Chapter 12: Eyes Flashcards
Mrs. Alden is a 29-year-old pregnant patient in her third trimester. She 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
a. get new lenses as soon as possible to avoid complications.
b. wait until several weeks after delivery to get new lenses.
c. go to the nearest emergency department for evaluation.
d. change her diet to include more yellow vegetables.
ANS: B
Because of the increased level of lysozyme in the tears during pregnancy, a blurred sensation
may occur but will subside several weeks after pregnancy. The blurred vision is a normal
occurrence during pregnancy. It is not an emergency, nor is it diet-dependent.
A condition that typically develops by the age of 45 years is
a. presbyopia.
b. hyperopia.
c. myopia.
d. astigmatism.
ANS: A
By 45 years of age, a condition known as presbyopia develops; presbyopia involves a
weakening of accommodation. Hyperopia occurs in early infancy. Myopia and astigmatism
can occur at any time.
Which finding, when seen in the infant, is ominous?
a. Difficulty tracking objects with the eyes
b. Appearing to have better peripheral than central vision
c. Blinking when bright light is directed at the face
d. White pupils on photographs
ANS: D
The absence of a red reflex, determined by physical examination or the appearance of white
pupils on a photograph, is indicative of retinoblastoma, a serious retinal tumor.
Mr. C’s visual acuity is 20/50. This means that he
a. can see 50% of what the average person sees at 20 feet.
b. has perfect vision when tested at 50 feet.
c. can see 20% of the letters on the chart’s 20/50 line.
d. can read letters while standing 20 feet from the chart that the average person could
read at 50 feet.
ANS: D
Visual acuity is measured as a fraction, in which the top number is the distance that the patient
is standing from the chart; the bottom number is the distance that an average person can stand
and still read the line.
The criterion for determining the adequacy of a patient’s visual field is
a. the ability to discriminate primary colors.
b. the ability to discriminate details.
c. correspondence with the visual field of the examiner.
d. distance vision equal to that of an average person.
ANS: C
The examiner compares his or her own peripheral vision to that of the patient while
performing the confrontation test, so unless the examiner is aware of a problem with his or her
own vision, the examiner could assume that the fields are full if they match.
Mrs. S. is a 69-year-old woman who presents for a physical examination. On inspection of her
eyes, you note that the left upper eyelid droops, covering more of the iris than does the right.
This is recorded as
a. exophthalmos on the right.
b. ptosis on the left.
c. nystagmus on the left.
d. astigmatism on the right.
ANS: B
Ptosis is when one of the upper eyelids covers more of the iris than the other lid, possibly
extending over the pupil.
A condition in which the eyelids do not completely meet to cover the globe is called
a. glaucoma.
b. lagophthalmos.
c. exophthalmos.
d. hordeolum.
ANS: B
Lagophthalmos is a term used to describe the condition in which eyelids do not completely
meet when closing. Glaucoma involves elevated pressure in the eye. Exophthalmus involves
bulging eyes. A hordeolum is better known as a stye.
Mr. Morris is a 38-year-old patient who presents to the clinic with complaints of allergies. An
allergy can cause the conjunctiva to have a
a. cobblestone pattern.
b. dry surface.
c. subconjunctival hemorrhage.
d. rust-colored pigment.
ANS: A
A red or cobblestone pattern, especially to the upper conjunctiva, indicates allergic
conjunctivitis. Allergies also cause itchy, watery eyes rather than dry surfaces, hemorrhage, or
rust-colored pigment.
A pterygium is more common in people heavily exposed to
a. high altitudes.
b. tuberculosis.
c. ultraviolet light.
d. cigarette smoke.
ANS: C
Persons heavily exposed to ultraviolet light are more susceptible to the development of a
pterygium.
Mr. Brown 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
a. in a coma.
b. taking sympathomimetic drugs (cocaine).
c. taking opioid drugs (morphine).
d. treated for head trauma.
ANS: C
Pupil constriction to less than 2 mm is called miosis. With miosis, the pupils fail to dilate in
the dark, a common result of opioid ingestion or the use of drops for glaucoma. Pupils are
usually dilated greater than 6 mm in a patient described in the other choices.
When testing corneal sensitivity controlled by cranial nerve V, you should expect the patient
to respond with
a. brisk blinking.
b. copious tearing.
c. pupil dilation.
d. reflex smiling.
ANS: A
Brisk blinking is an expected response to corneal sensitivity testing, which involves gently
touching the cornea with a piece of cotton
You observe pupillary response as the patient looks at a distant object and then at an object
held 10 cm from the bridge of the nose. You are assessing for
a. confrontation reaction.
b. accommodation.
c. pupillary light reflex.
d. nystagmus.
ANS: B
Testing for accommodation involves asking the patient to look at an object at a distance
(pupils dilate) and then to look at another, much closer object (pupils constrict
When inspecting the region of the lacrimal gland, palpate
a. the lower orbital rim, near the inner canthus.
b. in the area between the arch of the eyebrow and upper lid.
c. beneath the lower lid, adjacent to the inner canthus.
d. adjacent to the lateral aspect of the eye, just beneath the upper lid.
ANS: A
The lacrimal gland is located at the lower orbital rim near the inner canthus of the eye.
Examination to assess for extraocular muscle imbalance is conducted by
a. comparing pupillary responses to different shapes.
b. having the patient follow your finger through planes.
c. inspecting slightly closed lids for fasciculations.
d. transilluminating the cornea with tangential light.
ANS: B
The test for extraocular muscle function is to have the patient follow an object as you move it
through planes of vision while observing for nystagmus.
Mr. Older is a 40-year-old patient who presents to the office for a follow-up eye examination
after the diagnosis of myopia. To see retinal details in a myopic patient, you will need to
a. adjust your ophthalmoscope into the plus lens.
b. move your ophthalmoscope backward.
c. move your hand farther forward.
d. turn your ophthalmoscope to a minus lens.
ANS: D
The myopic patient (nearsighted) has longer eyeballs, so that light rays focus in front of the
retina. To see the retina, use the minus (red) numbers by moving the diopter wheel
counterclockwise; to assess a hyperopic patient, use a plus lens.
