Eyes

Temoporary monocular vision loss from decreased blood supply to retina (arteritis, mural thrombus r/t cardiac arrhythmia)

Macular degeneration

Glaucoma

retinal or vitreous detachment. One or two may be nml

R/t acute narrow angle glaucoma or digoxin toxicity

Blind spots. Glaucoma, visual pathway disorders (e.g. ocular migraines)

R/t optic atrophy (age related), laucoma, vitamin A deficiency

Double vision

light sensitivity

Crossed eyes. In childhood. Weak muscles

• 1. infection
• 2. allergies
• 3. dryness
• 4. mechanical (foreign body)

Excessive tearing. May be due to irritants (allergies), infection or obstruction of lacrimal ducts

bacterial infection

• leading cause of blindness
• may have eye changes within 10 years of dx

Near sighted. Distance vision is impaired r/t inappropriate refraction of light rays on the retina

Far sighted. Near vision is imparied d/t inappropriate refraction of light rays on the retina

right eye

Left eye

Both eyes

20/2000 after correction

20/40 or better using both eyes

Decreased power of accomodation with aging. Decreased ability of the lens to change shape to acocmodate for near vision (requires bifocals). Usually occurs 42-46 y.o.

• Far and near vision
• Peripheral vision (Confrontation test)

Face patient at 2 feet. Assess when patient can see at periphery.

• Superior Rectus
• Inferior Rectus
• Lateral Rectus
• Medial Rectus

• Superior Oblique
• Inferior Oblique

CN 3, 4, 6

Lateral Rectus and CN 6

Superiod Rectus and CN 3

Inferior Rectus and CN 3

Medial Rectus and CN 3

Inferior Oblique and CN 3

Superior Oblique and CN 4

• Involuntary movement of eyeballs. 1-2 beats of nystagmus nml in extreme lateral gaze
• Abn in all other positions of gaze

Tests parallel alignment of eyes. Direct light source towards nasal bridge and note the position of the light reflection on each cornea

Deviation of and eye

Inward turn of eye

Outward turn of eye

Detects eye muscle weakness. Patient focuses on fixed object while covering one eye. A weak eye will drift into a relaxed position once the eye is covered. If the eye moves to reestablish fixation, then eye muscle weakness is present.

Eye drift inward torwards nose

Eye drift outward towards temporal

Loss of outer 1/3

Irresistable urge to pull out hair

• Lubricates lids
• Prevents evaporation of tears
• Provides an air tight seal when eyes are clsed

Papule with ulcerated center

Sty. Localized staph infection of hair follicle at lid margin

Infection or retention cyst of a meibomian gland (swelling with nontender firm, discrete nodule on lid)

Inflammation of eyelids secondary t staph infection or sebrrheic dematitis. Red, scaley, crusted lid margin. Treat with baby shampoo

Inward curve of lid and lashes. Occurs with weak muscles and nml aging

• Most prominent on medial side. Caused increased tearing, loss of tears and dry eyes.
• Occurs with muscle loss and nml againg
• Cna cause conuunctivitis d/t exposure of palpebral conjunctiva

Drooping of upper lid – may involve CN 3, 5, 7

The first symptom in 75% of myestenia gravis cases

Corner of eye. Angle where lids meet

Small fleshy mass of inner canthus containing sebaceous glands

Infection and blockage of lacrimal sac and duct

Sunken eyeball= Dehydration

Buldging eyeball= hyperthyroidism

Tough fibrous, white, outer covering under transparent bulbar conjunctiva

Protective thim mucous membrane covering the sclera

Red sclera secondary to increased IOP (coughing, sneezing) should resolve in a few weeks.

Yellowish nodles on bulbar conjuctiva at 3 and 9 o'clock. Due to thickening secondary to sun, wind and dust exposure.

Overgrowth of conjunctival tissue. Starts at inner canthus and progresses torwards cornea. May affect vision if extend to pupil

Border of sclera and iris. Bulbar conjuctiva merges with the cornea

Grayish around cornea at limbus. May be nml in patient >60yo or indicate lipid abn in younger people

Inflammation of cornea

The spherical curve of the cornea is asymmetric around the eye, thus light rays are spread over a diffuse area rather than on a focal point on the retina.

Unequal pupils. Occurs nml in 5% of the population

Coulding of lens

13-22mmHg

IOP>22mmHg. Affects peripheral vision

impaired drainage of aqueous humor causing increased IOP

the angle that drains the aqueous humor is nml but doesn't fxn nml

loss of vision or blindness d/t disuse

Lipid deposits at inner canthus

Lids may droop and cover secondary to loss of elasticity, fat and muscle atrophy, thus loose skin

Collection of broken down lipds forming a gray-white circle around the limbus