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Methods > B10 > Flashcards

B10 Flashcards

1
Q

What kind of image does a BIO give you?

A

Real, inverted, and lateral reversed image formed in front of the lens

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2
Q

Why is BIO considered indirect?

A

Because the fundus is seen through a condensing lens

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3
Q

The image for BIO is formed close to the ____ between the lens and the observer

A

Principle focus of the lens

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4
Q

Higher power lenses offer ____FOV and can aid with examination through ___ pupils

A

Greater FOV and aid through small pupils

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5
Q

This lens is a good balance between magnification and FOV

A

20D lens

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6
Q

What 3 things does the power of the condensing lens determine?

A
  • working distance
  • magnification
  • FOV
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7
Q

As the power of the condensing lens decreases, the FOV ___ but the working distance and magnification ____

A

FOV decreases, working distance and mag increases

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8
Q 
For a 30 power lens 
What is the mag?
What is the FOV?
What is the stereo?
What is the working distance from the cornea?
A

Mag: 2x
FOV: 60 degrees
Stereo: 1/2
Working distance: 26mm

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9
Q 
For a 20 power lens 
What is the mag?
What is the FOV?
What is the stereo?
What is the working distance from the cornea?
A

Mag: 3.25x
FOV: 40 degrees
Stereo: 3/4
Working distance: 47mm

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10
Q 
For a 14/15 power lens 
What is the mag?
What is the FOV?
What is the stereo?
What is the working distance from the cornea?
A

Mag: 4.17x
FOV: 30 degrees
Stereo: 1
Working distance: 72mm

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11
Q

Lens used to obtain a panoramic view when detail and stereopsis are not as important, and used with small pupil

A

30D lens

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12
Q

Which lens has the shortest working distance?

A

+30 lens

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13
Q

most widely lens used, since it provides an adequate field of view, stereopsis and magnification

A

20D lens

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14
Q

lens is most useful for detailed view of the macula or optic disc or for determining elevation of the retina in shallow retinal detachment

A

15D lens

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15
Q

What kind of lighting do you use for BIO?

A

Dim lighting; enough to achieve sufficient contrast

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16
Q

T/F: begin with the brightest light when doing BIO

A

False. Start lower and gradually turn it up to double check the selected area

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17
Q

T/F: have a sequential system for BIO

A

True, look in one quadrant and proceed to the next

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18
Q

What are the 7 advantages of BIO?

A
  • Image is not affected by the patient’s refractive power
  • Great for eyes with nystagmus
  • Great for use in children
  • Portable
  • BIO allows for examination into the far periphery
  • Large field of view
  • Stereopsis
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19
Q

Disadvantages of BIO

A

-Difficult to learn
-Less magnification, therefore details of a small lesion not visualized
properly
-Impossible with very small pupils
-More uncomfortable for some patients

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20
Q

What are the advantages of having a systemic approach?

A

-Minimizing the risk of overlooking any area of the ocular fundus
-Aiding in the recall of the location of findings that are
recorded at the conclusion of the examination

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21
Q

The recommended approach is to complete the

examination of the ___ eye before beginning the ___eye

A

OD before OS

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22
Q

T/F: The peripheral fundus is usually examined before the posterior pole to allow the patient some time to light adapt

A

True

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23
Q

How many meridians are there when examining the fundus?

A

8

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24
Q

How do you need to stand when examining the periphery?

A

180 degrees away from the meridian that you wish to examine

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25
Q

The fundus image viewed through the condensing lens is

A

Inverted and reversed

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26
Q

Whatever appears closest to the observer in the lens is actually more ___ in the fundus

A

Anterior

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27
Q

T/F: if there is something located at the observers right within the lens it is actually located to the left on fundus

A

True

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28
Q

What are two way to indicate the location of the retinal lesion?

A

–Estimate the meridian in clock hours
–Estimate the distance from the posterior pole or fundus landmarks such as the equator and the ora
serrata in disc diameters

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29
Q

What does the color red mean for a retinal drawing of a fundus exam finding?

A
  • Retinal arterioles
  • retinal hemorrhage
  • microaneurysm
  • attached retina hole/break
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30
Q

What does the color blue mean for a retinal drawing of a fundus exam finding?

A
  • retinal venules
  • detached retina
  • outline of a break
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31
Q

What does the color yellow mean for a retinal drawing of a fundus exam finding?

A
  • exudate

- edema

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32
Q

What does the color green mean for a retinal drawing of a fundus exam finding?

A
  • vitreous opacity

- vitreous bleed

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33
Q

What does the color brown mean for a retinal drawing of a fundus exam finding?

A
  • pigmentation

- detached choroid

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34
Q

What does the color black mean for a retinal drawing of a fundus exam finding?

A
  • ora serrata

- drusen

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35
Q

What is the disadvantage of the OCT?

A

Limited scanned area

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36
Q

What instruments can we use to look at the fundus?

