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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
Direct retroillumination of iris
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
26
Conical section
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
27
Tear meniscus
Beam angle 45-60; parallelepiped beam, max height, low to moderate illumination 0.5-1 mm = normal; less than 0.5 mm = deficiency
28
Tonometry settings
Cobalt blue filter; 45-60 displacement; 10-16x mag; widest and highest beam; highest illumination level
29
Gonioscopy settings
White light; vertical parallelepiped 1-3mm wide beam; in click position; moderate illumination and mag
30
Fundus exam settings
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
31
Field of view increased with higher/lower lens power
Higher
32
Magnification increased with higher/lower lens power
Lower
33
Standard BIO lens
20 D (focal length 5 cm); mag = 3x; Field of view = 9 DD
34
Low power BIO lens
12-16 D
35
Medium power BIO lens
18-25 D
36
Higher power BIO lens
30-40 D
37
Mag of 30 D lens
2x
38
Mag of 20 D lens
3x
39
Equator
Imaginary circle through ampullae of vortex veins
40
Ora serrata
Junction between the neural retina and ciliary body | 2 layers; scalloped appearance
41
Ciliary body
Not normally seen during BIO
42
Short posterior ciliary nerves
Run perpendicular to ora serrata; located at 12 and 6 o clock positions 10-12 nerves/eye; surrounded by choroidal pigment
43
Long posterior ciliary nerves
Located at 3 and 9 o clock positions; divide retina into superior and inferior hemispheres Run from midperiphery to ora serrata
44
Vitreous body
Fills 2/3 of globe | 98% water; made of unbranched collagen (type II) fibrils
45
Vitreous cortex
Shell of condensed vitreous that surrounds gel | Two areas: anterior and posterior hyaloid face
46
Firmest attachments of vitreous cortex
Vitreous base, optic disc, macula, retinal blood vessels
47
Vitreous base
Vitreoretinal symphysis: where the structures grow together | Adhesion is so tight that vitreous will never detach here
48
CHRPE
Congenital hypertrophy of the RPE; bear tracks; atypical pigmented lesions
49
Cystic retinal tuft
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
Chroidal nevus
Hyperpigmentation of the choroid; indistinct margins; may have overlying drusen and other RPE changes
51
White with pressure
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
White without pressure
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
Retinoschisis (typical/flat)
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
Retinoschisis (reticular/bulbous)
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
Pavingstone degeneration
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
Retinal holes: atrophic hole
Retinal break without vitreoretinal traction; pinpoint-2 DD round red lesion; occurs in 2-3% of population; usually between equator and ora serrata
57
Retinal holes: tractional hole
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
Ophthalmic solutions/suspensions
pH 5-8 | 2 year shelf life
59
Ophthalmic gels
Stays on the eye longer | Highly viscous with saline aqueous base
60
Ophthalmic ointments
Non-aqueous; oily base; must be sterile
61
Proparacaine hydrochloride
0.5% ophthalmic solution; Lasts 10-20 minutes Inhibits action potential; blocks nerve signals Anesthetizes surface; decreases blink reflex; removes touch sensation
62
Fluress/Fluorox/Flucaine
Used to assess integrity of ocular surface, anesthetize eye during tonometry
63
Sodium fluorescein dye
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
Rose Bengal Vital dye
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
Lissamine green vital dye
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
Fluramene
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
Before dilating a patient, always...
Check distance VAs, check pupils, check IOP, check angles (van Herick or shadow test)
68
Less than grade II van Herick angle =
Risk of angle closure
69
Cycloplegia
Paralysis of the ciliary muscle; reduction of accommodation
70
Mydriasis
Dilation of the pupil
71
Phenylephrine hydrochloride
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
Tropicamide hydrochloride
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
Affect of eye color on ocular drugs
Darker pigment, reduced effect of ocular medications
74
Paremyd
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
Cyclopentolate
Parasympatholytic/antimuscarinic Used in cycloplegic refraction, pupil dilation, uveitis treatment (prevent posterior synechiae, reduce pain) Lasts 6-24 hours
76
Atropine
Used in uveitis, dilated eye exam (uncommon) | Lasts 7 days
77
Homatropine
Used in uveitis, dilated eye exam | Lasts 1-3 days
78
Scopolamine
Used to break synechiae, pre and post surgery, dilated eye exam, uveitis Lasts 3-7 days
79
Rev-Eyes
Drop that reverses dilation; affects iris dilator muscle
80
Ophthalmic drop color code: red
Mydriatics and cycloplegics
81
Ophthalmic drop color code: pink
Anti-inflammatories
82
Ophthalmic drop color code: tan
Anti-infectives, antibiotics, antivirals
83
Ophthalmic drop color code: gray
Nonsteroidal anti-inflammatories
84
Ophthalmic drop color code: green
Miotics
85
Ophthalmic drop color code: turquoise
Prostaglandin analogues
86
Ophthalmic drop color code: purple
Adrenergic agonists
87
Ophthalmic drop color code: orange
Carbonic anhydrase inhibitors
88
Ophthalmic drop color code: blue/yellow
Beta blockers

Theory and Methods III (2 decks)

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