Chapter 1 - Eye Exam

Question 1

Risk factors in ocular disease when taking Hx

Answer 1

FH (blindness, glaucoma, ocular tumor, RD, strabismus, MD) Poor vision, Eye trauma, Medical history (DM, HTN, Thyroid, RA, Malignancy)

Question 2

Eyelids

Answer 2

Outer structure protect and lubricate ocular surface, tarsal plate + meibomian gland, join medial and lateral canthi. Space is PALPEBRAL FISSURE

Question 3

Cornea

Answer 3

transparent front “window”, serves as major refractive surface

Question 4

Sclera

Answer 4

Thick outer coat eye, white and opaque

Question 5

Limbus

Answer 5

Junction between cornea, sclera

Question 6

Conjunctiva

Answer 6

Thin vascular mucous membrane covering inner aspect eyelids (PALPEBRAL conjunctiva) and sclera (BULBAR CONJUNCTIVA)

Question 7

Anterior chamber

Answer 7

Space lies between cornea anteria and iris posteriorly. Contains AQUEOUS HUMOR

Question 8

Iris

Answer 8

colored part screens out light via pigmented epithelium, which lines posterior surface

Question 9

Pupil

Answer 9

Circular opening center of iris adjusts light entering eye. Size determined by P and S innervation

Question 10

Ciliary body

Answer 10

Produces aqueous humor. Contration of ciliary muscle changes tension on zonular fibers that suspend lens.

Question 11

Posterior Chamber

Answer 11

Small space filled with aqueous humor behind iris and in front of anterior lens capsule

Question 12

Vitreous cavity

Answer 12

Large space (4.5 cc) behind lens extends to retina. Filled with transparent jelly-like material called VITREOUS HUMOR

Question 13

Optic Disc

Answer 13

Optic nerve visible within the eye, axons whose cell bodies are located in the GANGLION cell layer of retina

Question 14

Retina

Answer 14

Neural tissue lining vitreous cavity posteriorly. Essentially transparent except for BV on inner surface. Sends signals to brain via optic nerve.

Question 15

Fundus

Answer 15

Also known as retinal fundus = RETINA + MACULA + CHOROID + OPTIC DISC

Question 16

Macula

Answer 16

area of retina at posterior pole of eye responsible for fine central vision.

Question 17

Fovea

Answer 17

Oval depression in center of macula responsible for fine central vision

Question 18

Choroid

Answer 18

Vascular, pigmented tissue layer between sclera and retina. Provides blood supply for outer retinal layers.

Question 19

Make up refractive surfaces of eye

Answer 19

Cornea and lens. Cornea provides 2/3 of refractive power. Lens provides 1/3 refractive power.

Question 20

Hyperopia

Answer 20

Axial length of eye is too short, also called hypermetropia

Question 21

Myopia

Answer 21

Axial length of the eye is too LONG for the refracting power of lens and cornea.

Question 22

Astigmatism

Answer 22

Reduced visual acuity if refracting power of cornea and lens is different in one meridian than another.

Question 23

Accommodation

Answer 23

Ability of ciliary muscle to contract and lens to become more CONVEX.

Question 24

Presbyopia

Answer 24

Decreased ability to focus on near objects, distance visual acuity remains normal. Due to progressive hardening of lense and loss of ability to change its shape.

Question 25

Visual acuity

Answer 25

measurement of smallest object a person can identify at a given distance from the eye

Question 26

OD

Answer 26

oculus dexter (right eye)

Question 27

OS

Answer 27

oculus sinister (left eye)

Question 28

OU

Answer 28

oculus uterque (both eyes)

Question 29

Visual acuity impairment vs. visual disability

Answer 29

visual impairment describes condition of eyes. Visual disability describes a condition of the individual. Ability to adapt and compensate. two individauls with same visual impairment measured on snellen eye chart may show different levels of functional disability.

Question 30

Normal vision

Answer 30

20/12 to 20/25

Question 31

Near-normal vision

Answer 31

20/30 to 20/70 (able to get DL)

Question 32

Moderate low vision

Answer 32

20/80 to 20/160

Question 33

Severe low vision

Answer 33

Legal blindness 20/200 to 20/400 or counting fingers CF at 10 feet. Legal blindness by US definition. Gross orientation and mobility adequate

Question 34

Profound low vision

Answer 34

CF 8 feet to 4 feet. Long cane useful

Question 35

Near-total blindness

Answer 35

Less than CF 4 feet. Must rely on nonvisual aids

Question 36

NLP

Answer 36

Total blindness. No light perception; must rely entirely on other senses.

Question 37

Red reflex

Answer 37

light reflected off fundus produces red reflex when viewed through the ophthalmoscope at a distance of 1 foot. Evenly colored, not interrupted by shadows, clear.

Question 38

Physiological cup

Answer 38

Central whitish depression in surface of disc. Yardstick of ocular fundus. Lesions seen measured in disc diameters (1.5 mm)

Question 39

Normal vein to artery diameter

Answer 39

3:2. Arteries are lighter with more prominent light reflex than veins. Follow arteries from disc and veins back to disc in each quadrant noting AV crossing patterns.

Question 40

Foveolar reflex

Answer 40

light reflection produced from central depression of fovea, acting as concave mirror during ophthalmoscopy.

Question 41

Next step with unexplained decrease in vision in one or both eyes

Answer 41

referral to ophthalmologist