CM: PE of Eye Flashcards
What are the eight parts of the general eye exam?
visual acuity external exam pupillary rxns ocular motility and alignment visual fields anterior segment exam intraocular pressure funduscopic exam
What are myopia, hyperopia, and astigmatism?
myopia - can see near - focal plane in front of retina
hyperopia - can see far, focal plane behind retina
astigmatism - blurry, refracting power different in one meridian than another
What is the proper technique for testing standard snellen visual acuity?
pt should wear their corrective lenses
measure at distance 20 ft and/or near (16 in)
smallest letters or numbers pt can read are denominator, 20 is numerator
credit for line if at least half letters correct
if can’t see biggest letter - hold up fingers - if can’t see that use hand motion - if can’t see that use penlight to see if they have light detection
test each eye individually!
What is the proper technique for testing pupillary rxn to light and accommodation?
if response to light normal, don’t need to test near
light-near dissociation: light reflex abnormal w intact near, never vice versa
What is physiologic anisocoria?
unequally sized pupils
difference b/w diameter is usually <2 mm
usually difference in size constant despite change in illumination
if increases in darkness or light - can suggest abnormal path
How can Horner’s syndrome be suspected off the pupillary exam?
anisocoria greater in dim light than in bright light
miosis of affected pupil and slight ptosis, may also have anhydrosis of ipsilateral face
How can an afferent pupillary defect (APD, Marcus Gunn pupil) be recognized?
if swinging flashlight from one eye to the other causes both to dilate, afferent defect present on side of the flashlight = pupil has normal consensual w abnormal direct
indicates damage to optic nerve (CN II)
How can an efferent pupillary defect be recognized?
failure of consensual rxn w normal direct reaction = deficit in contralateral eye
(affected eye never constricts)
indicates damage to oculomotor nerve (CN III)
Which movements isolate: inf oblique, sup oblique, inf rectus, sup rectus?
inf oblique - up and in
sup oblique - down in and in
inf rectus - look down and out
sup rectus - look up and out
How do you test visual fields by confrontation?
stand 3 ft from pt, cover an eye have pt cover same eye and keep their fixation on your eye
hold hand in different quadrants b/w you and pt and have pt count number of fingers
then present fingers on both hands simultaneously in two quadrants and have pt count them
both hands palms forward toward pt with all fingers extended and ask if pt notes any differences
then test other eye same way
