EM Ophtha 1: Pearls, part 1

Question 1

orbital bone most likely to break in blunt eye trauma

Answer 1

lamina papyracea of ethmoid bone

Question 2

which is more serious, preseptal or postseptal?

Answer 2

postseptal condition

-septum is generally imperviou to bacteria

Question 3

which eye blood vessel communicates directly to the cavernous sinus?

Answer 3

ophthalmc veins

Question 4

cornea is attached to the sclera at the

Answer 4

limbus

Question 5

5 layers of cornea

Answer 5

epithelium
Bowman layer
stroma
Descemet membrane
endothelium

Question 6

components of the uveal tract

Answer 6

iris
ciliary body
choroid

Question 7

ophthalmic history should first catergorize the symptoms as

Answer 7

vision loss
change in appearance of the eye
eye pain / discomfort
trauma

Question 8

eye discomfort should be characterized as

Answer 8

pain (aching, burning, throbbing, etc.)
pruritus
foreign body sensation
- as seen with corneal foreign bodies, abrasino, or ulcers

Question 9

this suggests retinal detachment

Answer 9

“flashing lights” and a “curtain or veil” obstructing a portion of the visual field

Question 10

Full exam should in include:

Answer 10

1. visual acuity
2. confrontational visual vields
3. extraocular movements
4. pupillary rections
   ~
5. lids and adnexa
6. conjunctiva and sclerae
7. cornea
8. anterior chamber
   ~
9. iris
10. lens
11. vitreous
12. intraocular pressure
    ~
13. funduscopic exam

Question 11

vital sign of the eye

Answer 11

visual acuity testing

Question 12

how to DIY. a pinhole occluder

Answer 12

note card perforated with an 18-gauge needle

Question 13

explain 20/20

Answer 13

numerator - the distance form which the patient can read the line (always 20)

denominator - the distance from which a person with normal vision can read the same line

the visual acuity is determined by the smallest line a patient can read with one half of the letters correct

Question 14

examples of VA charts

Answer 14

Snellen chart

Rosenbaum chart - held at 14 in (36cm)
-patients in their mid-40s or older may require reading glasses or bifocals to read a near card because of presbyopia

Allen chart - pictures for children

Bailey-Lovie chart
- new
- 5 letters on each row
- ensure equal contour interaction

Question 15

bitemporal hemianopia can occur in

Answer 15

pituitary adenoma

Question 16

homonymous hemianopia is associated with

Answer 16

come cerebrovascular accidents

Question 17

remarks on afferent pupillary defect

Answer 17

aka Marcus-Gunn pupil

indicates an optic nerve disorder (e.g. optic neuritis) or central retinal artery occlusion

Question 18

a single dilated pupil may represent

Answer 18

impending uncal herniation (from pressure on the third nerve)

Question 19

what to do when looking for abrasions and lacerations

Answer 19

apply fluorescein