Head, Eyes, Ears, Nose

1
Head, Eyes, Ears, Nose Throat Diagnosis

• Class Notes

2
Head, Eyes, Ears, Nose Throat Diagnosis

• Eye Chapter 10

3
Eye

• Review of Anatomy
• External Eye
• Eyelid
• Conjunctiva
• Lacrimal Gland
• Extra-Ocular Muscles
• Clinical Pearl

4
Eye

• Review of Anatomy
• Internal Eye
• Sclera
• Cornea
• Iris
• Lens
• Retina

5
Eye

• Case History
• The case history will determine if examination of
  the eyes is clinically indicated.

6
Eye

• Case History
• Possible complaints necessitating examination
• Possible items in the patients PMH which could
  necessitate examination

7
Eye

• Examination
• Equipment Needed
• Snellen Eye Chart
• Penlight
• Cotton Wisp
• Ophthalmoscope
• Eye Cover

8
Eye

• Examination
• Vision Snellen Eye Chart
• Tests fcn of CN II
• Measured at a 20 distance
• Each eye tested individually
• Process
• Recording

9
Eye

• Examination
• Vision Peripheral Fields via Confrontation
• Fields
• Each eye is tested individually
• Process
• Expected Results

10
Eye

• Examination
• Six Cardinal Fields of Gaze EOMI Extra Ocular
  Muscles Intact
• Tests fcn of CN III, IV, VI
• Both eyes are tested simultaneously
• Fields
• Process

11
Eye

• Examination
• Corneal Light Reflex EOMI
• Tests balance of the extra-ocular muscles (CN
  III, IV, VI)
• Process
• Expected Results

12
Eye

• Examination
• Cover-Uncover Test EOMI
• Tests balance of the extra-ocular muscles (CN
  III, IV, VI)
• Process
• Interpreting Results
• Orthophoria
• Heterophoria
• Heterotropia
• Esotropia cross-eye
• Exotropia - Walleye

13
Eye

• Examination
• Pupillary Light Reflex PERRLA Pupils Equally
  Round Reactive to Light w/ Accommodation
• Light Reflex Process
• Accommodation
• Clinical Pearl

14
Eye

• Examination
• Inspection
• Eyebrows
• Extension
• Texture
• Orbit
• Edema puffiness
• Xanthelasma
• Eyelids
• Closure
• Ptosis
• Inversion/Eversion
• Stye
• Palpation

15
Eye

• Examination
• Inspection
• Conjunctiva
• Normal clear free of erythema
• Erythmatous
• Subconjunctival Hemorrhage
• Pterygium
• Cornea
• Normal clear of any vessels
• Sensory Testing
• Arcus Senilis

16
Eye

• Examination
• Inspection
• Iris Pupil
• Meiosis
• Mydriasis
• Anisocoria
• Argyle Robertson Pupil
• Adie Pupil
• Lens
• Sclera
• Senile Hyaline Plaque

17
Eye

• Examination
• Fundoscopic
• Need adequate pupillary dilation in order to
  visualize the retina.
• Process
• Structures
• Vessels
• 4 Branches
• Arterioles Venules
• Optic Disc
• Macula (Fovea Centralis)

18
Eye

• Clinical Conditions
• Palpebral Conditions
• Hordeolum
• Chalazion
• Entropion
• Ectropion

19
Eye

• Clinical Conditions
• Conjunctival Disorders
• Conjunctivitis
• Allergic
• Bacterial
• Viral
• STD

20
Eye

• Clinical Conditions
• Palpebral Conditions
• Blepharitis
• General S/S
• Staphyloccal
• Seborrheic

21
Eye

• Clinical Conditions
• Palpebral Conditions
• Dacryocysitis
• AKA The Watering Eye
• Pathogenesis
• Epiphora d/t inadequate drainage or over
  secretion

22
Eye

• Clinical Conditions
• Pupil Disorders
• Normal Pupil
• CN III Palsy
• Horners Syndrome
• Light-Near Dissociation
• Afferent Pupil Defect
• http//www.mrcophth.com/pupils/rapd.html

23
Eye

• Clinical Conditions
• Pupil Disorders
• Mydriasis
• Miosis
• Argyll Robertson Pupil
• Adie Pupil
• Anisocoria

24
Eye

• Clinical Conditions
• Corneal
• Ulcer
• Keratitis
• Uveitis
• Anterior Iritis
• Posterior

25
Eye

• Clinical Conditions
• Lens Disorders
• Cataract
• Subcapsular
• Nuclear
• Cortical
• Mature

26
Eye

• Clinical Conditions
• Corneal Lens Disorders
• Glaucoma
• Common Features
• Types
• Primary vs Secondary
• Open vs Closed
• Congenital vs Acquired

27
Eye

• Clinical Conditions
• Retinal Disorders
• Hypertensive Retinopathy
• Clinical Features
• Arteriole Narrowing
• AV Nicking
• Arteriole Light Reflex Changes
• Flame Hemorrhages
• Cotton Wool Spots Exudates
• Disc Swelling Aneurysms

28
Eye

• Clinical Conditions
• Retinal Disorders
• Diabetic Retinopathy
• Background
• Clinical Features
• Classification
• Background/Non-Proliferative
• Pre-Proliferative
• Proliferative

29
Eye

• Clinical Conditions
• Retinal Disorders
• Papilledema
• Pathogenesis
• Clinical Features
• Optic Nerve Dysfunction
• Underlying Disease
• Associated Findings

30
Eye

• Clinical Conditions
• Retinal Disorders
• Macular Degeneration
• Background
• Classification
• Dry
• Wet

31
Eye

• Clinical Conditions
• Retinal Disorders
• Vitreous Detachment
• Background
• Pathophysiology
• Aging process
• PVD
• Symptoms

32
Eye

• Clinical Conditions
• Retinal Disorders
• Retinal Detachment
• Background 2 layers
• Neurosensory Retina
• Retinal Pigment Epithelium

33
Eye

• Clinical Conditions
• Retinal Disorders
• Retinal Detachment
• Pathophysiology
• Retinal Detachment Def
• Rhegmatogenous
• Non-Regmatogenous

34
Eye

• Clinical Conditions
• Retinal Disorders
• Retinal Detachment
• Rhegmatogenous
• Clinical Features
• Examination Findings

35
Eye

• Clinical Conditions
• Retinal Disorders
• Retinal Detachment
• Non- Rhegmatogenous
• 2 Types Tractional Exudative
• Clinical Features