A
  • DO
  • fundus bio
  • BIO
  • panoptic
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37
Q

Which ophthalmoscope gives you a direct orientation of the image?

A

Direct

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38
Q

Which ophthalmoscope give you an inverted, reversed orientation of the image?

A

Indirect (+20 lens)

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39
Q

Does the DO give you a limited or full view of the periphery

A

Limited

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40
Q

Does the indirect give you a limited or full view of periphery

A

Full

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41
Q

The depth of focus for an indirect is large or small?

A

Large

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42
Q

The depth of focus for a direct opht is small or large?

A

Small

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43
Q

What ophthalmoscope has the highest magnification?

A

Direct oph.

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44
Q

The DO give you a ___degree view

A

5

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45
Q

The BIO give you a ___degree view

A

45-60

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46
Q

What 3 conditions can you not see in the eye?

A
  • dense cataract
  • vitreous hemorrhage
  • asteroid hyalosis
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47
Q

What does a laser do to the tissue?

A

It burns it

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48
Q

If there is dark blood and it looks like it is forward what would this be?

A

A pre-retinal hemorrhage

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49
Q

Will people with asteroid hyalosis have floaters?

A

Probably not

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50
Q

Is a asteroid hyalosis usually unilateral or bilateral?

A

Unilateral

51
Q

Is an asteroid hyalosis a serious condition?

A

No

52
Q

A disease where if they cant see out we cant see in

A

Vitreous hemorrhage

53
Q

How do you treat a lattice-rt?

A

Laser that shit

54
Q

What is the mnemonic for structures in gonio?

A 
I- iris 
Cant-ciliary body
See-sclera spur 
This- trabecular meshwork
Stuff- schwalbes line
55
Q

What angle is the deepest and the most pigmented when doing gonio?

A

Inferior angle

56
Q

Why is the anatomy usually most clearly defined in the inferior angle?

A

Because the increasedpigmentation highlights the posterior(pigmented) TM

57
Q

What angle should you always start with when going gonio?

What is the mirror view?

A

Inferior angle

Mirror view: 12 o’clock

58
Q

When will you use the over the hill technique?

A

When the iris is bowed forward making the iridocorneal angle challenging

59
Q

What do you want the patient to do when the persons iris is bowed?

A

Have the patient look into the examining mirror or tip the lens towards the angle being examined to look “over the hill” and into the angle.

60
Q

T/F: if one can readily see over the hill and into the angle without indenting, the angle is not occludable

A

True

61
Q

If you are having trouble looking at the angles what are 2 things you can do?

A
  • look at the other eye

- do van herrick

62
Q

If corneal edema precludes viewing the angle in one eye what do you do?

A

Look in the other eye

63
Q

Are the eyes pretty symmetrical?

A

Why yeah

64
Q

What procedure do you do for a angle closure?

A

Yag PI

65
Q

T/F: YOU DO PERFORM A YAG PI TO PREVENT ANGLE CLOSURE IN ONE EYE – YOU DONT HAVE TO DO THE OTHER.

A

FALSE. Do the other eye too

66
Q

How should the slit beam be when performing the Van Herrick test

A

Beams is made very bright and thin

67
Q

The van herrick beam is offset ___ temporally to the slit lamp oculars

A

60 degrees

68
Q

If the anterior chamber depth is as deep as the

cornea is thick then the angle is presumed to be _____

A

Wide open

69
Q

The thickness of the cornea is compared to the ____ for van herrick

A

Depth of the peripheral anterior chamber

70
Q

If there is only a slit of aqueous then the angle is

estimated to _____

A

Dangerously narrow

71
Q

What is the angle grade if the chamber depth in corneal thickness is greater than or equal to the cornea?

A

4

72
Q

What is the angle grade if the chamber depth in corneal thickness is 1/4 to 1/2 to the cornea?

A

3

73
Q

What is the angle grade if the chamber depth in corneal thickness 1/4 the cornea?

A

2

74
Q

What is the angle grade if the chamber depth in corneal thickness is <1/4 the cornea?

A

1

75
Q

Describe normal vessels (4 characteristics)

A
  • radial orientation
  • thick
  • non-branching
  • do NOT cross the scleral spur
76
Q

Describe neovascularization (3 characteristics)

A
  • fine
  • arborising (branch out like a tree)
  • crosses scleral spur
77
Q

Why might the angle be difficult to interpret (pigment)?

A

Because there is too much or too little angle pigmentation

78
Q

If you have too much or too little angle pigmentation what might help with viewing and diagnosing?

A

Manipulations

79
Q

A manipulation technique where a thin slit of light hits the irido-corneal angle at an angle of 10-15 degrees

A

Corneal wedge

80
Q

A corneal wedge marks the ____ border of the TM

A

Anterior

81
Q

Two light reflections when doing a corneal wedge are seen from the ____ corneal surfaces which pipe down at the sclera-corneal junction

A

External and internal corneal surfaces

82
Q

The corneal wedge technique uses a slit lamp to create two visible lines that come together at the ___

A

Schwalbes line

83
Q

A corneal wedge line makes it easy to identify if a patient has___

A

No trabecular pigmentation

84
Q

The corneal wedge is useful to identify the TM in what 3 situations?

