Approach to Eye Complaint

Question 1

What is a relevant ROS for eye complaints?

Answer 1

Endocrine: Hyperglycemia

Question 2

When inspecting the periorbital area, what finding would indicate Grave’s disease?

Answer 2

Proptosis/exophthalmos

Question 3

What are slightly raised, yellowish, well-circumscribed cholesterol-filled plaques that appear along the nasal portion of one or both eyelids?

Answer 3

Xanthelasma

Question 4

What condition is characterized by blocked meibomian gland and are generally non tender/non painful unless becomes inflamed in the eyelid?

Answer 4

Chalazion

Question 5

What condition is characterized by blocked meibomian gland or tear eyelash follicle, are tender/painful, and occur along the lash line recurrent?

Answer 5

Hordeolum

Question 6

What condition is characterized by inflammation at the base of the hair follicles, is often from S. aureus, and can be caused by allergies? (yellow crusty stuff on eyelashes, common in long term care facilities)

Answer 6

Blepharitis

Question 7

What condition is characterized by the white of eyes turning red due to ruptured blood vessels and it doesn’t affect vision, is non painful, and will go away?

Answer 7

Subconjunctival hemorrhage

Question 8

What condition is due to excessive sun exposure and tissue grows on to iris?

Answer 8

Pterygium

Question 9

What condition is due to viral, bacterial, allergic causes and the patients might complain of Gritty, irritated feeling, swollen eyelids?

Answer 9

Conjunctivitis

Question 10

The cornea should be clear; what is the cause if there is a brown tint?

Answer 10

Hyphema (blood from trauma in anterior chamber)

Question 11

If you can see brown speckles when checking the red reflex what does this indicate?

Answer 11

Cataracts

Question 12

If a newborn does not have a red reflex what is it important to look for?

Answer 12

Tumor

Question 13

If the sclera is blue instead of white, what does this indicate?

Answer 13

Brittle bone disease

Question 14

If the sclera is yellow instead of white, what does this indicate?

Answer 14

Icterus liver disease, pancreatic cancer, GB disease

Question 15

What test should be done if there was an imbalance of corneal light reflex?

Answer 15

Cover/Uncover test

Question 16

What are the steps for the cover/uncover test?

Answer 16

1. Stare straight ahead at near fixed point
2. Cover one eye and observe uncovered eye as it focuses on point
3. Remove cover and watch for movement of newly covered eye
4. Repeat on other side

Question 17

During a Cover/Uncover test, what is it called if the eye turns in?

Answer 17

Esotropia

Question 18

During a Cover/Uncover test, what is it called if the eye turns out?

Answer 18

Exotropia

Question 19

Esotropia and exotropia are forms of?

Answer 19

Strabismus (lazy eye)

Question 20

What do the numbers mean in a visual acuity test such as 20/30?

Answer 20

20: The distance of the patient from the chart
30: The distance at which a normal eye can read the line of letters

Question 21

What test is used when having the physician closes one eye and the patient covers the opposite eye while staring at your open eye; the physician’s wiggles their fingers 2 feet apart out of the patient’s view (lateral to patient’s ears) and slowly brings moving fingers forward into patient’s center of view; the patient is asked to tell the physician as soon as they see finger movement?

Answer 21

Static Finger wiggle test

Question 22

What test is used when facing the patient, move a 5mm red topped pin inward from beyond the boundary of each quadrant along a line bisecting the horizontal and vertical meridians. Ask the patient when the pin appears to be red?

Answer 22

Kinetic Red Target Test

Question 23

When using the ophthalmoscope, when do you NEVER dilate the pupils?

Answer 23

Patient has a shallow anterior chamber (dilation may trigger an acute narrow angle glaucoma)

Question 24

Which hand and eye do you use when performing an ophthalmoscopic exam for a patient’s right eye?
Left eye?

Answer 24

1) Your R hand/eye for patient’s R eye

2) Your L hand/eye for patient’s L eye

Question 25

When performing an ophthalmoscopic exam, what do you want to focus on?

Answer 25

Optic disc (yellowing, orange oval)

Question 26

What condition is characterized by increased intracranial pressure which causes intraazonal edema along the optic nerve, leading to swelling and engorgement of the optic disc?

Answer 26

Papilledema

Question 27

Cotton Wool Spots which result from extruded axoplasm from retinal ganglion cells caused by microinfarcts of the retinal nerve fiber layer are seen with what condition?

Answer 27

Diabetes

Question 28

Drusen bodies which are yellowish, round spots that consist of dead pigment epithelial cells are seen in?

Answer 28

Age-related macular degeneration

Question 29

While normal cup to disc ratio is 0.4, a ratio of 0.7 would suggest possible?

Answer 29

Glaucoma

Question 30

What is the term for the pupillary reflex when one pupil is exposed to a light source and the other eye constricts?

Answer 30

Consensual reflex