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Theory and Methods III > Exam I > Flashcards

Exam I Flashcards

1
Q

Slitlamp 3 magnification systems

A

Flip-type, Galilean rotating barrel, zoom

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2
Q

Slitlamp 3 illumination systems

A

Haag streit type, zeiss type, Vogt illumination principle

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3
Q

Parfocality

A

The point at which the microscope is focused corresponds to the point on which the light is focused

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4
Q

Diffuser filter

A

Used in anterior segment photography; creates even lighting

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5
Q

Cobalt blue filter

A

Used for goldmann tonometry, tear film analysis, TBUT, analysis of GP contact lenses; used with fluorescein dye

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6
Q

Red-free (green) filter

A

Used to analyze blood vessels

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7
Q

Neutral density filter

A

Dims light for light-sensitive patients, not very common

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8
Q

Yellow (Wratten) filter

A

Not very common filter; used for increased patient comfort; enhances fluorescein dye

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9
Q

Diffuse/wide beam

A

Low light intensity; maximum width and height; gross examination of lids and skin; magnification low

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10
Q

Arcus senilis

A

Cholesterol deposition in the subepithelial/basement membrane of cornea

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11
Q

Melanosis

A

Increases with age; hyperpigmentation of cornea; common in African americans; not harmful

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12
Q

Examination of cornea

A

Parallelepiped beam; moderate magnification and illumination

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13
Q

Limbal Girdle of Vogt

A

Found with aging (late 50s/60s); degeneration of` the cornea; found near edge of limbus

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14
Q

Parallelepiped

A

Used to evaluate corneal epithelium, lashes, lid margins, conjunctiva, iris, crystalline lens
Direct focal illumination; 45-60 degree angle displacement; low/moderate magnification and illumination; full beam height, narrow beam

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15
Q

Specular reflection

A

Used to assess corneal epithelium, endothelium, lens surface, tear film
Direct focal illumination; small beam width, maximum beam height; moderate illumination, high magnification
Angle of incidence = angle of reflection

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16
Q

Guttata

A

Disease of the inner cornea; Descemet’s membrane invades endothelial cells; kills endothelial cells in that area

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17
Q

Optic section

A

Corneal evaluation, anterior chamber angle (van Herick technique), lens evaluation
Narrowest width possible, full beam height; moderate to high illumination and magnification, 45-60 degree angle displacement

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18
Q

Van Herick Gradings

A

1 (almost closed) through 4 (wide open)

Test has high sensitivity and specificity

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19
Q

Grade 4

A

1:1 ratio

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20
Q

Grade 3

A

1:1/2 ratio

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21
Q

Grade 2

A

1:1/4 ratio

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22
Q

Grade 1

A

1:

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23
Q

Sclerotic scatter

A

Used to view central corneal haze, common for PMMA Cls historically
Technique not used often anymore; beam angle 60, maximum height, moderate illumination, low magnification; viewed outside slit lamp
Indirect illumination; highlights subtle findings on cornea
Light directed towards limbus

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24
Q

Indirect retroillumination of retina

A

Light reflects off retina while focusing on structure in front of it
Any magnification, high illumination, in click position, small beam width, beam height the size of pupil

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25
Q

Direct retroillumination of iris

A

Look at structure beside the beam; use iris as background; focus on cornea
Similar to direct illumination
High illumination, any mag, small beam width, beam height size of the pupil

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26
Q

Conical section

A

High illumination and magnification, examiner must dark adapt
Used to evaluate anterior chamber for cells and flare
Focus light between cornea and iris surface
Circular or short square beam; direct illumination

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27
Q

Tear meniscus

A

Beam angle 45-60; parallelepiped beam, max height, low to moderate illumination
0.5-1 mm = normal; less than 0.5 mm = deficiency

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28
Q

Tonometry settings

A

Cobalt blue filter; 45-60 displacement; 10-16x mag; widest and highest beam; highest illumination level

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29
Q

Gonioscopy settings

A

White light; vertical parallelepiped 1-3mm wide beam; in click position; moderate illumination and mag

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30
Q

Fundus exam settings

A

White light; can use yellow, ND, or red free filter; in click position; Parallelepiped of moderate width and height; low to medium illumination; low magnification

