special senses: the eye
DESCRIPTION
16. Special Senses: The Eye. Learning Outcomes. State the description and primary functions of the eye. Analyze, build, spell, and pronounce medical words. Comprehend the drugs highlighted in this chapter. Describe diagnostic and laboratory tests related to the eye. - PowerPoint PPT PresentationTRANSCRIPT
Medical TerminologyMedical TerminologyA Word-Building Approach
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
CHAPTER
Seventh Edition
Special Senses:The Eye
16
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
Learning OutcomesLearning Outcomes
• State the description and primary functions of the eye.
• Analyze, build, spell, and pronounce medical words.
• Comprehend the drugs highlighted in this chapter.
• Describe diagnostic and laboratory tests related to the eye.
• Identify and define selected abbreviations.
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
Multimedia DirectoryMultimedia Directory
Slide 6 Virtual Tour of the Eye Animation
Slide 10 Structures of the Eye Animation
Slide 35 Retina Animation
Slide 36 Rods and Cones Animation
Slide 40 Optic Nerve and Optic Disk Animation 1
Slide 41 Optic Nerve and Optic Disk Animation 2
Slide 50 Cataracts Video
Slide 52 Conjunctivitis Video
Slide 65 Macular Degeneration Video
Copyright ©2012 by Pearson Education, Inc.All rights reserved.
Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
Anatomy and Physiology Anatomy and Physiology OverviewOverview
• Eye– Composed of special anatomical structures
that work together to facilitate sight: Cornea Pupil Lens Vitreous body
– Light stimulates sensory receptors (rods and cones) in the retina or innermost layer of the eye.
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Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
Anatomy and Physiology Anatomy and Physiology OverviewOverview
• Vision is made possible through the coordinated actions of nerves that control:– the movement of the eyeball– the amount of light admitted by the pupil– the focusing of that light on the retina by the
lens– the transmission of the resulting sensory
impulses to the brain by the optic nerve.
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Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
Virtual Tour of the Eye AnimationVirtual Tour of the Eye Animation
Click on the screenshot to view an animation of the tour of the eye.
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Insert table 16-1
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Insert table 16-1
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Figure 16.1Internal structure of the eye.
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Structures of the Eye AnimationStructures of the Eye Animation
Click on the screenshot to view an animation of the structures of the eye.The animation may take a moment to begin playing.
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External Structures of the EyeExternal Structures of the Eye
• Orbit– A cone-shaped cavity in the front of the skull
that contains the eyeball.– Formed by the combination of several bones
and is lined with fatty tissue that cushions the eyeball.
– This cavity has several foramina (openings) through which blood vessels and nerves pass. Largest opening is the optic foramen for the optic
nerve and ophthalmic artery.
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Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
External Structures of the EyeExternal Structures of the Eye
• Muscles of the Eye– Six eye muscles control the movement of the
eye.– Four are rectus muscles, and two are oblique
muscles. Rectus muscles allow a person to see up, down,
right, and left. Oblique muscles allow the eyes to turn to see
upper left and upper right, lower left and lower right.
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Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
External Structures of the EyeExternal Structures of the Eye
• Muscles of the Eye– Eye muscles help maintain the shape of the
eyeball.
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Figure 16.2(A) Lateral view, left eye.
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Figure 16.2 (continued)(B) Anterior view, left eye.
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External Structures of the EyeExternal Structures of the Eye
• Eyelids– Protect the eyeball from:
Intense light Foreign particles Impact
– Keep the eyeball’s surface lubricated and free from dust and debris.
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External Structures of the EyeExternal Structures of the Eye
• Eyelids– Canthus– Palpebral fissure– Eyelashes– Meibomian Glands
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External Structures of the EyeExternal Structures of the Eye
• Conjunctiva– A mucous membrane that lines the underside
of each eyelid and reflects onto the anterior portion of the eyeball.
– This membrane acts as a protective covering for the exposed surface of the eyeball.
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External Structures of the EyeExternal Structures of the Eye
• Lacrimal Apparatus– Those structures that produce, store, and
remove the tears that cleanse and lubricate the eye: Lacrimal gland Lacrimal canaliculi (ducts) Lacrimal sac Nasolacrimal duct
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Figure 16.3Lacrimal glands and lacrimal canaliculi (ducts).
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Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
External Structures of the EyeExternal Structures of the Eye
• Lacrimal Gland– Located above the outer corner of the eye.– Secretes tears through approximately 12
ducts onto the surface of the conjunctiva of the upper lid.
– This fluid washes across the anterior surface of the eye and is collected by the lacrimal canaliculi (ducts).
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Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
External Structures of the EyeExternal Structures of the Eye
• Lacrimal Canaliculi– Two ducts at the inner corner of the eye that
collect tears and drain into the lacrimal sac.
