Eye Exam Flashcards
What are the steps of the eye exam?
- Visual acuity and visual fields
- Pupils
- External eye exam
- Extraocular muscles
- Fundus exam
Preferred visual acuity test?
“Snellen chart”
- Ptn 20 ft. w/ glasses and eye covered
- Move closer if cannot read
Numerator and denominator in vision scale?
Numerator: distance in ft. that pt is positioned from chart
Denominator: distance at which a person with normal vision would be able to read same line
What is presbyopia?
- Normal impairment of near vision that comes with age is
- Result of progressive thickening of lens so it can no longer accommodate
What to do if visual field defect noted?
- Test one eye at a time
- Slowly move fingers in, noting where defect is located
- Assuming your field is normal- pt with normal vision would see your fingers the same time you do
What is Humphrey Automated Perimetry?
a. More sophisticated test of visual field if defects are suspected
b. Done in an ophthalmologist’s office
What causes Horizontal defect?
- Occlusion of branch of central retinal artery
- Ischemia of optic nerve
What is blind right eye?
- Lesion of optic nerve producing unilateral blindness
What is bitemporal hemianopsia?
- Lesion at optic chiasm
- Fibers originate in nasal half of each retina
- Visual loss to temporal side of each field
Homonymous hemianopsia?
- Lesion of optic tract
- Interrupts fibers originating on same side of both eyes
- Visual loss of half of each field
What is anisocoria?
- Pupillary inequality
- > 0.5 mm considered normal
- Unilateral blindness does not cause if PS and symp are normal to both eyes
What is tonic pupil?
“Adie’s pupil”
- Unilateral large, regular pupil
- Diminished rxn to light
- Slow accommodation = blurred vision
What is oculomotor nerve paralysis?
- Dilated pupil fixed to light
- Ptosis of upper eyelid
- lateral Deviation of eye
What is horner’s syndrome?
- Ptosis
- Anhydrosis
- Miosis
* **Congenital, effected pupil is lighter
What are argyll robertson pupils
- Seen in CNS syphilis
- Small, irregular pupils that accommodate but do not react to light
What is seen in unilateral blindness with PS and symp in tact?
- Light directed in seeing eye produces direct rxn and consensual in blind eye
- Light in blind eye causes zero response in either
Possible causes of ptosis?
- Myasthenia gravis
- Oculomotor damage
- Horner’s: damage to sympathetic
- Age
What is ENTROpion?
- Inward turn of lid margin allowing lashes to irritate cornea and conjunctiva
- Commonly seen in elderly
What is ECTROpion?
- Margin of lower lid turns out exposing conjunctiva
- Poor drainage leads to tearing
- Common in elderly
What is Exophthalmos?
- Wide eyed stare from retracted lids
- Sclera can be seen between iris and lid iris
- Can be sign of hyperthyroidism
What is bowing forward of the iris that casts a shadow toward nose indicative of?
Narrow angle glaucoma
What is episcleritis?
Localized inflammation of episcleral vessels
What is pinguecula?
Harmless yellow triangular conjunctival nodule on either side of iris
What is chalazion?
- Painless nodule on lid involving blocked gland
- In contrast to a sty, this points inward
