Ch. 12 - Eye

Question 1

A structure that protects the eye from foreign bodies is the

Answer 1

eyelid

Question 2

Tears flow over the cornea and drain via the lacrimal sac into the

Answer 2

nasal meatus

Question 3

Contraction of which eye structure controls the amount of light that reaches the retina?

Answer 3

iris

Question 4

Term infants have a visual acuity of about

Answer 4

20/400.

Question 5

At what age does an infant usually develop the ability to distinguish color?

Answer 5

6 months

Question 6

An increased level of lysozyme in the tears will occur normally during which life stage?

Answer 6

Pregnancy

causes blurry sensation

Question 7

A pregnant woman in her third trimester tells you that her vision has been a little blurred and she thinks she needs to get new contact lenses. You should advise her to

Answer 7

wait until several weeks after delivery to get new lenses.

d/t lysozyme in tears during pregnancy

Question 8

Which of the following is a relatively benign condition that may occur during pregnancy or labor?

Answer 8

Subconjunctival hemorrhage

Question 9

When does the lens usually become more rigid and the ciliary muscle of the iris become weaker?

Answer 9

around 45 y/o

Question 10

A condition that typically develops by the age of 45 years is

Answer 10

presbyopia.

weakening of accomodation

Question 11

Which of the following findings, when seen in an infant, is most ominous?

Answer 11

White pupils on photographs

Question 12

Which of the following is a genetic eye disorder that should be included in the history and
physical examination, under family history, for all members of the affected family?

Answer 12

retinoblastoma

Question 13

A Rosenbaum card is used to measure

Answer 13

near vision

Question 14

How should measurement of near vision tested

Answer 14

in each eye separately.

Rosenbaum card 35 cm away

Question 15

Mr. C’s visual acuity is 20/50. This means that he

Answer 15

can read letters while standing 20 feet
from the chart that the average person
could read at 50 feet.

Question 16

The criterion for adequacy of a patient’s visual field is

Answer 16

correspondence with the visual field of the examiner.

Question 17

Ptosis may be secondary to

Answer 17

paresis of a branch of cranial nerve III.

Question 18

What is the condition called when the eyelid is turned away, or everted, from the globe?

Answer 18

Ectropion

Question 19

A condition in which the eyelids do not completely meet to cover the globe is called

Answer 19

lagophthalmos.

Question 20

Inspection of the tarsal conjunctiva should be performed

Answer 20

when a foreign body may be present.

Question 21

An allergy can cause the conjunctiva to have a

Answer 21

cobblestone pattern.

Question 22

Mr. B was admitted from the emergency department, and you are completing his physical
examination. His pupils are 2 mm bilaterally, and you notice that they fail to dilate when the
penlight is moved away. This is characteristic in patients who are or have been

Answer 22

taking opioid drugs (e.g., morphine).

Question 23

Mydriasis accompanies

Answer 23

coma

Question 24

When inspecting the region of the lacrimal gland, palpate

Answer 24

the lower orbital rim near the inner canthus.

Question 25

You note a dark, slate gray pigment just anterior to the insertion of the medial rectus muscle in an 80-year-old woman. Which action is appropriate?

Answer 25

record finding in patient's chart (senile hyaline plaque- does not indicate an emergency or disease process)

Question 26

When there is an imbalance found with the corneal light test, you should then perform the _____ test.

Answer 26

cover–uncover

Question 27

To see retinal details in a patient with myopia, the examiner will need to

Answer 27

turn the ophthalmoscope to a minus lens. (A patient with myopia (nearsighted) has longer eyeballs, so light rays focus in front of the retina. To see the retina, the examiner should use the minus (red) numbers)

Question 28

The unit of measurement in describing lesion size and location on the fundus is the

Answer 28

disc diameter. (vessels branch away from the optic disc and can be used as landmarks to locate the optic disc. The disc = ~1.5 mm in diameter and is used as the unit of measurement used to describe lesion size and location on the fundus)

Question 29

Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the

Answer 29

macula | The macula is the site of central vision and is observed when the patient looks directly at the ophthalmoscope light

Question 30

After focusing on a blood vessel in the retina with your ophthalmoscope, you attempt to locate the optic disc. You should

Answer 30

follow the vessel as it converges into larger vessels. | Vessels nearer the disc are directionally toward the nose, are larger, and have less branching.

Question 31

After completion of your ophthalmoscopic examination, you record that the arteriole-to-venule ratio is 1:2 This indicates that the

Answer 31

arterioles are narrowed (The expected ratio of arterioles to venules is 3:5 to 2:3. A 1:2 ratio indicates that the arterioles are narrower than normal.)

Question 32

If a patient has early papilledema, the examiner will be able to detect

Answer 32

dilated retinal veins.

Question 33

When drusen bodies are noted to be increasing in number or in intensity of color, the patient should be further evaluated with a(n)

Answer 33

Amsler grid.

Question 34

Cotton wool spots are most closely associated with

Answer 34

HTN

Question 35

The Keith-Wagner-Barker system group IV is characterized by the development of

Answer 35

papilledema (The Keith-Wagner-Barker system is used to classify changes to the eyes caused by hypertension. - Group I = Increased light reflex. - Group II = crossing defects - Group III = cotton wool spots and retinal hemorrhages)

Question 36

You are attempting to examine the eyes of a newborn. To facilitate eye opening, you would first

Answer 36

dim room lights

Question 37

White specks scattered in a linear pattern around the entire circumference of the iris are called

Answer 37

Brushfield spots | strongly suggest Down syndrome or mental retardation

Question 38

Opacities of the red reflex may indicate the presence of

Answer 38

cataracts.

Question 39

The Snellen E chart is appropriate for initial visual acuity in a child of which age?

Answer 39

3 years

Question 40

You normally expect a child to achieve 20/20 vision by age ____ years.

Answer 40

3 years

Question 41

What maneuver can be done to reduce the systemic absorption of cycloplegic and mydriatic agents when examining a pregnant woman if the examination is mandatory?

Answer 41

Use nasolacrimal occlusion after instillation. (pinching the upper bridge of the nose. Keeping the eyes closed, instilling half of the usual dosage, and having the patient position her head a certain way will not prevent absorption through the nasal membranes.)

Question 42

Episcleritis may indicate

Answer 42

an autoimmune disorder. | inflammation of the sclera, involves purplish bumps

Question 43

Horner syndrome is manifested by

Answer 43

ipsilateral miosis and mild ptosis.

Question 44

Dot hemorrhages, or microaneurysms, and the presence of hard and soft exudates are most commonly seen in

Answer 44

diabetic retinopathy

Question 45

Changes seen in proliferative diabetic retinopathy are the result of

Answer 45

anoxic stimulation. | New vessels are a characteristic seen in proliferative retinopathy resulting from anoxic stimulation.

Question 46

Bone spicule pigmentation is a hallmark of

Answer 46

retinitis pigmentosa. | inherited night blindness, characterized by the hallmark pigmentation of the peripheral fields or bone spicules.

Question 47

An initial sign of retinoblastoma in an infant is

Answer 47

the cat’s eye reflex. | aka white reflex

Question 48

Retinal hemorrhages in an infant require investigation for

Answer 48

child abuse | indicate infection, allergy, or trauma and should be further investigated.