Clinical Skills Flashcards
1
Q
perimetry
A
visual field testing
2
Q
FOLDARS
A
F- Frequency O - Onset L - Location D - Duration A - Associated signs/symptoms R - Relief S - Severity Note - do for every chief complaint
3
Q
DEA
A
Drug Enforcement Administration
4
Q
CSA
A
Controlled Substances Act
5
Q
ROI
A
Release of Information
6
Q
AIDET
A
Model of Patient Satisfaction A - Acknowledge I - Introduce D - Duration E - Explanation T - Thank you.
7
Q
PII
A
Personally Identifiable Information eg) name, address
8
Q
PHI
A
Protected Health Information
9
Q
HIPAA
A
Health Insurance Portability & Accountability Act - sets standards for protecting patient data)
10
Q
Symptoms of Eye Problems
A
- reported by patient; story
eg) visual symptoms, visual disturbances, physical discomfort, physical changes
11
Q
Signs of Eye Problems
A
abnormalities of the eye directly observed
12
Q
Dose
A
quantity of medication ie) 500 mg
13
Q
Dosage
A
size or frequency of dose ie) 3 times a day
14
Q
emergent
A
- immediate attention
15
Q
urgent
A
- seen with a day
16
Q
routine
A
- longer standing problem
17
Q
optical infinity
A
- distance where light rays are virtually parallel
18
Q
visual acuity
A
- ie) 20/70 - the greater the denominator, the worse the vision
- 3 phenomena: detection, recognition & resolution
19
Q
snellen chart
A
- for visual acuity
- optotype: letters
20
Q
sloan chart
A
- for visual acuity
- letters with standard spacing, upside down pyramid
21
Q
ETDRS
A
- early treatment diabetic retinopathy study chart
- inverted pyramid with 5 optotypes
- for low vision patients
22
Q
Lea numbers
A
- numbers 5, 6, 8 & 9 blur into nondescript once past limits of recognition ability
23
Q
allen pictures
A
- objects universally recognized
- ie) hand, truck, horse
24
Q
Lea symbols
A
- four: square, circle, house, apple
- all are blurry circles beyond acuity
25
tumbling E's
- resolution test
26
Landolt's Broken Rings
- resolution test
27
one minute of arc
- amount of angle where a normal eye can detect the separation of two points
- one degree = 60 min of arc
ie) person with 20/20 can distinguish an object that subtends 5 min of arc
28
crowding phenomenon
- patient sees smaller letters if shown one at a time vs. a row of letters
29
pinhole
- opaque disk with a tiny hole in center to look through
- allows only direct light rays (not scattered) into eye
- increased acuity through pinhole if refractive error causing reduced far vision
30
Teller acuity cards
- for babies
- gratings of various frequencies (babies prefer pattern over blank)
- peep hole in card for examiner to watch babies response
31
Photostress Recovery test
- how quickly pigments in cone cells regenerate after being depleted of ligth sensitive pigments with white light
32
Pelli Robson Chart
- for contrast sensitivity
| - letters same size but decrease in contrast
33
Brightness Acuity Test (BAT)
- testing glare
| - look through an illuminated half globe & read eye chart
34
S.A.F.E
```
- range of motion of eyes into 9 positions of gaze
S - smooth
A - accurate
F - fast
E - equal
```
35
PERRLA
- pupils equal, round & reactive to light
| - (A) accomodation normal
36
Oblique Flashlight Test
- for angle evaluation
| - if temporal & nasal iris appear illuminated, then angle open
37
saccades
- rapid eye movements to quickly change point of fixation
38
smooth pursuits
- slower eye movements to follow moving object
39
vergence
- moving both eyes
- convergence - inward, looking closer
- divergence - outward, looking farther
40
vestibulo-ocular reflex
- eyes move opposite to head movement
| - want this in emergency to lessen brainstem damage
41
prism diopter
- unit of measure for refractive power
- 1 diopter = deflection of light ray by 1 cm at a distance of 1 m
