hypersecretion of tears; blockage of drainage
drynes: possible causes
sjogren's syndrome; decreased secretion from aging
sandiness, grittiness: possible causes
fullness of eyes: possible causes
proptosis; agning changes in lids
twitching: possible causes
fibrillation of orbicularis oculi
eyelid heavingeess: possible causes
fatigue; eyelid edema
diszziness: possible causes
refractive error; cerebellar disease; vestibular disease
excessive blinking: possible causes
local irritation; facial tic
eyelids sticking together: possible causes
inflammatory diesease of eyelids or conjunctivae
adie's tonic pupil: laterality
often unilateral
adie's tonic pupil: reaction to light
minimally reactive
adie's tonic pupil: accommodation
sluggishly reactive
adie's tonic pupil: pupillary size
adie's tonic pupil: reflexes
absent or diminished tendon reflexes
argyll robertson pupil: laterality
argyll robertson pupil: reaction to light
argyll robertson pupil: accommodation
argyll robertson pupil: pupillary size
argyll robertson pupil: reflexes
absent knee-jerk reflexes
horner's syndrome: laterality
horner's syndrome: reaction to light
horner's syndrome: accommodation
horner's syndrome: pupillary size
ddx of whitish lesions of the fundus: x4
cotton wool spots; fatty exudates; drusen; chorioretinitis
cause: cotton wool spots
hypertension; diabetic retinopathy; AIDS; lupus; dermatomyositis; papilledema
cause: fatty exudates (of fundus)
diabetes; retinal venous occlusion; hypertensive retinopathy
cause: drusen
normal with aging; age related macular degeneration
cause: chorioretinitis
toxoplasmosis; sarcoidosis; cytomegalovirus
border: cotton wool spots
border: fatty exudates (of fundus)
well defined
border: drusen
well defined; nonpigmented
border: chorioretinitis
large with ragged edge; heavily pigmented
shape: cotton wool spots
shape: fatty exudates (of fundus)
small irregular
shape: drusen
round, well circumscribed
shape: chorioretinitis
very variable
paterns: cotton wool spots
paterns: fatty exudates (of fundus)
often clustered in circles or stars
paterns: drusen
variable; symmetrical in both eyes
paterns: chorioretinitis
histopathology: cotton wool spots
ischemic infarct of the nerve fiber layer of retina; obscures retinal blood vessels
histopathology: fatty exudates (of fundus)
in deep retinal layer
histopathology: drusen
deep to retinal blood vessels (as opposed to fatty exudate)
histopathology: chorioretinitis
acute with white exudate; healed lesion with pigmented scar (toxoplasmosis)
glaucoma: Spanish
el glaucoma
glaucoma: French
le glaucome
glaucoma: Chinese
% of all glaucoma: primary open angle glaucoma
85% of all glaucoma
% of all glaucoma: narrow angle glaucoma
15% of glaucoma
cause: primary open angle glaucoma
cause: narrow angle glaucoma
closed angle prevents aqueous drainage
age at onset: primary open angle glaucoma
age at onset: narrow angle glaucoma
50-85 yrs
anterior chamber: primary open angle glaucoma
usually normal
anterior chamber: narrow angle glaucoma
chamber angle: primary open angle glaucoma
chamber angle: narrow angle glaucoma
sx: primary open angle glaucoma
usually none, decreased vision late
sx: narrow angle glaucoma
headache; halos around lights; sudden onset of severe eye pain; vomiting during attack
cupping of disc: primary open angle glaucoma
progressive if not treated
cupping of disc: narrow angle glaucoma
after untreated attack
visual fields: primary open angle glaucoma
peripheral fields involved early; central involvement very late
visual fields: narrow angle glaucoma
involvement is a late sign
ocular pressure: primary open angle glaucoma
progressively higher if not medically controlled
ocular pressure: narrow angle glaucoma
early: detected with provocative tests only
pupil, conjunctiva; and corea: narrow angle glaucoma
fixed partially dilated pupil; conjunctival injection; steamy cornea
tx: primary open angle glaucoma
medical; laser surgery
tx: narrow angle glaucoma
prognoosis: primary open angle glaucoma
good if recognized early; dependent on patient compliance
prognoosis: narrow angle glaucoma
blurred disc margins ddx: full ddx
papilledema; papillitis; drusen; myelinated nerve fibers; central retinal vein occlusion
blurred disc margins ddx: with normal visual acuity
papilledema; drusen; myelinated nerve fibers