A
  • In non-pigmented or excessively pigmented eyes it is sometimes difficult to mark where TM begins
  • In young patients where the TM has not yet developed any pigmentation
  • To differentiate wide-open angles and non-pigmented angle and a totally closed angle where you are looking at the internal cornea.
85
Q

This technique is very useful in patients where the iris covers the TM.

A

Indentation gonioscopy

86
Q

Name 3 situations where is easy to mistake when the iris covers the TM

A
  • the non-pigmented TM for scleral spur
  • pigmented schwalbes line for TM
  • apposition of synechiae
87
Q

When the iris swells during iritis and will stick to the lens or anterior chamber

A

Synechiae

88
Q

Who will you do indentation gonio on?

A

On every glaucoma patient

89
Q

Indentation gonio is useful when the iris surface is ____

A

Convex

90
Q

4 reasons indentation gonioscopy is used

A
  • differentiate appositional vs. synechial closure in pupillary block
  • Measures extent of angle closure
  • Identifies plateau iris configuration
  • Identifies lens induced angle closure
91
Q

Large or anteriorly positioned ciliary processes that push the peripheral iris forward

A

Plateau iris configuration

92
Q

If someone has a a flat iris what test can you use?

A

Indentation gonio

93
Q

If the scleral spur is visible this is _____

A

Open angle

94
Q

If the scleral spur is not visible and there is synechiae what is this?

A

Primary angle closure (synechiae)

95
Q

If the scleral spur is not visible, there isnt synechiae, and IOP is raised what is this?

A

Primary angle closure (apposition)

96
Q

If the scleral spur is not visible, there isnt synechiae, and IOP isn’t raised what is this?

A

Primary angle closure suspect

97
Q

Gonioscopy looks at the anterior chamber from the ____part of the iris to the ____part of the cornea using the help of the gonio lens and slit lamp

A

Anterior part of the iris to the posterior part of the cornea

98
Q

T/F: gonio is done on all glaucoma suspects

A

True

99
Q

How often should you do gonio on narrow angle or angle closure glaucoma patients?

A

Periodically

100
Q

What two types of mirrors do we use when doing gonio?

A

3 and 4 mirror

101
Q

All 4 mirrors on the lens is an angle of ___ degrees

A

64

102
Q

Posterior curvature of all these lenses are
_____ to that of the cornea which allows the patients own tear film to form the “fluid bridge” between the lens and the surface of the cornea

A

Equal

103
Q

Which mirror on the 3 mirror do we to see the angle mostly in gonio?

A

Apical mirro (D mirror)

104
Q

The rectangle mirror on the gonio is called what

A

Peripheral mirror

105
Q

The trapezoid looking mirror is called what

A

Equatorial mirror

106
Q

Name the structures you see in gonio from posterior to anterior

A 
Iris
Ciliary body
Scleral spur
Trabecular meshwork 
Schwalbes line
107
Q

Gonio is important for what kind of surgery we will be able to do someday

A

Peripheral iridotomy

108
Q

Which mirror do you use coupling solution for

A

The 3 mirror

109
Q

What 3 things does gonio evaluate?

A
  • glaucoma
  • iris cysts and tumors
  • neovascularization of the anterior chamber
110
Q

The part of the anterior chamber that you examine is ___ degrees away from the position of the mirror you use

A

180

111
Q

When the D lens is at the 12 o clock postion what angle are you viewing?

A

Inferior

112
Q

When the D lens is at the 3 o clock position you are examining the ___ in the OD and the ___ in the OS

A

OD: temporal angle
OS: nasal edge

113
Q

When the D lens is at the 6o clock postion what angle are you examining?

A

Superior angle

114
Q

When the D lens is at the 9 o clock position you are examining the ___ in the OD and the ___ in the OS

A

OD: nasal angle
OD: temporal angle

115
Q

When removing the 3 mirror lens what do you tell the patient to do?

A
  • to squeeze the lids firmly
116
Q

What is the easiest way to avoid bubbles when you are applying the mirror lens to the cornea?

A

To maintain a smooth accurate motion

117
Q

What is the angle of the apical (D) mirror?

A

59 degrees

118
Q

What is the angle of the peripheral mirror?

A

67 degrees

119
Q

What is angle of the equatorial mirror?

A

73 degrees

120
Q

What do you see with an apical mirror?

A

Angle

121
Q

What does the peripheral mirror look at?

A

Ora serrata or anterior

122
Q

What does the equatorial mirror look at?

A

Equator

123
Q

For gonio the image is ____

A

Inverted only

124
Q

The Biomicroscopy beam is focused on the mirror that is ___to it (gonio)

A

Diametrically opposite

Methods (2 decks)

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