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Opthalmology > Basic Eye Examination > Flashcards

Basic Eye Examination Flashcards

1
Q

Visual acuity testing for all patients including children

A

Distance Visual Acuity (DVA)

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2
Q

Visual acuity testing for patients over 35 years of age

A

Near Visual Acuity (NVA)

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3
Q

Bedside testing

A

Near Visual Acuity (NVA)

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4
Q

Charts for distance vision chart

A 
Snellen Chart 
Tumbling E /Illiterate E Chart 
Picture Chart
Ladolt Broken Ring Chart
Bailey-Lovie chart
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5
Q

Standard distance for Visual Acuity Testing

A

6 meters or 20 feet

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6
Q

Uses Snellen Chart

A

Distance Visual Acuity Testing

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7
Q

Occurs in >35 yrs old patient
Indication for Near Visual Acuity Testing
Gradual loss of the ability to accommodate (focus on near objects), and it occurs irrespective of the person’s underlying refractive error.

A

Presbiopya

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8
Q

Distance of focus of retina

A

20ft distance

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9
Q

One letter in Snellen Chart is how many arcmin?

A

5 arcmins (1 arcmin per line)

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10
Q

Visual Acuity Testing: with or without eyeglasses?

A

With AND Without

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11
Q

Equation for Visual Acuity computation

A

Distance of patient from the chart over distance at which the normal eye can read the given line

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12
Q

Interpret: VA= 20/60

A

Patient can see at 20 feet what a person with normal visual acuity can see at 60 feet

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13
Q

What will you do if the patient cannot see the largest letter in the Snellen chart? VA=20/200

A
  1. Decrease distance from the chart 5ft increment (example 15/200)
  2. If not able to see at 3 feet: do counting fingers (CF) at 1-3 feet distance
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14
Q

What if the patient cannot do CF? What is the next step?

A

Test for Hand Movement (HM)

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15
Q

What if the patient cannot detect HM? What is the next step?

A

Test for Light Projection (LPj)

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16
Q

Scoring for light projection (LPj)

A

Good- 4 quadrants
Fair- 2-3 quadrants
Poor- 1 quadrant

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17
Q

What if the patient cannot detect Light Projection? What is the next step?

A

Test for Light Perception (LP)- dark room

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18
Q

How do you report LP?

A

Absence or Presence of Light Perception

Do not label as “blind”

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19
Q

How to report visual acuity using snellen?

A

No correct reading: The line or score BEFORE that line
1 letter mistake: 20/n -1
Only 2 letters correct: 20/n +2

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20
Q

Determine if the vision is due to an uncorrected refractive error

A

Pinhole Test

Patient’s VA is <20/20

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21
Q

Standard test distance for Near Vision

A

14 inches or 35 centimeter

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22
Q

Near vision charts contain numbers , letters or figures in different sizes designed to subtend an angle of _____ at various distances Jaeger notation( J1)

A

5 minutes

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23
Q

Gross examination of eye findings

A

Symmetry between two eyes, redness, masses or abnormal pigmentation, discoloration on the eyelids and periocular tissue, eyelashes should be directed outward, inspect the lids, palpebral fissure and the surrounding tissues

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24
Q

What is being assessed in Pupil Examination?

A

Pupillary size and shape
Direct pupillary reaction
Consensual pupillary reaction
Swinging flashlight test

