Disorders of the Lens & Posterior Chamber

Question 1

A pt comes in complaining of difficulty seeing. She has difficulty with the Rosenberg chart, and you notice that when you hand her something to read, she holds it far away from her eyes. What is the most likely diagnosis?

Answer 1

Presbyopia

Question 2

A pt comes in because he has noticed that over the past year it’s been progressively harder for him to focus on near objects and he has to hold menus and magazines farther away to read them. What is the likely cause of this pt’s condition?

Answer 2

Hardening of the lends due to aging
Slow, progressive failing of accommodation
(the pt has presbyopia)

Question 3

What treatment options would you recommend for a pt with presbyopia?

Answer 3

Reading glasses

Optometrist referral for prescription reading glasses (optional)

Question 4

What are 3 types of refractive errors?

Answer 4

Myopia (nearsightedness)
Hyperopia (farsightedness)
Astigmatism

Question 5

A pt comes in complaining of slow, progressive visual loss. Her vision is 20/60, but it’s 20/20 through a pinhole. What condition does the pt have?

Answer 5

Refractive error

Question 6

When testing visual acuity, if a pt can’t read the chart, how do you measure VA?

Answer 6

Count fingers
Hand motions
Light perception

Question 7

A 6 year old pt comes in with a lazy eye. What condition does the pt have? What could this turn into if not treated?

Answer 7

Strabismus (lazy eye)

Can turn into amblyopia

Question 8

What is the cause of amblyopia?

Answer 8

The eyes are not in tandem

The brain shuts down the image from the lazy eye (hard to reverse)

Question 9

A pt comes in with diplopia. He had a history of strabismus as a child but it was not treated. What will you do now to treat the pt?

Answer 9

Eye muscle exercise

Question 10

A pt comes in complaining of nearsightedness. What is the cause of the pt’s condition?

Answer 10

The globe is too big, the image falls in front of the retina

pt has myopia

Question 11

How would you treat a pt with myopia?

Answer 11

Refractive correction

Question 12

A pt comes in complaining of farsightedness. How would you treat the pt’s condition?

Answer 12

Refractive correction

pt has hyperopia

Question 13

What is the cause of hyperopia?

Answer 13

The globe is too small, the image falls behind the retina

Question 14

An 84 year old pt comes in because she’s been seeing haloes around light, has noticed an increased glare, and has worsening night vision. You notice a loss of the red reflex and clouding of the eye. What condition does the pt have?

Answer 14

Cataracts

Question 15

An 86 year old pt with a history of smoking comes in because he’s noticed a slow decrease in vision and colors appear faded. His visual acuity is decreased and you notice opacification of the lens. What treatment would you recommend for this pt?

Answer 15

The cataract is mature, so recommend surgical excision and replace his lens with an artificial lens

Question 16

An 82 year old patient with a history of diabetes comes in complaining of decreased vision, haloes around lights, and poor night vision. You notice loss of the red reflex and clouding of the eye. What is the cause of the pt’s condition?

Answer 16

Clouding of the lens due to aging