• Lacrimal Sac– The enlargement of the upper portion of the
lacrimal duct.– Tears secreted by the lacrimal glands are
pulled into this sac and forced into the nasolacrimal duct by the blinking action of the eyelids.
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External Structures of the EyeExternal Structures of the Eye
• Nasolacrimal duct– The passageway draining lacrimal fluid into
the nose.– The lacrimal sac is the enlarged upper portion
of this duct.
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Life Span ConsiderationsLife Span Considerations
• The eyes begin to develop as an outgrowth of the forebrain in the 4-week-old embryo and are complete at 24 weeks.
• At 28 weeks, eyebrows and eyelashes are present, and the eyelids open.
• The newborn can see, and visual acuity is estimated to be around 20/400.
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Life Span ConsiderationsLife Span Considerations
• Most newborns appear to have crossed eyes because their eye muscles are not fully developed.
• At first, the eyes appear to be blue or gray.• Permanent coloring becomes fixed between
6 and 12 months of age.• Tears do not appear until approximately 1
to 3 months because the lacrimal gland ducts are immature.
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Life Span ConsiderationsLife Span Considerations
• Depth perception begins to develop around 9 months of age.
• Visual acuity improves with age, and, by the age of 2 or 3 years, it is around 20/30 or 20/20.
• Children are farsighted until about 5 years of age.
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Internal Structures of the EyeInternal Structures of the Eye
• The eyeball, its various structures, and the nerve fibers connecting it to the brain make up the internal eye.
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Internal Structures of the EyeInternal Structures of the Eye
• Eyeball– The organ of vision, globe shaped and divided
into two cavities: The ocular cavity
– The space in front of the lens.– Further divided by the iris into anterior and posterior
chambers.• Anterior chamber is filled with a watery fluid known as the
aqueous humor.
A much larger cavity behind the lens is filled with a jellylike material, the vitreous humor, which maintains the eyeball’s spherical shape.
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Internal Structures of the EyeInternal Structures of the Eye
• Eyeball’s Outer Layer– Composed of:
Sclera, or white of the eye Cornea, or transparent anterior portion of the eye’s
fibrous outer surface.– The curved surface of the cornea is important because it
bends light rays and helps to focus them on the surface of the retina.
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Internal Structures of the EyeInternal Structures of the Eye
• Eyeball’s Middle Layer– Known as the uvea, it lies just below the
sclera and consists of the: Iris Ciliary body Choroid
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Internal Structures of the EyeInternal Structures of the Eye
• Middle Layer: Iris– A colored membrane attached to the ciliary
body and suspended between the lens and cornea in the aqueous humor.
– Has a circular opening in its center called the pupil.
– Has two muscles that contract or dilate to regulate the amount of light admitted by the pupil.
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Internal Structures of the EyeInternal Structures of the Eye
• Middle Layer: Ciliary body– A thickened portion of the vascular membrane
to which the iris is attached.– Smooth muscle forming a part of the ciliary
body governs the convexity of the lens.– Secretes aqueous humor that nourishes the
cornea, lens, and surrounding tissues.
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Internal Structures of the EyeInternal Structures of the Eye
• Middle Layer: Choroid– A pigmented vascular membrane that
prevents internal reflection of light.
• Inner Layer– The retina contains photoreceptive cells (rods
and cones) that translate light waves into nerve impulses.
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Figure 16.4Retina as seen through an ophthalmoscope.
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Retina AnimationRetina Animation
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Rods and Cones AnimationRods and Cones Animation
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Internal Structures of the EyeInternal Structures of the Eye
• Inner Layer– Most of the approximately 6 million cone cells
are grouped into a small area called the macula lutea.
– In the center of the macula lutea is a small depression, the fovea centralis, which is the central focusing point within the eye and contains only cone cells.
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Internal Structures of the EyeInternal Structures of the Eye
• Inner Layer– The eye contains approximately 120 million
rods that are sensitive to dim light.– The rods contain rhodopsin, a pigment
necessary for night vision.– Optic disk: the point at which nerve fibers
from the retina converge to form the optic nerve.
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Internal Structures of the EyeInternal Structures of the Eye
• Inner Layer– Blind spot: the absence of rods and cones in
the area of the optic disk creates a blind spot on the retina’s surface; the only part of the retina that is insensitive to light.
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Optic Nerve and Optic Disk Optic Nerve and Optic Disk Animation 1Animation 1
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Optic Nerve and Optic Disk Optic Nerve and Optic Disk Animation 2Animation 2
Click on the screenshot to view an animation on the optic nerve and optic disk.
