Optic Disc

Cup:disc ratio

1:3

physiologic cup

A small whitish depression in the optic disc, entry point for retinal vessels

Eye examination

A. Visual Acuity B. Gross inspection C. Color vision D. EOMs E. Position & Alignment F. Visual Fields G. Funduscopic exam what are these components of?

more visible

Are disc vessels more or less visible with papilledema?

open angled

Chronic glaucoma or _______ is when the canal is blocked by microdeposits; most common

x chromosome

Defective color vision is hereditary, a recessive gene carried on ______

optic atrophy

Disc appears white, vessels are absent

pale

In Glaucomatous Cupping, the base of the enlarged cup is _____

diabetes

In ____ may see dilated veins, exudates, hemorrhages, neovascularization (fine networks of new blood vessels)

chronic hypertension; acute severe hypertension

In ____ may see: A-V nicking, "copper wiring", "silver wiring"; In _____ may see arteriolar narrowing, hemorrhages, exudates, even papilledema

Lacrimal apparatus

Inspect & palpate region of lacrimal gland and lower orbital rim for nodules, discharge. Look for ↑ tearing or lack of drainage

glaucoma

May see ↑ cup size in _____

same

Most important is that the cup be the ____ in both eyes.

increased intraocular pressure -- glaucoma

Result of blocking the canal of schlemm

refractive; non-refractive problem

Testing vision using both snellen and rosenbaum may be helpful in determining whether decreased vision is a ____ or _____ problem

color of disc

You observe these where? pink-white - normal White - can see with optic atrophy Angry looking with dilated, tortuous vessels -- papilledema

rings and crescents

___ and ___ are often seen around the optic disc; not part of the disc

Grayish

___ spots are often seen at the base of the cup

Arcus senilis

a narrow opaque band encircling the cornea, common in old age

presbyopia

aging vision or difficulty to see close

Strabismus

an abnormal turning of either eye inward (crossed eyes; esotropia) or outward (wall-eyes; exotropia).

optic disc

appears yellowish/orange to creamy pink with tiny vessels

Non-paralytic Strabismus

caused by imbalance in muscle tone, seen more commonly in kids, constant in all fields of gaze. "Cover-uncover" test may be helpful.

paralytic strabismus

caused by paralysis of 1 or more extraocular muscles, defect will be more or less severe depending on direction of gaze

bulbar conjunctiva

clear mucous membrane that covers most of the anterior eyeball

presbyopia

commonly arises & progresses from age 40-60; also manifests as "farsightedness"; accommodation (thickening of lens) is needed for near vision; with age the lens becomes stiffer and doesn't thicken as readily

optic atrophy

death of optic nerve fibers leads to loss of the tiny disc vessels

myopia

develops as eye grows, often seen in children/young adults; may need glasses to see distant

Ptosis

drooping of eyelids (defect in CN3)

Ishihara

example of a color chart

cataracts

example of a non-refractive problem

hyperopia

farsightedness- difficulty to see close

cataracts or macular degeneration

gradual onset of bilateral visual loss

pink; hyperemic; margins blurred; visible

in papilledema, optic disc is ___ or _____ the disc is swollen with ______; physiologic cup is not _____

Glaucomatous Cupping

increased pressure within the eye, leading to increase cupping or backward depression of the disc and atrophy

medullated nerve fibers

irregular white patches with featured margins, obscure the disc edge and retinal vessels; uncommon; no pathological significance

fovea

lateral and slightly inferior to the disc; darkened circular area

myopia

nearsightedness- difficulty to see far

aqueous humor

produced by ciliary body → posterior chamber → anterior chamber→ canal of Schlemm- this describes the flow of what?

acute (narrow) (open angled)

rare eye disease; canal is blocked by the iris which is position at and abnormal angle

blepharitis

reddish and scaling in eyelids

developmental; sclera

rings and crescents are ___ variations that appear as either white ___ or black retinal pigment, or both. (usually temporal side of the disc)

optic atrophy

seen in optic neuritis, MS, and temporal arteritis

fundus

structures on this included the retina, choroid, fovea, macula, optic disc, and retinal vessels

macula

surrounds the fovea; no discernible margins

papilledema

swelling of the optic disc; elevated intracranial pressure causes intraaxonal edema along the optic disc

Snellen Test

tests distance vision; testing is done at 20 ft.

Rosenbaum

tests near vision; at 14 in. is "equivalent" to Snellen

larger

the _____ the second number in vision scores, the worse the vision

less than half

the cup is normally ____ of the disc

open angled and narrow

two types of glaucoma

patient could read the 40 line with glasses

what does 20/40 corrected mean?

at 20 ft a pt can read print that a person with normal vision could see at 200 ft

what does vision at 20/200 mean?

vision in the better eye is 20/200 (corrected) or less

when is a person considered legally blind?

temporal hemianopsia

when the patient repeatedly doesn't see your fingers until they have crossed the line of gaze

centrally or toward temporal side of the disc

where is the cup located on the optic disc?

optic disc

where is the physiologic cup?