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31
Q

Field of view increased with higher/lower lens power

A

Higher

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32
Q

Magnification increased with higher/lower lens power

A

Lower

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33
Q

Standard BIO lens

A

20 D (focal length 5 cm); mag = 3x; Field of view = 9 DD

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34
Q

Low power BIO lens

A

12-16 D

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35
Q

Medium power BIO lens

A

18-25 D

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36
Q

Higher power BIO lens

A

30-40 D

37
Q

Mag of 30 D lens

A

2x

38
Q

Mag of 20 D lens

A

3x

39
Q

Equator

A

Imaginary circle through ampullae of vortex veins

40
Q

Ora serrata

A

Junction between the neural retina and ciliary body

2 layers; scalloped appearance

41
Q

Ciliary body

A

Not normally seen during BIO

42
Q

Short posterior ciliary nerves

A

Run perpendicular to ora serrata; located at 12 and 6 o clock positions
10-12 nerves/eye; surrounded by choroidal pigment

43
Q

Long posterior ciliary nerves

A

Located at 3 and 9 o clock positions; divide retina into superior and inferior hemispheres
Run from midperiphery to ora serrata

44
Q

Vitreous body

A

Fills 2/3 of globe

98% water; made of unbranched collagen (type II) fibrils

45
Q

Vitreous cortex

A

Shell of condensed vitreous that surrounds gel

Two areas: anterior and posterior hyaloid face

46
Q

Firmest attachments of vitreous cortex

A

Vitreous base, optic disc, macula, retinal blood vessels

47
Q

Vitreous base

A

Vitreoretinal symphysis: where the structures grow together

Adhesion is so tight that vitreous will never detach here

48
Q

CHRPE

A

Congenital hypertrophy of the RPE; bear tracks; atypical pigmented lesions

49
Q

Cystic retinal tuft

A

Peripheral retinal thinning; greyish to white lesions in peripheral retina; located between equator and ora serrata; causes small vitreous floaters; occur bilaterally; occur in 15% of population

50
Q

Chroidal nevus

A

Hyperpigmentation of the choroid; indistinct margins; may have overlying drusen and other RPE changes

51
Q

White with pressure

A

Retinal hypopigmentation or whitening due to scleral indentation
Does not happen naturally
Less potential to cause retinal breaks
Same prognosis and management as WW/OP

52
Q

White without pressure

A

Retinal hypopigmentation between equator and ora serrata due to vitreous attachment
Retina appears thickened
Incidence increases with age (40-50 most common)
May be associated with retinal tears

53
Q

Retinoschisis (typical/flat)

A

Splitting of neurosensory retina at outer plexiform layer
0.7% of population; increased with age; need to monitor
Shows scotoma on VF test; usually bilateral

54
Q

Retinoschisis (reticular/bulbous)

A

Splitting of nerve fiber layer; ballooning of tissue/blister
Outer layer shows reduced choroidal detail and honeycomb pattern
33% have associated retinal detachment
70% have snowflake bodies on surface
Pts can be asymptomatic

55
Q

Pavingstone degeneration

A

Primary chorioretinal atrophy
Choriocapillaris occlusion with subsequent RPE and retinal tissue loss
Often associated with RPE hyperplasia and non-pigmented areas between equator and ora serrata
Usually located between 5 and 7 o clock

56
Q

Retinal holes: atrophic hole

A

Retinal break without vitreoretinal traction; pinpoint-2 DD round red lesion; occurs in 2-3% of population; usually between equator and ora serrata

57
Q

Retinal holes: tractional hole

A

Result from abnormal vitreoretinal adhesion; round red hole with overlying floating fragment of tissue; occur between equator and ora serrata; may have localized retinal detachment

58
Q

Ophthalmic solutions/suspensions

A

pH 5-8

2 year shelf life

59
Q

Ophthalmic gels

A

Stays on the eye longer

Highly viscous with saline aqueous base

60
Q

Ophthalmic ointments

A

Non-aqueous; oily base; must be sterile

61
Q

Proparacaine hydrochloride

A

0.5% ophthalmic solution; Lasts 10-20 minutes
Inhibits action potential; blocks nerve signals
Anesthetizes surface; decreases blink reflex; removes touch sensation

