Eye Exam

Question 1

“flashing lights” or a “curtain/veil” in a person’s eyesight is suggestive of what process?

Answer 1

Retinal detatchment

Question 2

Vision changes in a pt with a history of trauma and lens placement = ?

Answer 2

Lens displacement

Question 3

What is the vital sign of the eye?

Answer 3

visual acuity

Question 4

What is the first step in any eye complaint, save for chemical injury?

Answer 4

Visual acuity

Question 5

What is the role of pinhole testing?

Answer 5

Used if a patient’s corrective lenses are unavailable to test for acuity

Question 6

How is a patient’s visual acuity charted with the use of a Snellen chart?

Answer 6

Document at the last line able to get half of letters correct. 20/x + # wrong (e.g. 20/40-2)

Question 7

True or false: a pinhole occluder can assist with presbyopia

Answer 7

True

Question 8

What is an Allen chart?

Answer 8

Visual acuity test showing pictures for testing children

Question 9

What motion of the eye are the oblique muscles primarily responsible for?

Answer 9

Inferior = superior medial
Superior = inferomedial

Question 10

What eye muscles are responsible for movement of the eye superolaterally, and inferolaterally?

Answer 10

Superolaterally = superior rectus

Inferolaterally = inferior rectus

Question 11

What are the causes of monocular diplopia? (3)

Answer 11

• Corneal irregularity
• Lens problem
• Intraocular lens dislocation

Question 12

Resolution of diplopia when one eye is covered suggests what etiology of the diplopia?

Answer 12

EOM dysfunction

Question 13

A positive afferent pupillary defect indicates what pathology?

Answer 13

Optic nerve disorder or light is not getting to CNS (e.g. vitreous hemorrhage, lens opacification etc)

Question 14

True or false: an afferent pupillary defect will cause a baseline anisocoria?

Answer 14

False–needs to be tested for directly

Question 15

How do you differentiate baseline anisocoria from pathologic?

Answer 15

Physiologic has no other symptoms, and is less than 1 mm difference

Question 16

What are four major causes of pathologic anisocoria?

Answer 16

• Posterior communicating artery aneurysm
• intraocular surgery
• Trauma
• Uncal herniation

Question 17

What breathing treatment can cause anisocoria if splashed into the eye?

Answer 17

Ipratropium (anticholinergic)

Question 18

True or false: attempting to reverse the cause of a chemically altered pupil can be useful diagnostically

Answer 18

False–results are unreliable

Question 19

How can you assess for an orbital blowout in trauma on physical exam? (2)

Answer 19

• Palpate the orbital rim for step offs

- Assess for SQ emphysema

Question 20

What is the only part of the anterior segment of the eye that cannot be assessed with a slit lamp exam?

Answer 20

Ciliary body

Question 21

Bulbar and palpebral follicles are commonly seen in what etiologies of an injected eye?

Answer 21

Viral or allergic

Question 22

What is hypopyon?

Answer 22

WBCs in the anterior chamber

Question 23

What is hyphema?

Answer 23

Blood in the anterior chamber

Question 24

What is flare?

Answer 24

The appearance of “headlights in fog” in the anterior chamber, cause by increased protein, common to inflammatory conditions such as iritis

Question 25

What causes pupil irregularity?

Answer 25

One portion of the iris is tethered into place

Question 26

What causes the pupil irregularity seen with uveitis?

Answer 26

Iris is adhesed to the anterior lens capsule

Question 27

Why must you always remove contact lenses prior to staining with fluorescein?

Answer 27

Will stain lens

Question 28

What is the normal artery to vein thickness?

Answer 28

2:3

Question 29

What is the normal intraocular pressure?

Answer 29

10-20 mmHg

Question 30

Where should your fingers be placed when measuring intraocular pressure?

Answer 30

On the bony orbit, so as to not falsely increase the pressure in the globe