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25
Normal pupil size
2-4 mm
26
Abnormal pupil assymetry
Asymmetry of both pupils by >2 mm
27
What is being checked by Swinging Flashlight Test?
APD Afferent pupillary defect | Dilatation of pupil in presence of light
28
What nerve defect is present in APD?
Optic Nerve CN2
29
Cause of APD
Contussion, avulsion and transection Retinal injuries such as commotio retinae, retinal detachment Major vitreous hemorrhage
30
Test for Ocular Alignment
Hirschberg test
31
Inward Misalignment | Light reflection appears displaced laterally in the non-fixating eye
Esotropia
32
Outward Misalignment | Light reflection appears displaced medially in the non-fixating eye
Exotropia
33
Downward Misalignment | Light reflection appears displaced superiorly in the non-fixating eye
Hypotropia
34
Upward Misalignment | Light reflection appears displaced inferiorly in the non-fixating eye
Hypertropia
35
Ocular Motility Testing | Eye movement tested with both eyes open
Version
36
Ocular Motility Testing | One eye at a time is tested
Ductions
37
Normal IOP
10-21mmhg
38
Refers to the pressure that is created within the closed environment of the eye
Intraocular Pressure
39
Intraocular Pressure is governed by a balance between the production and drainage of _________
Aqueous humor
40
Methods for Intraocular Pressure Determination
Indentation (Shiotz) Tonometry Applanation (Goldmann) Tonometry- gold standard Finger Palpation- harder globe means high IOP
41
3 methods in viewing the ocular fundus:
Direct ophthalmoscopy Indirect ophthalmoscopy Biomicroscopy/ lens
42
Fundoscopic exam checks for what segment of the eye?
Posterior segment
43
What to inspect during direct fundoscopic examination?
Optic Nerve Optic Media (Cornea, Lens, Aqueous humor, Vitreous humor) Optic Disc (Normally yellow orange) Retinal Vasculature (AV ratio: normally 2:3) Retinal Background (presence of hemorrhage and exudates) Macular Area
44
Magnification of Direct Opthalmoscope
15x magnification
45
Indications of Direct Ophthalmoscopy
High power study of disc and macula Measure elevations/ depressions Measure diopteric power of eye Study of small lesions
46
Advantages of Ophthalmoscopy
* High magnification * Erect Image * Measurement capabilities (elevations/ depressions/ size) * Easy to learn
47
Disadvantages of Opthalmoscopy
* Small field 10-12D * Poor illumination * Monocular * Distortion near periphery
48
Red Diopter Power Display
Subtraction/ Negative
49
Green Diopter Power Display
Addition/ Positive
50
Light Settings of Direct Ophthalmoscope: | Used for a dilated pupil after administering mydriatic drops.
Large aperture
51
Light Settings of Direct Ophthalmoscope: | The standard for a nondilated pupil in a dark room.
Medium aperture
52
Light Settings of Direct Ophthalmoscope: | Used for a constricted pupil in a well-lit room.
Small aperture
53
Used to look closely at the vasculature and nerve fiber
Red free filter
54
Used to look for corneal abrasions or ulcers with fluorescein dye.
Blue filter
55
Used to look at contour abnormalities of the cornea, lens or retina.
Slit filter
56
Used to approximate the relative distance between retinal lesions.
Grid filter
57
Indication of Indirect Opthalmoscopy
``` Presence of media opacities High refractive errors Children Total fundus examination Examination of large lesions ```
58
Advantages of indirect ophthalmoscopy
Wide field 30–35D View anterior to equator possible Strong illumination Stereopsis
59
Disadvantages of indirect ophthalmoscopy
Low magnification 2–5X Inverted Image Difficult to learn
60
Differentiate DIRECT and INDIRECT ophthalmoscopy
Magnification 15X Greater magnification- DIRECT 5X Lesser magnification- INDIRECT Field 10 - 12 D (3 DD) Less field of view- DIRECT 30 - 35 D (9 DD) Wider field of view- INDIRECT Illumination Limited- DIRECT Bright- INDIRECT Stereopsis ( - ) - DIRECT ( + )- INDIRECT Image Direct (Upright) - DIRECT Inverted- INDIRECT Periphery view Limited - DIRECT Full- INDIRECT Working Distance Close - DIRECT Arm's length- INDIRECT Scleral Indentation Difficult - DIRECT Easy- INDIRECT Maximum Resolving Power 70 u - DIRECT 200 u- INDIRECT
61
Initial distance of physician from patient in DIRECT ophthalmoscopy?
1 foot
62
Ophthalmoscope at RIGHT hand = L/R eye of the patient?
Right Eye
63
What reflex is being observed in fundoscopy?
Red Orange Reflex
64
Angle in fundoscopy
15 degrees temporal to the patient’s line of sight
65
When the retinal vessels come into view, follow it as it widens to the _____, which lies ______ to the center of the retina.
optic disc, nasal
66
Jaeger chart equivalents on Snellen chart
``` J1+ = 20/20 J1= 20/25 J2= 20/20 J3= 20/40 J5= 20/50 J7= 20/70 J10= 20/100 J16= 20/200 ```
67
Use of pseudoisochromatic images
Ishihara color plates | Testing for color vision
68
Normal color vision is a function of?
Macula and Optic Nerve
69
Who designed the Ishihara Chart?
Dr. Shinobu Ishihara, University of Toyko, Japan
70
In Ishihara test, the plates are held ___ cm from the eyes of the subject and tilted such that the plane of paper is at _____ angle with the line of vision.
75 cm, right angle
71
In Ishihara test, the numbers should be recognized w/out ___ secs delay.
>3 seconds
72
Test which measures more of color vision less of pattern discrimination
Farnsworth-Munsell 100-hue test
73
Visual fields is the function of?
Peripheral Retina
74
Detect targets that stimulate the retina at varying distance from the fovea
Visual Field Measurement
75
Measures the gross estimate of the visual field
Confrontation Test
76
Distance of examiner from the patient in confrontation test
1 meter
77
Size of pin used in Confrontation test
Hat pin with a 3 to 5 mm white tip
78
Measures the anterior projection of the cornea relative to lateral orbital rim and quantifies the amount of proptosis and enopthalmos
Exopthalmometry
79
Measurement between 2 eyes are usually within?
2 mm of each other
80
Measurement in exopthalmometry that indicates further investigation even if readings fall within the normal range
Difference of >3 mm or greater
81
3 general types of eye symptoms
Abnormal VISION Abnormal OCULAR APPEARANCE Abnormal OCULAR SENSATION
82
In Greytone Colored Printout, Darker shade is?
Humphrey
83
In Greytone Colored Printout, Warmer color is?
Octopus

Opthalmology (3 decks)

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