62
Q

Fluress/Fluorox/Flucaine

A

Used to assess integrity of ocular surface, anesthetize eye during tonometry

63
Q

Sodium fluorescein dye

A

2% solution; single dose pipettes; used in combination with cobalt blue filter
Used to assess integrity of ocular surface, stains cells and marks damaged areas; conjunctiva stains yellow/orange, cornea stains green, anterior chamber flare appears green

64
Q

Rose Bengal Vital dye

A

Available in paper strip; put a drop of saline on the strip
Paste the strip onto the conjunctiva; stains dead cells a vivid pink; may be used for dry eye eval or Herpes simplex keratitis
Can cause significant stinging, staining of cornea, conjunctiva, lids
Dye will last ~5 minutes in the eye

65
Q

Lissamine green vital dye

A

Stains dead cells and mucous; stains membrane damaged epithelial cells and corneal stroma; non-toxic to healthy cells; stains blue-green color with white light
Less discomfort than rose bengal

66
Q

Fluramene

A

Combination of fluorescein sodium and lissamine green B solution
Allows assessment of tear film and corneal surface integrity with one drop
Does not disrupt tear film assessment

67
Q

Before dilating a patient, always…

A

Check distance VAs, check pupils, check IOP, check angles (van Herick or shadow test)

68
Q

Less than grade II van Herick angle =

A

Risk of angle closure

69
Q

Cycloplegia

A

Paralysis of the ciliary muscle; reduction of accommodation

70
Q

Mydriasis

A

Dilation of the pupil

71
Q

Phenylephrine hydrochloride

A

Direct acting sympathomimetic; contraction of the radial dilator muscle of the iris = pupil dilation
Mydriasis only; no cycloplegia
0.12% solution-treatment of allergies
2.5% solution- routine pupil dilation; pre and post cataract surgery
10% solution- used to break posterior synechia (can cause systemic side effects
Lasts up to 6 hours

72
Q

Tropicamide hydrochloride

A

Muscarinic antagonist; blocks muscarinic receptors in the sphincter eye muscles
0.5% and 1% solutions
Causes mydraisis and cycloplegia
Used for routine dilation, pre and post surgery, cycloplegic refraction
Lasts up to 6 hours

73
Q

Affect of eye color on ocular drugs

A

Darker pigment, reduced effect of ocular medications

74
Q

Paremyd

A

Combination of tropicamide and hydroxyamphetaine (sympathomimetic agent)
Provides good dilation with minimal affect on accommodation
Less effect on dark irises, older pts, diabetics
Causes mydriasis and cycloplegia

75
Q

Cyclopentolate

A

Parasympatholytic/antimuscarinic
Used in cycloplegic refraction, pupil dilation, uveitis treatment (prevent posterior synechiae, reduce pain)
Lasts 6-24 hours

76
Q

Atropine

A

Used in uveitis, dilated eye exam (uncommon)

Lasts 7 days

77
Q

Homatropine

A

Used in uveitis, dilated eye exam

Lasts 1-3 days

78
Q

Scopolamine

A

Used to break synechiae, pre and post surgery, dilated eye exam, uveitis
Lasts 3-7 days

79
Q

Rev-Eyes

A

Drop that reverses dilation; affects iris dilator muscle

80
Q

Ophthalmic drop color code: red

A

Mydriatics and cycloplegics

81
Q

Ophthalmic drop color code: pink

A

Anti-inflammatories

82
Q

Ophthalmic drop color code: tan

A

Anti-infectives, antibiotics, antivirals

83
Q

Ophthalmic drop color code: gray

A

Nonsteroidal anti-inflammatories

84
Q

Ophthalmic drop color code: green

A

Miotics

85
Q

Ophthalmic drop color code: turquoise

A

Prostaglandin analogues

86
Q

Ophthalmic drop color code: purple

A

Adrenergic agonists

87
Q

Ophthalmic drop color code: orange

A

Carbonic anhydrase inhibitors

88
Q

Ophthalmic drop color code: blue/yellow

A

Beta blockers

Theory and Methods III (2 decks)

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