Exam #2: Eye Flashcards
What is the leading cause of blindness in individuals under 65 in the US?
Diabetes
What type of vision loss occurs in Macular Degeneration?
Central vision loss
What is the hallmark of Glaucoma, and what type of vision loss occurs?
- Elevated intra-ocular pressure
- Peripheral vision loss
What is the most likely cause of transient vision loss in the young?
Migraine
What causes transient vision loss in the elderly?
Emboli & TIA
Flashes of light are a red flag for_____?
Retinal Detachment
What is the most common cause of exopthalmos?
Thyroid Disease
What are the causes of diplopia?
- One eye optical problem
- Two eye alignment problem
What cardiac symptoms can eye medications cause?
BOTH bradycardia and tachycardia
What do you use to evert the upper eyelid?
Cotton-tip applicator
Snellen Eye Chart
typical visual acuity exam
Numerator in Snellen Eye Chart
Distance from chart
Denominator in Snellen Eye Chart
Distance the average eye can read the chart
Rosenbaum Chart
Tests near vision with hand held chart
What three nerves control extra-ocular movement?
CN III, IV, and VI
How do you test EOM?
Draw and “X” then a cross
Visual Fields by Confrontation
Peripheral vision test
Accommodation Testing or Near Reaction Testing
Checking to see if the eyes will converge & pupils will constrict
In accommodation testing, what should happen when the patient looks at your fingers?
Eyes converge and pupils constrict
In accommodation testing, what should happen when the patient looks at the wall?
Eyes diverge and pupils dilate
Direct pupillary response to light
Constriction of the pupil being tested in response to light
Consensual response to light
Constriction of the pupil opposite of the one being shined with light
Lateral Penlight Test
Estimates depth of anterior chamber
When should you do the lateral penlight test?
Before applying mydriatic drops
What is a normal lateral penlight test?
When the entire iris lights up
If the lateral penlight test is abnormal, what does this mean?
DO NOT give mydriatic drops, patient at risk of acute-angle glaucoma
Swinging Light Test
Test for functional impairment of the optic nerves
Abnormal Swinging Light Test
- Shine light in one eye and then switch to other eye
- Second eye should constrict
- Transition back to first
- If eye DILATES then abnormal and afferent defect
Corneal Light Reflex
Tests for ocular alignment
Normal Corneal Light Reflex
Light reflects from center of both pupils
Esotropia
- Eye turned IN
- Light reflex is LATERAL
Exotropia
- Eye turned OUT
- Light reflex is MEDIAL
Cover test
Test used to detect tropia
Tropia
full-time eye misdirection
Sensory Nerve in Corneal Sensitivity
CN V
Motor Nerve in Corneal Sensitivity
CN VII
Cover- Uncover Test
Test used to detect phoria
Phoria
eye movement because of disturbance in binocular vision
Small Light Source
use when room not dimmed or small pupils
Large Light Source
use for dilated pupils
Green Light
use for drusen bodies, nerve fiber defects, & blood
GRID pattern
use to identify size of a lesion
Slit
used to examine anterior chamber/ corneal injury
Blue
used to examine corneal abrasion
Myopic
near-sighted- red lens
Hyperopic
far-sighted- black lens
Red Reflex
- Single most important screening tool for infants and young children
- Light strikes retina and bounces back
Epicanthal Fold
- Vertical fold of skin nasally that covers the lacrimal caruncle
- Normal Variant in Asians
What is a normal red reflex?
an equal & bilateral reflection from the fundus
Leukocoria
- a white reflex instead of red reflex
- caused by congenital cataract or retinoblastoma
- refer to Ophthamologist
When is visual fixation well developed?
6-9 weeks
When does visual following start?
3 months
When do accommodation and stereopsis start?
4 months
When is poor fixation considered pathologic?
- Beyond 6 months
- Refer to Ophthalmology
Newborn visual acuity
20/400 - 20/800
When does visual acuity normalize?
~ 3 years (20/40)
Strabismus
Misalignment of the eyes
Esotropia
misalignment of the eyes inward
Exotropia
misalignment of the eyes outward
Hypertropia
misalignment of the eyes upward
Hypotropia
misalignment of the eyes downward
Pseudostrabisumus
- Appearance of misalignment of the eyes without actual strabismus present
- Light reflection occurs in the same place in both eyes
Amblyopia
- Loss of visual acuity due to active cortical suppression of the vision of the eye
- Can be caused by strabismus (misalignment of the eye)
Single most effective screening test for amblyopia?
Visual acuity via noninvasive screening
What are the three requirements for normal visual development?
1) Clear retinal image
2) Equal image clarity
3) Proper eye alignment
