Eye Exam Principles And Procedures

Question 1

Patient History Includes

Answer 1

1.) Demographic information
2.) Chief complaint
3.) History of the present illness
4.) Review of systems (general health)
5.) Social History
6.) Current Medications
7.) Medication Allergies

Question 2

Cover-Uncover Testing/ Cover Test

Answer 2

Examines the binocular relationship of the eyes. This objective test is used to evaluate and quantify ocular deviations that may be present, which are called tropias (strabismus) and phorias.

The patient is asked to fixate on a distant object (near testing can be done as well) the patient’s eyes are observed.
If they appear to be obviously misaligned, there will be typically one eye that fixates and the other eye will either deviate outward (exotropia), inward (esotropia), or upward (hypertropia)
There may be one eye that dominates fixation, or this may switch freely between the eyes.
If occluder is placed over the fixating eye, the deviated eye will rapidly refixate.
Thus, you look for movement of the uncovered eye. If you then rapidly switch to the other eye, the previously covered eye will refixate.
By the nature of the direction of these fixation movements, you can easily identify the problem, and measure it using prism.

Question 3

Corneal Topography

Answer 3

Used for screening patients before refractive surgery, for fitting contact lenses, for adjusting post surgical corneal transplants, and for diagnosing refractive disorders and diseases.

Question 4

Manifest/ Subjective Refraction

Answer 4

Uses the patient’s responses to determine the best correction. This instrument used for refracting is a phoropter.

“Is 1 better or 2”

Question 5

Blood Pressure

Answer 5

Force exerted against the arterial walls during the left ventricular contraction (heart beat) and relaxation (heart at rest).

Question 6

Systolic Pressure

Answer 6

First and largest number of a blood pressure measurement. It reflects the amount of force on the artery walls when the heart beats.

Also the point on manometer at which first clear sound of two consecutive beats is heard.

Question 7

Diastolic Pressure

Answer 7

Second, smaller number. It reflects the amount of force when the heart is at rest.

Question 8

What is High Blood Pressure

Answer 8

Consistently elevated blood pressure of at least (either or both) 140 mmHg systolic and 90 mmHg diastolic (140/90) in adults.

Question 9

What is Normal Blood Pressure

Answer 9

Less than 120 mmHg systolic and 80 mmHg diastolic (120/80) in adults.

Question 10

Manometer

Answer 10

An instrument used to measure and indicate pressure. There are two types analog and digital.

Question 11

Where should BP cuff be placed on body?

Answer 11

Place cuff on upper arm about 1 inch above the brachial artery pulse or the inner crease of the arm.

Question 12

Correct Position For Proper Bp Reading

Answer 12

-Patient should be relaxed
-Sitting comfortably, with his or her arm slightly flexed and supported at heart level
- Palms of hand facing up.
- Legs uncrossed

Wrap the cuff on arm snugly, center arrows marked on the cuff over the brachial artery. Fasten cuff securely.

Question 13

Tonometry

Answer 13

The test used to measure the pressure inside the eye.

Question 14

Goldman Tonometer

Answer 14

The specific instrument used to measure the pressure inside the eye.

Question 15

Case History

Answer 15

The part of the eye examination that serves as a guide for the tests to be performed during the visit

May include chief complaint, review of systems (ROS), social history.

Question 16

Retinoscope

Answer 16

An instrument that can obtain an estimate of the patient’s prescription (refractive power of eye) without the patient’s response.

Question 17

Biomicroscope/ Slit-Lamp

Answer 17

An instrument that gives the examiner a magnified view of the structures of the eye – particularly the front structures of the eye including eyes, lids and lashes.

Question 18

Alternate Cover Testing

Answer 18

This objective test is done after Cover-Uncover Test and is used to measure the magnitude and direction of a deviation regardless of whether it is a tropia or phoria. First determines direction of deviation then measures magnitude of it with prism.

Question 19

Phoropter

Answer 19

Instrument that contains lenses and can be used to determine an eyeglass correction.

Question 20

Snellen Chart

Answer 20

Chart most often used to measure visual acuity at a distance.

Question 21

Ophthalmoscopy

Answer 21

Examination of the inside of the eye.

A test that allows a doctor to see inside the back of the eye and other structures using a magnifying instrument and a light source.

Question 22

Visual Field

Answer 22

The entire area that can be seen when the eye is directed forward including that which is seen with peripheral vision.

Question 23

Optical Coherence Tomography (OCT)

Answer 23

Laser-based, non invasive, non contact imaging technique. Capable of obtaining high resolution retina images.

Question 24

What is the difference between a Tropia and Phoria?

Answer 24

Tropia is a physical misalignment in one or both eyes that can also be called strabismus. Present all the time.

Phoria is a deviation that may only be present when the eyes are not looking at the same object. Only there some of the time.

Question 25

Pupil Dilation

Answer 25

Often done as part of complete eye examination in order to get a more complete look at the back of the eye.

Question 26

Retinoscopy

Answer 26

A method of determining the state of refraction of the eye by illuminating the retina with a mirror and observing the direction of movement of the retinal illumination and adjacent shadow when the mirror is turned.

Question 27

Biomicroscopy

Answer 27

Ophthalmic examination of the eye by use of a slit lamp and a magnifying lens.

Question 28

Fundus Photography

Answer 28

The creation of a photograph of the interior surface of the eye.

Question 29

Tomography

Answer 29

Refers to imaging by section or sectioning - through the use of any kind of penetrating wave.