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Internal Structures of the EyeInternal Structures of the Eye
• Lens– A colorless crystalline body biconvex in shape
and enclosed in a transparent capsule.– Suspended by ligaments just behind the iris.– Contraction and relaxation of the ciliary
muscle control the tension of the suspensory ligaments to change the shape of the lens.
– The function of the lens is to sharpen the focus of light on the retina.
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Internal Structures of the EyeInternal Structures of the Eye
• Lens– Accommodation keeps the image in the same
place on both retinae by combining changes in: The size of the pupil. The curvature of the lens. The convergence of the optic axes.
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How Sight OccursHow Sight Occurs
• Light rays strike the eye and pass through the cornea, pupil, aqueous humor, lens, and vitreous humor.
• Light rays then reach the retina and stimulate rods and cones.
• An upside-down image is relayed along nerve impulses to the optic nerve.
• The images are transferred to the brain, which turns the images right-side-up.
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Figure 16.5Light entering the eye.
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Figure 16.6Image inverted on the retina.
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• Accommodation
• Amblyopia
• Anisocoria
• Aphakia
• Astigmatism
a-
stigmat
-ism
Audio PronunciationsAudio Pronunciations
= lack of, without
= point
= condition
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• Bifocal
• Blepharitis
• Blepharoptosis
• Cataract
• Chalazion
• Choroiditis
blephar/o
-ptosis
Audio PronunciationsAudio Pronunciations
= eyelid
= prolapse, drooping
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Figure 16.7Cataract of the right eye.
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Cataracts VideoCataracts Video
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Audio PronunciationsAudio Pronunciations
• Conjunctivitis
• Corneal
• Corneal transplant
• Cryosurgery
• Cycloplegia
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Conjunctivitis VideoConjunctivitis Video
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Audio PronunciationsAudio Pronunciations
• Dacryoma
• Diplopia
• Electroretinogram
• Emmetropia
• Entropion
• Enucleation
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Figure 16.8Visual abnormalities. (A) In normal vision, the lens focuses the visual image on the retina. Common problems with the accommodation mechanism involve
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Figure 16.8Visual abnormalities. (B) myopia, the inability to lengthen the focal distance enough to focus the image of a distant object on the retina and
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Figure 16.8Visual abnormalities. (C) hyperopia, the inability to shorten the focal distance adequately for nearby objects. These conditions can be corrected by placing appropriately shaped lenses in front of the eyes.
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Figure 16.8Visual abnormalities. (D) Diverging lens is used to correct myopia and
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Figure 16.8Visual abnormalities. (E) converging lens is used to correct hyperopia.
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• Esotropia
• Exotropia
• Glaucoma
• Gonioscope
• Hemianopia
• Hyperopia
hyper-
-opia
Audio PronunciationsAudio Pronunciations
= beyond
= sight, vision
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Figure 16.9In glaucoma, the accumulation of aqueous humor in the anterior chamber of the eye causes pressure to build, resulting in eventual loss of vision. (A) and (B) show two forms of glaucoma
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Figure 16.9In glaucoma, the accumulation of aqueous humor in the anterior chamber of the eye causes pressure to build, resulting in eventual loss of vision. (A) and (B) show two forms of glaucoma
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Figure 16.9In glaucoma, (C ) shows the narrowing of the optic field that is a typical symptom of untreated glaucoma.
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Audio PronunciationsAudio Pronunciations
• Intraocular
• Iridectomy
• Iridocyclitis
• Keratitis
• Keratoconjunctivitis
• Keratoplasty
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Audio PronunciationsAudio Pronunciations
• Lacrimal
• Laser
• Macular degeneration
• Microlens
• Miotic
• Mydriatic
• Myopia
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Macular Degeneration VideoMacular Degeneration Video
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Life Span ConsiderationsLife Span Considerations
• Macular degeneration– An incurable, age-related, progressive eye
disease that affects more than 10 million Americans.
– Leading cause of blindness for those ages 55 and older.
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Life Span ConsiderationsLife Span Considerations
• Macular degeneration– For the first time, researchers have linked
gene defects to macular degeneration. Could lead to the ability to identify people at high
risk for the disorder and perhaps to ways to treat or prevent vision loss.
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Life Span ConsiderationsLife Span Considerations
• Stargardt’s disease– Also known as juvenile macular degeneration.– An inherited disease that usually manifests
itself between the ages of 7 and 12.– Believed to cause the eye’s central vision to
deteriorate because the rod cells just outside the macula erode, which eventually harms the retinal pigment epithelium (RPE).
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Life Span ConsiderationsLife Span Considerations
• Stargardt’s disease– As the RPE fails, the disease can spread to
the macula’s cone cells, causing the characteristic loss of central vision.
– Vision loss is usually slow until the 20/40 level and then rapidly progresses to the 20/200 level.
