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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
Q

Normal pupil size

A

2-4 mm

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26
Q

Abnormal pupil assymetry

A

Asymmetry of both pupils by >2 mm

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27
Q

What is being checked by Swinging Flashlight Test?

A

APD Afferent pupillary defect

Dilatation of pupil in presence of light

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28
Q

What nerve defect is present in APD?

A

Optic Nerve CN2

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29
Q

Cause of APD

A

Contussion, avulsion and transection

Retinal injuries such as commotio retinae, retinal detachment

Major vitreous hemorrhage

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30
Q

Test for Ocular Alignment

A

Hirschberg test

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31
Q

Inward Misalignment

Light reflection appears displaced laterally in the non-fixating eye

A

Esotropia

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32
Q

Outward Misalignment

Light reflection appears displaced medially in the non-fixating eye

A

Exotropia

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33
Q

Downward Misalignment

Light reflection appears displaced superiorly in the non-fixating eye

A

Hypotropia

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34
Q

Upward Misalignment

Light reflection appears displaced inferiorly in the non-fixating eye

A

Hypertropia

35
Q

Ocular Motility Testing

Eye movement tested with both eyes open

36
Q

Ocular Motility Testing

One eye at a time is tested

37
Q

Normal IOP

38
Q

Refers to the pressure that is created within the closed environment of the eye

A

Intraocular Pressure

39
Q

Intraocular Pressure is governed by a balance between the production and drainage of _________

A

Aqueous humor

40
Q

Methods for Intraocular Pressure Determination

A

Indentation (Shiotz) Tonometry
Applanation (Goldmann) Tonometry- gold standard
Finger Palpation- harder globe means high IOP

41
Q

3 methods in viewing the ocular fundus:

A

Direct ophthalmoscopy
Indirect ophthalmoscopy
Biomicroscopy/ lens

42
Q

Fundoscopic exam checks for what segment of the eye?

A

Posterior segment

43
Q

What to inspect during direct fundoscopic examination?

A

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
Q

Magnification of Direct Opthalmoscope

A

15x magnification

45
Q

Indications of Direct Ophthalmoscopy

A

High power study of disc and macula
Measure elevations/ depressions
Measure diopteric power of eye
Study of small lesions

46
Q

Advantages of Ophthalmoscopy

A
  • High magnification
  • Erect Image
  • Measurement capabilities (elevations/ depressions/ size)
  • Easy to learn
47
Q

Disadvantages of Opthalmoscopy

A
  • Small field 10-12D
  • Poor illumination
  • Monocular
  • Distortion near periphery
48
Q

Red Diopter Power Display

A

Subtraction/ Negative

49
Q

Green Diopter Power Display

A

Addition/ Positive

50
Q

Light Settings of Direct Ophthalmoscope:

Used for a dilated pupil after administering mydriatic drops.

A

Large aperture

51
Q

Light Settings of Direct Ophthalmoscope:

The standard for a nondilated pupil in a dark room.

A

Medium aperture

52
Q

Light Settings of Direct Ophthalmoscope:

Used for a constricted pupil in a well-lit room.

A

Small aperture

53
Q

Used to look closely at the vasculature and nerve fiber

A

Red free filter

54
Q

Used to look for corneal abrasions or ulcers with fluorescein dye.

A

Blue filter

55
Q

Used to look at contour abnormalities of the cornea, lens or retina.

A

Slit filter

56
Q

Used to approximate the relative distance between retinal lesions.

A

Grid filter

57
Q

Indication of Indirect Opthalmoscopy

A 
Presence of media opacities	
High refractive errors	
Children	
Total fundus examination	
Examination of large lesions
58
Q

Advantages of indirect ophthalmoscopy

A

Wide field 30–35D
View anterior to equator possible
Strong illumination
Stereopsis

59
Q

Disadvantages of indirect ophthalmoscopy

A

Low magnification 2–5X
Inverted Image
Difficult to learn

60
Q

Differentiate DIRECT and INDIRECT ophthalmoscopy

A

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
Q

Initial distance of physician from patient in DIRECT ophthalmoscopy?

62
Q

Ophthalmoscope at RIGHT hand = L/R eye of the patient?

63
Q

What reflex is being observed in fundoscopy?

A

Red Orange Reflex

64
Q

Angle in fundoscopy

A

15 degrees temporal to the patient’s line of sight

65
Q

When the retinal vessels come into view, follow it as it widens to the _____, which lies ______ to the center of the retina.

A

optic disc, nasal

66
Q

Jaeger chart equivalents on Snellen chart

A 
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
Q

Use of pseudoisochromatic images

A

Ishihara color plates

Testing for color vision

68
Q

Normal color vision is a function of?

A

Macula and Optic Nerve

69
Q

Who designed the Ishihara Chart?

A

Dr. Shinobu Ishihara, University of Toyko, Japan

70
Q

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.

A

75 cm, right angle

71
Q

In Ishihara test, the numbers should be recognized w/out ___ secs delay.

A

> 3 seconds

72
Q

Test which measures more of color vision less of pattern discrimination

A

Farnsworth-Munsell 100-hue test

73
Q

Visual fields is the function of?

A

Peripheral Retina

74
Q

Detect targets that stimulate the retina at varying distance from the fovea

A

Visual Field Measurement

75
Q

Measures the gross estimate of the visual field

A

Confrontation Test

76
Q

Distance of examiner from the patient in confrontation test

77
Q

Size of pin used in Confrontation test

A

Hat pin with a 3 to 5 mm white tip

78
Q

Measures the anterior projection of the cornea relative to lateral orbital rim and quantifies the amount of proptosis and enopthalmos

A

Exopthalmometry

79
Q

Measurement between 2 eyes are usually within?

A

2 mm of each other

80
Q

Measurement in exopthalmometry that indicates further investigation even if readings fall within the normal range

A

Difference of >3 mm or greater

81
Q

3 general types of eye symptoms

A

Abnormal VISION
Abnormal OCULAR APPEARANCE
Abnormal OCULAR SENSATION

82
Q

In Greytone Colored Printout, Darker shade is?

83
Q

In Greytone Colored Printout, Warmer color is?

Opthalmology (3 decks)

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