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Review of Ocular Diseases

In this post I wanted to give a summary of disease that will help you study for the COA (Certified Ophthalmic Assistant) Exam. 

Orbit

Exophthalmos – a forward protrusion of the eyes. Occurs in graves disease. Blowout fracture– break in the bony orbital floor walls

Extraocular Muscles

Strabismus – when eyes are out of alignment. When the foveas of the two eyes are not focused at the same object double vision occurs. Strabismus is broken down into what kind of deviation it is (exo or eso) and if it is continually present or only present when one of the eyes is covered. Exo deviation – outward deviation of the eyes Eso deviation – inward deviation of the eyes Hyper deviation – upward deviations of the eyes Hypo deviation – downward deviations of the eyes tropia- this is a continual manifestation of a deviation phoria- this is when the deviation is only present when one eye is covered. Thus there are eight types of strabismus that you need to know as summarized below.

  1. Exotropia
  2. Exophoria
  3. Esotropia
  4. Esophoria
  5. Hypertropia
  6. Hyperphoria
  7. Hypotropia
  8. Hypophoria

Congenital strabismus must be corrected at an early age. If not corrected it can result in stereopsis. Stereopsis is a loss in three dimensional perception. Nystagmus is a condition in which the eyes shake back and forth.

Eyelids

A chalazion is a non-infectious granulomatous inflammation of a meibomian gland. A stye or hordeolum is like a pimple usually at the base of an eyelash. Blepharitis: Recall that “itis” means inflammation and “Bleph” is eyelid. Blepharitis is an inflammation of the eyelid. Ptosis: a drooping of the upper eyelid. Ectropion: is a turning of the lid margin outward and away from the eyelid Entropion:  is a turning of the lid margin inward and toward the eyelid. This causes trichiasis which is when the eyelashes rub against the eyeball.

Lacrimal Apparatus

Keratoconjunctivitis sicca – dry eye syndrome Lid lacerations – The important thing to remember about lid lacerations is that those which cut through the lacrimal duct are the most difficult to repair.

Abnormalities of the eye

Three kinds of conjunctiva (pink eye)

  1. Viral – this is the most common type of conjunctivitis. Red,Watery,Starts in one eye then spreads to the other.
  2. Bacterial – Mucous discharge
  3. Allergic – red and puffy. Sometimes called an “allergic shiner” because it looks like you got punched in the eye. Usually itchy.

Subconjunctival hemorrhage – This is usually harmless, but it appears bright red and alarms patients. Pinguecula- is a small mass on the conjunctiva. May cause minor eye irritation. Pterygium- is a growth on the conjunctiva which may grow onto the cornea and may cause irritation.

Cornea and Sclera

Keratitis- “kera” cornea “itis”. This is an inflammation of the cornea. Abrasions and lacerations- Abrasions and lacerations are lesions(breaks in tissue). An abrasion is a scratch, like a really bad rug burn. A laceration is a tear. Corneal Ulcer – An infected lesion. Herpes simplex virus – a dendritic figure that shows under fluorescence is one of the hallmarks of this infection. Arcus senilis – an opaque ring which forms around the eye after age 50. Scleritis – an inflammation of the sclera.

Anterior Chamber

Hypopyon – puss in the anterior chamber Hyphema – pooled blood in the anterior chamber

Uveal Tract

Iritis – The inflammation of the iris.

Crystalline Lens

Presbyopia – Loss of accommodation Cataract – opacification of the lens Aphakia – Absence of a lens Pseudophakic – intraocular lens implant

Vitreous

Floaters– vitreous collagen fibers

Retina

Retinal Detachment – a separation of the sensory layers of the retina from the underlying pigment layer Diabetic retinopathy – Leaky blood vessels due to high blood sugar. May cause new blood vessel growth in which case it would be called proliferative diabetic retinopathy. Age related macular degeneration (AMD) – This is the degeneration of the macula. There are two types. Dry and wet. Wet AMD is the more dangerous of the two. Wet AMD is a sign of neovascularization. Vascular occlusion– blockage of a blood vessel resulting in hypoxia.

Optic Nerve

Optic neuritis – inflammation of the optic nerve. Glaucoma – death of the optic nerve related to high eye pressure.

 

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