blurred disc margins ddx: with decreased visual acuity
papillitis; central retinal vein occlusion
blurred disc margins ddx: with absent venous pulsations
papilledema; central retinal vein occlusion; papillitis (variable)
blurred disc margins ddx: with present venous pulsations
drusen; myelinated nerve fibers; papillitis (variable)
blurred disc margins ddx: with headache
blurred disc margins ddx: with eye movement pain
blurred disc margins ddx: with no pain
drusen; myelinated nerve fibers; central retinal vein occlusion
blurred disc margins ddx: with normal light reaction
papilledema; drusen; myelinated nerve fibers; central retinal vein occlusion
blurred disc margins ddx: marcuss gunn light reaction
blurred disc margins ddx: with hemorrhage
papilledema; papillitis; central retinal vein occlusion
blurred disc margins ddx: with no hemorrhage
drusen; myelinated nerve fibers
blurred disc margins ddx: with enlarged blind spot
papilledema; drusen
blurred disc margins ddx: with central scotoma
blurred disc margins ddx: with scotoma corresponding to areas of lesion
myelinated nerve fibers
blurred disc margins ddx: variable visual field sx
central retinal vein occlusion
blurred disc margins ddx: bilateral
papilledema; drusen;
blurred disc margins ddx: unilateral
papillitis; myelinated nerve fibers (usually); central retinal vein occlusion
diabetes: primary retinal findings
microaneurysms; neovascularization; retinitis proliferans
diabetes: distribution of retinal findings
posterior pole
diabetes: secondary retinal findings
hard exudates; deep hemorrhages; retinal venous occlusions; vitreous hemorrhages
diabetes: Spanish
la diabetes
diabetes: French
le diabète
diabetes: Chinese
hypertension: primary retinal findings
arteriolar narrowing; copper wiring; flame hemorrhages; arteriovenous nicking
hypertension: distribution of retinal findings
throughout retina
hypertension: secondary retinal findings
hard and soft exudates; retinal venous occlusions; macular stars
hypertension: Spanish
la hipertensión
hypertension: French
hypertension: Arabic
فَرْطُ ضَغْطِ الدَّم
hypertension: Chinese
papilledema: primary retinal findings
hyperemia of the disc; venous engorgement; retinal hemorrhages; disc elevation; loss of spntaneous venous pulsations; cotton wool spots
papilledema: distribution of retinal findings
on or near disc
papilledema: secondary retinal findings
hard exudates; optic atrophy (late)
retinal venous occlusion: primary retinal findings
hemorrhages; neovascularization
retinal venous occlusion: distribution of retinal findings
confined to area drained by affected vein
retinal venous occlusion: secondary retinal findings
retinal artery occlusion: primary retinal findings
pallor of retina; decreased width of artery; embolus possibly visible
retinal artery occlusion: distribution of retinal findings
confined to area supplied
retinal artery occlusion: secondary retinal findings
optic atrophy, late
anrteriolar sclerosis: primary retinal findings
widening of light reflex; copper wiring; arteriovenous nicking
anrteriolar sclerosis: distribution of retinal findings
throughout retina
anrteriolar sclerosis: secondary retinal findings
decrease in retinal pigment
blood dyscrasias: primary retinal findings
diffuse hemorrhages; venous dilation; roth's spots (hemorrhagic lesions with white centers)
sickle cell disease: primary retinal findings
sharp cutoff of arterioles; arteriovenous anastomoses; neovascularization in "sea fan: formations
sickle cell disease: distribution of retinal findings
peripheral retina
sickle cell disease: secondary retinal findings
vitreous hemorrhages; retinal detachments
macular lesion: whitish exudate that radiates around macula
macular degeneration
macular lesion: broken ring shaped whitish exudate around macula
macular star
macular lesion: etiologies
circinate retinopathy
macular star: etiologies
hypertension; papilledema; papillitis; central retinal vein occlusion
circinate retinopathy: etiologies
diabetes; central retinal vein occlusion
right superior oblique palsy: head tilt
down to the left
left superior oblique palsy: head tilt
down to the right
right inferior oblique palsy: head tilt
up to the left
left inferior oblique palsy: head tilt
up to the right

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