– Unfortunately, in some cases, vision can degenerate to 10/200 in a period of months.
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Life Span ConsiderationsLife Span Considerations
• Stargardt’s disease– Peripheral vision generally remains. – Presently, there is no cure or effective
treatment.
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Audio PronunciationsAudio Pronunciations
• Nyctalopia
• Nystagmus
• Ocular
• Ocular fundus
• Ophthalmologist
• Ophthalmology
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• Ophthalmoscope
• Optic
• Optician
• Optometrist
• Optomyometer
• Orthoptics
opt/o
my/o
-meter
Audio PronunciationsAudio Pronunciations
= eye
= muscle
= instrument to measure
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Figure 16.10Use of an ophthalmoscope to examine the interior of the eye.
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• Phacoemulsification
• Phacolysis
• Phacosclerosis
• Photocoagulation
• Photophobia
• Presbyopia
• Pupillary
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Figure 16.11Phacoemulsification is used to remove the cataract, then an artificial lens is implanted.
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Figure 16.11 (continued)Phacoemulsification is used to remove the cataract, then an artificial lens is implanted.
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Figure 16.11 (continued)Phacoemulsification is used to remove the cataract, then an artificial lens is implanted.
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Audio PronunciationsAudio Pronunciations
• Radial keratotomy
• Retinal detachment
• Retinitis
• Retinitis pigmentosa
• Retinoblastoma
• Retinopathy
• Retrolental fibroplasia
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Figure 16.12Retinal detachment.
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Figure 16.13Appearance of the ocular fundus in diabetic retinopathy. (Courtesy of the National Eye Institute, National Institutes of Health)
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Audio PronunciationsAudio Pronunciations
• Scleritis
• Strabismus
• Sty(e)
• Tonography
• Tonometer
• Trichiasis
• Trifocal
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Figure 16.14Schiötz tonometer for measuring intraocular pressure.
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Audio PronunciationsAudio Pronunciations
• Uveal
• Uveitis
• Xenophthalmia
• Xerophthalmia
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Drug HighlightsDrug Highlights
• Drugs used to treat glaucoma: Either increase the outflow of aqueous humor, decrease its production, or produce both of these actions.
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Drug HighlightsDrug Highlights
• Drugs used to treat glaucoma– Prostaglandin analogues– Adrenergic drugs– Alpha antagonist
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Drug HighlightsDrug Highlights
• Drugs used to treat glaucoma– Beta blockers– Carbonic anhydrase inhibitors– Cholinergic (miotic)
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Drug HighlightsDrug Highlights
• Drugs used to treat glaucoma– Cholinesterase– Combination of beta blocker and carbonic
anhydrase inhibitor
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Drug HighlightsDrug Highlights
• Mydriatics: Agents used to dilate the pupil.– Anticholinergics– Sympathomimetics
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Drug HighlightsDrug Highlights
• Antibiotics– Used to treat infectious diseases, especially
those caused by bacteria. Can be in the form of an ointment, cream, or solution.
– Antifungal Agents– Antiviral Agents
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Diagnostic and Lab TestsDiagnostic and Lab Tests
• Color vision tests– Use of polychromatic (multicolored) charts or
an anomaloscope (a device for detecting color blindness) to assess an individual’s ability to recognize differences in color.
• Exophthalmometry– Process of measuring the forward protrusion
of the eye via an exophthalmometer.
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Figure 16.15Color vision chart. A person who is color blind will not see the number 27 in the circle.
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Diagnostic and Lab TestsDiagnostic and Lab Tests
• Gonioscopy– Examination of the anterior chamber of the
eye via a gonioscope.
• Keratometry– Process of measuring the cornea via a
keratometer.
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Diagnostic and Lab TestsDiagnostic and Lab Tests
• Ocular ultrasonography– Use of high-frequency sound waves (via a
small probe placed on the eye) to measure for intraocular lenses and to detect orbital and periorbital lesions.
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Diagnostic and Lab TestsDiagnostic and Lab Tests
• Ophthalmoscopy– Examination of the interior of the eyes via an
ophthalmoscope.
• Tonometry– Measurement of the intraocular pressure of
the eye via a tonometer.
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Diagnostic and Lab TestsDiagnostic and Lab Tests
• Visual acuity– Acuteness or sharpness of vision.– A Snellen eye chart can be used to test it; the
patient reads letters of various sizes from a distance of 20 feet. Normal vision is 20/20.
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Figure 16.16Test of distance vision using the Snellen eye chart.
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Abbreviations
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Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice
Combining Form Match Up QuizCombining Form Match Up Quiz
1. ambly/o a. angle
2. anis/o b. unequal
3. goni/o c. straight
4. orth/o d. old
5. presby/o e. dull