-
42
abduction
lateral movement of one eye away from midline
43
adduction
medial movement of one eye toward midline
44
supraduction
upward movement of one eye
45
infraduction
downward movement of one eye
46
dextroelevation
movement up and to the right of one eye
47
laevoelevation
movement up and to the left of one eye
48
incycloduction
nasal rotation of one eye of one eye
49
excycloduction
temporal rotation of one eye
50
dextroversion
binocular movement to the right
51
laevoversion
binocular movement to the left
52
supraversion
binocular movement up
53
infraversion
binocular movement down
54
dextroinfraversion
binocular movement down & to the right
55
laevoinfraversion
binocular movement down & to the left
56
fusional convergence
eyes move inward to avoid double vision
57
tonic convergence
inherent reflex to reposition our eyes from a divergent position
58
convergence
- both eye move inward
- near focus
- 20 to 35 diopters
59
divergence
- both eyes outward
- far focus
- 6 to 10 diopters
60
AC/A
accommodative convergence/accommodation ratio
= amount of convergence for each diopter accomodation
- normal 3-5 diopters convergence / 1 diopter accommodation
- esodeviations (+), exo (-)
61
near point convergence
- closest point a person can converge both eyes
| - normal 3-4 inches (8-10 cm)
62
Cover Testing
- detects & quantifies strabismus and assesses control
1) Cover/Uncover
2) Alternate Cross/Cover
3) Repeat Cover/Uncover
63
deviation measurements
- use prisms of increasing power until reversal of movement
64
Bielschowsky Head Tilt Test
- EOM movement test
| - gaze measurements when head turned rigth & left, tilted right and left
65
Hirschbert Test
- EOM & light reflex test
- tests for tropias only
- light shone 33 cm away & cornea reflexes observed
- normal reflex seen centrally or slightly nasal
66
Krimsky Test
- measure of strabismus
| - uses light & prisms to move deviated light reflex back to center of pupil
67
angle kappa
- visual axis an pupillary axis do not coincide
68
Red (Bruckner) Reflex Test
- should see red reflection of white light from eyes
69
Single/Double Maddox Rod Testing
- transparent "lens" made of series of parallel red cylinders
- white light viewed through rod should show a red line 90 degrees to the direction of cylinders
70
SOAP
Subjective
Objective
Assessment
Plan
71
Slit Lamp Diffuse Illumination
- beam covered by diffusing filter
| - for conjunctiva, lids and cornea
72
Slit Lamp Direct-Narrow Slit Illumination
- for conjunctiva, cornea, lens, vitreous
73
Slit Lamp Direct-Wide Slit Illumination
- for cornea, iris & lens
74
Slit Lamp Indirect Illumination
- decentering slit beam
| - conjunctiva & iris
75
Slit Lamp Retro from iris Illumination
- light reflected off iris to illuminate pathology from behind
- cornea
76
Slit Lamp Retro from fundus Illumination
- light reflected off fundus to illuminate pathology from behind
- lens
77
phakic eye
- has natural lens
78
pseudophakic eye
- has intraocular lens implant
79
aphakie eye
- no lens
80
potential acuity meter (PAM)
- mini eye chart mounted on slit lamp, patient's prescription dialled into PAM so no glasses worn
81
super pinhole
- lightbox to produce ultra high contrast eye chart (white letters on black background)
- use a pinhole
82
Ways to assess anterior chamber angle
1 - flashlight (shine light on temporal side)
2 - slit lamp
3- goniolens (specialized contact lens to examine chamber angle structures)
83
accommodative triad
- when looking at near object
1 - eyes converge
2 - pupils constrict
3 - lens accommodates
84
confrontation fields
- check for gross defects in visual field
- use "counting fingers" in each quadrant of visual field
- static or kinetic
- follow up with automated perimetry
