Block 1 - Ophthalmologic Exam

Question 1

Describe how direct central vision is assessed and documented

Answer 1

Snellen chart: pt stands 20’ behind chart, tests far vision. Recorded as 20 (feet pt is from chart) over a the number an average person could read (higher is worse).
Rosenbaum chart : chart held about 14” away from pt’s face, tests near vision. Recorded as above.

Question 2

Describe how peripheal vision is assessed and documented

Answer 2

Confrontation test. Clinician cover contralateral eye as pt. Temporal, nasal, superior, inferior vision fields tested.

Question 3

Describe how color vision is assessed and documented

Answer 3

Color plates are produced with numerals in primary colors surrounded by confusing colors. Ischihara test.

Question 4

Describe appropriate usage and function of diopter settings

Answer 4

Lenses in varying powers of magnification used to focus on the structure being examined.

Question 5

Describe appropriate usage and function of aperture settings

Answer 5

Small: used for examination with small pupils
Large: produces a large round beam for large, dilated pupils
Slit: anterior eye
Grid: estimation of size and location of lesions

Question 6

Describe appropriate usage and function of polarizing filter

Answer 6

Works similar to polarized lenses in sunglasses used to reduce glare.

Question 7

Describe appropriate usage and function of cobalt blue light

Answer 7

Elicit the flourescence of a dye when added to the eye. Corneal lesions can be seen easier.

Question 8

Define visual impairment/loss

Answer 8

Descrimination of small details is assessed via acuity testing. Any fraction under 20/20 refers to a visual impairment.

Question 9

Define legal blindness

Answer 9

Vision not correctable to better than 20/200.

Question 10

Define exophthalmos/proptosis

Answer 10

Bulging of eye anteriorly out of orbit.

Question 11

Define ptosis

Answer 11

Congenital or acquired weakness of levator muscle or paresis of occulomotor (CN III) nerve.

Question 12

Define nystagmus

Answer 12

Involuntary rhythmic movements of the eyes that can occur in a horizontal, vertical, rotary, or mixed pattern. These movements will be appreciated during EOM exam.

Question 13

Define strabismus

Answer 13

Both eyes do not focus on an object simultaneously, but can focus with either eye. Evaluate with cover/uncover test.

Question 14

Define diplopia

Answer 14

Double vision.

Question 15

Define emmetropia

Answer 15

Normal refractive condition of the eye.

Question 16

Define hyperopia

Answer 16

Farsightedness. Visual image focused beyond retina. Blurriness with near objects.

Question 17

Define myopia

Answer 17

Nearsightedness. Visual image focused in front of retina. Blurriness with far objects.

Question 18

Define astigmatism

Answer 18

Blurred vision caused by irregular shape of cornea or irregular curvature of lens.

Question 19

Define presbyopia

Answer 19

Aging vision. Progressive condition of lens of eye losing its ability to focus.

Question 20

Define mydriasis and micosis

Answer 20

Pupillary dilation and pupillary constriction, respectively.

Question 21

Define anisocoria

Answer 21

Unequal size of pupil.

Question 22

Describe typical physical findings during fundoscopy with diabetes

Answer 22

Flame and dot-blot hemorrhages, cotton wool spots, hard and soft exudates; thin vessels.

Question 23

Describe typical physical findings during fundoscopy with HTN

Answer 23

Cotton wool spots, decreased arteriole size, hemorrhages and papilledema (central vessels pushed forward).

Question 24

Describe typical physical findings during fundoscopy with hyperthyroidism

Answer 24

Vision loss, tremors of eyelid when closed, exophthalmos, ptosis, lid lag.

Question 25

Describe typical physical findings during fundoscopy with hypercholesteremia

Answer 25

Lipemia retinalis: blood vessels increasingly pink then white as triglyceride levels rise. Arcus cornealis: accumulation of cholesterol around edges of cornea causing grey colored ring.